Hospital Weirton-Steubenville, WV-OH

Trinity Hospital Holding

Listed in its price file as “Trinity Hospital Holding Company”.

Trinity Hospital Holding in Steubenville, OH publishes cash prices for 264 common procedures listed here, from its own machine-readable price file updated Feb 28, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Ohio median for 171 of 262 procedures and above it for 90. By typical cash price it ranks #26 of 116 Ohio hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

4000 Johnson Rd, Steubenville, OH 43952 Collected Sep 27, 2026 Source price file

Scans and imaging

ProcedureCash price List priceInsurers payvs OhioOff list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ABI - ANKLE BRACHIAL INDEX $111.59 $225.00 $103.88–$492.65 77% below 50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ABI - ANKLE BRACHIAL INDEX $111.59 $225.00 — — 50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 FL-BARIUM SWALLOW-ESOPHAGUS $423.53 $854.00 $164.49–$708.60 2% below 50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FL-BARIUM SWALLOW-ESOPHAGUS $423.53 $854.00 — — 50%
Bone scan, whole body (nuclear medicine) CPT 78306 NM-BONE SCAN WHOLE BODY $909.54 $1,834.00 $347.27–$1,590.70 41% below 50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM-BONE SCAN WHOLE BODY $909.54 $1,834.00 — — 50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT-CTA CHEST W&W/O CONTRAST $1,240.33 $2,501.00 $164.49–$1,925.77 12% below 50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT-CTA CHEST W&W/O CONTRAST $1,240.33 $2,501.00 — — 50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA HRT COR ART BYPASS GR W/ $221.19 $446.00 $164.56–$1,071.35 86% below 50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA HRT COR ART BYPASS GR W/ $221.19 $446.00 — — 50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART W/O CONT W/CA TEST $69.93 $141.00 $74.52–$1,071.35 77% below 50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART W/O CONT W/CA TEST $69.93 $141.00 — — 50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT-ABD & PELVIS W/O CONTRAST $1,525.49 $3,076.00 $211.97–$2,368.52 3% below 50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT-ABD & PELVIS W/O CONTRAST $1,525.49 $3,076.00 — — 50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT-ABD & PELVIS WITH CONTRAS $1,676.25 $3,380.00 $329.98–$2,602.60 13% below 50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT-ABD & PELVIS WITH CONTRAS $1,676.25 $3,380.00 — — 50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT-ABD & PELVIS W&W/O CONTRA $2,464.28 $4,969.00 $329.98–$3,826.13 17% above 50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT-ABD & PELVIS W&W/O CONTRA $2,464.28 $4,969.00 — — 50%
CT scan of the abdomen with contrast CPT 74160 CT-ABDOMEN W/CONTRAST $861.93 $1,738.00 $164.49–$1,338.26 22% below 50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT-ABDOMEN W/CONTRAST $861.93 $1,738.00 — — 50%
CT scan of the abdomen without contrast CPT 74150 CT-ABDOMEN W/O CONTRAST $786.05 $1,585.00 $98.26–$1,292.00 25% below 50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT-ABDOMEN W/O CONTRAST $786.05 $1,585.00 — — 50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT-SINUSES W/O CONTRAST $790.52 $1,594.00 $98.26–$1,292.00 10% below 50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT-SINUSES W/O CONTRAST $790.52 $1,594.00 — — 50%
CT scan of the head or brain, no contrast dye CPT 70450 CT-HEAD/BRAIN W/O CONTRAST $790.52 $1,594.00 $98.26–$1,292.00 5% below 50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT-HEAD/BRAIN W/O CONTRAST $790.52 $1,594.00 — — 50%
CT scan of the head with contrast CPT 70460 CT-HEAD W/CONTRAST $1,114.86 $2,248.00 $164.49–$1,730.96 11% above 50%
CT scan of the head with contrast inpatient CPT 70460 CT-HEAD W/CONTRAST $1,114.86 $2,248.00 — — 50%
CT scan of the head without and with contrast CPT 70470 CT-HEAD W & W/O CONTRAST $1,312.73 $2,647.00 $164.49–$2,038.19 21% above 50%
CT scan of the head without and with contrast inpatient CPT 70470 CT-HEAD W & W/O CONTRAST $1,312.73 $2,647.00 — — 50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT-LUMBAR SPINE W/O CONTRAST $790.52 $1,594.00 $98.26–$1,292.00 25% below 50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT-LUMBAR SPINE W/O CONTRAST $790.52 $1,594.00 — — 50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT-CERVICAL SPINE W/O CONTRA $779.61 $1,572.00 $98.26–$1,292.00 24% below 50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT-CERVICAL SPINE W/O CONTRA $779.61 $1,572.00 — — 50%
CT scan of the pelvis, with contrast dye CPT 72193 CT-PELVIS W/CONTRAST $1,383.65 $2,790.00 $164.49–$2,148.30 24% above 50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT-PELVIS W/CONTRAST $1,383.65 $2,790.00 — — 50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DUPLEX BILATERAL $573.80 $1,157.00 $211.97–$945.07 — 50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US-CAROTID DUPLEX/DOPPER $516.76 $1,042.00 $211.97–$945.07 29% below 50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DUPLEX BILATERAL $573.80 $1,157.00 — — 50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US-CAROTID DUPLEX/DOPPER $516.76 $1,042.00 — — 50%
Chest X-ray, 2 views CPT 71046 WC CHEST STANDARD PA & LAT $90.76 $183.00 $74.52–$350.47 65% below 50%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS $219.21 $442.00 $74.52–$350.47 16% below 50%
Chest X-ray, 2 views inpatient CPT 71046 WC CHEST STANDARD PA & LAT $90.76 $183.00 — — 50%
Chest X-ray, 2 views inpatient CPT 71046 X-RAY EXAM CHEST 2 VIEWS $219.21 $442.00 — — 50%
Chest X-ray, single view CPT 71045 WC CHEST SINGLE VIEW $113.57 $229.00 $74.52–$350.47 47% below 50%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW $168.62 $340.00 $74.52–$350.47 22% below 50%
Chest X-ray, single view inpatient CPT 71045 WC CHEST SINGLE VIEW $113.57 $229.00 — — 50%
Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW $168.62 $340.00 — — 50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US-RENAL $489.49 $987.00 $98.26–$759.99 27% below 50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US-RENAL $489.49 $987.00 — — 50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US-OB DETAILED FETAL EXAM $380.38 $767.00 $211.97–$945.07 55% below 50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US-OB DETAILED FETAL EXAM $380.38 $767.00 — — 50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT-THORAX W/O CONTRAST DX $790.52 $1,594.00 $98.26–$1,292.00 12% below 50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT-THORAX W/O CONTRAST DX $790.52 $1,594.00 — — 50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT-THORAX W/CONTRAST $1,004.26 $2,025.00 $164.49–$1,559.25 10% below 50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT-THORAX W/CONTRAST $1,004.26 $2,025.00 — — 50%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAPHY BILATERAL IMAGES $335.75 $677.00 $286.00–$521.29 — 50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMOGRAPHY BILATERAL IMAGES $335.75 $677.00 — — 50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 ARTERIAL DUPLEX LOWER BILAT $585.20 $1,180.00 $211.97–$945.07 — 50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US-LOWER EXTREM ARTERIAL/BIL $622.40 $1,255.00 $211.97–$966.35 32% below 50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 ARTERIAL DUPLEX LOWER BILAT $585.20 $1,180.00 — — 50%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US-LOWER EXTREM ARTERIAL/BIL $622.40 $1,255.00 — — 50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS DUPLEX UPPER BILAT $538.09 $1,085.00 $211.97–$945.07 — 50%
Duplex ultrasound of the leg veins, both legs CPT 93970 US-UP EXTREM VESSEL MAP-BILA $578.76 $1,167.00 $211.97–$945.07 31% below 50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS DUPLEX UPPER BILAT $538.09 $1,085.00 — — 50%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US-UP EXTREM VESSEL MAP-BILA $578.76 $1,167.00 — — 50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CR-ECHOCARDIOGRAM-2D-M RECOR $1,101.96 $2,222.00 $445.13–$2,127.69 35% below 50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CR-ECHOCARDIOGRAM-2D-M RECOR $1,101.96 $2,222.00 — — 50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM-HIDA-HEPATOBILIARY $784.07 $1,581.00 $347.27–$1,590.70 48% below 50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM-HIDA-HEPATOBILIARY $784.07 $1,581.00 — — 50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY W/CPAP/BIPAP/ASV $3,091.63 $6,234.00 $847.55–$4,800.18 14% below 50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY W/CPAP/BIPAP/ASV $3,091.63 $6,234.00 — — 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US-ABDOMEN LIMITED $399.23 $805.00 $98.26–$619.85 28% below 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US-ABDOMEN LIMITED $399.23 $805.00 — — 50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT-THORAX LOW DOSE SCREENING $814.32 $1,642.00 $98.26–$1,292.00 208% above 50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT-THORAX LOW DOSE SCREENING $814.32 $1,642.00 — — 50%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MR BREAST BILAT W/0 W/CONT $2,168.71 $4,373.00 $1,146.00–$3,367.21 — 50%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MR BREAST BILAT W/0 W/CONT $2,168.71 $4,373.00 — — 50%
MRI of the abdomen without contrast CPT 74181 MR-ABDOMEN W/O CONTRAST $1,203.63 $2,427.00 $211.97–$2,407.00 26% below 50%
MRI of the abdomen without contrast inpatient CPT 74181 MR-ABDOMEN W/O CONTRAST $1,203.63 $2,427.00 — — 50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR-ABDOMEN W&W/O CONTRAST $2,111.68 $4,258.00 $329.98–$3,278.66 3% above 50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR-ABDOMEN W&W/O CONTRAST $2,111.68 $4,258.00 — — 50%
MRI of the brain, no contrast dye CPT 70551 MR-BRAIN W/O CONTRAST $1,872.64 $3,776.00 $211.97–$2,907.52 33% above 50%
MRI of the brain, no contrast dye inpatient CPT 70551 MR-BRAIN W/O CONTRAST $1,872.64 $3,776.00 — — 50%
MRI of the brain, with and without contrast dye CPT 70553 MR-PITUITARY W & W/O CONTRAS $3,052.46 $6,155.00 $329.98–$4,739.35 51% above 50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR-PITUITARY W & W/O CONTRAS $3,052.46 $6,155.00 — — 50%
MRI of the lower back, no contrast dye CPT 72148 MR-LUMBAR SPINE W/O CONTRAST $1,981.25 $3,995.00 $211.97–$3,076.15 51% above 50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR-LUMBAR SPINE W/O CONTRAST $1,981.25 $3,995.00 — — 50%
MRI of the lower back, without and then with contrast dye CPT 72158 MR-LUMBAR SPINE W & W/O CONT $3,348.53 $6,752.00 $329.98–$5,199.04 58% above 50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR-LUMBAR SPINE W & W/O CONT $3,348.53 $6,752.00 — — 50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR-DORSAL SPINE W/O CONTRAST $2,117.63 $4,270.00 $211.97–$3,287.90 49% above 50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR-DORSAL SPINE W/O CONTRAST $2,117.63 $4,270.00 — — 50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR-CERVICAL W & W/O CONTRAST $3,348.53 $6,752.00 $329.98–$5,199.04 54% above 50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR-CERVICAL W & W/O CONTRAST $3,348.53 $6,752.00 — — 50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR-CERVICAL SPINE W/O CONTRA $1,981.25 $3,995.00 $211.97–$3,076.15 46% above 50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR-CERVICAL SPINE W/O CONTRA $1,981.25 $3,995.00 — — 50%
MRI of the pelvis without and with contrast CPT 72197 MR-PELVIS W&W/O CONTRAST $2,536.69 $5,115.00 $329.98–$3,938.55 34% above 50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR-PELVIS W&W/O CONTRAST $2,536.69 $5,115.00 — — 50%
MRI of the pelvis, no contrast dye CPT 72195 MR-PELVIS W/O CONTRAST $1,724.85 $3,478.00 $211.97–$2,678.06 24% above 50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR-PELVIS W/O CONTRAST $1,724.85 $3,478.00 — — 50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM-MUTI SPECT-STRESS-SEQ $2,805.48 $5,657.00 $1,203.85–$5,476.52 23% below 50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM-MUTI SPECT-STRESS-SEQ $2,805.48 $5,657.00 — — 50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT-SKULL BASE TO MID THI $3,884.63 $7,833.00 $1,347.71–$6,033.80 20% below 50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT-SKULL BASE TO MID THI $3,884.63 $7,833.00 — — 50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US-PELVIC-LIMITED $455.27 $918.00 $98.26–$706.86 9% above 50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US-PELVIC-LIMITED $455.27 $918.00 — — 50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US-PELVIC $455.27 $918.00 $98.26–$706.86 5% below 50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US-PELVIC $455.27 $918.00 — — 50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US-OB >=14WKS/SINGLE GESTATI $584.21 $1,178.00 $98.26–$907.06 13% above 50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US-OB >=14WKS/SINGLE GESTATI $584.21 $1,178.00 — — 50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US-OB <14 WKS/SINGLE GESTATI $503.37 $1,015.00 $98.26–$781.55 1% above 50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US-OB <14 WKS/SINGLE GESTATI $503.37 $1,015.00 — — 50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US-OB LIMITED 1 OR MORE FETU $368.98 $744.00 $98.26–$572.88 23% below 50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US-OB LIMITED 1 OR MORE FETU $368.98 $744.00 — — 50%
Screening mammogram, both breasts CPT 77067 SCREENING MAMMO INC CAD $275.25 $555.00 $286.00–$427.35 58% above 50%
Screening mammogram, both breasts inpatient CPT 77067 SCREENING MAMMO INC CAD $275.25 $555.00 — — 50%
Sleep study in a lab (polysomnography) CPT 95810 DIAGNOSTIC SLEEP STUDY $2,972.61 $5,994.00 $847.55–$4,615.38 13% below 50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 DIAGNOSTIC SLEEP STUDY $2,972.61 $5,994.00 — — 50%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CR-STRESS ECHOCARDIOGRAM $1,132.21 $2,283.00 $445.13–$2,127.69 45% below 50%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CR-STRESS ECHOCARDIOGRAM $1,132.21 $2,283.00 — — 50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 FL-BARIUM SWALLOW-FUNCTION $385.84 $778.00 $164.49–$708.60 24% below 50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 FL-BARIUM SWALLOW-FUNCTION $385.84 $778.00 — — 50%
Transvaginal pelvic ultrasound CPT 76830 US-TRANS-VAG-PELVIS $470.15 $948.00 $98.26–$729.96 12% below 50%
Transvaginal pelvic ultrasound inpatient CPT 76830 US-TRANS-VAG-PELVIS $470.15 $948.00 — — 50%
Transvaginal ultrasound during pregnancy CPT 76817 US-OB-TRANSVAGINAL $420.55 $848.00 $98.26–$652.96 12% below 50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US-OB-TRANSVAGINAL $420.55 $848.00 — — 50%
Ultrasound of the abdomen, complete CPT 76700 US-ABDOMEN $539.08 $1,087.00 $98.26–$836.99 5% below 50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US-ABDOMEN $539.08 $1,087.00 — — 50%
Ultrasound of the scrotum and testicles CPT 76870 US-TESTICLES $455.76 $919.00 $98.26–$707.63 10% below 50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US-TESTICLES $455.76 $919.00 — — 50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US-NECK $505.36 $1,019.00 $98.26–$784.63 8% below 50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US-NECK $505.36 $1,019.00 — — 50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL-UPPER GI INCLUDING SCOUT $499.90 $1,008.00 $164.49–$776.16 13% below 50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL-UPPER GI INCLUDING SCOUT $499.90 $1,008.00 — — 50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 GSV MAPPING $520.73 $1,050.00 $98.26–$808.50 29% below 50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US-SAPHENOUS VEIN MAPING-BIL $578.76 $1,167.00 $98.26–$898.59 21% below 50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 GSV MAPPING $520.73 $1,050.00 — — 50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US-SAPHENOUS VEIN MAPING-BIL $578.76 $1,167.00 — — 50%
X-ray of the abdomen, 1 view CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW $172.09 $347.00 $74.52–$350.47 30% below 50%
X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW $172.09 $347.00 — — 50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 WC SPINE/LUMBAR-LIMITED 2-3V $107.13 $216.00 $98.26–$424.01 64% below 50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 EX-SPINE/LUMBAR-2 OR 3 VWS $199.86 $403.00 $98.26–$424.01 32% below 50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 GD-SPINE/LUMBAR-2 OR 3 VWS $201.85 $407.00 $98.26–$424.01 32% below 50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 WC SPINE/LUMBAR-LIMITED 2-3V $107.13 $216.00 — — 50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 EX-SPINE/LUMBAR-2 OR 3 VWS $199.86 $403.00 — — 50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 GD-SPINE/LUMBAR-2 OR 3 VWS $201.85 $407.00 — — 50%
X-ray of the lower back, 4 or more views CPT 72110 GD-SPINE/LUMBAR-MIN 4 VIEWS $255.41 $515.00 $98.26–$424.01 41% below 50%
X-ray of the lower back, 4 or more views CPT 72110 EX-SPINE/LUMBAR-MIN 4 VIEWS $295.58 $596.00 $98.26–$458.92 31% below 50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 GD-SPINE/LUMBAR-MIN 4 VIEWS $255.41 $515.00 — — 50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 EX-SPINE/LUMBAR-MIN 4 VIEWS $295.58 $596.00 — — 50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 GD-SPINE/DORSAL-AP & LAT VWS $272.77 $550.00 $98.26–$424.01 6% below 50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 EX-SPINE/DORSAL-AP & LAT VWS $298.06 $601.00 $98.26–$462.77 2% above 50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 GD-SPINE/DORSAL-AP & LAT VWS $272.77 $550.00 — — 50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 EX-SPINE/DORSAL-AP & LAT VWS $298.06 $601.00 — — 50%
X-ray of the nasal bones, 3 or more views CPT 70160 EX-NASAL BONES $181.02 $365.00 $74.52–$350.47 36% below 50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 EX-NASAL BONES $181.02 $365.00 — — 50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 EX-SPINE/CERV-2 OR 3 VIEWS $196.39 $396.00 $74.52–$350.47 33% below 50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 EX-SPINE/CERV-2 OR 3 VIEWS $196.39 $396.00 — — 50%
X-ray of the pelvis, 1 or 2 views CPT 72170 EX-PELVIS-1 OR 2 VIEWS $221.69 $447.00 $98.26–$424.01 10% below 50%
X-ray of the pelvis, 1 or 2 views CPT 72170 GD-PELVIS-1 OR 2 VIEWS $229.12 $462.00 $98.26–$424.01 7% below 50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 EX-PELVIS-1 OR 2 VIEWS $221.69 $447.00 — — 50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 GD-PELVIS-1 OR 2 VIEWS $229.12 $462.00 — — 50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 GD-SPINE/SACRUM-COCCYX $167.13 $337.00 $74.52–$350.47 42% below 50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 GD-SPINE/SACRUM-COCCYX $167.13 $337.00 — — 50%

Lab tests

ProcedureCash price List priceInsurers payvs OhioOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASEALANINE AMINO $47.12 $95.00 $2.62–$73.15 71% above 50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT $52.57 $106.00 $2.62–$81.62 90% above 50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASEALANINE AMINO $47.12 $95.00 — — 50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT $52.57 $106.00 — — 50%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASEASPARTATE AMINO $47.12 $95.00 $2.56–$73.15 87% above 50%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT $52.57 $106.00 $2.56–$81.62 109% above 50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASEASPARTATE AMINO $47.12 $95.00 — — 50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT $52.57 $106.00 — — 50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PROFILE $368.98 $744.00 $23.52–$572.88 73% above 50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PROFILE $368.98 $744.00 — — 50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY TEST EACH ALLERGEN $35.71 $72.00 $2.58–$55.44 53% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOR PARROT FEATHERS $55.05 $111.00 $2.58–$85.47 135% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS MIXED NUTS $55.05 $111.00 $2.58–$85.47 135% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS GAME $55.05 $111.00 $2.58–$85.47 135% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENANIMAL FEATHER $73.40 $148.00 $2.58–$113.96 214% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 OV RESP ALLERGEN SPECIFIC $437.42 $882.00 $2.58–$679.14 1769% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ALLERGEN PROFILE DR.MAS $476.59 $961.00 $2.58–$739.97 1937% above 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY TEST EACH ALLERGEN $35.71 $72.00 — — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS GAME $55.05 $111.00 — — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST FOR PARROT FEATHERS $55.05 $111.00 — — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS MIXED NUTS $55.05 $111.00 — — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENANIMAL FEATHER $73.40 $148.00 — — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OV RESP ALLERGEN SPECIFIC $437.42 $882.00 — — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ALLERGEN PROFILE DR.MAS $476.59 $961.00 — — 50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 IMMUNOASSAY $127.96 $258.00 $6.39–$198.66 121% above 50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 IMMUNOASSAY $127.96 $258.00 — — 50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI-NUCLEAR ANTIBODIES $57.53 $116.00 $5.97–$89.32 7% above 50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI-NUCLEAR ANTIBODIES $57.53 $116.00 — — 50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO BRAIN NATRIURETIC PEPTID $99.19 $200.00 $16.76–$175.10 30% below 50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PEPTIDE(B $162.67 $328.00 $16.76–$252.56 14% above 50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO BRAIN NATRIURETIC PEPTID $99.19 $200.00 — — 50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC PEPTIDE(B $162.67 $328.00 — — 50%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC (CHEM 7) TOT $89.77 $181.00 $4.18–$139.37 51% above 50%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC (CHEM 7) TOT $89.77 $181.00 — — 50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 BONE MARROW ASP-TC $168.62 $340.00 $18.21–$261.80 7% below 50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK-TC $168.62 $340.00 $18.21–$261.80 7% below 50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK-TC $168.62 $340.00 — — 50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BONE MARROW ASP-TC $168.62 $340.00 — — 50%
Blood culture for bacteria CPT 87040 CULTURE - BLOOD AEROBIC $133.41 $269.00 $5.10–$207.13 43% above 50%
Blood culture for bacteria inpatient CPT 87040 CULTURE - BLOOD AEROBIC $133.41 $269.00 — — 50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 WC VENIPUNCTURE $2.98 $6.00 $1.20–$26.76 80% below 50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE (WRADTH $17.86 $36.00 $1.20–$39.38 21% above 50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE (ER) $18.35 $37.00 $1.20–$39.38 24% above 50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE - ROUTINE (PEDS $19.35 $39.00 $1.20–$39.38 31% above 50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 WC VENIPUNCTURE $2.98 $6.00 — — 50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE (WRADTH $17.86 $36.00 — — 50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE (ER) $18.35 $37.00 — — 50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE - ROUTINE (PEDS $19.35 $39.00 — — 50%
Blood glucose (sugar) test CPT 82947 BGM-CBN $14.39 $29.00 $1.94–$22.33 31% below 50%
Blood glucose (sugar) test CPT 82947 GLUCOSE $44.64 $90.00 $1.94–$69.30 113% above 50%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANITATIVE $56.54 $114.00 $1.94–$87.78 169% above 50%
Blood glucose (sugar) test inpatient CPT 82947 BGM-CBN $14.39 $29.00 — — 50%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE $44.64 $90.00 — — 50%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANITATIVE $56.54 $114.00 — — 50%
Blood lead test CPT 83655 **LEAD $24.31 $49.00 $5.98–$54.01 39% below 50%
Blood lead test CPT 83655 24HR URINE LEAD $26.29 $53.00 $5.98–$54.01 34% below 50%
Blood lead test CPT 83655 LEAD $39.68 $80.00 $5.98–$61.60 1% below 50%
Blood lead test CPT 83655 *URINE LEAD $43.65 $88.00 $5.98–$67.76 9% above 50%
Blood lead test CPT 83655 LEAD TEST $77.37 $156.00 $5.98–$120.12 93% above 50%
Blood lead test inpatient CPT 83655 **LEAD $24.31 $49.00 — — 50%
Blood lead test inpatient CPT 83655 24HR URINE LEAD $26.29 $53.00 — — 50%
Blood lead test inpatient CPT 83655 LEAD $39.68 $80.00 — — 50%
Blood lead test inpatient CPT 83655 *URINE LEAD $43.65 $88.00 — — 50%
Blood lead test inpatient CPT 83655 LEAD TEST $77.37 $156.00 — — 50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SERUM QUAL $49.10 $99.00 $3.72–$76.23 at median 50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SERUM QUAL $49.10 $99.00 — — 50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 (RCR) ABO TYPING $83.82 $169.00 $1.48–$492.65 72% above 50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HEMAGGLUTINATION INHIBITION $83.82 $169.00 $1.48–$492.65 72% above 50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HEMAGGLUTINATION INHIBITION $83.82 $169.00 — — 50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 (RCR) ABO TYPING $83.82 $169.00 — — 50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN $10.92 $22.00 $2.56–$23.10 75% below 50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 WELLNESS HSCRP $53.57 $108.00 $2.56–$83.16 23% above 50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C - REACTIVE PROTEIN (CRP) $53.57 $108.00 $2.56–$83.16 23% above 50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN $10.92 $22.00 — — 50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C - REACTIVE PROTEIN (CRP) $53.57 $108.00 — — 50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 WELLNESS HSCRP $53.57 $108.00 — — 50%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE $112.58 $227.00 $17.33–$174.79 13% below 50%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICLE $139.36 $281.00 $17.33–$216.37 7% above 50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE $112.58 $227.00 — — 50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICLE $139.36 $281.00 — — 50%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAYTUMOR CA 19-9 $164.16 $331.00 $10.28–$254.87 143% above 50%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAYTUMOR OTHER $202.34 $408.00 $10.28–$314.16 199% above 50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAYTUMOR CA 19-9 $164.16 $331.00 — — 50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAYTUMOR OTHER $202.34 $408.00 — — 50%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 $123.49 $249.00 $10.28–$191.73 32% above 50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY TUMOR CA 125 $123.49 $249.00 — — 50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 IN HOUSE TESTING $98.20 $198.00 $51.31–$228.84 30% below 50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 IN HOUSE TESTING $98.20 $198.00 — — 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE $74.39 $150.00 $17.33–$156.50 19% below 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 **C.TRACHOMATIS AMPLIFIED PR $114.07 $230.00 $17.33–$177.10 23% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLMYD TRACH DNA AMP PROBE $74.39 $150.00 — — 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 **C.TRACHOMATIS AMPLIFIED PR $114.07 $230.00 — — 50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID $99.69 $201.00 $9.04–$154.77 92% above 50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID $99.69 $201.00 — — 50%
Complete blood count (CBC) with differential CPT 85025 TCC - COMPLETE BLOOD COUNT $69.44 $140.00 $3.84–$107.80 98% above 50%
Complete blood count (CBC) with differential CPT 85025 COMP CBC-AUTO DIFF-PLATELET $72.41 $146.00 $3.84–$112.42 106% above 50%
Complete blood count (CBC) with differential inpatient CPT 85025 TCC - COMPLETE BLOOD COUNT $69.44 $140.00 — — 50%
Complete blood count (CBC) with differential inpatient CPT 85025 COMP CBC-AUTO DIFF-PLATELET $72.41 $146.00 — — 50%
Complete blood count (CBC), no differential CPT 85027 TCC - CBC W/OUT AUTO DIFF $65.96 $133.00 $3.19–$102.41 104% above 50%
Complete blood count (CBC), no differential CPT 85027 CBC (NO DIFF) $72.41 $146.00 $3.19–$112.42 123% above 50%
Complete blood count (CBC), no differential inpatient CPT 85027 TCC - CBC W/OUT AUTO DIFF $65.96 $133.00 — — 50%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC (NO DIFF) $72.41 $146.00 — — 50%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANE $14.88 $30.00 $5.22–$47.10 75% below 50%
Comprehensive metabolic panel (blood test) CPT 80053 COMMUNITY SCREEN PROFILE $19.84 $40.00 $5.22–$47.10 67% below 50%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC $164.65 $332.00 $5.22–$255.64 172% above 50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANE $14.88 $30.00 — — 50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMMUNITY SCREEN PROFILE $19.84 $40.00 — — 50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC $164.65 $332.00 — — 50%
D-dimer blood test (blood clot marker) CPT 85379 DIMER QT $107.62 $217.00 $5.02–$167.09 55% above 50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 DIMER QT $107.62 $217.00 — — 50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA DEHYDROEPIANDROSTERONE- $133.41 $269.00 $10.98–$207.13 36% above 50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA DEHYDROEPIANDROSTERONE- $133.41 $269.00 — — 50%
Estradiol blood test CPT 82670 ESTROGEN $147.79 $298.00 $13.80–$229.46 42% above 50%
Estradiol blood test inpatient CPT 82670 ESTROGEN $147.79 $298.00 — — 50%
FSH (follicle-stimulating hormone) test CPT 83001 FSH $104.15 $210.00 $9.18–$161.70 23% above 50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH $104.15 $210.00 — — 50%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTINFECAL $209.78 $423.00 $9.70–$325.71 40% above 50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTINFECAL $209.78 $423.00 — — 50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN $42.16 $85.00 $6.73–$65.45 44% below 50%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN $42.16 $85.00 — — 50%
Folate (folic acid) blood test CPT 82746 FOLATE $91.75 $185.00 $7.26–$142.45 40% above 50%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE $91.75 $185.00 — — 50%
Free T3 thyroid hormone test CPT 84481 T3 FREE BY EQUILIBRIUM DIAYL $126.47 $255.00 $8.37–$196.35 85% above 50%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE BY EQUILIBRIUM DIAYL $126.47 $255.00 — — 50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 - (THYROXINE) $99.19 $200.00 $4.45–$154.00 146% above 50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 BY DIALYSIS $104.15 $210.00 $4.45–$161.70 158% above 50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 - (THYROXINE) $99.19 $200.00 — — 50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 BY DIALYSIS $104.15 $210.00 — — 50%
Free testosterone test CPT 84402 TESTOSTERONE FREE $116.05 $234.00 $12.58–$180.18 23% above 50%
Free testosterone test CPT 84402 FREE TESTOSTERONE $226.15 $456.00 $12.58–$351.12 141% above 50%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE $116.05 $234.00 — — 50%
Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE $226.15 $456.00 — — 50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL $303.02 $611.00 $17.36–$470.47 37% above 50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL $303.02 $611.00 — — 50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 3 HR PP - GLUCOSE $46.13 $93.00 $2.34–$71.61 58% above 50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 2 HR PP - GLUCOSE $48.11 $97.00 $2.34–$74.69 65% above 50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 3 HR PP - GLUCOSE $46.13 $93.00 — — 50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 2 HR PP - GLUCOSE $48.11 $97.00 — — 50%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE - OB $87.78 $177.00 $6.36–$136.29 52% above 50%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE - OB $87.78 $177.00 — — 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB $74.39 $150.00 $17.33–$156.50 20% below 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 *N GONORRHOEAE AMPLIFIED PRO $86.30 $174.00 $17.33–$156.50 7% below 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE DNA AMP PROB $74.39 $150.00 — — 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 *N GONORRHOEAE AMPLIFIED PRO $86.30 $174.00 — — 50%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ABIGA/I $150.27 $303.00 $7.16–$233.31 120% above 50%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI IGM AB $153.74 $310.00 $7.16–$238.70 125% above 50%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI ABIGA/I $150.27 $303.00 — — 50%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI IGM AB $153.74 $310.00 — — 50%
H. pylori stool antigen test CPT 87338 STOOL H. PYLORI ANTIGEN $178.54 $360.00 $7.10–$277.20 169% above 50%
H. pylori stool antigen test inpatient CPT 87338 STOOL H. PYLORI ANTIGEN $178.54 $360.00 — — 50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QUANT (PDNA) $343.68 $693.00 $42.02–$533.61 3% above 50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QUANT (PDNA) $343.68 $693.00 — — 50%
HIV-1 and HIV-2 antibody test CPT 86703 HIV $60.01 $121.00 $6.77–$93.17 2% above 50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV $60.01 $121.00 — — 50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPVAMPLIFIED PROBE TECHNIQU $145.31 $293.00 $17.33–$225.61 29% above 50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPVAMPLIFIED PROBE TECHNIQU $145.31 $293.00 — — 50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLOBIN $77.37 $156.00 $4.80–$120.12 77% above 50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HEMOGLOBIN $77.37 $156.00 — — 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HBS AB $102.17 $206.00 $5.30–$158.62 112% above 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HBSAB OS $102.17 $206.00 $5.30–$158.62 112% above 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HBSAB OS $102.17 $206.00 — — 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HBS AB $102.17 $206.00 — — 50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBS AG $102.17 $206.00 $5.10–$158.62 121% above 50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBS AG $102.17 $206.00 — — 50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C $102.17 $206.00 $7.04–$158.62 60% above 50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C $102.17 $206.00 — — 50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QUANT TMA $338.23 $682.00 $21.15–$525.14 76% above 50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUANT $338.23 $682.00 $21.15–$525.14 76% above 50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS PCR ASSAY $352.12 $710.00 $21.15–$546.70 83% above 50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QUANT TMA $338.23 $682.00 — — 50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA QUANT $338.23 $682.00 — — 50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRUS PCR ASSAY $352.12 $710.00 — — 50%
Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY;HERPES SIMPLEX TYPE $39.68 $80.00 $6.51–$61.60 33% below 50%
Herpes blood test, HSV-1 antibody CPT 86695 *HSV 1 AB $67.95 $137.00 $6.51–$105.49 15% above 50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY;HERPES SIMPLEX TYPE $39.68 $80.00 — — 50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 *HSV 1 AB $67.95 $137.00 — — 50%
Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY;HERPES SIMPLEX TYPE $59.52 $120.00 $9.56–$92.40 10% below 50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY;HERPES SIMPLEX TYPE $59.52 $120.00 — — 50%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HI SENSIT $69.93 $141.00 $6.39–$108.57 17% above 50%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SESITIVITY CRP $69.93 $141.00 $6.39–$108.57 17% above 50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HIGH SESITIVITY CRP $69.93 $141.00 — — 50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HI SENSIT $69.93 $141.00 — — 50%
Homocysteine blood test CPT 83090 ASSAYHOMOCYSTEINE $33.73 $68.00 $8.33–$79.92 57% below 50%
Homocysteine blood test CPT 83090 HOMOCYSTEINEPLASMA $107.62 $217.00 $8.33–$167.09 38% above 50%
Homocysteine blood test CPT 83090 HOMOCYSTINE $107.62 $217.00 $8.33–$167.09 38% above 50%
Homocysteine blood test inpatient CPT 83090 ASSAYHOMOCYSTEINE $33.73 $68.00 — — 50%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE $107.62 $217.00 — — 50%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINEPLASMA $107.62 $217.00 — — 50%
Insulin blood test CPT 83525 INSULIN TIMED SPECIMEN $69.93 $141.00 $5.64–$108.57 36% above 50%
Insulin blood test CPT 83525 INSULIN FASTING $77.87 $157.00 $5.64–$120.89 52% above 50%
Insulin blood test inpatient CPT 83525 INSULIN TIMED SPECIMEN $69.93 $141.00 — — 50%
Insulin blood test inpatient CPT 83525 INSULIN FASTING $77.87 $157.00 — — 50%
Iron blood test (serum iron) CPT 83540 IRON (FE) $53.07 $107.00 $3.20–$82.39 56% above 50%
Iron blood test (serum iron) CPT 83540 IRON LIVER TISSUE $193.42 $390.00 $3.20–$300.30 469% above 50%
Iron blood test (serum iron) inpatient CPT 83540 IRON (FE) $53.07 $107.00 — — 50%
Iron blood test (serum iron) inpatient CPT 83540 IRON LIVER TISSUE $193.42 $390.00 — — 50%
Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING CAPACITY $61.00 $123.00 $4.32–$94.71 56% above 50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING CAPACITY $61.00 $123.00 — — 50%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL $110.10 $222.00 $4.29–$170.94 76% above 50%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL $110.10 $222.00 — — 50%
LH (luteinizing hormone) test CPT 83002 LH $104.15 $210.00 $9.14–$161.70 9% above 50%
LH (luteinizing hormone) test inpatient CPT 83002 LH $104.15 $210.00 — — 50%
Lipase blood test (pancreas enzyme) CPT 83690 URINARY LIPASE $63.48 $128.00 $3.40–$98.56 24% above 50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE $63.48 $128.00 $3.40–$98.56 24% above 50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 URINARY LIPASE $63.48 $128.00 — — 50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE $63.48 $128.00 — — 50%
Liver function blood test panel CPT 80076 LIVER PROFILE (HEPATIC FUNCT $111.59 $225.00 $4.04–$173.25 98% above 50%
Liver function blood test panel inpatient CPT 80076 LIVER PROFILE (HEPATIC FUNCT $111.59 $225.00 — — 50%
Lyme disease antibody test CPT 86618 ANTIBODYBORRELIA BURGDOFERI $32.74 $66.00 $8.41–$75.95 57% below 50%
Lyme disease antibody test CPT 86618 ANTIBODY BORRELIA BURGDOR $32.74 $66.00 $8.41–$75.95 57% below 50%
Lyme disease antibody test CPT 86618 BORRELIA BURGDOFERI ABS $73.90 $149.00 $8.41–$114.73 3% below 50%
Lyme disease antibody test inpatient CPT 86618 ANTIBODY BORRELIA BURGDOR $32.74 $66.00 — — 50%
Lyme disease antibody test inpatient CPT 86618 ANTIBODYBORRELIA BURGDOFERI $32.74 $66.00 — — 50%
Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDOFERI ABS $73.90 $149.00 — — 50%
Magnesium blood test CPT 83735 MAGNESIUM $54.56 $110.00 $3.31–$84.70 72% above 50%
Magnesium blood test CPT 83735 URINE MAGNESIUMRANDOM $57.53 $116.00 $3.31–$89.32 81% above 50%
Magnesium blood test CPT 83735 RBC & PLASMA MAGNESIUM $89.77 $181.00 $3.31–$139.37 183% above 50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM $54.56 $110.00 — — 50%
Magnesium blood test inpatient CPT 83735 URINE MAGNESIUMRANDOM $57.53 $116.00 — — 50%
Magnesium blood test inpatient CPT 83735 RBC & PLASMA MAGNESIUM $89.77 $181.00 — — 50%
Measles (rubeola) antibody test CPT 86765 ANTIBODY; RUBEOLA $32.74 $66.00 $6.36–$57.44 38% below 50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG $112.58 $227.00 $6.36–$174.79 114% above 50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM $181.02 $365.00 $6.36–$281.05 244% above 50%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY; RUBEOLA $32.74 $66.00 — — 50%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG $112.58 $227.00 — — 50%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM $181.02 $365.00 — — 50%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN $31.74 $64.00 $2.56–$49.28 38% below 50%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE PRESUMPTIVEIGM $47.12 $95.00 $2.56–$73.15 9% below 50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SCREEN $31.74 $64.00 — — 50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE PRESUMPTIVEIGM $47.12 $95.00 — — 50%
Obstetric blood test panel CPT 80055 OB PANEL $351.12 $708.00 $23.61–$545.16 77% above 50%
Obstetric blood test panel inpatient CPT 80055 OB PANEL $351.12 $708.00 — — 50%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSAFREE $85.80 $173.00 $9.08–$133.21 6% above 50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSAFREE $85.80 $173.00 — — 50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSATOTAL $90.26 $182.00 $9.08–$140.14 18% above 50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSATOTAL (DIAGNOSTIC) $94.73 $191.00 $9.08–$147.07 24% above 50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSATOTAL $90.26 $182.00 — — 50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSATOTAL (DIAGNOSTIC) $94.73 $191.00 — — 50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR (GRANT) ABNORMAL $87.29 $176.00 $11.48–$135.52 3% below 50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR (GRANT) ABNORMAL $87.29 $176.00 — — 50%
Parathyroid hormone (PTH) blood test CPT 83970 INTRAOPERATIVE RAPID PTH $110.10 $222.00 $20.38–$184.11 20% below 50%
Parathyroid hormone (PTH) blood test CPT 83970 PTH-N TERMINAL $193.42 $390.00 $20.38–$300.30 40% above 50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTRAOPERATIVE RAPID PTH $110.10 $222.00 — — 50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH-N TERMINAL $193.42 $390.00 — — 50%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT $51.58 $104.00 $2.97–$80.08 48% above 50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT $51.58 $104.00 — — 50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 NON-INVASIVE PRENATAL TESTIN $902.10 $1,819.00 $500.00–$3,385.36 38% below 50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 NON-INVASIVE PRENATAL TESTIN $902.10 $1,819.00 — — 50%
Progesterone blood test CPT 84144 PROGESTERONE $107.62 $217.00 $10.30–$167.09 52% above 50%
Progesterone blood test inpatient CPT 84144 PROGESTERONE $107.62 $217.00 — — 50%
Prolactin blood test CPT 84146 PROLACTIN $107.62 $217.00 $9.57–$167.09 32% above 50%
Prolactin blood test CPT 84146 MACROPROLACTIN $166.64 $336.00 $9.57–$258.72 105% above 50%
Prolactin blood test inpatient CPT 84146 PROLACTIN $107.62 $217.00 — — 50%
Prolactin blood test inpatient CPT 84146 MACROPROLACTIN $166.64 $336.00 — — 50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME $23.81 $48.00 $1.94–$36.96 2% above 50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME-INR $54.56 $110.00 $1.94–$84.70 133% above 50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME $23.81 $48.00 — — 50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME-INR $54.56 $110.00 — — 50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 WORKERS COMP URINE DRUG SCRE $29.26 $59.00 $5.38–$56.20 49% below 50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN BY NON TLC DEVIC $82.83 $167.00 $5.38–$128.59 43% above 50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 WORKERS COMP URINE DRUG SCRE $29.26 $59.00 — — 50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN BY NON TLC DEVIC $82.83 $167.00 — — 50%
Rapid flu test (influenza antigen) CPT 87804 RAPID INFLUENZA $58.03 $117.00 $6.62–$90.09 12% below 50%
Rapid flu test (influenza antigen) inpatient CPT 87804 RAPID INFLUENZA $58.03 $117.00 — — 50%
Rheumatoid factor (RF) test CPT 86431 RA QUANTITATIVE BODY FLUID $30.26 $61.00 $2.80–$46.97 3% below 50%
Rheumatoid factor (RF) test CPT 86431 RF - QUANT $60.51 $122.00 $2.80–$93.94 94% above 50%
Rheumatoid factor (RF) test inpatient CPT 86431 RA QUANTITATIVE BODY FLUID $30.26 $61.00 — — 50%
Rheumatoid factor (RF) test inpatient CPT 86431 RF - QUANT $60.51 $122.00 — — 50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG AB ACUTE $48.61 $98.00 $7.11–$75.46 42% above 50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IMMUNE STATUS $66.96 $135.00 $7.11–$103.95 95% above 50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY $66.96 $135.00 $7.11–$103.95 95% above 50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM ANTIBODY $127.96 $258.00 $7.11–$198.66 273% above 50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG AB ACUTE $48.61 $98.00 — — 50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IMMUNE STATUS $66.96 $135.00 — — 50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY $66.96 $135.00 — — 50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM ANTIBODY $127.96 $258.00 — — 50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE - AUTO $53.07 $107.00 $1.33–$82.39 62% above 50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE - AUTO $53.07 $107.00 — — 50%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMINAL FLUID COMPLETE $129.44 $261.00 $5.95–$200.97 3% below 50%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMINAL FLUID COMPLETE $129.44 $261.00 — — 50%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES $48.11 $97.00 $4.40–$74.69 21% above 50%
Stool ova and parasites exam CPT 87177 OVA PARASITEDIR SMEARBODY $51.09 $103.00 $4.40–$79.31 29% above 50%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES $48.11 $97.00 — — 50%
Stool ova and parasites exam inpatient CPT 87177 OVA PARASITEDIR SMEARBODY $51.09 $103.00 — — 50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 TCC - OCCULT BLOOD CA SCREE $32.24 $65.00 $1.75–$50.05 27% above 50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 FECAL OCCULT BLOOD - SCREENI $34.22 $69.00 $1.75–$53.13 35% above 50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 TCC - OCCULT BLOOD CA SCREE $32.24 $65.00 — — 50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 FECAL OCCULT BLOOD - SCREENI $34.22 $69.00 — — 50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RAPID PLASMA REAGIN $48.11 $97.00 $2.11–$74.69 155% above 50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR-SYPHILLIS TEST $53.07 $107.00 $2.11–$82.39 182% above 50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RAPID PLASMA REAGIN $48.11 $97.00 — — 50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR-SYPHILLIS TEST $53.07 $107.00 — — 50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD IN TUBE $106.63 $215.00 $30.61–$276.43 4% below 50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD IN TUBE $106.63 $215.00 — — 50%
Testosterone blood test, total (not free testosterone) CPT 84403 **TESTOSTERONE TOTAL $46.13 $93.00 $12.75–$115.11 47% below 50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (RIA) $112.58 $227.00 $12.75–$174.79 30% above 50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE 24 HR URINE $302.52 $610.00 $12.75–$469.70 248% above 50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 **TESTOSTERONE TOTAL $46.13 $93.00 — — 50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE (RIA) $112.58 $227.00 — — 50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE 24 HR URINE $302.52 $610.00 — — 50%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THY MICROSOMIAL ANTIBOD $68.94 $139.00 $7.18–$107.03 17% above 50%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER CYTOSOL ANTIBODY $170.11 $343.00 $7.18–$264.11 190% above 50%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER/KIDNEY MICROSOMAL ANTI $175.56 $354.00 $7.18–$272.58 199% above 50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-THY MICROSOMIAL ANTIBOD $68.94 $139.00 — — 50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER CYTOSOL ANTIBODY $170.11 $343.00 — — 50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER/KIDNEY MICROSOMAL ANTI $175.56 $354.00 — — 50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH $92.74 $187.00 $8.30–$143.99 35% above 50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH $92.74 $187.00 — — 50%
Trichomonas test (NAAT) CPT 87661 TRICH TMA $72.91 $147.00 $17.33–$156.50 15% below 50%
Trichomonas test (NAAT) inpatient CPT 87661 TRICH TMA $72.91 $147.00 — — 50%
Uric acid blood test CPT 84550 URIC ACID BLOOD $52.57 $106.00 $2.23–$81.62 54% above 50%
Uric acid blood test CPT 84550 BODY FLUID URIC ACID $53.57 $108.00 $2.23–$83.16 57% above 50%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD $52.57 $106.00 — — 50%
Uric acid blood test inpatient CPT 84550 BODY FLUID URIC ACID $53.57 $108.00 — — 50%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS - ROUTINE MAC/MI $56.05 $113.00 $1.57–$87.01 112% above 50%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS - ROUTINE MAC/MI $56.05 $113.00 — — 50%
Urinalysis with microscope exam, manual CPT 81000 WC COLLECTION SITE FEE BLOOD $10.92 $22.00 $1.61–$17.93 40% below 50%
Urinalysis with microscope exam, manual CPT 81000 TCC - URINE MICROSCOPIC CHAR $52.08 $105.00 $1.61–$80.85 186% above 50%
Urinalysis with microscope exam, manual inpatient CPT 81000 WC COLLECTION SITE FEE BLOOD $10.92 $22.00 — — 50%
Urinalysis with microscope exam, manual inpatient CPT 81000 TCC - URINE MICROSCOPIC CHAR $52.08 $105.00 — — 50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS MACRO ONLY WORKCA $32.74 $66.00 $1.11–$50.82 44% above 50%
Urinalysis without microscope exam, automated CPT 81003 URINE KETONE $33.73 $68.00 $1.11–$52.36 48% above 50%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS MACRO ONLY WORKCA $32.74 $66.00 — — 50%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE KETONE $33.73 $68.00 — — 50%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NON AUTOMATW/O MI $23.31 $47.00 $1.39–$36.19 49% above 50%
Urinalysis without microscope exam, manual CPT 81002 URINE DIPS $23.31 $47.00 $1.39–$36.19 49% above 50%
Urinalysis without microscope exam, manual CPT 81002 TCC - URINE CHARGE $32.24 $65.00 $1.39–$50.05 107% above 50%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPS $23.31 $47.00 — — 50%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NON AUTOMATW/O MI $23.31 $47.00 — — 50%
Urinalysis without microscope exam, manual inpatient CPT 81002 TCC - URINE CHARGE $32.24 $65.00 — — 50%
Urine culture for bacteria, with colony count CPT 87086 CULTURE - URINE $84.81 $171.00 $3.98–$131.67 54% above 50%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE - URINE $84.81 $171.00 — — 50%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY - URINE - QUAL $52.57 $106.00 $3.44–$81.62 16% above 50%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY URINE QUAL $56.54 $114.00 $3.44–$87.78 24% above 50%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY - URINE - QUAL $52.57 $106.00 — — 50%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY URINE QUAL $56.54 $114.00 — — 50%
Vitamin B12 (cobalamin) blood test CPT 82607 B-12 $78.86 $159.00 $7.44–$122.43 10% above 50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B-12 $78.86 $159.00 — — 50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D 25-HYDROXY $137.87 $278.00 $16.78–$214.06 75% above 50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VIT D 25-HYDROXY $137.87 $278.00 — — 50%
Zinc blood test CPT 84630 ZINC RBCS $126.47 $255.00 $5.62–$196.35 200% above 50%
Zinc blood test inpatient CPT 84630 ZINC RBCS $126.47 $255.00 — — 50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG SERUM QUANT. $96.22 $194.00 $7.44–$149.38 42% above 50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG SERUM QUANT. $96.22 $194.00 — — 50%

Surgery and procedures

ProcedureCash price List priceInsurers payvs OhioOff list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREAT DISTAL FIBULA FX WO M $134.40 $271.00 $0.58–$2,522.00 64% below 50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TREAT DISTAL FIBULA FX WO M $134.40 $271.00 — — 50%
Cardiac catheterization with coronary angiogram one side CPT 93458 CR-LEFT HEART CATH (PERC) $6,337.50 $12,779.00 $0.58–$12,567.61 47% below 50%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 CR-LEFT HEART CATH (PERC) $6,337.50 $12,779.00 — — 50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION $701.75 $1,415.00 $517.52–$2,510.09 66% below 50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXT $842.09 $1,698.00 $517.52–$2,510.09 59% below 50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION $701.75 $1,415.00 — — 50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXT $842.09 $1,698.00 — — 50%
Catheter ablation for atrial fibrillation CPT 93656 ATRIAL FIB ABLATION W EP $19,298.64 $38,914.00 $13,642.00–$91,600.60 34% below 50%
Catheter ablation for atrial fibrillation inpatient CPT 93656 ATRIAL FIB ABLATION W EP $19,298.64 $38,914.00 — — 50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREATN DISTAL RADIAL FX WO M $134.40 $271.00 $0.58–$2,522.00 67% below 50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREATN DISTAL RADIAL FX WO M $134.40 $271.00 — — 50%
Coronary stent placement, one artery CPT 92928 PTCA STENT W/ANGIOPLASTY SIN $7,372.01 $14,865.00 $0.58–$42,429.27 39% below 50%
Coronary stent placement, one artery CPT 92928 PTCA W/S V.STENTS;SIN.V.NOND $10,560.34 $21,294.00 $0.58–$42,429.27 12% below 50%
Coronary stent placement, one artery inpatient CPT 92928 PTCA STENT W/ANGIOPLASTY SIN $7,372.01 $14,865.00 — — 50%
Coronary stent placement, one artery inpatient CPT 92928 PTCA W/S V.STENTS;SIN.V.NOND $10,560.34 $21,294.00 — — 50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOV IMPACT CERUMEN USE IRR $71.42 $144.00 $0.58–$2,522.00 54% below 50%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOV IMPACT CERUMEN USE IRR $71.42 $144.00 — — 50%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR MAX $142.34 $287.00 $0.58–$2,522.00 8% below 50%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR MAX $142.34 $287.00 — — 50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECT SINGLE CERVICAL/THORC $522.22 $1,053.00 $0.58–$2,667.17 77% below 50%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECT SINGLE CERVICAL/THORC $522.22 $1,053.00 — — 50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ FACET JNT LUMBER/SACRUIM $588.18 $1,186.00 $0.58–$3,515.42 72% below 50%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ FACET JNT LUMBER/SACRUIM $588.18 $1,186.00 — — 50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJECT PROC SALPINGOGRAM $58.03 $117.00 $0.58–$100.62 85% below 50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJECT PROC SALPINGOGRAM $58.03 $117.00 — — 50%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF ABSCESS SIMPLE $115.06 $232.00 $0.58–$2,522.00 70% below 50%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS $250.45 $505.00 $0.58–$2,522.00 34% below 50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF ABSCESS SIMPLE $115.06 $232.00 — — 50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABSCESS $250.45 $505.00 — — 50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION PROC TENDON SHEATH $230.12 $464.00 $0.58–$2,522.00 32% below 50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION PROC TENDON SHEATH $230.12 $464.00 — — 50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECT PROC JOINT-RAD $509.82 $1,028.00 $0.58–$2,522.00 27% below 50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJECT JOINT BURSA HIP $509.82 $1,028.00 $0.58–$2,522.00 27% below 50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJECT JOINT BURSA HIP $509.82 $1,028.00 — — 50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJECT PROC JOINT-RAD $509.82 $1,028.00 — — 50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECT PROC INTERMED JOINT R $413.11 $833.00 $0.58–$2,522.00 34% below 50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN INJECT JOINT/BURSA ELB $413.11 $833.00 $0.58–$2,522.00 34% below 50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJECT PROC INTERMED JOINT R $413.11 $833.00 — — 50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN INJECT JOINT/BURSA ELB $413.11 $833.00 — — 50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJECT PROC SMALL JOINT-RAD $392.78 $792.00 $0.58–$2,522.00 20% below 50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJECT JOINT BURSA $392.78 $792.00 $0.58–$2,522.00 20% below 50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 INJECT PROC SMALL JOINT-RAD $392.78 $792.00 — — 50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJECT JOINT BURSA $392.78 $792.00 — — 50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE OF WOUND 2.5CM $520.24 $1,049.00 $0.58–$2,522.00 4% below 50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE OF WOUND 2.5CM $520.24 $1,049.00 — — 50%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ CAUDAL EPIDURAL LUMBAR/S $407.16 $821.00 $0.58–$2,667.17 80% below 50%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ CAUDAL EPIDURAL LUMBAR/S $407.16 $821.00 — — 50%
Lower-back epidural injection, without imaging guidance CPT 62322 INJ SINGLE LUMBAR/SACRAL $522.22 $1,053.00 $0.58–$3,515.42 68% below 50%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ SINGLE LUMBAR/SACRAL $522.22 $1,053.00 — — 50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ-LUMB/SACR NER BLK-SINGLE $548.50 $1,106.00 $0.58–$3,515.42 71% below 50%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ-LUMB/SACR NER BLK-SINGLE $548.50 $1,106.00 — — 50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC OTH BENIGH LESION 0.5CM $508.33 $1,025.00 $0.58–$2,713.55 63% below 50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC OTH BENIGH LESION 0.5CM $508.33 $1,025.00 — — 50%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE $182.01 $367.00 $0.58–$2,522.00 43% below 50%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE $182.01 $367.00 — — 50%
Paracentesis with imaging guidance CPT 49083 CT-PARACENTESIS W/IMAGING $1,193.71 $2,407.00 $0.58–$3,496.15 31% below 50%
Paracentesis with imaging guidance CPT 49083 ABD PARACENT W IMAGING GUID $1,193.71 $2,407.00 $0.58–$3,496.15 31% below 50%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENT W IMAGING GUID $1,193.71 $2,407.00 — — 50%
Paracentesis with imaging guidance inpatient CPT 49083 CT-PARACENTESIS W/IMAGING $1,193.71 $2,407.00 — — 50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED $611.49 $1,233.00 $0.58–$2,522.00 22% below 50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED $611.49 $1,233.00 — — 50%
Prostate biopsy CPT 55700 BIOPSY PROC PROSTATE $1,254.21 $2,529.00 $0.58–$7,855.58 14% below 50%
Prostate biopsy inpatient CPT 55700 BIOPSY PROC PROSTATE $1,254.21 $2,529.00 — — 50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 LUMBAR RHIZOTOMY $1,268.10 $2,557.00 $0.58–$7,446.64 60% below 50%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 LUMBAR RHIZOTOMY $1,268.10 $2,557.00 — — 50%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FB SUBCUTANEOUS TISS $513.79 $1,036.00 $0.58–$2,522.00 21% below 50%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY $513.79 $1,036.00 $0.58–$2,522.00 21% below 50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY $513.79 $1,036.00 — — 50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FB SUBCUTANEOUS TISS $513.79 $1,036.00 — — 50%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT $249.95 $504.00 $0.58–$2,522.00 13% below 50%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT $249.95 $504.00 — — 50%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST $119.03 $240.00 $0.58–$2,522.00 67% below 50%
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST $119.03 $240.00 — — 50%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT $270.78 $546.00 $0.58–$2,522.00 11% below 50%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION LOWER LEG SPLINT $270.78 $546.00 — — 50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SUPERFICIAL WOUNDS $194.41 $392.00 $0.58–$2,522.00 41% below 50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPAIR SUPERFICIAL WOUNDS $194.41 $392.00 — — 50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION $305.50 $616.00 $0.58–$2,522.00 32% below 50%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION $305.50 $616.00 — — 50%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS $131.43 $265.00 $0.58–$2,522.00 55% below 50%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS $131.43 $265.00 — — 50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DIAG $550.49 $1,110.00 $0.58–$2,667.17 47% below 50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL FLUID TAP DIAG $550.49 $1,110.00 — — 50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR WOUND 2.6CM TO 7.5CM $256.40 $517.00 $0.58–$2,522.00 27% below 50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPAIR WOUND 2.6CM TO 7.5CM $256.40 $517.00 — — 50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR WOUND 2.5CM OR LESS $214.74 $433.00 $0.58–$2,522.00 32% below 50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPAIR WOUND 2.5CM OR LESS $214.74 $433.00 — — 50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGEN BIOPSY OF SKIM SIN LE $99.69 $201.00 $0.58–$2,522.00 67% below 50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY 2 OR MORE LESIONS SKI $120.02 $242.00 $0.58–$2,522.00 60% below 50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGEN BIOPSY OF SKIM SIN LE $99.69 $201.00 — — 50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BIOPSY 2 OR MORE LESIONS SKI $120.02 $242.00 — — 50%
Thoracentesis with imaging guidance CPT 32555 THORACENT NEEDLE CATH ASPR W $946.74 $1,909.00 $0.58–$2,522.00 49% below 50%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAG GUIDANC $946.74 $1,909.00 $0.58–$2,522.00 49% below 50%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGE GUIDAN $1,034.02 $2,085.00 $0.58–$2,522.00 44% below 50%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAG GUIDANC $946.74 $1,909.00 — — 50%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENT NEEDLE CATH ASPR W $946.74 $1,909.00 — — 50%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGE GUIDAN $1,034.02 $2,085.00 — — 50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCLE $332.28 $670.00 $0.58–$2,522.00 55% below 50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCLE $332.28 $670.00 — — 50%
Upper endoscopy (EGD) with biopsy CPT 43239 EDG WITH BIOPSY $510.81 $1,030.00 $0.58–$3,496.15 82% below 50%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EDG WITH BIOPSY $510.81 $1,030.00 — — 50%
Upper endoscopy (EGD), diagnostic CPT 43235 EGDDIAGOSTIC $466.68 $941.00 $0.58–$3,496.15 82% below 50%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD $510.81 $1,030.00 $0.58–$3,496.15 80% below 50%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGDDIAGOSTIC $466.68 $941.00 — — 50%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD $510.81 $1,030.00 — — 50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 1ST 20 CM $247.47 $499.00 $0.58–$2,522.00 68% below 50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 1ST 20 CM $247.47 $499.00 — — 50%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 TREAT FX RAD EXTRA ARTICUL $3,898.51 $7,861.00 $0.58–$27,591.79 53% below 50%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 TREAT FX RAD EXTRA ARTICUL $3,898.51 $7,861.00 — — 50%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs OhioOff list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD PRODUCT ADMIN = 1 HR $352.61 $711.00 $0.58–$2,522.00 70% below 50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD PRODUCT ADMIN = 2 HRS $429.98 $867.00 $0.58–$2,522.00 63% below 50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD PRODUCT ADMIN = 3 HRS $516.27 $1,041.00 $0.58–$2,522.00 56% below 50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD PRODUCT ADMIN = 4 HRS $602.06 $1,214.00 $0.58–$2,522.00 48% below 50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE $623.89 $1,258.00 $0.58–$2,522.00 47% below 50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD PRODUCT ADMIN = 5 HRS $696.79 $1,405.00 $0.58–$2,522.00 40% below 50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD PRODUCT ADMIN = 6 HRS $774.15 $1,561.00 $0.58–$2,522.00 34% below 50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD PRODUCT ADMIN = 7 HRS $851.52 $1,717.00 $0.58–$2,522.00 27% below 50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD PRODUCT ADMIN = 8 HRS $946.24 $1,908.00 $0.58–$2,522.00 19% below 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD PRODUCT ADMIN = 1 HR $352.61 $711.00 — — 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD PRODUCT ADMIN = 2 HRS $429.98 $867.00 — — 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD PRODUCT ADMIN = 3 HRS $516.27 $1,041.00 — — 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD PRODUCT ADMIN = 4 HRS $602.06 $1,214.00 — — 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE $623.89 $1,258.00 — — 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD PRODUCT ADMIN = 5 HRS $696.79 $1,405.00 — — 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD PRODUCT ADMIN = 6 HRS $774.15 $1,561.00 — — 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD PRODUCT ADMIN = 7 HRS $851.52 $1,717.00 — — 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD PRODUCT ADMIN = 8 HRS $946.24 $1,908.00 — — 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT $146.80 $296.00 $173.16–$822.60 18% below 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT $146.80 $296.00 — — 50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV/IA INFUSION INIT HR $288.14 $581.00 $293.73–$1,306.16 61% below 50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUS INIT 16-76 $301.53 $608.00 $293.73–$1,306.16 60% below 50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION INIT HR $670.01 $1,351.00 $293.73–$1,306.16 10% below 50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV/IA INFUSION INIT HR $288.14 $581.00 — — 50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUS INIT 16-76 $301.53 $608.00 — — 50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION INIT HR $670.01 $1,351.00 — — 50%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 BASIC COMPREHENSIVE AUDIOMET $115.56 $233.00 $128.62–$602.46 59% below 50%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 BASIC COMPREHENSIVE AUDIOMET $115.56 $233.00 — — 50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE1ST 60 MINUTES $1,539.37 $3,104.00 $192.85–$3,422.43 48% below 50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE1ST 60 MINUTES $1,539.37 $3,104.00 — — 50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG-ROUTINEAWAKE & DROWSY $568.34 $1,146.00 $243.81–$1,210.58 46% below 50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG-ROUTINEAWAKE & DROWSY $568.34 $1,146.00 — — 50%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 WC EKG (INTERP AND REPORT) $37.20 $75.00 $45.00–$57.75 85% below 50%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 WC EKG (INTERP AND REPORT) $37.20 $75.00 — — 50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG $123.99 $250.00 $51.28–$235.89 33% below 50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG $123.99 $250.00 — — 50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED-MINOR/NON-URGEN LEVEL I $245.99 $496.00 $66.82–$785.50 15% below 50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED-MINOR/NON-URGEN LEVEL I $245.99 $496.00 — — 50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED-LOW SEVERITY LEVEL II $356.58 $719.00 $121.01–$785.50 30% below 50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED-LOW SEVERITY LEVEL II $356.58 $719.00 — — 50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED-MODERATE SEVERITY LEVEL I $528.67 $1,066.00 $213.19–$1,100.42 38% below 50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED-MODERATE SEVERITY LEVEL I $528.67 $1,066.00 — — 50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED-EXTENDED LEVEL IV $933.84 $1,883.00 $335.12–$1,848.00 30% below 50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED-EXTENDED LEVEL IV $933.84 $1,883.00 — — 50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED-HIGH SEVERITY LEVEL V $1,228.42 $2,477.00 $481.02–$4,081.00 22% below 50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED-HIGH SEVERITY LEVEL V $1,228.42 $2,477.00 — — 50%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST $594.63 $1,199.00 $243.81–$1,210.58 33% below 50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOVASCULAR STRESS TEST $594.63 $1,199.00 — — 50%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY SESSION W/PAT $114.56 $231.00 $123.26–$614.90 60% below 50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY SESSION W/PAT $114.56 $231.00 $966.00 — 50%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY THERAPY SESSION W/O P $263.34 $531.00 $123.26–$614.90 14% below 50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY THERAPY SESSION W/O P $263.34 $531.00 $966.00 — 50%
Group psychotherapy session CPT 90853 GROUP THERAPY PER SESSION $82.33 $166.00 $68.93–$343.78 50% below 50%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY PER SESSION $82.33 $166.00 $966.00 — 50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT $115.06 $232.00 $139.20–$826.66 72% below 50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT $115.06 $232.00 — — 50%
IV infusion of a medicine, first hour CPT 96365 IV INFUSIONINITIAL HOUR $255.41 $515.00 $188.46–$826.66 41% below 50%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT $280.70 $566.00 $188.46–$826.66 35% below 50%
IV infusion of a medicine, first hour CPT 96365 THERAPEUTIC INFUSION INIT HR $281.69 $568.00 $188.46–$826.66 35% below 50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSIONINITIAL HOUR $255.41 $515.00 — — 50%
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT $280.70 $566.00 — — 50%
IV infusion of a medicine, first hour inpatient CPT 96365 THERAPEUTIC INFUSION INIT HR $281.69 $568.00 — — 50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SUBQ INJECTION $46.62 $94.00 $56.40–$271.70 68% below 50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTIONRADIOLOGY RNEACH $96.71 $195.00 $57.12–$271.70 33% below 50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM $125.97 $254.00 $57.12–$271.70 13% below 50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SUBQ INJECTION $46.62 $94.00 — — 50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTIONRADIOLOGY RNEACH $96.71 $195.00 — — 50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM $125.97 $254.00 — — 50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 ARU ASSESSMENT $231.60 $467.00 $123.26–$614.90 26% below 50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 ARU ASSESSMENT $231.60 $467.00 — — 50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDY 7-8 S $453.29 $914.00 $243.81–$1,210.58 67% below 50%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDY 7-8 S $453.29 $914.00 — — 50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 DIET.CONSULT INIT INDIV.OBC $59.02 $119.00 $33.98–$154.58 10% below 50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 DIET.CONSULT INIT INDIV.OBC $59.02 $119.00 — — 50%
Psychotherapy for crisis, first 60 minutes CPT 90839 CRISIS INTERVENTION $116.55 $235.00 $123.26–$614.90 63% below 50%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 CRISIS INTERVENTION $116.55 $235.00 $966.00 — 50%
Psychotherapy session, 30 minutes CPT 90832 INDIVID.OP THERAPY 20-30 MIN $86.30 $174.00 $104.40–$614.90 52% below 50%
Psychotherapy session, 30 minutes CPT 90832 WVFPC-INDIVIUDAL COUNS.(30 M $86.30 $174.00 $104.40–$614.90 52% below 50%
Psychotherapy session, 30 minutes inpatient CPT 90832 WVFPC-INDIVIUDAL COUNS.(30 M $86.30 $174.00 $966.00 — 50%
Psychotherapy session, 30 minutes inpatient CPT 90832 INDIVID.OP THERAPY 20-30 MIN $86.30 $174.00 — — 50%
Psychotherapy session, 45 minutes CPT 90834 INDIVID.OP THERAPY 45-50 MIN $143.82 $290.00 $123.26–$614.90 45% below 50%
Psychotherapy session, 45 minutes CPT 90834 INDIVID.COUNSEL-45-50M(317 B $143.82 $290.00 $123.26–$614.90 45% below 50%
Psychotherapy session, 45 minutes inpatient CPT 90834 INDIVID.COUNSEL-45-50M(317 B $143.82 $290.00 $966.00 — 50%
Psychotherapy session, 45 minutes inpatient CPT 90834 INDIVID.OP THERAPY 45-50 MIN $143.82 $290.00 — — 50%
Psychotherapy session, 60 minutes CPT 90837 INDIV.THERAPY OP 75-80 MINUT $158.21 $319.00 $123.26–$614.90 47% below 50%
Psychotherapy session, 60 minutes CPT 90837 INDIVID. THERAPY PARTIAL OR $158.21 $319.00 $123.26–$614.90 47% below 50%
Psychotherapy session, 60 minutes inpatient CPT 90837 INDIV.THERAPY OP 75-80 MINUT $158.21 $319.00 — — 50%
Psychotherapy session, 60 minutes inpatient CPT 90837 INDIVID. THERAPY PARTIAL OR $158.21 $319.00 $966.00 — 50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING ED 3-10 MIIN SYMPTOM $21.33 $43.00 $24.21–$110.65 50% below 50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING ED 3-10 MIIN SYMPTOM $21.33 $43.00 — — 50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EXPF-PROFESSIONAL FEE LEVEL $132.91 $268.00 $160.80–$206.36 21% below 50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE OUTPATIENT VISIT EST $1,309.76 $2,641.00 $192.85–$2,033.57 676% above 50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EXPF-PROFESSIONAL FEE LEVEL $132.91 $268.00 — — 50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE OUTPATIENT VISIT EST $1,309.76 $2,641.00 — — 50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WORKCARE RX LEVEL III $16.87 $34.00 $20.40–$27.20 84% below 50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EXPF-PROFESSIONAL FEE LEVEL $69.44 $140.00 $84.00–$107.80 36% below 50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 LABOR DETERMIN - 61-90 MIN $477.09 $962.00 $577.20–$740.74 341% above 50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE OUTPATIENT VISIT EXT $602.06 $1,214.00 $192.85–$934.78 456% above 50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 COMPREHENSIVE VISIT $723.07 $1,458.00 $193.07–$1,122.66 568% above 50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WORKCARE RX LEVEL III $16.87 $34.00 — — 50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EXPF-PROFESSIONAL FEE LEVEL $69.44 $140.00 — — 50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 LABOR DETERMIN - 61-90 MIN $477.09 $962.00 — — 50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE OUTPATIENT VISIT EXT $602.06 $1,214.00 — — 50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 COMPREHENSIVE VISIT $723.07 $1,458.00 — — 50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EXPF-PROFESSIONAL FEE LEVEL $99.19 $200.00 $120.00–$154.00 30% below 50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 COMPLEX VISIT $1,115.85 $2,250.00 $193.07–$1,732.50 686% above 50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WORKCARE RX VISIT LEVEL IV $1,115.85 $2,250.00 $1,350.00–$1,800.00 686% above 50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EXPF-PROFESSIONAL FEE LEVEL $99.19 $200.00 — — 50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WORKCARE RX VISIT LEVEL IV $1,115.85 $2,250.00 — — 50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 COMPLEX VISIT $1,115.85 $2,250.00 — — 50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EXPF-PROFESSIONAL FEE LEVEL $45.13 $91.00 $54.60–$70.07 54% below 50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OUTPATIENT VISIT EXT $301.53 $608.00 $192.85–$468.16 209% above 50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ADVANCED VISIT $362.03 $730.00 $193.07–$562.10 271% above 50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EXPF-PROFESSIONAL FEE LEVEL $45.13 $91.00 — — 50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE OUTPATIENT VISIT EXT $301.53 $608.00 — — 50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ADVANCED VISIT $362.03 $730.00 — — 50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT RADIATION THERAPY $111.09 $224.00 $134.40–$172.48 40% below 50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 NM-TREATMENT CONSULTATION $255.91 $516.00 $309.60–$397.32 39% above 50%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULT RADIATION THERAPY $111.09 $224.00 — — 50%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 NM-TREATMENT CONSULTATION $255.91 $516.00 — — 50%
Spirometry (breathing test) CPT 94010 WC PULMONARY FUNCTION STUDY $113.57 $229.00 $128.62–$602.46 61% below 50%
Spirometry (breathing test) inpatient CPT 94010 WC PULMONARY FUNCTION STUDY $113.57 $229.00 — — 50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY (THERAPEUTIC) $91.75 $185.00 $103.88–$492.65 62% below 50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMYTHERAPEUTIC $241.03 $486.00 $103.88–$492.65 1% below 50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC $241.03 $486.00 $103.88–$492.65 1% below 50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY (THERAPEUTIC) $91.75 $185.00 — — 50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC $241.03 $486.00 — — 50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMYTHERAPEUTIC $241.03 $486.00 — — 50%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CARDIOVASCULAR STRESS TEST $1,165.44 $2,350.00 $1,410.00–$1,809.50 87% above 50%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CARDIOVASCULAR STRESS TEST $1,165.44 $2,350.00 — — 50%

Vaccines

ProcedureCash price List priceInsurers payvs OhioOff list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE (EMPLOYEE HEALTH $7.94 $16.00 $4.48–$33.53 83% below 50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE (EMPLOYEE HEALTH $7.94 $16.00 $4.48–$9.48 — 50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9-VALENT INJ $250.95 $506.00 $303.60–$461.42 52% below 50%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9-VALENT INJ $250.95 $506.00 — — 50%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TWINRIX $118.53 $239.00 $97.37–$189.30 61% below 50%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TWINRIX $118.53 $239.00 — — 50%
Hepatitis A vaccine, adult dose CPT 90632 HAVRIX VACCINE 720 UNITS $30.26 $61.00 $36.60–$105.72 84% below 50%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE $54.06 $109.00 $65.40–$105.72 72% below 50%
Hepatitis A vaccine, adult dose CPT 90632 HEP A VACE 50 UNITS $66.63 $134.34 $71.61–$105.72 66% below 50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX VACCINE 720 UNITS $30.26 $61.00 — — 50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE $54.06 $109.00 — — 50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACE 50 UNITS $66.63 $134.34 — — 50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE $37.70 $76.00 $24.32–$105.57 76% below 50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX-HB 10 MCG INJ $43.65 $88.00 $28.16–$105.57 72% below 50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B 20 MCG/1ML $64.48 $130.00 $41.60–$105.57 58% below 50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VACCINE 3 DOSES $81.83 $165.00 $52.80–$127.05 47% below 50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE $37.70 $76.00 $24.32–$45.00 — 50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RECOMBIVAX-HB 10 MCG INJ $43.65 $88.00 $28.16–$52.10 — 50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B 20 MCG/1ML $64.48 $130.00 $41.60–$76.96 — 50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VACCINE 3 DOSES $81.83 $165.00 $52.80–$97.68 — 50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HD INJ $39.68 $80.00 $22.40–$125.24 64% below 50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HD INJ $39.68 $80.00 $22.40–$47.36 — 50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM $151.64 $305.76 $115.88–$236.03 52% below 50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENACWYD/MENACWYCRM VACC IM $151.64 $305.76 — — 50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO IM INJ $110.97 $223.75 $134.25–$335.63 80% below 50%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO IM INJ $110.97 $223.75 — — 50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 VACCINE IM $327.46 $660.28 $396.17–$508.42 51% below 50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 VACCINE IM $327.46 $660.28 — — 50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 1 DOSE $142.83 $288.00 $80.64–$221.76 47% below 50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 1 DOSE $142.83 $288.00 $80.64–$170.50 — 50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE 1ML $370.46 $747.00 $288.31–$1,417.34 61% below 50%
Rabies vaccine, one dose CPT 90675 RABAVERT PCEC 1ML $403.20 $813.00 $288.31–$1,417.34 58% below 50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE 1ML $370.46 $747.00 — — 50%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT PCEC 1ML $403.20 $813.00 — — 50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTHERIA $34.72 $70.00 $33.48–$65.49 61% below 50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTHERIA $34.72 $70.00 — — 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 WC TDAP TETANUS VACCINE $21.83 $44.00 $26.40–$57.78 80% below 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL/TETANUS/DIPTH/PERTUSS $45.63 $92.00 $38.63–$70.84 59% below 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX/TDAP 0.5ML $46.62 $94.00 $38.63–$72.38 58% below 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP BOOSTRIX INJ $49.00 $98.80 $38.63–$76.08 56% below 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 WC TDAP TETANUS VACCINE $21.83 $44.00 — — 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL/TETANUS/DIPTH/PERTUSS $45.63 $92.00 — — 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX/TDAP 0.5ML $46.62 $94.00 — — 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP BOOSTRIX INJ $49.00 $98.80 — — 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 WC INJECTION FEE $16.37 $33.00 $19.80–$271.70 59% below 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADM 1 VACCINE $148.78 $300.00 $57.12–$271.70 271% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN $148.78 $300.00 $57.12–$271.70 271% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 WC INJECTION FEE $16.37 $33.00 — — 50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADM 1 VACCINE $148.78 $300.00 — — 50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN $148.78 $300.00 — — 50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADM EACH ADD VA $74.39 $150.00 $90.00–$115.50 114% above 50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD $74.39 $150.00 $90.00–$192.85 114% above 50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD $74.39 $150.00 — — 50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADM EACH ADD VA $74.39 $150.00 — — 50%

Source file: https://trinityhealth.com/341842025-1285715144_trinity-hospital-holding-company_standardcharges.json