Carilion Roanoke Memorial Hospital
Listed in its price file as “Carilion Medical Center doing business as Carilion Roanoke Memorial Hospital”.
Carilion Roanoke Memorial Hospital in Roanoke, VA publishes cash prices for 374 common procedures listed here, from its own machine-readable price file updated Apr 17, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Virginia median for 286 of 368 procedures and above it for 31. By typical cash price it ranks #18 of 66 Virginia hospitals and #4 of 6 hospitals in the Roanoke, VA area, cheapest first. Select a procedure to compare it with other hospitals nearby.
1906 Belleview Ave SE Roanoke VA 24014 Collected Sep 27, 2026 Source price file Check a bill from this hospital (540) 981-7000
Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 490024 · CMS hospital register NPI 1033102942
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Carilion Roanoke Memorial Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HB CT ABDOMEN W AND W/O CONTRAST | $1,233.05 | $3,523.00 | $153.99–$3,346.85 | 35% below | 65% |
| Abdominal X-ray, 2 views CPT 74019 HB XR ABDOMEN AP/DECUB OR ERECT | $201.95 | $577.00 | $32.82–$548.15 | 38% below | 65% |
| Abdominal X-ray, 2 views CPT 74019 HB XR ABDOMEN AP/DECUB OR ERECT OR | $201.95 | $577.00 | $32.82–$548.15 | 38% below | 65% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HB XR ANKLE COMPLETE 3+ VIEWS LT | $206.50 | $590.00 | $32.82–$560.50 | 39% below | 65% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HB XR ANKLE COMPL 3+ VIEWS OR LT | $206.50 | $590.00 | $32.82–$560.50 | 39% below | 65% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HB XR ANKLE COMPL 3+ VIEWS OR RT | $206.50 | $590.00 | $32.82–$560.50 | 39% below | 65% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HB XR ANKLE COMPLETE 3+ VIEWS RT | $206.50 | $590.00 | $32.82–$560.50 | 39% below | 65% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HB TCOM SINGLE LEVEL | $202.65 | $579.00 | $73.43–$550.05 | 48% below | 65% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HB DOPP SEG PRESS LWR LTD | $202.65 | $579.00 | $73.43–$550.05 | 48% below | 65% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HB CT UP EXT W/O CONTRAST LT | $873.60 | $2,496.00 | $91.78–$2,371.20 | 24% below | 65% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HB CT UP EXT W/O CONTRAST RT | $873.60 | $2,496.00 | $91.78–$2,371.20 | 24% below | 65% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HB XR ESOPHAGUS SINGLE CONTRAST | $301.35 | $861.00 | $87.13–$817.95 | 38% below | 65% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HB NM BONE WHOLE BODY | $974.75 | $2,785.00 | $241.09–$2,645.75 | 30% below | 65% |
| Breast ultrasound, complete, one breast both sides CPT 76641 HB US BREAST BILAT COMPLETE | $772.80 | $2,208.00 | $35.37–$2,097.60 | — | 65% |
| Breast ultrasound, complete, one breast one side CPT 76641 HB US BREAST UNILAT COMPLETE LT | $386.40 | $1,104.00 | $35.37–$2,097.60 | 31% below | 65% |
| Breast ultrasound, complete, one breast one side CPT 76641 HB US BREAST UNILAT COMPLETE RT | $386.40 | $1,104.00 | $35.37–$2,097.60 | 31% below | 65% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HB US BREAST BILAT LIMITED | $542.50 | $1,550.00 | $27.09–$1,472.50 | — | 65% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HB US BREAST UNILAT LIMITED LT | $271.25 | $775.00 | $27.09–$1,472.50 | 45% below | 65% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HB US BREAST UNILAT LIMITED RT | $271.25 | $775.00 | $27.09–$1,472.50 | 45% below | 65% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HB CTA ABD AND PELVIS W _ W/O CONTRAST (AAA ALERT) | $1,985.55 | $5,673.00 | $306.29–$5,389.35 | 34% below | 65% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HB CTA ABDOMEN AND PELVIS W AND W/O CONTRAST | $1,985.55 | $5,673.00 | $306.29–$5,389.35 | 34% below | 65% |
| CT angiography (CTA) of the head CPT 70496 HB CTA HEAD W AND WO STROKE ALERT | $1,121.05 | $3,203.00 | $153.99–$3,042.85 | 37% below | 65% |
| CT angiography (CTA) of the head CPT 70496 HB CTA HEAD W AND W/O CONT | $1,121.05 | $3,203.00 | $153.99–$3,042.85 | 37% below | 65% |
| CT angiography (CTA) of the neck CPT 70498 HB CTA NECK W AND W/O CONT | $1,042.30 | $2,978.00 | $153.99–$2,829.10 | 46% below | 65% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HB CTA CHEST W AND W/O CONT | $1,095.15 | $3,129.00 | $153.99–$2,972.55 | 39% below | 65% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HB CTA CHEST W AND W/O CONT (AAA ALERT) | $1,095.15 | $3,129.00 | $153.99–$2,972.55 | 39% below | 65% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HB CTA HEART | $1,016.05 | $2,903.00 | $295.40–$2,757.85 | 12% above | 65% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HB CTA CORONARY | $1,016.05 | $2,903.00 | $295.40–$2,757.85 | 12% above | 65% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HB CT HEART (CALCIUM SCORING) | $224.70 | $642.00 | $76.40–$609.90 | 13% above | 65% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HB CT ABDOMEN AND PELVIS W/O CONT | $1,190.70 | $3,402.00 | $167.99–$3,231.90 | 46% below | 65% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HB CT ABDOMEN AND PELVIS W/O CONT (AAA ALERT) | $1,190.70 | $3,402.00 | $167.99–$3,231.90 | 46% below | 65% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HB CT ABD AND PELVIS W ENTEROGRAPHY | $1,542.10 | $4,406.00 | $278.69–$4,185.70 | 50% below | 65% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HB CT PRESURG PANCREAS ABD/PEL W CONT | $1,542.10 | $4,406.00 | $278.69–$4,185.70 | 50% below | 65% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HB CT ABDOMEN AND PELVIS W CONT | $1,542.10 | $4,406.00 | $278.69–$4,185.70 | 50% below | 65% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HB CT ABDOMEN AND PELVIS W AND W/O CONT | $2,153.90 | $6,154.00 | $306.29–$5,846.30 | 38% below | 65% |
| CT scan of the abdomen with contrast CPT 74160 HB CT PRESURG PANCREAS ABDOMEN W CONT | $1,149.75 | $3,285.00 | $153.99–$3,120.75 | 30% below | 65% |
| CT scan of the abdomen with contrast CPT 74160 HB CT ABDOMEN W/CONTRAST | $1,149.75 | $3,285.00 | $153.99–$3,120.75 | 30% below | 65% |
| CT scan of the abdomen without contrast CPT 74150 HB CT ABDOMEN W/O CONTRAST | $660.80 | $1,888.00 | $91.78–$1,793.60 | 54% below | 65% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HB CT STEALTH SINUS WO | $775.60 | $2,216.00 | $91.78–$2,105.20 | 40% below | 65% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HB CT SINUS | $775.60 | $2,216.00 | $91.78–$2,105.20 | 40% below | 65% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HB CT MAXILLOFACIAL W/O CONTRA | $775.60 | $2,216.00 | $91.78–$2,105.20 | 40% below | 65% |
| CT scan of the head or brain, no contrast dye CPT 70450 HB CT HEAD W/O STROKE ALERT | $798.70 | $2,282.00 | $91.78–$2,167.90 | 40% below | 65% |
| CT scan of the head or brain, no contrast dye CPT 70450 HB CT HEAD NEURAVIVE WO | $798.70 | $2,282.00 | $91.78–$2,167.90 | 40% below | 65% |
| CT scan of the head or brain, no contrast dye CPT 70450 HB CT HEAD/BRAIN W/O CONTRAST | $798.70 | $2,282.00 | $91.78–$2,167.90 | 40% below | 65% |
| CT scan of the head or brain, no contrast dye CPT 70450 HB CT STEALTH W/O | $798.70 | $2,282.00 | $91.78–$2,167.90 | 40% below | 65% |
| CT scan of the head with contrast CPT 70460 HB CT STEALTH W CONTRAST | $1,029.00 | $2,940.00 | $136.06–$2,793.00 | 33% below | 65% |
| CT scan of the head with contrast CPT 70460 HB CT HEAD/BRAIN W/CONTRAST | $1,029.00 | $2,940.00 | $136.06–$2,793.00 | 33% below | 65% |
| CT scan of the head without and with contrast CPT 70470 HB CT STEALTH W&WO CONTRAST | $1,035.65 | $2,959.00 | $153.99–$3,423.80 | 41% below | 65% |
| CT scan of the head without and with contrast CPT 70470 HB CT HEADBRAIN W AND WO CONTRAST | $1,261.40 | $3,604.00 | $153.99–$3,423.80 | 28% below | 65% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HB CT L-SPINE W/O CONTRAST | $1,026.55 | $2,933.00 | $91.78–$2,786.35 | 35% below | 65% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HB CT C-SPINE W/O CONTRAST | $1,004.15 | $2,869.00 | $91.78–$2,725.55 | 37% below | 65% |
| CT scan of the pelvis, with contrast dye CPT 72193 HB CT PELVIS W/CONTRAST | $1,486.45 | $4,247.00 | $153.99–$4,034.65 | 12% below | 65% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HB DUPLEX EXTRACRANIAL/CAROTID BI | $469.70 | $1,342.00 | $168.95–$1,274.90 | — | 65% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HB US DUPLX EXTRACRAN/CAROTID BI | $469.70 | $1,342.00 | $168.95–$1,274.90 | — | 65% |
| Chest CT scan without and with contrast CPT 71270 HB CT CHEST W AND W/O CONTRAST | $1,373.40 | $3,924.00 | $153.99–$3,727.80 | 29% below | 65% |
| Chest X-ray, 2 views CPT 71046 HB XR CHEST 2 VIEWS HEALTH DEPT @ | $66.85 | $191.00 | $30.14–$394.25 | 76% below | 65% |
| Chest X-ray, 2 views CPT 71046 HB XR CHEST 2 VIEWS OR | $115.85 | $331.00 | $30.14–$394.25 | 59% below | 65% |
| Chest X-ray, 2 views CPT 71046 HB XR CHEST 1V W/1 OBLIQUE | $145.25 | $415.00 | $30.14–$394.25 | 48% below | 65% |
| Chest X-ray, 2 views CPT 71046 HB XR CHEST 2 VIEWS PST | $145.25 | $415.00 | $30.14–$394.25 | 48% below | 65% |
| Chest X-ray, 2 views CPT 71046 HB XR CHEST 2 VIEWS | $145.25 | $415.00 | $30.14–$394.25 | 48% below | 65% |
| Chest X-ray, single view CPT 71045 HB XR CHEST PA HEALTH DEPT @ | $44.45 | $127.00 | $22.97–$345.80 | 81% below | 65% |
| Chest X-ray, single view CPT 71045 HB XR CHEST LORDOTIC | $109.55 | $313.00 | $22.97–$345.80 | 53% below | 65% |
| Chest X-ray, single view CPT 71045 HB XR CHEST 1 VIEW OR | $127.40 | $364.00 | $22.97–$345.80 | 46% below | 65% |
| Chest X-ray, single view CPT 71045 HB XR CHEST 1 VIEW PST | $127.40 | $364.00 | $22.97–$345.80 | 46% below | 65% |
| Chest X-ray, single view CPT 71045 HB XR CHEST 1 VIEW | $127.40 | $364.00 | $22.97–$345.80 | 46% below | 65% |
| Chest X-ray, single view one side CPT 71045 HB XR CHEST DECUBITUS RT | $127.40 | $364.00 | $22.97–$345.80 | 46% below | 65% |
| Chest X-ray, single view one side CPT 71045 HB XR CHEST DECUBITUS LT | $127.40 | $364.00 | $22.97–$345.80 | 46% below | 65% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 HB XR CLAVICLE COMPLETE LT | $193.90 | $554.00 | $29.24–$526.30 | 35% below | 65% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 HB XR CLAVICLE COMPLETE RT | $193.90 | $554.00 | $29.24–$526.30 | 35% below | 65% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HB US RENAL COMPLETE | $394.80 | $1,128.00 | $91.78–$1,071.60 | 38% below | 65% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HB US RETROPERITONEAL COMPLETE | $394.80 | $1,128.00 | $91.78–$1,071.60 | 38% below | 65% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HB BONE DENSITY STUDY | $370.30 | $1,058.00 | $34.91–$1,005.10 | 37% below | 65% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HB US PREG COMP DETAIL STUDY | $431.20 | $1,232.00 | $178.76–$1,170.40 | 35% below | 65% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HB CT FOLLOW UP LUNG CANCER SCREENING | $868.70 | $2,482.00 | $91.78–$2,357.90 | 37% below | 65% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HB CT CHEST W/O CONTRAST | $868.70 | $2,482.00 | $91.78–$2,357.90 | 37% below | 65% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HB CT PULMONARY NODULE WO CONT | $868.70 | $2,482.00 | $91.78–$2,357.90 | 37% below | 65% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HB CT CHEST WO LOW DOSE TRAUMA FOLLOW UP | $868.70 | $2,482.00 | $91.78–$2,357.90 | 37% below | 65% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HB CT CHEST W/O CONTRAST (AAA ALERT) | $868.70 | $2,482.00 | $91.78–$2,357.90 | 37% below | 65% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HB CT CHEST WO EMPHYSEMA | $868.70 | $2,482.00 | $91.78–$2,357.90 | 37% below | 65% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HB CT PLANPOINT WO CONTRAST | $868.70 | $2,482.00 | $91.78–$2,357.90 | 37% below | 65% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HB CT CHEST W/CONTRAST | $1,028.65 | $2,939.00 | $153.37–$2,792.05 | 40% below | 65% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HB MAM SURG DIAGNOSTIC BILAT | $247.80 | $708.00 | $159.95–$779.00 | — | 65% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HB MAM DIAGNOSTIC BILAT | $287.00 | $820.00 | $159.95–$779.00 | — | 65% |
| Diagnostic mammogram, one breast one side CPT 77065 HB MAM SURG DIAGNOSTIC UNI LT | $193.90 | $554.00 | $126.35–$620.35 | 43% below | 65% |
| Diagnostic mammogram, one breast one side CPT 77065 HB MAM SURG DIAGNOSTIC UNI RT | $193.90 | $554.00 | $126.35–$620.35 | 43% below | 65% |
| Diagnostic mammogram, one breast one side CPT 77065 HB MAM DIAGNOSTIC UNI LT | $228.55 | $653.00 | $126.35–$620.35 | 33% below | 65% |
| Diagnostic mammogram, one breast one side CPT 77065 HB MAM DIAGNOSTIC UNI F/U RT | $228.55 | $653.00 | $126.35–$620.35 | 33% below | 65% |
| Diagnostic mammogram, one breast one side CPT 77065 HB MAM DIAGNOSTIC UNI F/U LT | $228.55 | $653.00 | $126.35–$620.35 | 33% below | 65% |
| Diagnostic mammogram, one breast one side CPT 77065 HB MAM DIAGNOSTIC UNI RT | $228.55 | $653.00 | $126.35–$620.35 | 33% below | 65% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HB DUPLEX LE ART/BPG; BILAT | $415.80 | $1,188.00 | $209.48–$1,128.60 | — | 65% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HB DUPLEX EXT VEINS BILAT | $572.25 | $1,635.00 | $166.26–$1,805.00 | — | 65% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HB US DUPLEX VENOUS EXTREM BILAT | $665.00 | $1,900.00 | $166.26–$1,805.00 | — | 65% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HB ECHO 2D COMPL SPEC AND COLOR DOP | $982.10 | $2,806.00 | $174.62–$2,665.70 | 43% below | 65% |
| Elbow X-ray, 2 views one side CPT 73070 HB XR ELBOW 2 VIEWS OR RT | $164.85 | $471.00 | $26.26–$447.45 | 39% below | 65% |
| Elbow X-ray, 2 views one side CPT 73070 HB XR ELBOW 2 VIEWS RT | $164.85 | $471.00 | $26.26–$447.45 | 39% below | 65% |
| Elbow X-ray, 2 views one side CPT 73070 HB XR ELBOW 2 VIEWS LT | $164.85 | $471.00 | $26.26–$447.45 | 39% below | 65% |
| Elbow X-ray, 2 views one side CPT 73070 HB XR ELBOW 2 VIEWS OR LT | $164.85 | $471.00 | $26.26–$447.45 | 39% below | 65% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 HB XR ELBOW COMPLETE 3+ VIEWS LT | $212.80 | $608.00 | $29.54–$577.60 | 50% below | 65% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 HB XR ELBOW COMPLETE 3+ VIEWS RT | $212.80 | $608.00 | $29.54–$577.60 | 50% below | 65% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HB CT ORBIT/SELLA/FOSSA/EAR W/O CON | $952.00 | $2,720.00 | $91.78–$2,584.00 | 30% below | 65% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HB XR FACIAL BONES COMPLETE 3+ | $155.40 | $444.00 | $42.37–$421.80 | 70% below | 65% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HB XR FOREARM 2 VIEWS RT | $204.75 | $585.00 | $26.26–$555.75 | 38% below | 65% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HB XR FOREARM 2 VIEWS OR RT | $204.75 | $585.00 | $26.26–$555.75 | 38% below | 65% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HB XR FOREARM 2 VIEWS OR LT | $204.75 | $585.00 | $26.26–$555.75 | 38% below | 65% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HB XR FOREARM 2 VIEWS LT | $204.75 | $585.00 | $26.26–$555.75 | 38% below | 65% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HB NM HEPATOBILIARY WO PHARMACOLOGIC | $748.65 | $2,139.00 | $265.57–$2,032.05 | 34% below | 65% |
| Hand X-ray, 2 views one side CPT 73120 HB XR HAND LIMITED 2 VIEWS LT | $159.60 | $456.00 | $28.35–$433.20 | 37% below | 65% |
| Hand X-ray, 2 views one side CPT 73120 HB XR HAND LIMITED 2 VIEWS RT | $159.60 | $456.00 | $28.35–$433.20 | 37% below | 65% |
| Hand X-ray, 2 views one side CPT 73120 HB XR HAND LIMITED 2 VIEWS OR LT | $159.60 | $456.00 | $28.35–$433.20 | 37% below | 65% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HB XR CALCANEUS 2+ VIEWS LT | $109.55 | $313.00 | $25.66–$316.76 | 61% below | 65% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HB XR CALCANEUS 2+ VIEWS RT | $109.55 | $313.00 | $25.66–$316.76 | 61% below | 65% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HB UNATTENDED SLEEP STUDY TYPE III | $435.40 | $1,244.00 | $85.22–$1,181.80 | 5% below | 65% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HB POLYSOMNOGRAM 4+ PAR SPLIT | $1,981.00 | $5,660.00 | $586.07–$5,377.00 | 12% below | 65% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HB ASV TITRATION | $1,981.00 | $5,660.00 | $586.07–$5,377.00 | 12% below | 65% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HB CPAP INCOMPLETE | $1,981.00 | $5,660.00 | $586.07–$5,377.00 | 12% below | 65% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HB POLYSOMNOGRAM 4+ PAR W/CPAP | $1,981.00 | $5,660.00 | $586.07–$5,377.00 | 12% below | 65% |
| Knee X-ray, 3 views one side CPT 73562 HB XR KNEE 3 VIEWS LT | $216.30 | $618.00 | $36.70–$587.10 | 35% below | 65% |
| Knee X-ray, 3 views one side CPT 73562 HB XR KNEE 3 VIEWS RT | $216.30 | $618.00 | $36.70–$587.10 | 35% below | 65% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HB XR KNEE COMPLETE 4+ VIEWS LT OR | $236.60 | $676.00 | $42.37–$642.20 | 46% below | 65% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HB XR KNEE COMPLETE 4+ VIEWS LT | $236.60 | $676.00 | $42.37–$642.20 | 46% below | 65% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HB XR KNEE COMPLETE 4+ VIEWS RT OR | $236.60 | $676.00 | $42.37–$642.20 | 46% below | 65% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HB XR KNEE COMPLETE 4+ VIEWS RT | $236.60 | $676.00 | $42.37–$642.20 | 46% below | 65% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HB CT LOW EXT W/O CONTRAST RT | $760.55 | $2,173.00 | $91.78–$2,064.35 | 37% below | 65% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HB CT LOW EXT W/O CONTRAST LT | $760.55 | $2,173.00 | $91.78–$2,064.35 | 37% below | 65% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB SP US ABDOMEN LIMITED | $411.60 | $1,176.00 | $77.88–$1,117.20 | 37% below | 65% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB US ABDOMEN LIMITED APPENDIX | $411.60 | $1,176.00 | $77.88–$1,117.20 | 37% below | 65% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB US PYLORIC STENOSIS STUDY | $411.60 | $1,176.00 | $77.88–$1,117.20 | 37% below | 65% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB US ABDOMEN LIMITED PANCREAS | $411.60 | $1,176.00 | $77.88–$1,117.20 | 37% below | 65% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB US ABDOMEN LIMITED SPLEEN | $411.60 | $1,176.00 | $77.88–$1,117.20 | 37% below | 65% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB US ABDOMEN PYLORUS LIMITED | $411.60 | $1,176.00 | $77.88–$1,117.20 | 37% below | 65% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB US ABDOMEN LIMITED GALLBLADDER | $411.60 | $1,176.00 | $77.88–$1,117.20 | 37% below | 65% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB US ABDOMEN LIMITED | $411.60 | $1,176.00 | $77.88–$1,117.20 | 37% below | 65% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB US ABDOMEN LIMITED LIVER | $411.60 | $1,176.00 | $77.88–$1,117.20 | 37% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB SP US EXTREMITY NONVASC LIM LT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US EXTREMITY FOOT RT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US EXTREMITY POPLITEAL LT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US BREAST AXILLA LT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB SP US EXTREMITY NONVASC LIM RT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US EXTREMITY POPLITEAL RT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US EXTREMITY HAND LT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US EXTREMITY HIP LT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US EXTREMITY NONVASC LIMIT LT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US EXTREMITY HIP RT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US BREAST AXILLA RT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US EXTREMITY FOOT LT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US EXTREMITY HAND RT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US SOFT TISSUE EXTREMITY LT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US SOFT TISSUE EXTREMITY RT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HB US EXTREMITY NONVASC LIMIT RT | $290.50 | $830.00 | $56.69–$788.50 | 5% below | 65% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HB CT LUNG CANCER ANNUAL SCREEN | $165.90 | $474.00 | $91.78–$450.30 | 41% below | 65% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HB XR TIBIA/FIBULA 2 VIEWS OR RT | $185.85 | $531.00 | $28.35–$504.45 | 40% below | 65% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HB XR TIBIA/FIBULA 2 VIEWS RT | $185.85 | $531.00 | $28.35–$504.45 | 40% below | 65% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HB XR TIBIA/FIBULA 2 VIEWS OR LT | $185.85 | $531.00 | $28.35–$504.45 | 40% below | 65% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HB XR TIBIA/FIBULA 2 VIEWS LT | $185.85 | $531.00 | $28.35–$504.45 | 40% below | 65% |
| MR angiography (MRA) of the head without contrast CPT 70544 HB MRA HEAD W/O CONT | $1,156.05 | $3,303.00 | $198.43–$3,137.85 | 49% below | 65% |
| MR angiography (MRA) of the head without contrast CPT 70544 HB MRA HEAD WO (STROKE) | $1,156.05 | $3,303.00 | $198.43–$3,137.85 | 49% below | 65% |
| MR angiography (MRA) of the head without contrast CPT 70544 HB MRV HEAD W/O | $1,156.05 | $3,303.00 | $198.43–$3,137.85 | 49% below | 65% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 HB MRI BREAST BILAT W&WO CONT W CAD NEWLY DIAGNOSED | $2,351.30 | $6,718.00 | $355.18–$6,382.10 | — | 65% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 HB MRI BREAST BILAT W&WO CONT W CAD | $2,351.30 | $6,718.00 | $355.18–$6,382.10 | — | 65% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HB MRI LOW EXT JNT W/O CONT RT | $1,352.75 | $3,865.00 | $186.49–$3,671.75 | 30% below | 65% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HB MRI LOW EXT JNT W/O CONT LT | $1,352.75 | $3,865.00 | $186.49–$3,671.75 | 30% below | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HB MRI LOWEXTJNT W AND WO CONT RT | $2,424.10 | $6,926.00 | $306.29–$6,579.70 | 29% below | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HB MRI LOWEXTJNT W AND WO CONT LT | $2,424.10 | $6,926.00 | $306.29–$6,579.70 | 29% below | 65% |
| MRI of the abdomen without contrast CPT 74181 HB MRI ABDOMEN W/O CONTRAST | $1,137.85 | $3,251.00 | $180.22–$3,088.45 | 30% below | 65% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HB MRI SECRETIN ABD CMC/NRV ONLY | $1,989.40 | $5,684.00 | $306.29–$5,399.80 | 30% below | 65% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HB MRI ABDOMEN W AND W/O CONTRAST | $1,989.40 | $5,684.00 | $306.29–$5,399.80 | 30% below | 65% |
| MRI of the brain, no contrast dye CPT 70551 HB MRI BRAIN W/O CONTRAST | $1,192.45 | $3,407.00 | $180.53–$3,236.65 | 38% below | 65% |
| MRI of the brain, no contrast dye CPT 70551 HB MRI BRAIN W/O HYDRO/SHUNT | $1,192.45 | $3,407.00 | $180.53–$3,236.65 | 38% below | 65% |
| MRI of the brain, no contrast dye CPT 70551 HB MRI BRAIN POST HIFU WO CON | $1,192.45 | $3,407.00 | $180.53–$3,236.65 | 38% below | 65% |
| MRI of the brain, no contrast dye CPT 70551 HB MRI BRAIN (ADULT STROKE ALERT) | $1,192.45 | $3,407.00 | $180.53–$3,236.65 | 38% below | 65% |
| MRI of the brain, no contrast dye CPT 70551 HB MRI BRAIN (PEDIATRIC HYPERACUTE STROKE ALERT) | $1,192.45 | $3,407.00 | $180.53–$3,236.65 | 38% below | 65% |
| MRI of the brain, with and without contrast dye CPT 70553 HB MRI BRAIN W AND W/O CONTRAST | $2,297.75 | $6,565.00 | $293.01–$6,236.75 | 15% below | 65% |
| MRI of the brain, with and without contrast dye CPT 70553 HB MRI BRAIN PRE OP HIFU W AND WO CON | $2,297.75 | $6,565.00 | $293.01–$6,236.75 | 15% below | 65% |
| MRI of the lower back, no contrast dye CPT 72148 HB MRI L-SPINE W/O CONTRAST | $1,252.30 | $3,578.00 | $176.04–$3,399.10 | 37% below | 65% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HB MRI L-SPINE W AND W/O CONTRAST | $2,103.50 | $6,010.00 | $293.91–$5,709.50 | 37% below | 65% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HB MRI T-SPINE W/O CONTRAST | $1,228.50 | $3,510.00 | $175.15–$3,334.50 | 39% below | 65% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HB MRI C-SPINE W AND W/O CONTRAST | $2,430.05 | $6,943.00 | $294.50–$6,595.85 | 26% below | 65% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HB MRI C-SPINE W/O CONTRAST | $1,444.80 | $4,128.00 | $175.46–$3,921.60 | 28% below | 65% |
| MRI of the pelvis without and with contrast CPT 72197 HB MRI PELVIS GYN/ONC W AND W/O CONTRAST | $2,877.00 | $8,220.00 | $306.29–$7,809.00 | 9% below | 65% |
| MRI of the pelvis without and with contrast CPT 72197 HB MRI PELVIS W/WO CONT PERIANAL FISTULA | $2,877.00 | $8,220.00 | $306.29–$7,809.00 | 9% below | 65% |
| MRI of the pelvis without and with contrast CPT 72197 HB MRI RECTAL W AND W/O CONTRAST | $2,877.00 | $8,220.00 | $306.29–$7,809.00 | 9% below | 65% |
| MRI of the pelvis without and with contrast CPT 72197 HB MRI PELVIS W AND W/O CONTRAST | $2,877.00 | $8,220.00 | $306.29–$7,809.00 | 9% below | 65% |
| MRI of the pelvis without and with contrast CPT 72197 HB MRI PROSTATE PELVIS W + WO CMC/CNRV | $2,877.00 | $8,220.00 | $306.29–$7,809.00 | 9% below | 65% |
| MRI of the pelvis, no contrast dye CPT 72195 HB MRI PELVIS W/O CONTRAST AND DEFECOGRAPHY | $1,744.40 | $4,984.00 | $209.48–$4,734.80 | 6% below | 65% |
| MRI of the pelvis, no contrast dye CPT 72195 HB MRI PELVIS W/O CONTRAST | $1,744.40 | $4,984.00 | $209.48–$4,734.80 | 6% below | 65% |
| MRI of the pelvis, no contrast dye CPT 72195 HB MRI RECTAL W/O CONTRAST | $1,744.40 | $4,984.00 | $209.48–$4,734.80 | 6% below | 65% |
| MRI of the pelvis, no contrast dye CPT 72195 HB MRI PROSTATE PELVIS W/O CMC | $1,744.40 | $4,984.00 | $209.48–$4,734.80 | 6% below | 65% |
| MRI of the pelvis, no contrast dye CPT 72195 HB MRI PELVIS GYN/ONC WO CONTRAST | $1,744.40 | $4,984.00 | $209.48–$4,734.80 | 6% below | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HB MRI UP EXT JNT W/O CONTRAST LT | $1,311.45 | $3,747.00 | $186.78–$3,559.65 | 32% below | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HB MRI UP EXT JNT W/O CONTRAST RT | $1,311.45 | $3,747.00 | $186.78–$3,559.65 | 32% below | 65% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HB XR C-SPINE 4 OR 5 VIEWS | $290.50 | $830.00 | $48.04–$788.50 | 40% below | 65% |
| Neck soft tissue CT scan with contrast CPT 70491 HB CT NECK W/CONTRAST | $1,016.40 | $2,904.00 | $153.99–$2,758.80 | 39% below | 65% |
| Neck soft tissue CT scan without contrast CPT 70490 HB CT NECK W/O CONTRAST | $468.65 | $1,339.00 | $91.78–$1,272.05 | 45% below | 65% |
| Neck soft tissue X-ray CPT 70360 HB XR NECK SOFT TISSUE | $136.85 | $391.00 | $28.05–$371.45 | 60% below | 65% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HB NM CARD LEXISCAN | $2,354.80 | $6,728.00 | $387.60–$6,391.60 | 26% below | 65% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HB CP NM CARD LEXISCAN | $2,354.80 | $6,728.00 | $387.60–$6,391.60 | 26% below | 65% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HB NM CARD DOBUTAMINE | $2,354.80 | $6,728.00 | $387.60–$6,391.60 | 26% below | 65% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HB NM CARD MULTI REST OR STRESS | $2,354.80 | $6,728.00 | $387.60–$6,391.60 | 26% below | 65% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HB PET/CT PSMA | $3,282.30 | $9,378.00 | $980.72–$8,909.10 | 26% below | 65% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HB PET/CT PROSTATE SKULL BASE TO MID-THIGH | $3,282.30 | $9,378.00 | $980.72–$8,909.10 | 26% below | 65% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HB PET/CT CU-DOTA | $3,282.30 | $9,378.00 | $980.72–$8,909.10 | 26% below | 65% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HB PET/CT DOTATATE | $3,282.30 | $9,378.00 | $980.72–$8,909.10 | 26% below | 65% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HB PET/CT SKULL BASE TO MID-TH | $3,282.30 | $9,378.00 | $980.72–$8,909.10 | 26% below | 65% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HB PET/CT ESTROGEN RECEPTOR IMAGING | $3,282.30 | $9,378.00 | $980.72–$8,909.10 | 26% below | 65% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HB PET/CT AXUMIN FLUCICLOVINE F-18 | $3,282.30 | $9,378.00 | $980.72–$8,909.10 | 26% below | 65% |
| Pelvic CT scan without contrast CPT 72192 HB CT PELVIS W/O CONTRAST | $700.35 | $2,001.00 | $91.78–$1,900.95 | 52% below | 65% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HB US PELVIS NON OB LIMITED | $298.20 | $852.00 | $49.73–$809.40 | 31% below | 65% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HB US PELVIC LIMITED | $298.20 | $852.00 | $49.73–$809.40 | 31% below | 65% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HB US PELVIS NON OB | $427.00 | $1,220.00 | $91.78–$1,159.00 | 42% below | 65% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HB US PREG COMP SIZE/DATE | $404.25 | $1,155.00 | $91.78–$1,097.25 | 33% below | 65% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HB US PREGNANCY DIAGNOSIS TA | $311.15 | $889.00 | $91.78–$844.55 | 35% below | 65% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HB US PREGNANCY LIMITED | $283.15 | $809.00 | $81.66–$768.55 | 40% below | 65% |
| Rib X-ray, one side, 2 views one side CPT 71100 HB XR RIBS UNILAT 2 VIEWS LT | $161.35 | $461.00 | $32.82–$437.95 | 51% below | 65% |
| Rib X-ray, one side, 2 views one side CPT 71100 HB XR RIBS UNILAT 2 VIEWS RT | $161.35 | $461.00 | $32.82–$437.95 | 51% below | 65% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HB XR RIBS UNILAT W/CHEST 3+ V RT | $202.65 | $579.00 | $37.89–$550.05 | 51% below | 65% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HB XR RIBS UNILAT W/CHEST 3+ V LT | $202.65 | $579.00 | $37.89–$550.05 | 51% below | 65% |
| Screening mammogram, both breasts both sides CPT 77067 HB MAM SCREEN BILAT | $221.90 | $634.00 | $129.03–$602.30 | — | 65% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HB XR SHOULDER COMPL 2+ VIEWS LT | $188.30 | $538.00 | $31.33–$511.10 | 41% below | 65% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HB XR SHOULDER COMPL 2+ VIEWS RT | $188.30 | $538.00 | $31.33–$511.10 | 41% below | 65% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HB XR SHOULDER COMPL 2+ VW OR RT | $188.30 | $538.00 | $31.33–$511.10 | 41% below | 65% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HB XR SHOULDER COMPL 2+ VW OR LT | $188.30 | $538.00 | $31.33–$511.10 | 41% below | 65% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HB XR SINUSES COMPLETE 3+ VIEW | $263.90 | $754.00 | $33.72–$716.30 | 46% below | 65% |
| Skull X-ray, fewer than 4 views CPT 70250 HB XR SKULL < 4 VIEWS OR | $223.30 | $638.00 | $32.22–$606.10 | 35% below | 65% |
| Skull X-ray, fewer than 4 views CPT 70250 HB XR SKULL < 4 VIEWS | $223.30 | $638.00 | $32.22–$606.10 | 35% below | 65% |
| Sleep study in a lab (polysomnography) CPT 95810 HB PSG (SLEEP STAGING) 4+ PARAMET | $1,531.60 | $4,376.00 | $560.10–$4,157.20 | 30% below | 65% |
| Sleep study in a lab (polysomnography) CPT 95810 HB PSG 4+ PARAMET INCOMPLETE | $1,531.60 | $4,376.00 | $560.10–$4,157.20 | 30% below | 65% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HB ECHO REST/STRESS ECG W/PHYS | $1,716.40 | $4,904.00 | $206.56–$4,658.80 | at median | 65% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HB XR FEMUR 2 VW RT | $170.45 | $487.00 | $31.93–$462.65 | 44% below | 65% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HB XR FEMUR 2 VW OR LT | $170.45 | $487.00 | $31.93–$462.65 | 44% below | 65% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HB XR FEMUR 2 VW OR RT | $170.45 | $487.00 | $31.93–$462.65 | 44% below | 65% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HB XR FEMUR 2 VW LT | $170.45 | $487.00 | $31.93–$462.65 | 44% below | 65% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HB CT T-SPINE W/O CONTRAST | $724.85 | $2,071.00 | $91.78–$1,967.45 | 55% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 HB XR TOE RIGHT FOOT 4TH DIGIT | $136.50 | $390.00 | $26.26–$370.50 | 46% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 HB XR TOE RIGHT FOOT 3RD DIGIT | $136.50 | $390.00 | $26.26–$370.50 | 46% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 HB XR TOE RIGHT FOOT GREAT | $136.50 | $390.00 | $26.26–$370.50 | 46% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 HB XR TOE LEFT FOOT 3RD DIGIT | $136.50 | $390.00 | $26.26–$370.50 | 46% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 HB XR TOE LEFT FOOT GREAT | $136.50 | $390.00 | $26.26–$370.50 | 46% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 HB XR TOE LEFT FOOT 2ND DIGIT | $136.50 | $390.00 | $26.26–$370.50 | 46% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 HB XR TOE RIGHT FOOT 2ND DIGIT | $136.50 | $390.00 | $26.26–$370.50 | 46% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 HB XR TOE LEFT FOOT 4TH DIGIT | $136.50 | $390.00 | $26.26–$370.50 | 46% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 HB XR TOE LEFT FOOT 5TH DIGIT | $136.50 | $390.00 | $26.26–$370.50 | 46% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 HB XR TOE RIGHT FOOT 5TH DIGIT | $136.50 | $390.00 | $26.26–$370.50 | 46% below | 65% |
| Transvaginal pelvic ultrasound CPT 76830 HB US TRANSVAGINAL LIMITED | $387.10 | $1,106.00 | $91.78–$1,050.70 | 34% below | 65% |
| Transvaginal pelvic ultrasound CPT 76830 HB US TRANSVAGINAL | $387.10 | $1,106.00 | $91.78–$1,050.70 | 34% below | 65% |
| Transvaginal ultrasound during pregnancy CPT 76817 HB US PREGNANCY TRANSVAGINAL | $345.45 | $987.00 | $91.78–$966.15 | 28% below | 65% |
| Transvaginal ultrasound during pregnancy CPT 76817 HB US PREG TRANS CERV LENGTH ONLY | $355.95 | $1,017.00 | $91.78–$966.15 | 26% below | 65% |
| Ultrasound of the abdomen, complete CPT 76700 HB US ABDOMEN | $527.45 | $1,507.00 | $91.78–$1,431.65 | 39% below | 65% |
| Ultrasound of the scrotum and testicles CPT 76870 HB US SCROTUM | $537.25 | $1,535.00 | $89.51–$1,458.25 | 25% below | 65% |
| Ultrasound of the scrotum and testicles CPT 76870 HB US SCROTUM AND CONTENTS | $537.25 | $1,535.00 | $89.51–$1,458.25 | 25% below | 65% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HB US SOFT TISSUE HEAD/NECK | $516.95 | $1,477.00 | $91.78–$1,403.15 | 16% below | 65% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HB US THYROID | $516.95 | $1,477.00 | $91.78–$1,403.15 | 16% below | 65% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HB SP US SOFT TISSUE HEAD/NECK | $516.95 | $1,477.00 | $91.78–$1,403.15 | 16% below | 65% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HB XR UGI W/SM BOWEL | $486.85 | $1,391.00 | $109.81–$1,321.45 | 41% below | 65% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HB XR UGI SINGLE CONTRAST W OR WO KUB | $486.85 | $1,391.00 | $109.81–$1,321.45 | 41% below | 65% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HB XR HUMERUS 2+ VIEWS OR RT | $188.30 | $538.00 | $28.64–$511.10 | 44% below | 65% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HB XR HUMERUS 2+ VIEWS OR LT | $188.30 | $538.00 | $28.64–$511.10 | 44% below | 65% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HB XR HUMERUS 2+ VIEWS RT | $188.30 | $538.00 | $28.64–$511.10 | 44% below | 65% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HB XR HUMERUS 2+ VIEWS LT | $188.30 | $538.00 | $28.64–$511.10 | 44% below | 65% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HB US EXTREM VEINS W/COMPRESS LTD | $381.50 | $1,090.00 | $91.78–$1,099.15 | 48% below | 65% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HB PRE OP DIALYSIS ACCESS EVAL | $385.35 | $1,101.00 | $91.78–$1,099.15 | 48% below | 65% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HB DUPLEX EXT VEINS; UNIL/LIMIT | $385.35 | $1,101.00 | $91.78–$1,099.15 | 48% below | 65% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HB US DUPLEX VENOUS EXTREM UNI LT | $404.95 | $1,157.00 | $91.78–$1,099.15 | 45% below | 65% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HB US DUPLEX VENOUS EXTREM UNI RT | $404.95 | $1,157.00 | $91.78–$1,099.15 | 45% below | 65% |
| Wrist X-ray, 2 views one side CPT 73100 HB XR WRIST 2 VIEWS RT | $156.10 | $446.00 | $30.44–$423.70 | 39% below | 65% |
| Wrist X-ray, 2 views one side CPT 73100 HB XR WRIST 2 VIEWS LT | $156.10 | $446.00 | $30.44–$423.70 | 39% below | 65% |
| Wrist X-ray, 2 views one side CPT 73100 HB XR WRIST 2 VIEWS OR RT | $156.10 | $446.00 | $30.44–$423.70 | 39% below | 65% |
| Wrist X-ray, 2 views one side CPT 73100 HB XR WRIST 2 VIEWS OR LT | $156.10 | $446.00 | $30.44–$423.70 | 39% below | 65% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HB XR WRIST COMPLETE 3+ VIEWS LT | $195.65 | $559.00 | $37.00–$531.05 | 36% below | 65% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HB XR WRIST COMPLETE 3+ VIEWS RT | $195.65 | $559.00 | $37.00–$531.05 | 36% below | 65% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HB XR HIP UNI [& PELVIS IF PERFORMED] 2 OR 3 VW LT | $142.10 | $406.00 | $42.67–$385.70 | 43% below | 65% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HB XR HIP UNI & PELVIS IF PERFORMED 2 OR 3 VW RT OR | $142.10 | $406.00 | $42.67–$385.70 | 43% below | 65% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HB XR HIP UNI & PELVIS IF PERFORMED 2 OR 3 VW LT OR | $142.10 | $406.00 | $42.67–$385.70 | 43% below | 65% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HB XR HIP UNI [& PELVIS IF PERFORMED] 2 OR 3 VW RT | $142.10 | $406.00 | $42.67–$385.70 | 43% below | 65% |
| X-ray of the abdomen, 1 view CPT 74018 HB XR ABDOMEN AP ONLY (KUB) OR | $145.25 | $415.00 | $27.15–$394.25 | 48% below | 65% |
| X-ray of the abdomen, 1 view CPT 74018 HB XR ABD AP SITZ MARKER | $145.25 | $415.00 | $27.15–$394.25 | 48% below | 65% |
| X-ray of the abdomen, 1 view CPT 74018 HB XR GASTROGRAFIN CHALLENGE | $145.25 | $415.00 | $27.15–$394.25 | 48% below | 65% |
| X-ray of the abdomen, 1 view CPT 74018 HB XR ABDOMEN AP ONLY (KUB) | $145.25 | $415.00 | $27.15–$394.25 | 48% below | 65% |
| X-ray of the ankle, 2 views one side CPT 73600 HB XR ANKLE 2 VIEWS OR RT | $164.50 | $470.00 | $28.95–$446.50 | 39% below | 65% |
| X-ray of the ankle, 2 views one side CPT 73600 HB XR ANKLE 2 VIEWS OR LT | $164.50 | $470.00 | $28.95–$446.50 | 39% below | 65% |
| X-ray of the ankle, 2 views one side CPT 73600 HB XR ANKLE 2 VIEWS LT | $164.50 | $470.00 | $28.95–$446.50 | 39% below | 65% |
| X-ray of the ankle, 2 views one side CPT 73600 HB XR ANKLE 2 VIEWS RT | $164.50 | $470.00 | $28.95–$446.50 | 39% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HB XR FINGER RIGHT HAND 2ND DIGIT | $132.30 | $378.00 | $34.31–$359.10 | 44% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HB XR FINGER RIGHT HAND THUMB | $132.30 | $378.00 | $34.31–$359.10 | 44% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HB XR FINGER LEFT HAND 3RD DIGIT | $132.30 | $378.00 | $34.31–$359.10 | 44% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HB XR FINGER LEFT HAND 5TH DIGIT | $132.30 | $378.00 | $34.31–$359.10 | 44% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HB XR FINGER LEFT HAND 4TH DIGIT | $132.30 | $378.00 | $34.31–$359.10 | 44% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HB XR FINGER RIGHT HAND 3RDD DIGIT | $132.30 | $378.00 | $34.31–$359.10 | 44% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HB XR FINGER RIGHT HAND 4TH DIGIT | $132.30 | $378.00 | $34.31–$359.10 | 44% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HB XR FINGER RIGHT HAND 5TH DIGIT | $132.30 | $378.00 | $34.31–$359.10 | 44% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HB XR FINGER LEFT HAND THUMB | $132.30 | $378.00 | $34.31–$359.10 | 44% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HB XR FINGER LEFT HAND 2ND DIGIT | $132.30 | $378.00 | $34.31–$359.10 | 44% below | 65% |
| X-ray of the foot, 2 views one side CPT 73620 HB XR FOOT 2 VIEWS OR LT | $176.05 | $503.00 | $25.66–$477.85 | 41% below | 65% |
| X-ray of the foot, 2 views one side CPT 73620 HB XR FOOT 2 VIEWS OR RT | $176.05 | $503.00 | $25.66–$477.85 | 41% below | 65% |
| X-ray of the foot, 2 views one side CPT 73620 HB XR FOOT 2 VIEWS LT | $176.05 | $503.00 | $25.66–$477.85 | 41% below | 65% |
| X-ray of the foot, 2 views one side CPT 73620 HB XR FOOT 2 VIEWS RT | $176.05 | $503.00 | $25.66–$477.85 | 41% below | 65% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HB XR FOOT COMPLETE 3+ VIEWS RT | $195.30 | $558.00 | $30.73–$530.10 | 38% below | 65% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HB XR FOOT COMPLETE 3+ VIEWS LT | $195.30 | $558.00 | $30.73–$530.10 | 38% below | 65% |
| X-ray of the hand, 3 or more views one side CPT 73130 HB XR HAND COMPLETE 3+ VIEWS LT | $184.10 | $526.00 | $33.42–$499.70 | 38% below | 65% |
| X-ray of the hand, 3 or more views one side CPT 73130 HB XR HAND COMPLETE 3+ VIEWS RT | $184.10 | $526.00 | $33.42–$499.70 | 38% below | 65% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HB XR KNEE <3 VIEWS LT | $151.20 | $432.00 | $30.73–$410.40 | 42% below | 65% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HB XR KNEE <3 VIEWS RT | $151.20 | $432.00 | $30.73–$410.40 | 42% below | 65% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HB XR KNEE <3 VIEWS OR RT | $151.20 | $432.00 | $30.73–$410.40 | 42% below | 65% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HB XR KNEE <3 VIEWS OR LT | $151.20 | $432.00 | $30.73–$410.40 | 42% below | 65% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HB XR L-SPINE 2 OR 3 VIEWS | $220.85 | $631.00 | $35.81–$599.45 | 40% below | 65% |
| X-ray of the lower back, 4 or more views CPT 72110 HB XR L-SPINE 4 OR 5 VIEWS | $345.45 | $987.00 | $46.55–$937.65 | 35% below | 65% |
| X-ray of the lower back, 4 or more views CPT 72110 HB XR L-SPINE AP/LAT/ FLEX/EXT | $345.45 | $987.00 | $46.55–$937.65 | 35% below | 65% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HB XR T SPINE 2 VIEWS OR | $145.25 | $415.00 | $29.54–$532.95 | 56% below | 65% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HB XR T-SPINE 2 VIEWS | $196.35 | $561.00 | $29.54–$532.95 | 40% below | 65% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HB XR NASAL BONES COMPLETE 3+ | $231.35 | $661.00 | $33.72–$627.95 | 19% below | 65% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HB XR C-SPINE 2 OR 3 VIEWS | $198.80 | $568.00 | $35.51–$539.60 | 47% below | 65% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HB XR C-SPINE 2 OR 3 VIEWS OR | $198.80 | $568.00 | $35.51–$539.60 | 47% below | 65% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HB XR C SPINE FLEX/EXT ONLY | $198.80 | $568.00 | $35.51–$539.60 | 47% below | 65% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HB XR PELVIS 1 OR 2 VIEWS | $187.25 | $535.00 | $25.06–$508.25 | 43% below | 65% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HB XR PELVIS 1 OR 2 VIEWS OR | $187.25 | $535.00 | $25.06–$508.25 | 43% below | 65% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HB XR SACRUM/COCCYX 2+ VIEWS | $215.25 | $615.00 | $29.24–$584.25 | 49% below | 65% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 HB ADRENOCORTICOTROPIC HORMONE | $178.15 | $509.00 | $40.55–$483.55 | 23% below | 65% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HB ALT | $50.05 | $143.00 | $5.57–$135.85 | at median | 65% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HB AST | $49.70 | $142.00 | $5.44–$134.90 | at median | 65% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HB ACUTE HEPATITIS PANEL | $215.25 | $615.00 | $50.01–$584.25 | 25% below | 65% |
| Albumin blood test CPT 82040 HB ALBUMIN | $39.20 | $112.00 | $5.20–$106.40 | at median | 65% |
| Aldosterone blood test CPT 82088 HB ALDOSTERONE | $167.30 | $478.00 | $36.87–$454.10 | 5% below | 65% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HB ALKALINE PHOSPHATASE | $36.75 | $105.00 | $5.44–$99.75 | at median | 65% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HB ALLERGEN SPECIFIC IGE | $22.75 | $65.00 | $5.48–$61.75 | 8% below | 65% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HB ALPHA FETOPROTEIN SERUM | $102.55 | $293.00 | $17.61–$278.35 | 8% below | 65% |
| Ammonia blood test CPT 82140 HB AMMONIA | $83.65 | $239.00 | $15.30–$227.05 | 9% below | 65% |
| Amylase blood test CPT 82150 HB AMYLASE | $56.00 | $160.00 | $6.80–$152.00 | at median | 65% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HB CYCLIC CITRULLINATED PEPTID | $50.40 | $144.00 | $13.60–$136.80 | 31% below | 65% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HB ANTINUCLEAR ANTIBODY | $64.05 | $183.00 | $12.69–$173.85 | 53% below | 65% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HB B TYPE NATRIURETIC PEPTIDE | $161.00 | $460.00 | $41.22–$437.00 | 17% below | 65% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE BACTERIA AEROBIC | $68.95 | $197.00 | $8.78–$187.15 | at median | 65% |
| Basic metabolic panel (blood test) CPT 80048 HB BASIC METABOLIC PANEL | $127.05 | $363.00 | $8.88–$344.85 | 69% above | 65% |
| Bilirubin blood test, total CPT 82247 HB BILIRUBIN TOTAL | $89.25 | $255.00 | $5.27–$242.25 | 100% above | 65% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HB SURG PATH LEVEL 4 GR/MICRO | $197.40 | $564.00 | $45.75–$535.80 | 9% below | 65% |
| Blood culture for bacteria CPT 87040 HB CULT BACTERIA BLOOD | $74.90 | $214.00 | $10.84–$203.30 | 28% below | 65% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HB VENIPUNCTURE | $16.10 | $46.00 | $23.05–$45.60 | 8% below | 65% |
| Blood glucose (sugar) test CPT 82947 HB GLUCOSE ISTAT | $31.15 | $89.00 | $4.13–$84.55 | 31% below | 65% |
| Blood lead test CPT 83655 HB LEAD | $60.55 | $173.00 | $12.72–$164.35 | 4% below | 65% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HB BETA HCG QUALITATIVE SERUM | $86.45 | $247.00 | $7.90–$234.65 | 18% below | 65% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HB BLOOD TYPING ABO | $159.95 | $457.00 | $3.14–$484.29 | 77% above | 65% |
| Blood urea nitrogen (BUN) test CPT 84520 HB UREA NITROGEN | $31.15 | $89.00 | $4.15–$84.55 | 40% below | 65% |
| C-peptide blood test CPT 84681 HB C-PEPTIDE | $109.20 | $312.00 | $21.85–$296.40 | at median | 65% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HB C-REACTIVE PROTEIN | $53.55 | $153.00 | $5.44–$145.35 | 37% below | 65% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HB CLOSTRIDIUM DIFFICILE TOXINGENES | $90.30 | $258.00 | $39.13–$245.10 | 28% below | 65% |
| CA 19-9 blood test (tumor marker) CPT 86301 HB CA 19-9 | $82.25 | $235.00 | $21.85–$223.25 | 20% below | 65% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HB CANCER ANTIGEN 125 | $122.85 | $351.00 | $21.85–$333.45 | at median | 65% |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 HB CORONA RT-PCR PANEL | $61.25 | $175.00 | $47.41–$166.25 | 20% below | 65% |
| Calcium blood test, total CPT 82310 HB CALCIUM | $20.65 | $59.00 | $5.42–$56.05 | 49% below | 65% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HB CARCINOEMBRYONIC ANTIGEN | $80.85 | $231.00 | $19.91–$219.45 | 30% below | 65% |
| Chickenpox (varicella) immunity blood test CPT 86787 HB VARICELLA ZOSTER AB IGM | $152.60 | $436.00 | $9.66–$414.20 | 45% above | 65% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HB CHLAMYDIA TRACH AMP PROBE T | $101.50 | $290.00 | $36.84–$275.50 | 23% below | 65% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HB LIPID PROFILE 1 | $64.05 | $183.00 | $14.06–$173.85 | 25% below | 65% |
| Complete blood count (CBC) with differential CPT 85025 HB CBC W/AUTO DIFF OTHER | $51.10 | $146.00 | $8.16–$138.70 | 77% above | 65% |
| Complete blood count (CBC), no differential CPT 85027 HB CBC WITHOUT DIFFERENTIAL | $51.10 | $146.00 | $6.79–$138.70 | 38% below | 65% |
| Comprehensive metabolic panel (blood test) CPT 80053 HB COMPREHENSIVE METABOLIC PAN | $170.45 | $487.00 | $11.09–$462.65 | at median | 65% |
| Cortisol blood test, total CPT 82533 HB CORTISOL TOTAL | $86.80 | $248.00 | $17.12–$235.60 | at median | 65% |
| Creatine kinase (CK) blood test, total CPT 82550 HB CREATINE KINASE (CPK) TOTAL | $36.40 | $104.00 | $6.84–$98.80 | 43% below | 65% |
| Creatinine blood test CPT 82565 HB CREATININE ISTAT | $36.40 | $104.00 | $5.38–$98.80 | 43% below | 65% |
| Creatinine blood test CPT 82565 HB CREATININE BLOOD | $36.40 | $104.00 | $5.38–$98.80 | 43% below | 65% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HB CYTOMEGALOVIRUS NEG UNIT CHARGE | $68.25 | $195.00 | $9.66–$185.25 | at median | 65% |
| D-dimer blood test (blood clot marker) CPT 85379 HB D DIMER QUAN ULTRA SEN | $78.05 | $223.00 | $3.69–$211.85 | 50% below | 65% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HB DEHYDROEPIANDOSTERONE SULFA | $120.05 | $343.00 | $23.34–$325.85 | at median | 65% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB DRUG SCREEN SINGLE | $208.60 | $596.00 | $65.25–$566.20 | 36% above | 65% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HB ELECTROLYTES | $95.90 | $274.00 | $7.36–$260.30 | at median | 65% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HB EPSTEIN BARR VIRAL CAP AB IGM | $91.70 | $262.00 | $9.66–$248.90 | 1% below | 65% |
| Estradiol blood test CPT 82670 HB ESTRADIOL TOTAL | $122.15 | $349.00 | $29.34–$331.55 | at median | 65% |
| FSH (follicle-stimulating hormone) test CPT 83001 HB FOLLICLE STIMULATING HORMON | $106.05 | $303.00 | $19.51–$287.85 | at median | 65% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HB CALPROTECTIN FECAL | $121.45 | $347.00 | $20.61–$329.65 | at median | 65% |
| Ferritin blood test (iron stores) CPT 82728 HB FERRITIN | $63.70 | $182.00 | $14.31–$172.90 | 51% below | 65% |
| Fibrinogen blood test CPT 85384 HB FIBRINOGEN | $77.70 | $222.00 | $3.82–$210.90 | 7% below | 65% |
| Folate (folic acid) blood test CPT 82746 HB FOLATES SERUM | $76.30 | $218.00 | $15.44–$207.10 | 30% below | 65% |
| Free T3 thyroid hormone test CPT 84481 HB T3 FREE | $76.30 | $218.00 | $14.49–$207.10 | 26% below | 65% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HB THYROXINE FREE | $56.35 | $161.00 | $9.47–$152.95 | 27% below | 65% |
| Free testosterone test CPT 84402 HB TESTOSTERONE FREE | $105.70 | $302.00 | $26.74–$286.90 | 42% below | 65% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HB GGT | $39.55 | $113.00 | $7.56–$107.35 | 7% below | 65% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HB GENERAL HEALTH PANEL | $329.00 | $940.00 | $8.78–$893.00 | 228% above | 65% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HB DIABETIC SCREEN | $40.95 | $117.00 | $4.99–$111.15 | at median | 65% |
| Glucose tolerance test, 3 samples CPT 82951 HB GLUCOSE TOLERANCE 3 SPECIME | $82.25 | $235.00 | $11.37–$223.25 | at median | 65% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HB NEISSERIA GONNORRHOEAE AMP | $108.85 | $311.00 | $36.84–$295.45 | at median | 65% |
| H. pylori stool antigen test CPT 87338 HB H PYLORI ANTIGEN STOOL EIA | $107.80 | $308.00 | $15.10–$292.60 | at median | 65% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HB HIV 1 QUAN | $268.80 | $768.00 | $84.54–$729.60 | 10% below | 65% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HB HIV 1 ANTIGENS W/HIV 1 & 2 AB | $96.25 | $275.00 | $25.28–$261.25 | 14% below | 65% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HB HPV HIGH RISK TYPES | $115.15 | $329.00 | $36.84–$312.55 | at median | 65% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HB HEMOGLOBIN A1C | $49.00 | $140.00 | $10.20–$133.00 | 55% below | 65% |
| Hemoglobin blood test CPT 85018 HB HEMOGLOBIN (H/H) | $17.50 | $50.00 | $2.49–$47.50 | 3% below | 65% |
| Hepatitis B core antibody test (total) CPT 86704 HB HEPATITIS B CORE AB TOTAL | $61.95 | $177.00 | $12.64–$168.15 | 6% below | 65% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HB HEPATITIS B SURF AB | $61.25 | $175.00 | $9.40–$166.25 | 27% below | 65% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HB HEPATITIS B SURF AG | $63.00 | $180.00 | $10.85–$171.00 | at median | 65% |
| Hepatitis C antibody blood test (screening) CPT 86803 HB HEPATITIS C AB | $78.40 | $224.00 | $14.98–$212.80 | at median | 65% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HB HEPATITIS C QUANTIFICATION | $204.40 | $584.00 | $34.43–$554.80 | 19% below | 65% |
| Herpes blood test, HSV-1 antibody CPT 86695 HB HERPES SIMPLEX AB TYPE 1 | $83.65 | $239.00 | $13.85–$227.05 | at median | 65% |
| Herpes blood test, HSV-2 antibody CPT 86696 HB HERPES SIMPLEX AB TYPE 2 | $99.40 | $284.00 | $20.32–$269.80 | 9% above | 65% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HB C-REACTIVE PROTEIN ULTRA | $50.40 | $144.00 | $13.60–$136.80 | 7% below | 65% |
| Homocysteine blood test CPT 83090 HB HOMOCYSTEINE | $110.95 | $317.00 | $18.82–$301.15 | at median | 65% |
| Insulin blood test CPT 83525 HB INSULIN | $63.35 | $181.00 | $9.22–$171.95 | 9% below | 65% |
| Iron blood test (serum iron) CPT 83540 HB IRON | $35.70 | $102.00 | $6.79–$96.90 | 55% below | 65% |
| Iron-binding capacity (TIBC) test CPT 83550 HB IRON BINDING CAPACITY UNSAT | $42.00 | $120.00 | $9.18–$114.00 | 37% below | 65% |
| Kidney function blood test panel CPT 80069 HB RENAL FUNCTION PANEL | $90.30 | $258.00 | $9.11–$245.10 | 16% below | 65% |
| LH (luteinizing hormone) test CPT 83002 HB LUTEINIZING HORMONE | $106.05 | $303.00 | $19.45–$287.85 | 21% below | 65% |
| Lactate (lactic acid) blood test CPT 83605 HB LACTIC ACID | $83.30 | $238.00 | $12.15–$226.10 | 7% below | 65% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HB LD | $31.15 | $89.00 | $6.34–$84.55 | 42% below | 65% |
| Lipase blood test (pancreas enzyme) CPT 83690 HB LIPASE | $52.15 | $149.00 | $7.23–$141.55 | 52% below | 65% |
| Liver function blood test panel CPT 80076 HB HEPATIC FUNCTION PANEL | $83.30 | $238.00 | $8.58–$226.10 | at median | 65% |
| Lyme disease antibody test CPT 86618 HB LYME DISEASE AB TOTAL IMMUN | $81.20 | $232.00 | $17.88–$220.40 | 7% below | 65% |
| Magnesium blood test CPT 83735 HB MAGNESIUM | $62.30 | $178.00 | $7.04–$169.10 | 14% above | 65% |
| Measles (rubeola) antibody test CPT 86765 HB RUBEOLA ANTIBODY QUAN IGG | $74.90 | $214.00 | $9.66–$203.30 | at median | 65% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HB MONO TEST | $82.25 | $235.00 | $5.44–$223.25 | 8% below | 65% |
| Mumps immunity blood test CPT 86735 HB MUMPS ANTIBODY IGG | $69.65 | $199.00 | $13.70–$189.05 | at median | 65% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HB PROSTATE SPECIFIC AG FREE | $64.75 | $185.00 | $19.31–$175.75 | 40% below | 65% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HB PROSTATE SPECIFIC AG TOTAL | $72.45 | $207.00 | $19.31–$196.65 | 27% below | 65% |
| Pap test (liquid-based, automated screening with review) CPT 88175 HB PAP THIN PREP IMAGING | $99.05 | $283.00 | $27.94–$268.85 | 1% above | 65% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HB CYTOPATH GYN SCR THIN LAY L | $65.80 | $188.00 | $21.27–$178.60 | 3% below | 65% |
| Parathyroid hormone (PTH) blood test CPT 83970 HB PARATHYROID HORMONE INTACT | $178.85 | $511.00 | $43.34–$485.45 | 22% below | 65% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HB PTT | $42.35 | $121.00 | $6.31–$114.95 | 29% below | 65% |
| Phosphorus (phosphate) blood test CPT 84100 HB PHOSPHORUS | $36.05 | $103.00 | $4.98–$97.85 | 25% below | 65% |
| Potassium blood test CPT 84132 HB POTASSIUM ISTAT | $24.50 | $70.00 | $5.00–$66.50 | 37% below | 65% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HB FETAL CHROMO ANEUPLOIDY | $762.30 | $2,178.00 | $741.35–$2,069.10 | 26% below | 65% |
| Progesterone blood test CPT 84144 HB PROGESTERONE | $119.35 | $341.00 | $18.83–$323.95 | 34% below | 65% |
| Prolactin blood test CPT 84146 HB PROLACTIN | $107.45 | $307.00 | $20.35–$291.65 | 9% below | 65% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HB PT | $25.90 | $74.00 | $4.50–$70.30 | at median | 65% |
| Rapid flu test (influenza antigen) CPT 87804 HB INFLUENZA ANTIGEN RAPID | $84.35 | $241.00 | $14.55–$228.95 | at median | 65% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HB STREP GRP A SCREEN IMMUNOAS | $62.65 | $179.00 | $14.55–$170.05 | 30% below | 65% |
| Renin blood test CPT 84244 HB RENIN | $132.30 | $378.00 | $23.09–$359.10 | at median | 65% |
| Rh blood typing CPT 86901 HB BLOOD TYPING RH D | $61.60 | $176.00 | $3.14–$167.20 | at median | 65% |
| Rheumatoid factor (RF) test CPT 86431 HB RHEUMATOID FACTOR QUANT | $32.20 | $92.00 | $5.95–$87.40 | 11% below | 65% |
| Rubella antibody test (immunity check) CPT 86762 HB RUBELLA ANTIBODY IGG | $105.35 | $301.00 | $9.66–$285.95 | 8% above | 65% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HB SEDIMENTATION RATE WESTERGR | $29.05 | $83.00 | $2.84–$78.85 | 49% below | 65% |
| Sodium blood test CPT 84295 HB SODIUM ISTAT | $27.30 | $78.00 | $5.05–$74.10 | 46% below | 65% |
| Stool ova and parasites exam CPT 87177 HB OVA AND PARASITE | $44.10 | $126.00 | $4.39–$119.70 | 18% below | 65% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HB BLOOD OCCULT FECAL IMMUNOASSAY | $51.45 | $147.00 | $16.72–$139.65 | 33% below | 65% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HB TREPONEMA PALLIDUM AB | $74.90 | $214.00 | $13.90–$203.30 | 6% above | 65% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HB RAPID PLASMA REAGIN | $25.20 | $72.00 | $4.39–$68.40 | at median | 65% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HB TB TEST ALL MEDIATED IMMUN | $220.50 | $630.00 | $3.83–$598.50 | at median | 65% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HB TESTOSTERONE TOTAL OTHER | $150.15 | $429.00 | $27.10–$407.55 | at median | 65% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HB THYROID MICROSOMAL ANTIBODIES | $57.05 | $163.00 | $15.28–$154.85 | 23% below | 65% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HB THYROID STIMULATING HORMONE | $97.65 | $279.00 | $17.64–$265.05 | at median | 65% |
| Total IgE blood test CPT 82785 HB IMMUNOGLOBULIN E | $78.75 | $225.00 | $17.28–$213.75 | 11% below | 65% |
| Total cholesterol blood test CPT 82465 HB CHOLESTEROL SERUM | $32.55 | $93.00 | $4.57–$88.35 | 40% below | 65% |
| Total thyroxine (T4) blood test CPT 84436 HB THYROXINE | $61.60 | $176.00 | $7.21–$167.20 | 28% above | 65% |
| Total triiodothyronine (T3) blood test CPT 84480 HB TRIIODOTHYRONINE (T-3) TOTA | $77.35 | $221.00 | $14.89–$209.95 | 24% below | 65% |
| Transferrin blood test CPT 84466 HB TRANSFERRIN | $58.80 | $168.00 | $11.16–$159.60 | 23% below | 65% |
| Trichomonas test (NAAT) CPT 87661 HB TRICH VAGINALIS AMP PROBE | $116.20 | $332.00 | $36.84–$315.40 | 5% above | 65% |
| Triglycerides blood test CPT 84478 HB TRIGLYCERIDE | $30.10 | $86.00 | $6.03–$81.70 | 44% below | 65% |
| Troponin test, quantitative CPT 84484 HB TROPONIN I | $58.45 | $167.00 | $11.94–$158.65 | 42% below | 65% |
| Uric acid blood test CPT 84550 HB URIC ACID BLOOD | $60.20 | $172.00 | $4.75–$163.40 | 14% below | 65% |
| Urinalysis with microscope exam, automated CPT 81001 HB UA AUTO W/MICRO | $40.60 | $116.00 | $3.33–$110.20 | 9% below | 65% |
| Urinalysis without microscope exam, automated CPT 81003 HB URINALYSIS WITHOUT MICROSCO | $24.50 | $70.00 | $2.36–$66.50 | 26% below | 65% |
| Urinalysis without microscope exam, manual CPT 81002 HB UA NONAUTO W/O MICRO | $12.25 | $35.00 | $3.11–$33.25 | 40% below | 65% |
| Urine culture for bacteria, with colony count CPT 87086 HB URINE CULT BACT COLONY CNT | $56.35 | $161.00 | $8.47–$152.95 | 27% below | 65% |
| Urine microalbumin (albumin) test CPT 82043 HB MICROALBUMIN URINE | $36.75 | $105.00 | $4.61–$99.75 | 38% below | 65% |
| Urine pregnancy test, read by color change CPT 81025 HB URINE PREGNANCY TEST | $57.05 | $163.00 | $7.67–$154.85 | 38% below | 65% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HB VITAMIN B12 | $73.15 | $209.00 | $15.83–$198.55 | 13% below | 65% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HB VITAMIN D3 25-OH HYDROXY | $110.95 | $317.00 | $31.08–$301.15 | 21% below | 65% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HB VITAMIN D1-25 DIHYDROXY | $217.70 | $622.00 | $40.43–$590.90 | at median | 65% |
| Zinc blood test CPT 84630 HB ZINC | $50.75 | $145.00 | $11.96–$137.75 | 21% below | 65% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB GONADOTROPIN CHORIONIC QUAN | $121.10 | $346.00 | $10.53–$328.70 | 10% below | 65% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 HB CHEMODENERV MUSC MIGRAINE | $649.25 | $1,855.00 | $138.45–$1,762.25 | 33% above | 65% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 HB MAM BREAST BX STEREO RT | $2,009.70 | $5,742.00 | $443.10–$6,011.53 | 26% below | 65% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 HB MAM BREAST BX STEREO LT | $2,009.70 | $5,742.00 | $443.10–$6,011.53 | 26% below | 65% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 HB CATH ANGIO ART/VENT LEFT HEART | $8,221.50 | $23,490.00 | $903.35–$22,315.50 | 15% below | 65% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HB CARDIOVERSION EXTERNAL | $811.65 | $2,319.00 | $136.86–$2,405.70 | 32% below | 65% |
| Catheter ablation for atrial fibrillation CPT 93656 HB EP COMPREHENSIVE W/AT FIB ABLATION | $22,147.65 | $63,279.00 | $826.94–$95,137.06 | 3% above | 65% |
| Cervical biopsy CPT 57500 HB CERVIX BIOPSY | $1,080.10 | $3,086.00 | $155.58–$3,352.45 | 35% below | 65% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HB CIRCUMCISION W/CLAMP | $2,541.00 | $7,260.00 | $133.08–$7,608.63 | 68% above | 65% |
| Colonoscopy with endoscopic ultrasound CPT 45391 HB COLONOSCOPY FLEX W/ENDO US | $1,462.65 | $4,179.00 | $226.47–$4,355.55 | at median | 65% |
| Colonoscopy with polyp removal CPT 45385 HB COLONOSCOPY W/REMOVE BY SNARE | $1,462.65 | $4,179.00 | $405.80–$4,355.55 | 62% below | 65% |
| Colonoscopy with tissue sample CPT 45380 HB COLONOSCOPY W/BIOPSY | $1,462.65 | $4,179.00 | $387.60–$4,355.55 | 16% below | 65% |
| Colonoscopy, diagnostic CPT 45378 HB COLONOSCOPY FLEX DX | $1,130.85 | $3,231.00 | $96.47–$3,384.89 | 20% below | 65% |
| Coronary stent placement, one artery CPT 92928 HB PRQ TCAT PLMT NTRAC STENT DES 1 LES | $25,624.20 | $73,212.00 | $513.39–$69,551.40 | 145% above | 65% |
| Coronary stent placement, one artery CPT 92928 HB PRQ TCAT PLMT NTRAC STENT BMS 1 LES | $25,624.20 | $73,212.00 | $513.39–$69,551.40 | 145% above | 65% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HB REMOVE CERUMEN VIA IRRIGATION | $67.20 | $192.00 | $14.32–$214.72 | 31% below | 65% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HB BX ENDOMETRIAL | $249.55 | $713.00 | $102.83–$735.87 | 18% below | 65% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HB ENDOMETRIAL BX WO CERV DILATION | $249.55 | $713.00 | $102.83–$735.87 | 18% below | 65% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HB INJ INTERLAMINAR CERV/THOR W IMG | $1,078.35 | $3,081.00 | $235.42–$2,926.95 | 20% below | 65% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HB SP INJ INTERLAMINAR CERV/THOR W IMG | $1,078.35 | $3,081.00 | $235.42–$2,926.95 | 20% below | 65% |
| Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 HB INJ PARA FACET LUM/SAC SGL BILATERAL | $2,123.80 | $6,068.00 | $159.04–$5,764.60 | — | 65% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HB SP INJ PARAV LUM/SAC 5GL GUID | $1,104.25 | $3,155.00 | $159.04–$5,764.60 | 21% below | 65% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 HB INJ PARA FACET LUM/SAC SGL RT | $1,104.25 | $3,155.00 | $159.04–$5,764.60 | 21% below | 65% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 HB INJ PARA FACET LUM/SAC SGL LT | $1,104.25 | $3,155.00 | $159.04–$5,764.60 | 21% below | 65% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HB SIGMOIDOSCOPY | $1,130.85 | $3,231.00 | $96.47–$3,384.89 | at median | 65% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HB LIGATION OF HEMORRHOID(S) | $1,130.85 | $3,231.00 | $96.47–$3,384.89 | 22% below | 65% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HB HEMORRHOIDECTOMY INT/EXT SGL | $3,401.65 | $9,719.00 | $295.83–$10,102.89 | at median | 65% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HB XR CATH/INTRODUCTION SALINE | $381.85 | $1,091.00 | $243.96–$1,036.45 | 27% below | 65% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HB I AND D ABSCESS SIMPLE | $278.60 | $796.00 | $114.28–$756.20 | 28% below | 65% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HB SP I AND D ABS Q OR SUBQ SIMPL | $278.60 | $796.00 | $114.28–$756.20 | 28% below | 65% |
| Injection into a tendon sheath or ligament (for example trigger finger) both sides CPT 20550 HB INJ TENDON/SHEATH/LIGAMENT BILAT | $502.60 | $1,436.00 | $51.92–$1,364.20 | — | 65% |
| Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 HB INJ TENDON/SHEATH/LIGAMENT RT | $366.45 | $1,047.00 | $51.92–$1,364.20 | at median | 65% |
| Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 HB INJ TENDON/SHEATH/LIGAMENT LT | $406.70 | $1,162.00 | $51.92–$1,364.20 | 11% above | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 HB ARTHROCENTESIS MAJOR JOI BILAT | $954.80 | $2,728.00 | $58.49–$2,591.60 | — | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HB SP ARTHROCENTESIS MAJOR JOI | $366.45 | $1,047.00 | $58.49–$2,591.60 | 5% below | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HB XR ARTHROCENTESIS MAJOR JOINT | $366.45 | $1,047.00 | $58.49–$2,591.60 | 5% below | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HB ARTHROCENTESIS MAJOR JOI LT | $477.40 | $1,364.00 | $58.49–$2,591.60 | 23% above | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HB ARTHROCENTESIS MAJOR JOI RT | $477.40 | $1,364.00 | $58.49–$2,591.60 | 23% above | 65% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HB INSERTION DRUG DELIVERY IMPLANT | $292.60 | $836.00 | $90.42–$794.20 | 48% below | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 HB ARTHROCENTESIS INTERMED JOI BILAT | $954.80 | $2,728.00 | $49.53–$2,591.60 | — | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HB XR ARTHROCENTESIS INTER JOINT | $477.40 | $1,364.00 | $49.53–$2,591.60 | 13% above | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HB SP ARTHROCENTESIS INTERM JO | $477.40 | $1,364.00 | $49.53–$2,591.60 | 13% above | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 HB ARTHROCENTESIS INTERMED JOI RT | $477.40 | $1,364.00 | $49.53–$2,591.60 | 13% above | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 HB SP ARTHROCENTESIS INTERM JNT RT | $477.40 | $1,364.00 | $49.53–$2,591.60 | 13% above | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 HB ARTHROCENTESIS INTERMED JOI LT | $477.40 | $1,364.00 | $49.53–$2,591.60 | 13% above | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 HB SP ARTHROCENTESIS INTERM JNT LT | $477.40 | $1,364.00 | $49.53–$2,591.60 | 13% above | 65% |
| Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 HB DRAIN INJ SMALL JOINT WO US BILAT | $690.20 | $1,972.00 | $48.34–$1,873.40 | — | 65% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HB XR ARTHROCENTESIS SM JOINT | $366.45 | $1,047.00 | $48.34–$1,873.40 | at median | 65% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HB SP ARTHROCENTESIS SM JOINT | $366.45 | $1,047.00 | $48.34–$1,873.40 | at median | 65% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 HB DRAIN INJ SMALL JOINT WO US RT | $366.45 | $1,047.00 | $48.34–$1,873.40 | at median | 65% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 HB DRAIN INJ SMALL JOINT WO US LT | $366.45 | $1,047.00 | $48.34–$1,873.40 | at median | 65% |
| Left heart catheterization, diagnostic one side CPT 93452 HB CATH LEFT HEART PERC | $5,969.60 | $17,056.00 | $778.73–$16,203.20 | 9% below | 65% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HB SP INJ INTERLAMINAR LUMB/SACRL W IMG | $980.00 | $2,800.00 | $231.55–$2,926.95 | 42% below | 65% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HB INJ INTERLAMINAR LUMB/SACRL W IMG | $1,078.35 | $3,081.00 | $231.55–$2,926.95 | 36% below | 65% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HB INJ EPI/SUBARACH LUMB/SAC | $1,104.25 | $3,155.00 | $121.15–$3,219.31 | 27% below | 65% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 HB INJ TRANSFORAM LUM/SAC SNGL BILATERAL | $2,394.00 | $6,840.00 | $220.80–$6,498.00 | — | 65% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HB SP INJ ANES TRAN LUM/SACRL W/GUI | $1,197.00 | $3,420.00 | $220.80–$6,498.00 | 21% below | 65% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 HB INJ TRANSFORAM LUM/SAC SNGL LT | $1,197.00 | $3,420.00 | $220.80–$6,498.00 | 21% below | 65% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 HB INJ TRANSFORAM LUM/SAC SNGL RT | $1,197.00 | $3,420.00 | $220.80–$6,498.00 | 21% below | 65% |
| Nail removal (partial or complete), one nail CPT 11730 HB AVULSION NAIL PLATE SINGLE | $246.75 | $705.00 | $103.24–$730.27 | 16% above | 65% |
| Occipital nerve block (injection for headaches) both sides CPT 64405 HB INJ AA&/STRD GREATER OCCIPITAL NERVE BILAT | $812.00 | $2,320.00 | $67.74–$2,204.00 | — | 65% |
| Occipital nerve block (injection for headaches) one side CPT 64405 HB INJ AA&/STRD GREATER OCCIPITAL NERVE RT | $406.00 | $1,160.00 | $67.74–$2,204.00 | 26% below | 65% |
| Occipital nerve block (injection for headaches) one side CPT 64405 HB INJ AA&/STRD GREATER OCCIPITAL NERVE LT | $436.45 | $1,247.00 | $67.74–$2,204.00 | 21% below | 65% |
| Pacemaker implant (dual chamber) CPT 33208 HB INSERTION PACEMAKER DUAL | $12,980.45 | $37,087.00 | $455.04–$38,043.36 | 11% above | 65% |
| Paracentesis with imaging guidance CPT 49083 HB US ABD PARACENTESIS W GUIDE | $1,163.05 | $3,323.00 | $119.31–$3,301.26 | at median | 65% |
| Paracentesis with imaging guidance CPT 49083 HB PARACENTESIS W/IMAGING | $1,163.05 | $3,323.00 | $119.31–$3,301.26 | at median | 65% |
| Paracentesis with imaging guidance CPT 49083 HB SP ABD PARACENTESIS W GUIDE | $1,163.05 | $3,323.00 | $119.31–$3,301.26 | at median | 65% |
| Paracentesis with imaging guidance CPT 49083 HB CT ABD PARACENTESIS W GUIDE | $1,163.05 | $3,323.00 | $119.31–$3,301.26 | at median | 65% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HB EXC NAIL AND MATRIX | $495.60 | $1,416.00 | $144.42–$1,479.63 | 18% below | 65% |
| Prostate biopsy CPT 55700 HB BIOPSY PROSTATE | $2,541.00 | $7,260.00 | $215.73–$6,897.00 | at median | 65% |
| Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 HB DESTROY LUMB/SAC FACET JNT SGL BILATERAL | $4,498.90 | $12,854.00 | $395.66–$12,211.30 | — | 65% |
| Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 HB DESTROY LUMB/SAC FACET JNT SGL LT | $2,422.35 | $6,921.00 | $395.66–$12,211.30 | 12% below | 65% |
| Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 HB DESTROY LUMB/SAC FACET JNT SGL RT | $2,422.35 | $6,921.00 | $395.66–$12,211.30 | 12% below | 65% |
| Removal of a foreign object under the skin, simple CPT 10120 HB INCISION/REMOVAL FOREIGN BODY | $495.60 | $1,416.00 | $136.96–$1,479.63 | 12% below | 65% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HB COLONOSCOPY SCRN PT NOT HI RISK | $1,130.85 | $3,231.00 | $96.47–$3,384.89 | 64% below | 65% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HB CANCER SCREEN COLONOSCOPY HI RISK | $1,130.85 | $3,231.00 | $96.47–$3,384.89 | 61% below | 65% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) one side CPT 50590 HB ESWL UNILATERAL LT | $8,793.75 | $25,125.00 | $664.20–$23,868.75 | at median | 65% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) one side CPT 50590 HB ESWL UNILATERAL RT | $8,793.75 | $25,125.00 | $664.20–$23,868.75 | at median | 65% |
| Short leg cast (below the knee) CPT 29405 HB PT APPLICATION SHORT LEG CAST | $329.70 | $942.00 | $73.41–$1,018.04 | 4% above | 65% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HB RPR LAC SMP SCALP <2.5 CM | $281.05 | $803.00 | $84.75–$762.85 | 23% below | 65% |
| Skin biopsy, punch, one lesion CPT 11104 HB PUNCH BX SKIN SINGLE LESION | $299.60 | $856.00 | $112.19–$1,479.63 | 4% below | 65% |
| Skin tag removal, up to 15 tags CPT 11200 HB REMOVE SKIN TAG <15 | $136.15 | $389.00 | $83.24–$730.27 | 46% below | 65% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HB PUNCTURE SPINAL LUMBAR DIAG | $859.25 | $2,455.00 | $130.99–$2,569.29 | at median | 65% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HB XR PUNCTURE SPINAL LUMBAR D | $859.25 | $2,455.00 | $130.99–$2,569.29 | at median | 65% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HB PUNCTURE SPINAL LUMBAR DIAGNOS | $859.25 | $2,455.00 | $130.99–$2,569.29 | at median | 65% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HB SP PUNCTURE SPINAL LUMBAR D | $859.25 | $2,455.00 | $130.99–$2,569.29 | at median | 65% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HB SIMPLE REPAIR 2.6-7.5 CM | $335.65 | $959.00 | $102.65–$911.05 | 20% below | 65% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HB RPR SMP FACE EAR 2.5 CM OR LESS | $294.35 | $841.00 | $100.85–$798.95 | 22% below | 65% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HB TANGNTL BX SKIN SINGLE LES | $199.50 | $570.00 | $90.11–$1,479.63 | 21% below | 65% |
| Thoracentesis with imaging guidance both sides CPT 32555 HB SP THORACENTESIS BILATERAL | $1,187.90 | $3,394.00 | $278.99–$3,224.30 | — | 65% |
| Thoracentesis with imaging guidance CPT 32555 HB THORACENTESIS ASP W/IMAGING | $766.85 | $2,191.00 | $278.99–$3,224.30 | 42% below | 65% |
| Thoracentesis with imaging guidance CPT 32555 HB THORACENTESIS W IMAGING GUIDANCE | $766.85 | $2,191.00 | $278.99–$3,224.30 | 42% below | 65% |
| Thoracentesis with imaging guidance one side CPT 32555 HB US THORACENTESIS W GUIDE LT | $766.85 | $2,191.00 | $278.99–$3,224.30 | 42% below | 65% |
| Thoracentesis with imaging guidance one side CPT 32555 HB CT THORACENTESIS W GUIDE LT | $766.85 | $2,191.00 | $278.99–$3,224.30 | 42% below | 65% |
| Thoracentesis with imaging guidance one side CPT 32555 HB SP THORACENTESIS W GUIDE LT | $766.85 | $2,191.00 | $278.99–$3,224.30 | 42% below | 65% |
| Thoracentesis with imaging guidance one side CPT 32555 HB US THORACENTESIS W GUIDE RT | $766.85 | $2,191.00 | $278.99–$3,224.30 | 42% below | 65% |
| Thoracentesis with imaging guidance one side CPT 32555 HB CT THORACENTESIS W GUIDE RT | $766.85 | $2,191.00 | $278.99–$3,224.30 | 42% below | 65% |
| Thoracentesis with imaging guidance one side CPT 32555 HB SP THORACENTESIS W GUIDE RT | $766.85 | $2,191.00 | $278.99–$3,224.30 | 42% below | 65% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HB INJ TRIGGER POINT(S) 1 OR 2 | $366.45 | $1,047.00 | $47.15–$1,117.25 | at median | 65% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HB SP INJ TRIGGER POINT(S) 1 O | $366.45 | $1,047.00 | $47.15–$1,117.25 | at median | 65% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HB US BREAST BX LT | $2,009.70 | $5,742.00 | $441.61–$6,011.53 | at median | 65% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HB US BREAST BX RT | $2,009.70 | $5,742.00 | $441.61–$6,011.53 | at median | 65% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HB EGD W/ESOPH BALLOON DILATION | $2,353.05 | $6,723.00 | $956.03–$6,984.47 | at median | 65% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HB EGD W/BIOPSY | $1,163.05 | $3,323.00 | $119.31–$3,301.26 | 22% below | 65% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 HB EGD W/DIR SUBMUC INJ | $1,665.30 | $4,758.00 | $119.31–$4,520.10 | at median | 65% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HB EGD W/TUMOR/POLYP REMOVE SNARE | $2,353.05 | $6,723.00 | $441.32–$6,984.47 | 36% below | 65% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HB EGD W/ESOPH DILATION OVER GUID | $1,163.05 | $3,323.00 | $119.31–$3,301.26 | 17% below | 65% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HB EGD DIAGNOSTIC | $1,163.05 | $3,323.00 | $119.31–$3,301.26 | 22% below | 65% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HB EGD W/DRAIN PSEUDOCYST | $7,383.60 | $21,096.00 | $344.34–$22,096.96 | at median | 65% |
| Wart removal, up to 14 warts CPT 17110 HB DESTRUCT BENIGN LESION <15 | $246.75 | $705.00 | $102.34–$730.27 | 80% above | 65% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HB DEBRIDE SKIN/SUBQ TISSUE | $495.60 | $1,416.00 | $116.37–$1,479.63 | 17% below | 65% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HB TRANSFUSE BLOOD/COMPONENT MASS | $565.25 | $1,615.00 | $37.89–$1,605.80 | 34% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 HB TRANSFUSE BLOOD/COMPONENT | $565.25 | $1,615.00 | $37.89–$1,605.80 | 34% below | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB AEROSOL INITIAL SPUTUM INDUCT | $252.35 | $721.00 | $7.16–$797.04 | 60% above | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB MDI TREATMENT INITIAL | $252.35 | $721.00 | $7.16–$797.04 | 60% above | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB INSUFFLATOR/EXSUFFLAT RX INIT | $252.35 | $721.00 | $7.16–$797.04 | 60% above | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB AEROSOL SUB SPUTUM INDUCT | $252.35 | $721.00 | $7.16–$797.04 | 60% above | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB MDI TREATMENT SUBSEQUENT | $252.35 | $721.00 | $7.16–$797.04 | 60% above | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB AEROSOL INITIAL SM VOL NEB BAN | $252.35 | $721.00 | $7.16–$797.04 | 60% above | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB AEROSOL SUB SM VOL NEB | $252.35 | $721.00 | $7.16–$797.04 | 60% above | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB PAP TREATMENT INITIAL | $252.35 | $721.00 | $7.16–$797.04 | 60% above | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB INSUFFLATOR/EXSUFFLAT RX SUB | $252.35 | $721.00 | $7.16–$797.04 | 60% above | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB PAP TREATMENT SUBSEQUENT | $252.35 | $721.00 | $7.16–$797.04 | 60% above | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB METANEB THERAPY | $252.35 | $721.00 | $7.16–$797.04 | 60% above | 65% |
| Chemotherapy IV infusion, first hour CPT 96413 HB IV CHEMO INIT TO 1 HR | $653.45 | $1,867.00 | $112.98–$1,773.65 | 14% below | 65% |
| Critical care, first 30 to 74 minutes CPT 99291 HB CRITICAL CARE 30-74 MINS | $1,454.60 | $4,156.00 | $209.58–$3,948.20 | 43% below | 65% |
| Critical care, first 30 to 74 minutes CPT 99291 HB CRITICAL CARE 30-74 ADDL SVC | $1,454.60 | $4,156.00 | $209.58–$3,948.20 | 43% below | 65% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY | $427.00 | $1,220.00 | $189.57–$1,159.00 | 24% below | 65% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HB EEG AWAKE AND DROWSY | $427.00 | $1,220.00 | $189.57–$1,159.00 | 24% below | 65% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HB EKG ROUTINE TRACING ONLY | $104.30 | $298.00 | $5.67–$283.10 | 50% below | 65% |
| Electroconvulsive therapy (ECT), one session CPT 90870 HB ECT | $658.35 | $1,881.00 | $195.47–$3,125.65 | 17% below | 65% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HB ER VISIT LEVEL 1 | $175.00 | $500.00 | $8.21–$475.00 | 7% below | 65% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HB LEVEL 1 W/ADDITIONAL SERVICE | $175.00 | $500.00 | $8.21–$475.00 | 7% below | 65% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HB OBED LEVEL 1 W/ADDL SVC | $175.00 | $500.00 | $8.21–$475.00 | 7% below | 65% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HB OBED VISIT LEVEL 1 | $175.00 | $500.00 | $8.21–$475.00 | 7% below | 65% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HB OBED LEVEL 2 W/ADDL SVC | $280.00 | $800.00 | $30.07–$760.00 | 16% below | 65% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HB LEVEL 2 W/ADDITIONAL SERVICE | $280.00 | $800.00 | $30.07–$760.00 | 16% below | 65% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HB OBED VISIT LEVEL 2 | $280.00 | $800.00 | $30.07–$760.00 | 16% below | 65% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HB ER VISIT LEVEL 2 | $280.00 | $800.00 | $30.07–$760.00 | 16% below | 65% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HB LEVEL 3 W/ADDITIONAL SERVICE | $462.00 | $1,320.00 | $50.96–$1,254.00 | 8% below | 65% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HB OBED LEVEL 3 W/ADDL SVC | $462.00 | $1,320.00 | $50.96–$1,254.00 | 8% below | 65% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HB ER VISIT LEVEL 3 | $462.00 | $1,320.00 | $50.96–$1,254.00 | 8% below | 65% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HB OBED VISIT LEVEL 3 | $462.00 | $1,320.00 | $50.96–$1,254.00 | 8% below | 65% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HB OBED VISIT LEVEL 4 | $762.30 | $2,178.00 | $86.82–$2,069.10 | 16% below | 65% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HB OBED LEVEL 4 W/ADDL SVC | $762.30 | $2,178.00 | $86.82–$2,069.10 | 16% below | 65% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HB ER VISIT LEVEL 4 | $762.30 | $2,178.00 | $86.82–$2,069.10 | 16% below | 65% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HB LEVEL 4 W/ADDITIONAL SERVICE | $762.30 | $2,178.00 | $86.82–$2,069.10 | 16% below | 65% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HB OBED LEVEL 5 W/ADDL SVC | $1,160.25 | $3,315.00 | $125.82–$3,149.25 | 19% below | 65% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HB LEVEL 5 W/ADDITIONAL SERVICE | $1,160.25 | $3,315.00 | $125.82–$3,149.25 | 19% below | 65% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HB ER VISIT LEVEL 5 | $1,160.25 | $3,315.00 | $125.82–$3,149.25 | 19% below | 65% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HB OBED VISIT LEVEL 5 | $1,160.25 | $3,315.00 | $125.82–$3,149.25 | 19% below | 65% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HB NM STRESS TEST | $476.35 | $1,361.00 | $34.03–$1,311.95 | 37% below | 65% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HB PET/CT STRESS TEST | $483.35 | $1,381.00 | $34.03–$1,311.95 | 36% below | 65% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HB STRESS TEST CARDIOVASCULAR | $483.35 | $1,381.00 | $34.03–$1,311.95 | 36% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HB IV HYD INIT 31 MIN-60 MIN | $261.45 | $747.00 | $28.36–$774.21 | 22% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HB CT IV HYD INIT 31 MIN-60 MIN | $261.45 | $747.00 | $28.36–$774.21 | 22% below | 65% |
| IV infusion of a medicine, first hour CPT 96365 HB IV TX INIT TO 1 HR | $261.45 | $747.00 | $54.77–$774.21 | 28% below | 65% |
| IV push of a medicine, first drug CPT 96374 HB INJECTION IV PUSH INITIAL | $152.60 | $436.00 | $32.09–$774.21 | 44% below | 65% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HB INJECTION IM/SUBQ/ANTIBIOTICS | $88.55 | $253.00 | $12.84–$262.07 | 19% below | 65% |
| Neuromuscular re-education, 15 minutes CPT 97112 HB PT EI NEUROMUSCULAR RE-ED 15 ED | $57.40 | $164.00 | $33.58–$155.80 | 47% below | 65% |
| Neuromuscular re-education, 15 minutes CPT 97112 HB OT NEUROMUSCULAR RE-ED 15 MIN | $57.40 | $164.00 | $33.58–$155.80 | 47% below | 65% |
| Neuromuscular re-education, 15 minutes CPT 97112 HB PT NEUROMUSCULAR RE-ED 15 MIN | $57.40 | $164.00 | $33.58–$155.80 | 47% below | 65% |
| New patient office visit, about 30 minutes CPT 99203 HB VISIT OP NEW LEVEL 3 | $122.50 | $350.00 | $85.93–$332.50 | 36% below | 65% |
| New patient office visit, about 30 minutes CPT 99203 HB VISIT OP NEW LEVEL 3 ADDL SERV L AND D | $122.50 | $350.00 | $85.93–$332.50 | 36% below | 65% |
| New patient office visit, about 30 minutes CPT 99203 HB VISIT OP NEW LEVEL 3 L AND D | $122.50 | $350.00 | $85.93–$332.50 | 36% below | 65% |
| New patient office visit, about 30 minutes CPT 99203 HB VISIT OP NEW LEVEL 3 ADDL SERV | $122.50 | $350.00 | $85.93–$332.50 | 36% below | 65% |
| New patient office visit, about 30 minutes CPT 99203 HB EVAL LABOR NEW 2 TO 3 HR ADDL | $122.50 | $350.00 | $85.93–$332.50 | 36% below | 65% |
| New patient office visit, about 45 minutes CPT 99204 HB VISIT OP NEW LEVEL 4 L AND D | $157.50 | $450.00 | $128.77–$427.50 | 3% below | 65% |
| New patient office visit, about 45 minutes CPT 99204 HB EVAL LABOR NEW 3 TO 4 HR ADDL | $157.50 | $450.00 | $128.77–$427.50 | 3% below | 65% |
| New patient office visit, about 45 minutes CPT 99204 HB VISIT OP NEW LEVEL 4 ADDL SERV L AND D | $157.50 | $450.00 | $128.77–$427.50 | 3% below | 65% |
| New patient office visit, about 45 minutes CPT 99204 HB VISIT OP NEW LEVEL 4 | $157.50 | $450.00 | $128.77–$427.50 | 3% below | 65% |
| New patient office visit, about 60 minutes CPT 99205 HB EVAL LABOR NEW > 4 HR ADDL | $204.75 | $585.00 | $169.94–$555.75 | 13% below | 65% |
| New patient office visit, about 60 minutes CPT 99205 HB VISIT OP NEW LEVEL 5 ADDL SERV | $204.75 | $585.00 | $169.94–$555.75 | 13% below | 65% |
| New patient office visit, about 60 minutes CPT 99205 HB VISIT OP NEW LEVEL 5 | $204.75 | $585.00 | $169.94–$555.75 | 13% below | 65% |
| New patient office visit, about 60 minutes CPT 99205 HB VISIT OP NEW LEVEL 5 L AND D | $204.75 | $585.00 | $169.94–$555.75 | 13% below | 65% |
| New patient office visit, about 60 minutes CPT 99205 HB VISIT OP NEW LEVEL 5 ADDL SERV L AND D | $204.75 | $585.00 | $169.94–$555.75 | 13% below | 65% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HB VISIT OP NEW LEVEL 1 ADDL SERV L AND D | $91.00 | $260.00 | $55.37–$247.00 | 14% below | 65% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HB EVAL LABOR NEW < 1 HR | $91.00 | $260.00 | $55.37–$247.00 | 14% below | 65% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HB VISIT OP NEW LEVEL 2 ADDL SERV | $91.00 | $260.00 | $55.37–$247.00 | 14% below | 65% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HB VISIT OP NEW LEVEL 1 | $91.00 | $260.00 | $55.37–$247.00 | 14% below | 65% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HB VISIT OP NEW LEVEL 1 ADDL SERV | $91.00 | $260.00 | $55.37–$247.00 | 14% below | 65% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HB VISIT OP NEW LEVEL 2 L AND D | $91.00 | $260.00 | $55.37–$247.00 | 14% below | 65% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HB EVAL LABOR NEW< I HR ADDL | $91.00 | $260.00 | $55.37–$247.00 | 14% below | 65% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HB VISIT OP NEW LEVEL 2 | $91.00 | $260.00 | $55.37–$247.00 | 14% below | 65% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HB EVAL LABOR NEW 1 TO 2 HR ADDL | $91.00 | $260.00 | $55.37–$247.00 | 14% below | 65% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HB VISIT OP NEW LEVEL 2 ADDL SERV L AND D | $91.00 | $260.00 | $55.37–$247.00 | 14% below | 65% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HB MNT EVAL IND 15 MIN@ | $7.70 | $22.00 | $11.02–$34.24 | 70% below | 65% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HB NUTRITION THERAPY INIT EA 15MN@ | $10.50 | $30.00 | $11.02–$34.24 | 60% below | 65% |
| Occupational therapy evaluation, low complexity CPT 97165 HB OT EVAL LOW | $116.55 | $333.00 | $103.28–$316.35 | 46% below | 65% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HB PT EVAL COMPLEX | $166.25 | $475.00 | $105.36–$451.25 | 33% below | 65% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HB PT EVAL LOW | $137.55 | $393.00 | $101.43–$373.35 | 36% below | 65% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HB PT EVAL MODERATE | $151.20 | $432.00 | $101.43–$410.40 | 35% below | 65% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HB PT MANUAL TX JNT MOB/STM 15 MN | $57.40 | $164.00 | $27.71–$166.25 | 35% below | 65% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HB PT IMT MANUAL THERAPY 15 MIN | $57.40 | $164.00 | $27.71–$166.25 | 35% below | 65% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HB PT EI IMT MANUAL THERAPY | $57.40 | $164.00 | $27.71–$166.25 | 35% below | 65% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HB OT MANUAL TX JNT MOB/STM 15 MN | $61.25 | $175.00 | $27.71–$166.25 | 30% below | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB OT EXERCISE THERAPEUTIC 15 MIN | $50.05 | $143.00 | $43.92–$135.85 | 46% below | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB PT EXERCISE THERAPEUTIC 15 MIN | $50.05 | $143.00 | $43.92–$135.85 | 46% below | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB OT EI EXERCISE THERAPEUTIC 15 MIN | $50.05 | $143.00 | $43.92–$135.85 | 46% below | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB PT EI EXERCISE THERAPEUTIC 15 MIN | $50.05 | $143.00 | $43.92–$135.85 | 46% below | 65% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HB SMOKING CESSATION COUNSEL 3-10 | $64.75 | $185.00 | $11.16–$175.75 | 35% above | 65% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB VISIT OP ESTAB LEVEL 5 | $136.50 | $390.00 | $138.75–$370.50 | 44% below | 65% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB EVAL LABOR ESTAB > 4 HRS ADDL | $136.50 | $390.00 | $138.75–$370.50 | 44% below | 65% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB VISIT OP EST LEVEL 5 ADDL SERV | $136.50 | $390.00 | $138.75–$370.50 | 44% below | 65% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB VISIT OP ESTAB LEVEL 5 ADDL SERV L AND D | $136.50 | $390.00 | $138.75–$370.50 | 44% below | 65% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB VISIT OP ESTAB LEVEL 5 L AND D | $136.50 | $390.00 | $138.75–$370.50 | 44% below | 65% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB VISIT OP EST LEVEL 5 F/U | $136.50 | $390.00 | $138.75–$370.50 | 44% below | 65% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB VISIT OP EST LEVEL 5 ADDL SERV F/U | $136.50 | $390.00 | $138.75–$370.50 | 44% below | 65% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB EVAL LABOR ESTAB > 4 HRS | $136.50 | $390.00 | $138.75–$370.50 | 44% below | 65% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB EVAL LABOR ESTAB 2 TO 3 HR | $78.75 | $225.00 | $70.08–$213.75 | 48% below | 65% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB VISIT OP EST LEVEL 3 F/U | $78.75 | $225.00 | $70.08–$213.75 | 48% below | 65% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB VISIT OP ESTAB LEVEL 3 ADDL SERV L AND D | $78.75 | $225.00 | $70.08–$213.75 | 48% below | 65% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB VISIT OP EST LEVEL 3 ADDL SERV | $78.75 | $225.00 | $70.08–$213.75 | 48% below | 65% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB EVAL LABOR ESTAB 2 TO 3 HR ADDL | $78.75 | $225.00 | $70.08–$213.75 | 48% below | 65% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB VISIT OP ESTAB LEVEL 3 | $78.75 | $225.00 | $70.08–$213.75 | 48% below | 65% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB VISIT OP ESTAB LEVEL 3 L AND D | $78.75 | $225.00 | $70.08–$213.75 | 48% below | 65% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB VISIT OP EST LEVEL 3 ADDL SERV F/U | $78.75 | $225.00 | $70.08–$213.75 | 48% below | 65% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB VISIT OP ESTAB LEVEL 4 L AND D | $105.00 | $300.00 | $98.72–$370.50 | 25% below | 65% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB EVAL LABOR ESTAB 3 TO 4 HR | $105.00 | $300.00 | $98.72–$370.50 | 25% below | 65% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB VISIT OP EST LEVEL 4 F/U | $105.00 | $300.00 | $98.72–$370.50 | 25% below | 65% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB VISIT OP EST LEVEL 4 ADDL SERV | $105.00 | $300.00 | $98.72–$370.50 | 25% below | 65% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB VISIT OP EST LEVEL 4 ADDL SERV F/U | $105.00 | $300.00 | $98.72–$370.50 | 25% below | 65% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB VISIT OP ESTAB LEVEL 4 ADDL SERV L AND D | $105.00 | $300.00 | $98.72–$370.50 | 25% below | 65% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB VISIT OP ESTAB LEVEL 4 | $105.00 | $300.00 | $98.72–$370.50 | 25% below | 65% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB EVAL LABOR ESTAB 3 TO 4 HR ADDL | $136.50 | $390.00 | $98.72–$370.50 | 2% below | 65% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB VISIT OP EST LEVEL 2 ADDL SERV | $61.25 | $175.00 | $43.48–$166.25 | 50% below | 65% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB VISIT OP ESTAB LEVEL 2 L AND D | $61.25 | $175.00 | $43.48–$166.25 | 50% below | 65% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB VISIT OP ESTAB LEVEL 2 ADDL SERV L AND D | $61.25 | $175.00 | $43.48–$166.25 | 50% below | 65% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB EVAL LABOR ESTAB 1 TO 2 HR ADDL | $61.25 | $175.00 | $43.48–$166.25 | 50% below | 65% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB VISIT OP ESTAB LEVEL 2 | $61.25 | $175.00 | $43.48–$166.25 | 50% below | 65% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB EVAL LABOR ESTAB 1 TO 2 HR | $61.25 | $175.00 | $43.48–$166.25 | 50% below | 65% |
| Speech and language evaluation CPT 92523 HB EVAL SPEECH/LANG 91-120 MIN | $216.65 | $619.00 | $208.93–$588.05 | 34% below | 65% |
| Speech and language evaluation CPT 92523 HB EVAL SPEECH/LANG 0-30 MIN | $216.65 | $619.00 | $208.93–$588.05 | 34% below | 65% |
| Speech and language evaluation CPT 92523 HB EVAL SPEECH/LANG 61-90 MIN | $216.65 | $619.00 | $208.93–$588.05 | 34% below | 65% |
| Speech and language evaluation CPT 92523 HB EVAL SPEECH/LANG 31-60 MIN | $216.65 | $619.00 | $208.93–$588.05 | 34% below | 65% |
| Speech therapy session, individual CPT 92507 HB ST TREATMENT 0-30 MIN | $79.10 | $226.00 | $82.07–$231.80 | 55% below | 65% |
| Speech therapy session, individual CPT 92507 HB ST EI CTR TREATMENT | $79.10 | $226.00 | $82.07–$231.80 | 55% below | 65% |
| Speech therapy session, individual CPT 92507 HB ST EI TREATMENT | $79.10 | $226.00 | $82.07–$231.80 | 55% below | 65% |
| Speech therapy session, individual CPT 92507 HB ST TREATMENT 31-60 MIN | $81.20 | $232.00 | $82.07–$231.80 | 54% below | 65% |
| Speech therapy session, individual CPT 92507 HB ST TREATMENT 61-90 MIN | $85.40 | $244.00 | $82.07–$231.80 | 52% below | 65% |
| Spirometry (breathing test) CPT 94010 HB PED BASIC SPIROMETRY | $220.50 | $630.00 | $24.48–$785.93 | 15% below | 65% |
| Spirometry (breathing test) CPT 94010 HB SPIROMETRY/PFT BASIC | $220.50 | $630.00 | $24.48–$785.93 | 15% below | 65% |
| Spirometry before and after a bronchodilator CPT 94060 HB SPIROME PFT PRE AND POST BRON | $386.40 | $1,104.00 | $34.92–$1,358.22 | 6% below | 65% |
| Spirometry before and after a bronchodilator CPT 94060 HB PED SPIROMETRY W/BRONCHODILAT | $386.40 | $1,104.00 | $34.92–$1,358.22 | 6% below | 65% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HB PT THERAPEUTIC ACTIVITY 15 MIN | $59.50 | $170.00 | $53.41–$161.50 | 42% below | 65% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HB OT EI THERAPEUTIC ACTIVITY 15 MIN | $59.50 | $170.00 | $53.41–$161.50 | 42% below | 65% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HB PT EI THERAPEUTIC ACTIVITY 15 MIN | $59.50 | $170.00 | $53.41–$161.50 | 42% below | 65% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HB PT EI CTR BASED THERAPEUTIC ACTIVITY 15 MIN | $59.50 | $170.00 | $53.41–$161.50 | 42% below | 65% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HB OT EI CTR BASED THERAPEUTIC ACTIVITY 15 MIN | $59.50 | $170.00 | $53.41–$161.50 | 42% below | 65% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HB OT THERAPEUTIC ACTIVITY 15 MIN | $59.50 | $170.00 | $53.41–$161.50 | 42% below | 65% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HB PHLEBOTOMY THERAPEUTIC | $128.80 | $368.00 | $82.98–$484.29 | 48% below | 65% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLUAD TRIV 2024-2565Y UPPF 45 MCG 15 MCG X 3-0.5 ML IM SYRINGE | $25.40 | $72.58 | $36.36–$269.94 | at median | 65% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLULAVAL TRIV 2024-2025 PF 45 MCG 15 MCG X 3-0.5 ML IM SYRINGE | $8.39 | $23.98 | $12.01–$63.86 | 76% below | 65% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB PF 10 MCG-0.5 ML INTRAMUSCULAR SOLUTION | $19.71 | $56.31 | $12.62–$53.49 | 29% below | 65% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO A-C-Y-W-135-DIP PF 10 MCG-5 MCG-0.5 ML IM KIT 2 VIALS | $266.00 | $760.00 | $151.39–$722.00 | at median | 65% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI PF 10 MCG-0.5 ML INTRAMUSCULAR SOLUTION | $273.00 | $780.00 | $148.50–$741.00 | 7% below | 65% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG-0.5 ML INTRAMUSCULAR SYRINGE | $504.47 | $1,441.33 | $211.35–$1,369.27 | 54% above | 65% |
| Rabies vaccine, one dose CPT 90675 RABAVERT PF 2.5 UNIT IM SUSPENSION | $265.48 | $758.50 | $288.57–$879.31 | 72% below | 65% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC PF 5 LF UNIT-2 LF UNIT-0.5 ML INTRAMUSCULAR SUSPENSION | $131.95 | $377.00 | $33.69–$358.15 | 2% above | 65% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL TDAP ADOLESN-ADULTPF2 LF-2.5-5-3-5-5 LF-0.5 ML IM SYRINGE | $39.84 | $113.84 | $35.82–$108.15 | 63% below | 65% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB FLU IMMUNIZATION ADMIN 1 VACCINE@ | $15.75 | $45.00 | $22.55–$262.07 | 72% below | 65% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB HEPATITIS B VACCINE ADMIN | $88.55 | $253.00 | $22.55–$262.07 | 57% above | 65% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB PNEUMOCOCCAL VACCINE ADMIN | $88.55 | $253.00 | $22.55–$262.07 | 57% above | 65% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB INJECT VACCINE/TOXOID FIRST | $88.55 | $253.00 | $22.55–$262.07 | 57% above | 65% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HB INJECT VACCINE/TOXOID EA ADDL | $19.60 | $56.00 | $28.06–$53.20 | 53% below | 65% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://www.carilionclinic.org/540506332_Carilion-Roanoke-Memorial-Hospital_StandardCharges.csv