Hospital Grand Rapids, MN

Bigfork Valley Hospital

Listed in its price file as “Northern Itasca Hospital District”.

Bigfork Valley Hospital in Bigfork, MN publishes cash prices for 312 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Minnesota median for 225 of 310 procedures and below it for 85. By typical cash price it ranks #60 of 79 Minnesota hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

258 Pine Tree Drive, Bigfork, MN, 56628 Collected Sep 27, 2026 Source price file (218) 743-3177

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 241316 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE MIN 3 VIEWS	$269.94	$380.20	$187.93–$368.79	23% above	29%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE MIN 3 VIEWS	$269.94	$380.20	$187.93–$368.79	—	29%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ABI LIMITED 1-2 LVLS	$610.88	$860.40	$425.26–$834.59	65% above	29%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ABI LIMITED 1-2 LVLS	$610.88	$860.40	$425.26–$834.59	—	29%
Bone scan, whole body (nuclear medicine) CPT 78306 SCAN BONE, WHOLE BODY	$1,252.80	$1,764.50	$872.11–$1,711.56	2% above	29%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 SCAN BONE, WHOLE BODY	$1,252.80	$1,764.50	$872.11–$1,711.56	—	29%
Breast ultrasound, complete, one breast CPT 76641 U/S BREAST COMPLETE	$406.83	$573.00	$283.21–$555.81	8% above	29%
Breast ultrasound, complete, one breast inpatient CPT 76641 U/S BREAST COMPLETE	$406.83	$573.00	$283.21–$555.81	—	29%
Breast ultrasound, limited (one breast or one area) CPT 76642 U/S BREAST LIMITED	$372.68	$524.90	$259.44–$509.15	18% above	29%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 U/S BREAST LIMITED	$372.68	$524.90	$259.44–$509.15	—	29%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST PULMONARY EMBOLISM	$1,852.11	$2,608.60	$1,289.31–$2,530.34	12% above	29%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA THORACIC AORTA	$1,852.11	$2,608.60	$1,289.31–$2,530.34	12% above	29%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST PULMONARY EMBOLISM	$1,852.11	$2,608.60	$1,289.31–$2,530.34	—	29%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA THORACIC AORTA	$1,852.11	$2,608.60	$1,289.31–$2,530.34	—	29%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN PELVIS W/O CONTRAST	$2,697.08	$3,798.70	$1,877.53–$3,684.74	41% above	29%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN PELVIS W/O CONTRAST	$2,697.08	$3,798.70	$1,877.53–$3,684.74	—	29%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN PELVIS W/CONTRAST	$3,217.65	$4,531.90	$2,239.91–$4,395.94	31% above	29%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN PELVIS W/CONTRAST	$3,217.65	$4,531.90	$2,239.91–$4,395.94	—	29%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN PELVIS WWO/CONTRAST	$3,806.81	$5,361.70	$2,650.05–$5,200.85	48% above	29%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN PELVIS WWO/CONTRAST	$3,806.81	$5,361.70	$2,650.05–$5,200.85	—	29%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN WITH DYE	$1,626.18	$2,290.40	$1,132.04–$2,221.69	11% above	29%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN WITH DYE	$1,626.18	$2,290.40	$1,132.04–$2,221.69	—	29%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O DYE	$1,427.95	$2,011.20	$994.04–$1,950.86	21% above	29%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O DYE	$1,427.95	$2,011.20	$994.04–$1,950.86	—	29%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXIL/FACIAL W/O DYE	$1,385.00	$1,950.70	$964.13–$1,892.18	11% above	29%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXIL/FACIAL W/O DYE	$1,385.00	$1,950.70	$964.13–$1,892.18	—	29%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O DYE	$1,425.11	$2,007.20	$992.08–$1,946.98	13% above	29%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O DYE	$1,425.11	$2,007.20	$992.08–$1,946.98	—	29%
CT scan of the head with contrast CPT 70460 CT HEAD WITH DYE	$1,495.54	$2,106.40	$1,041.09–$2,043.21	15% above	29%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD WITH DYE	$1,495.54	$2,106.40	$1,041.09–$2,043.21	—	29%
CT scan of the head without and with contrast CPT 70470 CT HEAD W & WO DYE	$1,765.91	$2,487.20	$1,229.32–$2,412.58	11% above	29%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W & WO DYE	$1,765.91	$2,487.20	$1,229.32–$2,412.58	—	29%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE	$1,568.60	$2,209.30	$1,091.98–$2,143.02	15% above	29%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O DYE	$1,568.60	$2,209.30	$1,091.98–$2,143.02	—	29%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERV. SPINE W/O DYE	$1,617.59	$2,278.30	$1,126.07–$2,209.95	20% above	29%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERV. SPINE W/O DYE	$1,617.59	$2,278.30	$1,126.07–$2,209.95	—	29%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH DYE	$1,624.13	$2,287.50	$1,130.61–$2,218.88	10% above	29%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH DYE	$1,624.13	$2,287.50	$1,130.61–$2,218.88	—	29%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 U/S CAROTID	$992.51	$1,397.90	$690.92–$1,355.96	20% above	29%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 U/S CAROTID	$992.51	$1,397.90	$690.92–$1,355.96	—	29%
Chest X-ray, 2 views CPT 71046 CHEST FRONT/LATERAL 2 VIEW	$278.25	$391.90	$193.71–$380.14	20% above	29%
Chest X-ray, 2 views inpatient CPT 71046 CHEST FRONT/LATERAL 2 VIEW	$278.25	$391.90	$193.71–$380.14	—	29%
Chest X-ray, single view CPT 71045 CHEST FRONT,1 VIEW	$268.95	$378.80	$187.22–$367.44	51% above	29%
Chest X-ray, single view inpatient CPT 71045 CHEST FRONT,1 VIEW	$268.95	$378.80	$187.22–$367.44	—	29%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA BONE DENSITY SCAN	$450.64	$634.70	$313.71–$615.66	44% above	29%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA BONE DENSITY SCAN	$450.64	$634.70	$313.71–$615.66	—	29%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA PERIPHERAL STUDY	$329.44	$464.00	$229.35–$450.08	71% above	29%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA PERIPHERAL STUDY	$329.44	$464.00	$229.35–$450.08	—	29%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O DYE	$1,498.38	$2,110.40	$1,043.07–$2,047.09	20% above	29%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST LOW DOSE	$1,498.38	$2,110.40	$1,043.07–$2,047.09	20% above	29%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O DYE	$1,498.38	$2,110.40	$1,043.07–$2,047.09	—	29%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST LOW DOSE	$1,498.38	$2,110.40	$1,043.07–$2,047.09	—	29%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX W/CONTRAST	$1,728.92	$2,435.10	$1,203.56–$2,362.05	16% above	29%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX W/CONTRAST	$1,728.92	$2,435.10	$1,203.56–$2,362.05	—	29%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAGNOSTIC BILATERAL	$299.48	$421.80	$208.47–$409.15	—	29%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIAGNOSTIC BILATERAL	$299.48	$421.80	$208.47–$409.15	—	29%
Diagnostic mammogram, one breast CPT 77065 MAMMO DIAGNOSITC UNLIATERAL	$240.19	$338.30	$167.21–$328.15	23% below	29%
Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO DIAGNOSITC UNLIATERAL	$240.19	$338.30	$167.21–$328.15	—	29%
Duplex ultrasound of the leg veins, both legs CPT 93970 VENOUS IMAGING DOPPLER	$912.78	$1,285.60	$635.42–$1,247.03	3% above	29%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VENOUS IMAGING DOPPLER	$912.78	$1,285.60	$635.42–$1,247.03	—	29%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTE W/DOPPLER, COMPLETE	$1,979.05	$2,787.40	$1,377.68–$2,703.78	57% above	29%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TTE W/DOPPLER, COMPLETE	$1,979.05	$2,787.40	$1,377.68–$2,703.78	—	29%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 LIVER FUNCTION / HEPATOBILIARY	$1,055.49	$1,486.60	$734.76–$1,442.00	22% below	29%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 LIVER FUNCTION / HEPATOBILIARY	$1,055.49	$1,486.60	$734.76–$1,442.00	—	29%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY W/CPAP	$3,469.13	$4,886.10	$2,414.98–$4,739.52	at median	29%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY W/CPAP	$3,469.13	$4,886.10	$2,414.98–$4,739.52	—	29%
Knee X-ray, 3 views one side CPT 73562 KNEE RIGHT 3 VIEWS	$287.83	$405.40	$200.38–$393.24	24% above	29%
Knee X-ray, 3 views one side CPT 73562 KNEE LEFT 3 VIEWS	$287.83	$405.40	$200.38–$393.24	24% above	29%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE RIGHT 3 VIEWS	$287.83	$405.40	$200.38–$393.24	—	29%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE LEFT 3 VIEWS	$287.83	$405.40	$200.38–$393.24	—	29%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S ABDOMEN LIMITED	$418.97	$590.10	$291.67–$572.40	at median	29%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S ABDOMEN LIMITED	$418.97	$590.10	$291.67–$572.40	—	29%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST LOW DOSE SCREENING WO	$931.02	$1,311.30	$648.12–$1,271.96	61% above	29%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST LOW DOSE SCREENING WO	$931.02	$1,311.30	$648.12–$1,271.96	—	29%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 LOWER EXTREMITY JT W/O CONTRAS	$2,431.32	$3,424.40	$1,692.54–$3,321.67	37% above	29%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 LOWER EXTREMITY JT W/O CONTRAS	$2,431.32	$3,424.40	$1,692.54–$3,321.67	—	29%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 LOWER EXTREMITY JT W/WO CONTRA	$2,714.69	$3,823.50	$1,889.78–$3,708.80	6% above	29%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 LOWER EXTREMITY JT W/WO CONTRA	$2,714.69	$3,823.50	$1,889.78–$3,708.80	—	29%
MRI of the abdomen without contrast CPT 74181 ABDOMEN W/O CONTRAST	$2,024.35	$2,851.20	$1,409.22–$2,765.66	7% below	29%
MRI of the abdomen without contrast inpatient CPT 74181 ABDOMEN W/O CONTRAST	$2,024.35	$2,851.20	$1,409.22–$2,765.66	—	29%
MRI of the abdomen, without and then with contrast dye CPT 74183 ABDOMEN W/WO CONTRAST	$3,430.72	$4,832.00	$2,388.25–$4,687.04	16% above	29%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 ABDOMEN W/WO CONTRAST	$3,430.72	$4,832.00	$2,388.25–$4,687.04	—	29%
MRI of the brain, no contrast dye CPT 70551 BRAIN W/O CONTRAST	$2,237.64	$3,151.60	$1,557.69–$3,057.05	10% above	29%
MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN W/O CONTRAST	$2,237.64	$3,151.60	$1,557.69–$3,057.05	—	29%
MRI of the brain, with and without contrast dye CPT 70553 BRAIN W/WO CONTRAST	$3,163.83	$4,456.10	$2,202.45–$4,322.42	17% above	29%
MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN W/WO CONTRAST	$3,163.83	$4,456.10	$2,202.45–$4,322.42	—	29%
MRI of the lower back, no contrast dye CPT 72148 LUMBAR SPINE W/O CONTRAST	$2,529.23	$3,562.30	$1,760.69–$3,455.43	21% above	29%
MRI of the lower back, no contrast dye inpatient CPT 72148 LUMBAR SPINE W/O CONTRAST	$2,529.23	$3,562.30	$1,760.69–$3,455.43	—	29%
MRI of the lower back, without and then with contrast dye CPT 72158 LUMBAR SPINE W/WO CONTRAST	$3,304.84	$4,654.70	$2,300.61–$4,515.06	29% above	29%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 LUMBAR SPINE W/WO CONTRAST	$3,304.84	$4,654.70	$2,300.61–$4,515.06	—	29%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 THORACIC SPINE W/O CONTRAST	$2,503.25	$3,525.70	$1,742.60–$3,419.93	18% above	29%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 THORACIC SPINE W/O CONTRAST	$2,503.25	$3,525.70	$1,742.60–$3,419.93	—	29%
MRI of the neck (cervical spine) without and with contrast CPT 72156 CERVICAL SPINE W/WO CONTRAST	$3,442.86	$4,849.10	$2,396.69–$4,703.63	38% above	29%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 CERVICAL SPINE W/WO CONTRAST	$3,442.86	$4,849.10	$2,396.69–$4,703.63	—	29%
MRI of the neck (cervical spine), no contrast dye CPT 72141 CERVICAL SPINE W/O CONTRAST	$2,434.09	$3,428.30	$1,694.45–$3,325.45	15% above	29%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 CERVICAL SPINE W/O CONTRAST	$2,434.09	$3,428.30	$1,694.45–$3,325.45	—	29%
MRI of the pelvis without and with contrast CPT 72197 PELVIS W/WO CONTRAST	$2,363.87	$3,329.40	$1,645.57–$3,229.52	11% below	29%
MRI of the pelvis without and with contrast inpatient CPT 72197 PELVIS W/WO CONTRAST	$2,363.87	$3,329.40	$1,645.57–$3,229.52	—	29%
MRI of the pelvis, no contrast dye CPT 72195 PELVIS W/O CONTRAST	$2,044.30	$2,879.30	$1,423.11–$2,792.92	3% below	29%
MRI of the pelvis, no contrast dye inpatient CPT 72195 PELVIS W/O CONTRAST	$2,044.30	$2,879.30	$1,423.11–$2,792.92	—	29%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 UPPER EXTREMITY JT W/O CONTRAS	$2,178.28	$3,068.00	$1,516.37–$2,975.96	3% above	29%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 UPPER EXTREMITY JT W/O CONTRAS	$2,178.28	$3,068.00	$1,516.37–$2,975.96	—	29%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 U/S PELVIC LIMITED	$384.89	$542.10	$267.93–$525.84	26% above	29%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 U/S PELVIC LIMITED	$384.89	$542.10	$267.93–$525.84	—	29%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 U/S PELVIS (NON-OB)	$557.99	$785.90	$388.44–$762.32	19% above	29%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 U/S PELVIS (NON-OB)	$557.99	$785.90	$388.44–$762.32	—	29%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 U/S OB > 14 WEEKS	$567.22	$798.90	$394.86–$774.93	19% above	29%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 U/S OB > 14 WEEKS	$567.22	$798.90	$394.86–$774.93	—	29%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 U/S OB < 14 WEEKS	$495.08	$697.30	$344.64–$676.38	18% above	29%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 U/S OB < 14 WEEKS	$495.08	$697.30	$344.64–$676.38	—	29%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 U/S PELVIS LIMITED (OB)	$357.91	$504.10	$249.15–$488.98	11% above	29%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 U/S PELVIS LIMITED (OB)	$357.91	$504.10	$249.15–$488.98	—	29%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILATERAL	$255.96	$360.50	$91.71–$349.68	—	29%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN BILATERAL	$255.96	$360.50	$91.71–$349.68	—	29%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER COMPLETE	$288.47	$406.30	$200.82–$394.11	28% above	29%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER COMPLETE	$288.47	$406.30	$200.82–$394.11	—	29%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY 4 OR MORE	$3,180.52	$4,479.60	$2,214.06–$4,345.21	3% above	29%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 4 OR MORE	$3,180.52	$4,479.60	$2,214.06–$4,345.21	—	29%
Transvaginal pelvic ultrasound CPT 76830 ECHOGRAPHY, TRANSVAGINAL	$511.56	$720.50	$356.10–$698.88	32% above	29%
Transvaginal pelvic ultrasound inpatient CPT 76830 ECHOGRAPHY, TRANSVAGINAL	$511.56	$720.50	$356.10–$698.88	—	29%
Transvaginal ultrasound during pregnancy CPT 76817 U/S TRANSVAGINAL OB	$452.34	$637.10	$314.88–$617.99	35% above	29%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 U/S TRANSVAGINAL OB	$452.34	$637.10	$314.88–$617.99	—	29%
Ultrasound of the abdomen, complete CPT 76700 U/S ABDOMEN COMPLETE	$877.63	$1,236.10	$610.94–$1,199.02	49% above	29%
Ultrasound of the abdomen, complete inpatient CPT 76700 U/S ABDOMEN COMPLETE	$877.63	$1,236.10	$610.94–$1,199.02	—	29%
Ultrasound of the scrotum and testicles CPT 76870 U/S SCROTUM	$423.66	$596.70	$294.92–$578.80	7% below	29%
Ultrasound of the scrotum and testicles inpatient CPT 76870 U/S SCROTUM	$423.66	$596.70	$294.92–$578.80	—	29%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 U/S THYROID/SOFT TISSUE	$550.61	$775.50	$383.28–$752.24	21% above	29%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 U/S THYROID/SOFT TISSUE	$550.61	$775.50	$383.28–$752.24	—	29%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS THROMBOSIS UNILATE	$684.01	$963.40	$476.16–$934.50	25% above	29%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS THROMBOSIS UNILATE	$684.01	$963.40	$476.16–$934.50	—	29%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST 3 VIEWS MINIMUM	$259.86	$366.00	$180.90–$355.02	19% above	29%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST 3 VIEWS MINIMUM	$259.86	$366.00	$180.90–$355.02	—	29%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP WITH PELVIS 2-3 VIEWS	$318.15	$448.10	$221.47–$434.66	15% above	29%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP WITH PELVIS 2-3 VIEWS	$318.15	$448.10	$221.47–$434.66	—	29%
X-ray of the abdomen, 1 view CPT 74018 ABDOM/1 AP VIEW	$268.95	$378.80	$187.22–$367.44	28% above	29%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOM/1 AP VIEW	$268.95	$378.80	$187.22–$367.44	—	29%
X-ray of the ankle, 2 views CPT 73600 ANKLE AP/LAT	$202.28	$284.90	$140.82–$276.35	25% above	29%
X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE AP/LAT	$202.28	$284.90	$140.82–$276.35	—	29%
X-ray of the finger(s), 2 or more views CPT 73140 FINGER MIN. 2 VIEWS	$193.12	$272.00	$134.44–$263.84	at median	29%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER MIN. 2 VIEWS	$193.12	$272.00	$134.44–$263.84	—	29%
X-ray of the foot, 2 views CPT 73620 FOOT AP/LAT	$169.76	$239.10	$118.18–$231.93	2% above	29%
X-ray of the foot, 2 views inpatient CPT 73620 FOOT AP/LAT	$169.76	$239.10	$118.18–$231.93	—	29%
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT COMP MN 3 VW	$191.98	$270.40	$133.64–$262.29	8% below	29%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT COMP MN 3 VW	$191.98	$270.40	$133.64–$262.29	—	29%
X-ray of the hand, 3 or more views CPT 73130 HAND COMP 3 VIEWS	$233.80	$329.30	$162.76–$319.42	9% above	29%
X-ray of the hand, 3 or more views inpatient CPT 73130 HAND COMP 3 VIEWS	$233.80	$329.30	$162.76–$319.42	—	29%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE AP & LATERAL 1 or 2 VIEWS	$243.96	$343.60	$169.84–$333.29	30% above	29%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE AP & LATERAL 1 or 2 VIEWS	$243.96	$343.60	$169.84–$333.29	—	29%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBOSACRAL AP/LAT	$361.53	$509.20	$251.68–$493.92	37% above	29%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBOSACRAL AP/LAT	$361.53	$509.20	$251.68–$493.92	—	29%
X-ray of the lower back, 4 or more views CPT 72110 LUMBOSAC SPINE 4 MINIMUM	$419.97	$591.50	$292.36–$573.76	23% above	29%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBOSAC SPINE 4 MINIMUM	$419.97	$591.50	$292.36–$573.76	—	29%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC AP & LAT	$410.66	$578.40	$285.89–$561.05	67% above	29%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC AP & LAT	$410.66	$578.40	$285.89–$561.05	—	29%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MINIMUM 3 VIEWS	$274.56	$386.70	$191.13–$375.10	26% above	29%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MINIMUM 3 VIEWS	$274.56	$386.70	$191.13–$375.10	—	29%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE-CERVICAL AP/L	$322.77	$454.60	$224.69–$440.96	30% above	29%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE-CERVICAL AP/L	$322.77	$454.60	$224.69–$440.96	—	29%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS AP ONLY	$233.80	$329.30	$162.76–$319.42	17% above	29%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS AP ONLY	$233.80	$329.30	$162.76–$319.42	—	29%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX	$258.94	$364.70	$180.24–$353.76	14% above	29%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX	$258.94	$364.70	$180.24–$353.76	—	29%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$55.38	$78.00	$5.19–$75.66	23% above	29%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT / ALT	$55.38	$78.00	$5.19–$75.66	23% above	29%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT / ALT	$55.38	$78.00	$5.19–$75.66	—	29%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$55.38	$78.00	$5.19–$75.66	—	29%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$53.25	$75.00	$5.08–$72.75	19% above	29%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT / AST	$53.25	$75.00	$5.08–$72.75	19% above	29%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$53.25	$75.00	$5.08–$72.75	—	29%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT / AST	$53.25	$75.00	$5.08–$72.75	—	29%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$271.93	$383.00	$46.68–$371.51	17% above	29%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$271.93	$383.00	$46.68–$371.51	—	29%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IgE	$27.69	$39.00	$5.12–$37.83	82% above	29%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LATEX RELATED / 5	$69.79	$98.30	$5.12–$95.35	359% above	29%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD GRAIN PANEL / 6	$83.71	$117.90	$5.12–$114.36	451% above	29%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD PROFILE / 6	$83.71	$117.90	$5.12–$114.36	451% above	29%
Allergy blood test, specific IgE, per allergen CPT 86003 NORTHERN RAST PANEL / 29	$403.28	$568.00	$5.12–$550.96	2553% above	29%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IgE	$27.69	$39.00	$5.12–$37.83	—	29%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LATEX RELATED / 5	$69.79	$98.30	$5.12–$95.35	—	29%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FOOD GRAIN PANEL / 6	$83.71	$117.90	$5.12–$114.36	—	29%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FOOD PROFILE / 6	$83.71	$117.90	$5.12–$114.36	—	29%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NORTHERN RAST PANEL / 29	$403.28	$568.00	$5.12–$550.96	—	29%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$30.81	$43.40	$12.69–$42.10	26% below	29%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$30.81	$43.40	$12.69–$42.10	—	29%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI NUCLEAR ANITBODY	$112.46	$158.40	$11.85–$153.65	150% above	29%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA W/MULT CONFIRM TESTS	$112.46	$158.40	$11.85–$153.65	150% above	29%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI NUCLEAR ANITBODY	$112.46	$158.40	$11.85–$153.65	—	29%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA W/MULT CONFIRM TESTS	$112.46	$158.40	$11.85–$153.65	—	29%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-proBNP	$196.67	$277.00	$38.47–$268.69	46% above	29%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-proBNP	$196.67	$277.00	$38.47–$268.69	—	29%
Basic metabolic panel (blood test) CPT 80048 BASIC MET PANEL TOTAL	$166.85	$235.00	$8.29–$227.95	87% above	29%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC MET PANEL TOTAL	$166.85	$235.00	$8.29–$227.95	—	29%
Blood culture for bacteria CPT 87040 CULTURE BACTERIAL BLOOD	$171.75	$241.90	$10.11–$234.64	56% above	29%
Blood culture for bacteria inpatient CPT 87040 CULTURE BACTERIAL BLOOD	$171.75	$241.90	$10.11–$234.64	—	29%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION VENIPUNCTURE	$32.73	$46.10	$9.15–$44.72	57% above	29%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION VENIPUNCTURE	$32.73	$46.10	$9.15–$44.72	—	29%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$37.06	$52.20	$3.85–$50.63	17% below	29%
Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD	$52.19	$73.50	$3.85–$71.30	18% above	29%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$37.06	$52.20	$3.85–$50.63	—	29%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD	$52.19	$73.50	$3.85–$71.30	—	29%
Blood lead test CPT 83655 LEAD LEVEL	$64.61	$91.00	$11.87–$88.27	107% above	29%
Blood lead test inpatient CPT 83655 LEAD LEVEL	$64.61	$91.00	$11.87–$88.27	—	29%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG (PREGNANCY TEST)	$113.32	$159.60	$7.37–$154.81	64% above	29%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG (PREGNANCY TEST)	$113.32	$159.60	$7.37–$154.81	—	29%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$87.19	$122.80	$2.93–$119.12	65% above	29%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$87.19	$122.80	$2.93–$119.12	—	29%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$83.78	$118.00	$5.08–$114.46	54% above	29%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$83.78	$118.00	$5.08–$114.46	—	29%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE BY PCR	$157.62	$222.00	$36.52–$215.34	19% above	29%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE BY PCR	$157.62	$222.00	$36.52–$215.34	—	29%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA19-9	$160.60	$226.20	$20.39–$219.41	58% above	29%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUMOR CA19-9	$160.60	$226.20	$20.39–$219.41	—	29%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA125	$159.68	$224.90	$20.39–$218.15	57% above	29%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY TUMOR CA125	$159.68	$224.90	$20.39–$218.15	—	29%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 CORONAVIRUS	$50.55	$71.20	$36.99–$69.06	58% below	29%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19	$140.01	$197.20	$50.28–$191.28	17% above	29%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID 19 BVH	$140.01	$197.20	$50.28–$191.28	17% above	29%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 NOVEL CORONAVIRUS RT PCR	$143.63	$202.30	$50.28–$196.23	20% above	29%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 2019 CORONAVIRUS	$50.55	$71.20	$36.99–$69.06	—	29%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19	$140.01	$197.20	$50.28–$191.28	—	29%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID 19 BVH	$140.01	$197.20	$50.28–$191.28	—	29%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 NOVEL CORONAVIRUS RT PCR	$143.63	$202.30	$50.28–$196.23	—	29%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS NAAT	$125.67	$177.00	$34.39–$171.69	34% above	29%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS NAAT	$125.67	$177.00	$34.39–$171.69	—	29%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$104.37	$147.00	$13.12–$142.59	13% above	29%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$104.37	$147.00	$13.12–$142.59	—	29%
Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD COUNT XP300	$117.15	$165.00	$7.61–$160.05	41% above	29%
Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CNT	$117.15	$165.00	$7.61–$160.05	41% above	29%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE BLOOD COUNT XP300	$117.15	$165.00	$7.61–$160.05	—	29%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE BLOOD CNT	$117.15	$165.00	$7.61–$160.05	—	29%
Comprehensive metabolic panel (blood test) CPT 80053 COMP PANEL	$209.45	$295.00	$10.35–$286.15	122% above	29%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP PANEL	$209.45	$295.00	$10.35–$286.15	—	29%
D-dimer blood test (blood clot marker) CPT 85379 FDP; QUANITATIVE	$147.68	$208.00	$9.98–$201.76	49% above	29%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FDP; QUANITATIVE	$147.68	$208.00	$9.98–$201.76	—	29%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$198.73	$279.90	$21.79–$271.50	244% above	29%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$198.73	$279.90	$21.79–$271.50	—	29%
Estradiol blood test CPT 82670 ESTRADIOL	$149.60	$210.70	$27.38–$204.38	126% above	29%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$149.60	$210.70	$27.38–$204.38	—	29%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$100.82	$142.00	$18.21–$137.74	43% above	29%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$100.82	$142.00	$18.21–$137.74	—	29%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL	$272.71	$384.10	$19.24–$372.58	224% above	29%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL	$272.71	$384.10	$19.24–$372.58	—	29%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$149.81	$211.00	$13.36–$204.67	67% above	29%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$149.81	$211.00	$13.36–$204.67	—	29%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$137.74	$194.00	$14.41–$188.18	72% above	29%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$137.74	$194.00	$14.41–$188.18	—	29%
Free T3 thyroid hormone test CPT 84481 FREE T3	$117.15	$165.00	$16.60–$160.05	14% above	29%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$117.15	$165.00	$16.60–$160.05	—	29%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$77.39	$109.00	$8.84–$105.73	13% above	29%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 / DIALYSIS / MASS SPEC	$77.39	$109.00	$8.84–$105.73	13% above	29%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 / DIALYSIS / MASS SPEC	$77.39	$109.00	$8.84–$105.73	—	29%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$77.39	$109.00	$8.84–$105.73	—	29%
Free testosterone test CPT 84402 TESTOSTERONE, FREE	$155.99	$219.70	$24.96–$213.11	150% above	29%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE	$155.99	$219.70	$24.96–$213.11	—	29%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 OB GLUCOSE SCREEN	$58.72	$82.70	$4.66–$80.22	39% above	29%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 OB GLUCOSE SCREEN	$58.72	$82.70	$4.66–$80.22	—	29%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST	$160.60	$226.20	$12.61–$219.41	67% above	29%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST	$160.60	$226.20	$12.61–$219.41	—	29%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRIHOEAE NAAT	$124.25	$175.00	$34.39–$169.75	47% above	29%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRIHOEAE NAAT	$124.25	$175.00	$34.39–$169.75	—	29%
H. pylori antibody blood test CPT 86677 H PYLORI IgG	$96.56	$136.00	$16.51–$131.92	18% below	29%
H. pylori antibody blood test CPT 86677 H PYLORI IgM	$96.56	$136.00	$16.51–$131.92	18% below	29%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IgG	$96.56	$136.00	$16.51–$131.92	—	29%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IgM	$96.56	$136.00	$16.51–$131.92	—	29%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI, STOOL	$230.04	$324.00	$14.09–$314.28	112% above	29%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI, STOOL	$230.04	$324.00	$14.09–$314.28	—	29%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANTIFICATION	$465.33	$655.40	$83.40–$635.74	305% above	29%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANTIFICATION	$465.33	$655.40	$83.40–$635.74	—	29%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV I/II	$39.05	$55.00	$23.60–$53.35	38% below	29%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV I/II	$39.05	$55.00	$23.60–$53.35	—	29%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV	$136.32	$192.00	$34.39–$186.24	6% above	29%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV	$136.32	$192.00	$34.39–$186.24	—	29%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCATED	$71.00	$100.00	$9.52–$97.00	23% above	29%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCATED	$71.00	$100.00	$9.52–$97.00	—	29%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$87.33	$123.00	$10.53–$119.31	33% above	29%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY	$87.33	$123.00	$10.53–$119.31	—	29%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$86.62	$122.00	$10.12–$118.34	63% above	29%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$86.62	$122.00	$10.12–$118.34	—	29%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$108.63	$153.00	$13.98–$148.41	36% above	29%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$108.63	$153.00	$13.98–$148.41	—	29%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV PCR QUANT	$517.24	$728.50	$41.98–$706.64	317% above	29%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV PCR QUANT	$517.24	$728.50	$41.98–$706.64	—	29%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE I	$85.77	$120.80	$12.93–$117.18	85% above	29%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE I	$85.77	$120.80	$12.93–$117.18	—	29%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES II AB	$102.17	$143.90	$18.96–$139.58	77% above	29%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES II AB	$102.17	$143.90	$18.96–$139.58	—	29%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP hs	$94.79	$133.50	$12.69–$129.50	34% above	29%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP hs	$94.79	$133.50	$12.69–$129.50	—	29%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTINE	$212.50	$299.30	$17.56–$290.32	137% above	29%
Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTINE	$212.50	$299.30	$17.56–$290.32	—	29%
Insulin blood test CPT 83525 INSULIN TOTAL	$75.26	$106.00	$11.20–$102.82	37% above	29%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$75.26	$106.00	$11.20–$102.82	—	29%
Iron blood test (serum iron) CPT 83540 IRON	$73.84	$104.00	$6.34–$100.88	44% above	29%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$73.84	$104.00	$6.34–$100.88	—	29%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$81.86	$115.30	$8.57–$111.84	27% above	29%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$81.86	$115.30	$8.57–$111.84	—	29%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$211.58	$298.00	$8.51–$289.06	100% above	29%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$211.58	$298.00	$8.51–$289.06	—	29%
LH (luteinizing hormone) test CPT 83002 LH	$102.95	$145.00	$18.15–$140.65	27% above	29%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$102.95	$145.00	$18.15–$140.65	—	29%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$78.81	$111.00	$6.75–$107.67	33% above	29%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$78.81	$111.00	$6.75–$107.67	—	29%
Liver function blood test panel CPT 80076 LIVER PANEL	$123.54	$174.00	$8.01–$168.78	21% above	29%
Liver function blood test panel inpatient CPT 80076 LIVER PANEL	$123.54	$174.00	$8.01–$168.78	—	29%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI	$147.68	$208.00	$16.69–$201.76	129% above	29%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI, IGG	$147.68	$208.00	$16.69–$201.76	129% above	29%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI, TOTAL AB	$147.68	$208.00	$16.69–$201.76	129% above	29%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI, IGM	$147.68	$208.00	$16.69–$201.76	129% above	29%
Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI	$147.68	$208.00	$16.69–$201.76	—	29%
Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI, TOTAL AB	$147.68	$208.00	$16.69–$201.76	—	29%
Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI, IGG	$147.68	$208.00	$16.69–$201.76	—	29%
Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI, IGM	$147.68	$208.00	$16.69–$201.76	—	29%
Magnesium blood test CPT 83735 MAGNESIUM RBC	$81.65	$115.00	$6.57–$111.55	162% above	29%
Magnesium blood test CPT 83735 MAGNESIUM	$81.65	$115.00	$6.57–$111.55	162% above	29%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC	$81.65	$115.00	$6.57–$111.55	—	29%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$81.65	$115.00	$6.57–$111.55	—	29%
Measles (rubeola) antibody test CPT 86765 RUBEOLA	$13.49	$19.00	$9.87–$18.43	63% below	29%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA	$13.49	$19.00	$9.87–$18.43	—	29%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$58.22	$82.00	$5.08–$79.54	14% above	29%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$58.22	$82.00	$5.08–$79.54	—	29%
Obstetric blood test panel CPT 80055 PRENATAL PROFILE	$288.26	$406.00	$46.85–$393.82	9% above	29%
Obstetric blood test panel inpatient CPT 80055 PRENATAL PROFILE	$288.26	$406.00	$46.85–$393.82	—	29%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE	$106.00	$149.30	$18.02–$144.82	195% above	29%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE	$106.00	$149.30	$18.02–$144.82	—	29%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$115.02	$162.00	$18.02–$157.14	42% above	29%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$115.02	$162.00	$18.02–$157.14	—	29%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR DIAGNOSTIC	$83.07	$117.00	$19.85–$113.49	8% above	29%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR THIN PREP SCREEN	$83.07	$117.00	$19.85–$113.49	8% above	29%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR DIAGNOSTIC	$83.07	$117.00	$19.85–$113.49	—	29%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR THIN PREP SCREEN	$83.07	$117.00	$19.85–$113.49	—	29%
Parathyroid hormone (PTH) blood test CPT 83970 PTH	$257.80	$363.10	$40.45–$352.21	120% above	29%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH	$257.80	$363.10	$40.45–$352.21	—	29%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT/THROMBOPLASTIN	$73.13	$103.00	$5.89–$99.91	24% above	29%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT/THROMBOPLASTIN	$73.13	$103.00	$5.89–$99.91	—	29%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MATERNIT21 PLUS	$853.49	$1,202.10	$624.53–$1,166.04	38% below	29%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MATERNIT21 PLUS	$853.49	$1,202.10	$624.53–$1,166.04	—	29%
Progesterone blood test CPT 84144 PROGESTERONE	$153.15	$215.70	$20.44–$209.23	90% above	29%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$153.15	$215.70	$20.44–$209.23	—	29%
Prolactin blood test CPT 84146 PROLACTIN	$108.63	$153.00	$18.99–$148.41	66% above	29%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$108.63	$153.00	$18.99–$148.41	—	29%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$46.15	$65.00	$4.20–$63.05	52% above	29%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$46.15	$65.00	$4.20–$63.05	—	29%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A	$50.55	$71.20	$16.22–$69.06	10% below	29%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B	$50.55	$71.20	$16.22–$69.06	10% below	29%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA RAPID TEST	$85.77	$120.80	$16.22–$117.18	53% above	29%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A	$50.55	$71.20	$16.22–$69.06	—	29%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B	$50.55	$71.20	$16.22–$69.06	—	29%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA RAPID TEST	$85.77	$120.80	$16.22–$117.18	—	29%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN	$81.01	$114.10	$16.20–$110.68	52% above	29%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP SCREEN	$81.01	$114.10	$16.20–$110.68	—	29%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR; QUANT	$57.51	$81.00	$5.56–$78.57	19% above	29%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR; QUANT	$57.51	$81.00	$5.56–$78.57	—	29%
Rubella antibody test (immunity check) CPT 86762 RUBEOLA, IgM	$62.48	$88.00	$14.10–$85.36	32% above	29%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$62.48	$88.00	$14.10–$85.36	32% above	29%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBEOLA, IgM	$62.48	$88.00	$14.10–$85.36	—	29%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$62.48	$88.00	$14.10–$85.36	—	29%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE	$40.47	$57.00	$2.65–$55.29	7% above	29%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE	$40.47	$57.00	$2.65–$55.29	—	29%
Stool ova and parasites exam CPT 87177 OVA & PARASITE	$104.02	$146.50	$8.72–$142.10	195% above	29%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITE	$104.02	$146.50	$8.72–$142.10	—	29%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLD FHG QUAL 1-3	$80.23	$113.00	$15.60–$109.61	39% above	29%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLD FHG QUAL 1-3	$80.23	$113.00	$15.60–$109.61	—	29%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST; RPR	$43.31	$61.00	$4.18–$59.17	46% above	29%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST; RPR	$43.31	$61.00	$4.18–$59.17	—	29%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST BY GAMMA INTERFERON	$203.13	$286.10	$60.74–$277.52	65% above	29%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST BY GAMMA INTERFERON	$203.13	$286.10	$60.74–$277.52	—	29%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$117.86	$166.00	$25.29–$161.02	88% above	29%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$117.86	$166.00	$25.29–$161.02	—	29%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EACH	$73.13	$103.00	$14.26–$99.91	39% above	29%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE	$74.41	$104.80	$14.26–$101.66	41% above	29%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES EACH	$73.13	$103.00	$14.26–$99.91	—	29%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE	$74.41	$104.80	$14.26–$101.66	—	29%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$105.79	$149.00	$16.46–$144.53	13% above	29%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$105.79	$149.00	$16.46–$144.53	—	29%
Trichomonas test (NAAT) CPT 87661 TRICHOMANAS, NAA	$114.38	$161.10	$34.39–$156.27	128% above	29%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMANAS, NAA	$114.38	$161.10	$34.39–$156.27	—	29%
Uric acid blood test CPT 84550 URIC ACID; BLOOD	$48.99	$69.00	$4.43–$66.93	13% above	29%
Uric acid blood test inpatient CPT 84550 URIC ACID; BLOOD	$48.99	$69.00	$4.43–$66.93	—	29%
Urinalysis with microscope exam, automated CPT 81001 COMP URINALYSIS	$56.09	$79.00	$3.11–$76.63	13% above	29%
Urinalysis with microscope exam, automated inpatient CPT 81001 COMP URINALYSIS	$56.09	$79.00	$3.11–$76.63	—	29%
Urinalysis without microscope exam, automated CPT 81003 URINE PROTEIN/GLUCOSE SCREEN	$36.21	$51.00	$2.20–$49.47	42% above	29%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS PARTIAL	$36.21	$51.00	$2.20–$49.47	42% above	29%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS PARTIAL	$36.21	$51.00	$2.20–$49.47	—	29%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE PROTEIN/GLUCOSE SCREEN	$36.21	$51.00	$2.20–$49.47	—	29%
Urine culture for bacteria, with colony count CPT 87086 CULTURE - URINE	$105.01	$147.90	$7.91–$143.46	91% above	29%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE - URINE	$105.01	$147.90	$7.91–$143.46	—	29%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY QUALITATIVE	$100.39	$141.40	$8.44–$137.16	158% above	29%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY QUALITATIVE	$100.39	$141.40	$8.44–$137.16	—	29%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$140.58	$198.00	$14.78–$192.06	58% above	29%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$140.58	$198.00	$14.78–$192.06	—	29%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALCIFEDIOL (VIT D, 25)	$178.21	$251.00	$29.01–$243.47	83% above	29%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CALCIFEDIOL (VIT D, 25)	$178.21	$251.00	$29.01–$243.47	—	29%
Zinc blood test CPT 84630 ZINC LEVEL	$110.48	$155.60	$11.16–$150.93	267% above	29%
Zinc blood test inpatient CPT 84630 ZINC LEVEL	$110.48	$155.60	$11.16–$150.93	—	29%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC hCG	$166.21	$234.10	$14.75–$227.08	80% above	29%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 TUMOR MARKER HCG	$166.21	$234.10	$14.75–$227.08	80% above	29%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 TUMOR MARKER HCG	$166.21	$234.10	$14.75–$227.08	—	29%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIONIC hCG	$166.21	$234.10	$14.75–$227.08	—	29%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDEC RPTD APPENDIX ABSC	$1,811.00	$2,550.70	$839.76–$2,474.18	11% above	29%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY RUPTURED APDX	$5,172.28	$7,284.90	$3,600.61–$7,066.35	217% above	29%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDEC RPTD APPENDIX ABSC	$1,811.00	$2,550.70	$839.76–$2,474.18	—	29%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDECTOMY RUPTURED APDX	$5,172.28	$7,284.90	$3,600.61–$7,066.35	—	29%
Appendectomy, open surgery CPT 44950 APPENDIC	$1,947.46	$2,742.90	$618.95–$2,660.61	75% above	29%
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$3,216.80	$4,530.70	$2,239.32–$4,394.78	189% above	29%
Appendectomy, open surgery inpatient CPT 44950 APPENDIC	$1,947.46	$2,742.90	$618.95–$2,660.61	—	29%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$3,216.80	$4,530.70	$2,239.32–$4,394.78	—	29%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 KNEE ARTHROSCOPY LIGAMENT REPR	$5,461.46	$7,692.20	$3,801.93–$7,461.43	61% above	29%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 KNEE ARTHROSCOPY LIGAMENT REPR	$5,461.46	$7,692.20	$3,801.93–$7,461.43	—	29%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOPY SHOULDER	$3,121.94	$4,397.10	$1,031.46–$4,265.19	22% above	29%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 SHOULDER ARTHROSCOPY W/ROT CUF	$4,780.36	$6,732.90	$3,327.78–$6,530.91	86% above	29%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 ARTHROSCOPY SHOULDER	$3,121.94	$4,397.10	$1,031.46–$4,265.19	—	29%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 SHOULDER ARTHROSCOPY W/ROT CUF	$4,780.36	$6,732.90	$3,327.78–$6,530.91	—	29%
Botox injections for chronic migraine CPT 64615 CHEMODERVATE FACIAL	$415.85	$585.70	$289.49–$568.13	31% below	29%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODERVATE FACIAL	$415.85	$585.70	$289.49–$568.13	—	29%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS	$579.43	$816.10	$322.37–$791.62	24% above	29%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS	$579.43	$816.10	$322.37–$791.62	—	29%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLTX METAR FX W/O MNPJ	$434.80	$612.40	$231.93–$594.03	17% above	29%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLTX METAR FX W/O MNPJ	$434.80	$612.40	$231.93–$594.03	—	29%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 BUNION CORRECTION	$3,478.93	$4,899.90	$2,421.81–$4,752.90	112% above	29%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 BUNION CORRECTION	$3,478.93	$4,899.90	$2,421.81–$4,752.90	—	29%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRECTION OF BUNION	$2,965.74	$4,177.10	$2,064.54–$4,051.79	104% above	29%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORRECTION OF BUNION	$2,965.74	$4,177.10	$2,064.54–$4,051.79	—	29%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$973.13	$1,370.60	$677.43–$1,329.48	5% below	29%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE HOSP	$973.13	$1,370.60	$677.43–$1,329.48	5% below	29%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE ER	$973.13	$1,370.60	$677.43–$1,329.48	5% below	29%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE HOSP	$973.13	$1,370.60	$677.43–$1,329.48	—	29%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$973.13	$1,370.60	$677.43–$1,329.48	—	29%
Carpal tunnel release, open surgery CPT 64721 CARPEL TUNNEL SURGERY	$2,469.10	$3,477.60	$1,718.81–$3,373.27	69% above	29%
Carpal tunnel release, open surgery CPT 64721 NEURP&/TRPOS MEDIAN NRV CARPL	$2,778.80	$3,913.80	$458.16–$3,796.39	90% above	29%
Carpal tunnel release, open surgery inpatient CPT 64721 CARPEL TUNNEL SURGERY	$2,469.10	$3,477.60	$1,718.81–$3,373.27	—	29%
Carpal tunnel release, open surgery inpatient CPT 64721 NEURP&/TRPOS MEDIAN NRV CARPL	$2,778.80	$3,913.80	$458.16–$3,796.39	—	29%
Cataract surgery with lens implant CPT 66984 CATARACT SURGERY W/IOL	$2,910.08	$4,098.70	$2,025.81–$3,975.74	19% below	29%
Cataract surgery with lens implant inpatient CPT 66984 CATARACT SURGERY W/IOL	$2,910.08	$4,098.70	$2,025.81–$3,975.74	—	29%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION	$2,821.26	$3,973.60	$1,963.98–$3,854.39	105% above	29%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION	$2,821.26	$3,973.60	$1,963.98–$3,854.39	—	29%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DSTL RADIAL FX	$552.45	$778.10	$384.58–$754.76	12% above	29%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL S	$552.45	$778.10	$384.58–$754.76	12% above	29%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS	$764.32	$1,076.50	$378.51–$1,044.20	55% above	29%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLTX DSTL RADIAL FX	$552.45	$778.10	$384.58–$754.76	—	29%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREAT FRACTURE RADIUS	$764.32	$1,076.50	$378.51–$1,044.20	—	29%
Colonoscopy with polyp removal CPT 45385 COLSC FLX PROX REML SNARE TQ	$1,337.14	$1,883.30	$240.20–$1,826.80	7% above	29%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY LESION REM W/SNR	$2,430.12	$3,422.70	$1,691.68–$3,320.02	95% above	29%
Colonoscopy with polyp removal inpatient CPT 45385 COLSC FLX PROX REML SNARE TQ	$1,337.14	$1,883.30	$240.20–$1,826.80	—	29%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY LESION REM W/SNR	$2,430.12	$3,422.70	$1,691.68–$3,320.02	—	29%
Colonoscopy with tissue sample CPT 45380 SCOPE OF COLON WITH BIOPSY	$1,038.45	$1,462.60	$190.69–$1,418.72	17% below	29%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY WITH BIOPSY	$2,317.09	$3,263.50	$1,613.00–$3,165.60	85% above	29%
Colonoscopy with tissue sample inpatient CPT 45380 SCOPE OF COLON WITH BIOPSY	$1,038.45	$1,462.60	$190.69–$1,418.72	—	29%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY WITH BIOPSY	$2,317.09	$3,263.50	$1,613.00–$3,165.60	—	29%
Colonoscopy, diagnostic CPT 45378 SCOPE OF COLON FOR DIAGNOSIS	$944.37	$1,330.10	$176.17–$1,290.20	22% below	29%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY DIAGNOSTIC	$1,741.84	$2,453.30	$1,212.56–$2,379.70	44% above	29%
Colonoscopy, diagnostic inpatient CPT 45378 SCOPE OF COLON FOR DIAGNOSIS	$944.37	$1,330.10	$176.17–$1,290.20	—	29%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY DIAGNOSTIC	$1,741.84	$2,453.30	$1,212.56–$2,379.70	—	29%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELT	$2,384.96	$3,359.10	$1,660.25–$3,258.33	231% above	29%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELT	$2,384.96	$3,359.10	$1,660.25–$3,258.33	—	29%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$891.55	$1,255.70	$620.63–$1,218.03	19% above	29%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$891.55	$1,255.70	$620.63–$1,218.03	—	29%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE	$2,486.85	$3,502.60	$1,731.18–$3,397.52	72% above	29%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURETTAGE	$2,486.85	$3,502.60	$1,731.18–$3,397.52	—	29%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTROY BENIGN PRELLG LESION	$145.83	$205.40	$101.52–$199.24	19% below	29%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESIO	$174.80	$246.20	$53.10–$238.81	3% below	29%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTROY BENIGN PRELLG LESION	$145.83	$205.40	$101.52–$199.24	—	29%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGNANT LESIO	$174.80	$246.20	$53.10–$238.81	—	29%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING	$351.45	$495.00	$131.20–$480.15	18% below	29%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 CREATE EARDRUM OPENING	$351.45	$495.00	$131.20–$480.15	—	29%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN	$172.25	$242.60	$19.47–$235.32	123% above	29%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN	$172.25	$242.60	$119.90–$235.32	123% above	29%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL IMPACTED CERUMEN	$172.25	$242.60	$19.47–$235.32	—	29%
Earwax removal with instruments, one ear CPT 69210 EAR WAX REMOVAL	$115.38	$162.50	$28.79–$157.62	6% below	29%
Earwax removal with instruments, one ear CPT 69210 EAR WAX REMOVAL	$115.38	$162.50	$80.32–$157.62	6% below	29%
Earwax removal with instruments, one ear inpatient CPT 69210 EAR WAX REMOVAL	$115.38	$162.50	$28.79–$157.62	—	29%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECT SPINE CERVICAL/THORACIC	$1,554.55	$2,189.50	$1,082.18–$2,123.82	55% above	29%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECT SPINE CERVICAL/THORACIC	$1,554.55	$2,189.50	$1,082.18–$2,123.82	—	29%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 LUMBAR SPINE INJ 1ST LVL	$431.54	$607.80	$89.03–$589.57	69% below	29%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 LUMBAR SPINE FACET INJ 1ST LVL	$912.21	$1,284.80	$635.02–$1,246.26	34% below	29%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 LUMBAR SPINE INJ 1ST LVL	$431.54	$607.80	$89.03–$589.57	—	29%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 LUMBAR SPINE FACET INJ 1ST LVL	$912.21	$1,284.80	$635.02–$1,246.26	—	29%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HRN 1ST 3-10 REDUCIBLE	$9,812.20	$13,820.00	$6,830.60–$13,405.40	531% above	29%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 RPR AA HRN 1ST 3-10 REDUCIBLE	$9,812.20	$13,820.00	$6,830.60–$13,405.40	—	29%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HERNIA 1ST>10CM RDC	$10,530.72	$14,832.00	$7,330.80–$14,387.04	510% above	29%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 RPR AA HERNIA 1ST>10CM RDC	$10,530.72	$14,832.00	$7,330.80–$14,387.04	—	29%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR AA HERNIA 1ST <3 CM RDC	$4,095.28	$5,768.00	$2,850.85–$5,594.96	167% above	29%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 REPAIR AA HERNIA 1ST <3 CM RDC	$4,095.28	$5,768.00	$2,850.85–$5,594.96	—	29%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY DIAGNOSTIC	$704.46	$992.20	$490.40–$962.43	18% below	29%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY DIAGNOSTIC	$704.46	$992.20	$490.40–$962.43	—	29%
Gallbladder removal, laparoscopic CPT 47562 LAPS SURG CHOLECSTC	$3,042.56	$4,285.30	$648.03–$4,156.74	84% above	29%
Gallbladder removal, laparoscopic CPT 47562 CHOLECYSTECTOMY LAPAROSCOPIC	$5,993.04	$8,440.90	$4,171.95–$8,187.67	262% above	29%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPS SURG CHOLECSTC	$3,042.56	$4,285.30	$648.03–$4,156.74	—	29%
Gallbladder removal, laparoscopic inpatient CPT 47562 CHOLECYSTECTOMY LAPAROSCOPIC	$5,993.04	$8,440.90	$4,171.95–$8,187.67	—	29%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY	$4,724.84	$6,654.70	$3,289.11–$6,455.06	175% above	29%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLECYSTECTOMY	$4,724.84	$6,654.70	$3,289.11–$6,455.06	—	29%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE	$2,188.15	$3,081.90	$1,523.25–$2,989.44	7% below	29%
Hammertoe correction surgery inpatient CPT 28285 REPAIR OF HAMMERTOE	$2,188.15	$3,081.90	$1,523.25–$2,989.44	—	29%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY SMPL	$486.71	$685.50	$216.09–$664.94	40% below	29%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY SMPL LIGATURE	$646.95	$911.20	$450.37–$883.86	20% below	29%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY SMPL	$486.71	$685.50	$216.09–$664.94	—	29%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY SMPL LIGATURE	$646.95	$911.20	$450.37–$883.86	—	29%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 CONV PREV HIP TOT HIP	$7,751.43	$10,917.50	$5,396.04–$10,589.98	66% above	29%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 CONV PREV HIP TOT HIP	$7,751.43	$10,917.50	$5,396.04–$10,589.98	—	29%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTSC BX ENDOMETRIUM&/POLYPC	$2,985.98	$4,205.60	$2,078.64–$4,079.43	35% above	29%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTSC BX ENDOMETRIUM&/POLYPC	$2,985.98	$4,205.60	$2,078.64–$4,079.43	—	29%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION INTRAUTERINE	$691.40	$973.80	$481.29–$944.59	173% above	29%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION INTRAUTERINE	$691.40	$973.80	$481.29–$944.59	—	29%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE	$226.28	$318.70	$111.71–$309.14	21% below	29%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE	$228.19	$321.40	$158.86–$311.76	21% below	29%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS	$228.19	$321.40	$158.86–$311.76	21% below	29%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS	$233.09	$328.30	$111.71–$318.45	19% below	29%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE	$226.28	$318.70	$111.71–$309.14	—	29%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINAGE	$228.19	$321.40	$158.86–$311.76	—	29%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABSCESS	$233.09	$328.30	$111.71–$318.45	—	29%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR 1ST INGUN HERNIA	$1,947.46	$2,742.90	$524.11–$2,660.61	12% above	29%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HERNIA REPAIR > 5 YEARS	$4,041.18	$5,691.80	$2,813.20–$5,521.05	132% above	29%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 RPR 1ST INGUN HERNIA	$1,947.46	$2,742.90	$524.11–$2,660.61	—	29%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HERNIA REPAIR > 5 YEARS	$4,041.18	$5,691.80	$2,813.20–$5,521.05	—	29%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON	$77.60	$109.30	$54.03–$106.02	79% below	29%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 LIGAMENT TENDON INJECTION	$117.22	$165.10	$35.46–$160.15	68% below	29%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIAGMENT	$280.45	$395.00	$195.22–$383.15	24% below	29%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 LIGAMENT TENDON INJECTION	$117.22	$165.10	$35.46–$160.15	—	29%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIAGMENT	$280.45	$395.00	$195.22–$383.15	—	29%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHRO ASPIR&/NJX MAJOR JT	$152.30	$214.50	$41.67–$208.06	58% below	29%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECTION MAJOR JOINT	$234.73	$330.60	$163.39–$320.68	35% below	29%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN INJECT JOINT	$234.73	$330.60	$163.39–$320.68	35% below	29%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCNTS ASPIR/NJX MAJOR JT	$234.73	$330.60	$163.39–$320.68	35% below	29%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHRO ASPIR&/NJX MAJOR JT	$152.30	$214.50	$41.67–$208.06	—	29%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJECTION MAJOR JOINT	$234.73	$330.60	$163.39–$320.68	—	29%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCNTS ASPIR/NJX MAJOR JT	$234.73	$330.60	$163.39–$320.68	—	29%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG IMPLANT	$530.23	$746.80	$369.11–$724.40	92% above	29%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG IMPLANT	$530.23	$746.80	$369.11–$724.40	—	29%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECT JOINT BURSA	$77.60	$109.30	$54.03–$106.02	75% below	29%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 JOINT/BURSA DRAIN/INJECTION	$125.10	$176.20	$34.26–$170.91	59% below	29%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCNTS ASPIR/NJX INTRM JT	$209.45	$295.00	$145.81–$286.15	31% below	29%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 JOINT/BURSA DRAIN/INJECTTION	$209.45	$295.00	$145.81–$286.15	31% below	29%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECT JOINT BURSA	$209.45	$295.00	$145.81–$286.15	31% below	29%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 JOINT/BURSA DRAIN/INJECTION	$125.10	$176.20	$34.26–$170.91	—	29%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJECT JOINT BURSA	$209.45	$295.00	$145.81–$286.15	—	29%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 JOINT/BURSA DRAIN/INJECTTION	$209.45	$295.00	$145.81–$286.15	—	29%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATION	$120.77	$170.10	$33.51–$165.00	63% below	29%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCNTS ASPIR/NJX SM JT	$124.39	$175.20	$33.51–$169.94	62% below	29%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJECTION SMALL JOINT	$209.45	$295.00	$145.81–$286.15	35% below	29%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATION/INJ	$209.45	$295.00	$145.81–$286.15	35% below	29%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATION	$120.77	$170.10	$33.51–$165.00	—	29%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCNTS ASPIR/NJX SM JT	$124.39	$175.20	$33.51–$169.94	—	29%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATION/INJ	$209.45	$295.00	$145.81–$286.15	—	29%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 INJECTION SMALL JOINT	$209.45	$295.00	$145.81–$286.15	—	29%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ARTHRS KNEE SURG	$4,097.62	$5,771.30	$2,852.49–$5,598.16	69% above	29%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHRS KNEE SURG	$4,097.62	$5,771.30	$2,852.49–$5,598.16	—	29%
Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY MEDIAL & LAT	$4,360.96	$6,142.20	$3,035.83–$5,957.93	125% above	29%
Knee arthroscopy with meniscus trim inpatient CPT 29881 KNEE ARTHROSCOPY MEDIAL & LAT	$4,360.96	$6,142.20	$3,035.83–$5,957.93	—	29%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHR KNE SURG W/MENISCECTOMY	$2,378.78	$3,350.40	$569.76–$3,249.89	at median	29%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY MEDIAL OR LAT	$4,895.38	$6,894.90	$3,407.84–$6,688.05	106% above	29%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHR KNE SURG W/MENISCECTOMY	$2,378.78	$3,350.40	$569.76–$3,249.89	—	29%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 KNEE ARTHROSCOPY MEDIAL OR LAT	$4,895.38	$6,894.90	$3,407.84–$6,688.05	—	29%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE ARTHROSCOPY DEBRIDEMENT	$3,379.81	$4,760.30	$2,352.81–$4,617.49	89% above	29%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 KNEE ARTHROSCOPY DEBRIDEMENT	$3,379.81	$4,760.30	$2,352.81–$4,617.49	—	29%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPROSCOPY APPENDECTOMY	$3,903.08	$5,497.30	$2,717.07–$5,332.38	198% above	29%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPROSCOPY APPENDECTOMY	$3,903.08	$5,497.30	$2,717.07–$5,332.38	—	29%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 AFTER CATARACT LASER SURGERY	$1,556.60	$2,192.40	$1,083.60–$2,126.63	2% above	29%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 AFTER CATARACT LASER SURGERY	$1,556.60	$2,192.40	$1,083.60–$2,126.63	—	29%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LYR CLSR S/A/T/E 2.5 CM	$323.26	$455.30	$146.07–$441.64	29% below	29%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE OF WOUND	$368.99	$519.70	$256.86–$504.11	19% below	29%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2	$368.99	$519.70	$256.86–$504.11	19% below	29%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LYR CLSR S/A/T/E/ 2.5 CM	$368.99	$519.70	$256.86–$504.11	19% below	29%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LYR CLSR S/A/T/E 2.5 CM	$323.26	$455.30	$146.07–$441.64	—	29%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LYR CLSR S/A/T/E/ 2.5 CM	$368.99	$519.70	$256.86–$504.11	—	29%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2	$368.99	$519.70	$256.86–$504.11	—	29%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECT SPINE W/CATH LMB/SCRL	$1,554.55	$2,189.50	$1,082.18–$2,123.82	59% above	29%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECT SPINE W/CATH LMB/SCRL	$1,554.55	$2,189.50	$1,082.18–$2,123.82	—	29%
Lower-back epidural injection, without imaging guidance CPT 62322 INJECT SPINE W/CATH CRV/THRC	$657.74	$926.40	$457.88–$898.61	37% below	29%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECT SPINE W/CATH CRV/THRC	$657.74	$926.40	$457.88–$898.61	—	29%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 L-S TRANSFORAMEN ESI	$575.74	$810.90	$108.72–$786.57	55% below	29%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 LUMBAR OR SACRAL SINGLE LEVEL	$1,773.51	$2,497.90	$1,234.60–$2,422.96	37% above	29%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 L-S TRANSFORAMEN ESI	$575.74	$810.90	$108.72–$786.57	—	29%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 LUMBAR OR SACRAL SINGLE LEVEL	$1,773.51	$2,497.90	$1,234.60–$2,422.96	—	29%
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PRTL	$4,057.79	$5,715.20	$2,824.75–$5,543.74	175% above	29%
Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PRTL	$4,057.79	$5,715.20	$2,824.75–$5,543.74	—	29%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMPLE COMPLETE	$5,150.20	$7,253.80	$3,585.23–$7,036.19	93% above	29%
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SIMPLE COMPLETE	$5,150.20	$7,253.80	$3,585.23–$7,036.19	—	29%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION OF LESION < .5 cm	$488.41	$687.90	$340.00–$667.26	21% above	29%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LEX MRGN XCP SK TG	$488.41	$687.90	$340.00–$667.26	21% above	29%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B9 LEX MRGN XCP SK TG	$488.41	$687.90	$340.00–$667.26	—	29%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION OF LESION < .5 cm	$488.41	$687.90	$340.00–$667.26	—	29%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC B9 LES MRGN XCP SK TG	$255.67	$360.10	$109.34–$349.30	52% below	29%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION OF LESION <.5 cm F	$488.41	$687.90	$340.00–$667.26	7% below	29%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC B9 LES MRGN XCP SK TG	$255.67	$360.10	$109.34–$349.30	—	29%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION OF LESION <.5 cm F	$488.41	$687.90	$340.00–$667.26	—	29%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$204.05	$287.40	$142.05–$278.78	27% below	29%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$204.05	$287.40	$142.05–$278.78	27% below	29%
Nail removal (partial or complete), one nail CPT 11730 AVLSN NAIL PLATE	$219.75	$309.50	$53.22–$300.22	21% below	29%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE	$204.05	$287.40	$142.05–$278.78	—	29%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVLSN NAIL PLATE	$219.75	$309.50	$53.22–$300.22	—	29%
Occipital nerve block (injection for headaches) CPT 64405 OCCIPITAL NERVE BLOCK PC	$215.91	$304.10	$46.66–$294.98	64% below	29%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION GREATER OCCIPITAL NV	$686.71	$967.20	$478.05–$938.18	14% above	29%
Occipital nerve block (injection for headaches) inpatient CPT 64405 OCCIPITAL NERVE BLOCK PC	$215.91	$304.10	$46.66–$294.98	—	29%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION GREATER OCCIPITAL NV	$686.71	$967.20	$478.05–$938.18	—	29%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,188.75	$1,674.30	$827.53–$1,624.07	36% above	29%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,212.04	$1,707.10	$843.73–$1,655.89	39% above	29%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$1,212.04	$1,707.10	$843.73–$1,655.89	—	29%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$342.29	$482.10	$103.68–$467.64	32% below	29%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL MATRIX	$442.05	$622.60	$103.68–$603.92	12% below	29%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL BED REMOVAL	$470.09	$662.10	$327.25–$642.24	6% below	29%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED	$342.29	$482.10	$103.68–$467.64	—	29%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL MATRIX	$442.05	$622.60	$103.68–$603.92	—	29%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 NAIL BED REMOVAL	$470.09	$662.10	$327.25–$642.24	—	29%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DSTR NROLYTC AGNT PARV	$2,496.08	$3,515.60	$1,737.60–$3,410.13	19% above	29%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DSTR NROLYTC AGNT PARV	$2,496.08	$3,515.60	$1,737.60–$3,410.13	—	29%
Removal of a breast lump, open surgery CPT 19120 EXC CYST BREAST TISSUE	$765.10	$1,077.60	$426.63–$1,045.27	48% below	29%
Removal of a breast lump, open surgery CPT 19120 EXC CYST/ABERRANT BREAST TISSU	$2,421.46	$3,410.50	$1,685.65–$3,308.18	64% above	29%
Removal of a breast lump, open surgery CPT 19120 BREAST LESION REMOVAL	$3,686.46	$5,192.20	$2,566.27–$5,036.43	149% above	29%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST BREAST TISSUE	$765.10	$1,077.60	$426.63–$1,045.27	—	29%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST/ABERRANT BREAST TISSU	$2,421.46	$3,410.50	$1,685.65–$3,308.18	—	29%
Removal of a breast lump, open surgery inpatient CPT 19120 BREAST LESION REMOVAL	$3,686.46	$5,192.20	$2,566.27–$5,036.43	—	29%
Removal of a foreign object under the skin, simple CPT 10120 INC & RMVL OF FB SUBQ	$225.99	$318.30	$113.37–$308.75	44% below	29%
Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL OF FB	$309.84	$436.40	$215.68–$423.31	23% below	29%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOR	$309.84	$436.40	$215.68–$423.31	23% below	29%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC & RMVL OF FB SUBQ	$225.99	$318.30	$113.37–$308.75	—	29%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOR	$309.84	$436.40	$215.68–$423.31	—	29%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING	$1,777.13	$2,503.00	$1,237.12–$2,427.91	62% above	29%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLORECTAL CANCER SCREENING	$1,777.13	$2,503.00	$1,237.12–$2,427.91	—	29%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING	$868.40	$1,223.10	$176.17–$1,186.41	26% below	29%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREEN HIRSK	$1,792.82	$2,525.10	$1,248.04–$2,449.35	52% above	29%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL CANCER SCREENING	$868.40	$1,223.10	$176.17–$1,186.41	—	29%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL CANCER SCREEN HIRSK	$1,792.82	$2,525.10	$1,248.04–$2,449.35	—	29%
Short arm cast (elbow to hand) CPT 29075 CAST APPLICATION ELBOW TO FING	$334.77	$471.50	$233.05–$457.36	42% above	29%
Short arm cast (elbow to hand) CPT 29075 APPL CST ELBW FNGR SHORT ARM	$334.77	$471.50	$233.05–$457.36	42% above	29%
Short arm cast (elbow to hand) CPT 29075 CAST APPLICATION ELBOW TO FING	$334.77	$471.50	$233.05–$457.36	42% above	29%
Short arm cast (elbow to hand) inpatient CPT 29075 APPL CST ELBW FNGR SHORT ARM	$334.77	$471.50	$233.05–$457.36	—	29%
Short arm cast (elbow to hand) inpatient CPT 29075 CAST APPLICATION ELBOW TO FING	$334.77	$471.50	$233.05–$457.36	—	29%
Short arm splint (forearm and hand) CPT 29125 SPLINT APPLICATION SHORT ARM	$178.14	$250.90	$124.01–$243.37	10% below	29%
Short arm splint (forearm and hand) CPT 29125 APPL SHORT ARM SPLINT	$282.51	$397.90	$196.68–$385.96	42% above	29%
Short arm splint (forearm and hand) inpatient CPT 29125 APPL SHORT ARM SPLINT	$282.51	$397.90	$196.68–$385.96	—	29%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG	$236.86	$333.60	$60.25–$323.59	13% below	29%
Short leg cast (below the knee) CPT 29405 CAST SHORT LEG APPLICATION	$355.14	$500.20	$247.22–$485.19	30% above	29%
Short leg cast (below the knee) CPT 29405 CAST SHORT LEG APPLICATION	$355.14	$500.20	$247.22–$485.19	30% above	29%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG	$236.86	$333.60	$60.25–$323.59	—	29%
Short leg cast (below the knee) inpatient CPT 29405 CAST SHORT LEG APPLICATION	$355.14	$500.20	$247.22–$485.19	—	29%
Short leg splint (calf to foot) CPT 29515 APPL SHORT LEG SPLNT CALF FOOT	$127.94	$180.20	$53.63–$174.79	43% below	29%
Short leg splint (calf to foot) CPT 29515 APPL SHORT LEG SPLNT CALF FOOT	$131.85	$185.70	$53.63–$180.13	41% below	29%
Short leg splint (calf to foot) CPT 29515 SPLINT APPLICATION SHORT LEG	$236.64	$333.30	$164.74–$323.30	6% above	29%
Short leg splint (calf to foot) inpatient CPT 29515 APPL SHORT LEG SPLNT CALF FOOT	$127.94	$180.20	$53.63–$174.79	—	29%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SHOULDER ARTHROSCOPY DISTAL CL	$2,188.15	$3,081.90	$1,523.25–$2,989.44	3% above	29%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 SHOULDER ARTHROSCOPY DISTAL CL	$2,188.15	$3,081.90	$1,523.25–$2,989.44	—	29%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHOULDER ARTHROSCOPY DECOMPRES	$3,831.80	$5,396.90	$2,667.45–$5,234.99	249% above	29%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SHOULDER ARTHROSCOPY DECOMPRES	$3,831.80	$5,396.90	$2,667.45–$5,234.99	—	29%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL RPR SUPFC	$252.55	$355.70	$45.28–$345.03	7% below	29%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SUPERFICIAL WOUND	$267.95	$377.40	$186.53–$366.08	1% below	29%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL RPR SUPFC	$267.95	$377.40	$45.28–$366.08	1% below	29%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SUPERFICIAL WOUND SNHF	$267.95	$377.40	$186.53–$366.08	1% below	29%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 WOUND REPAIR 2.5 CM OR LESS	$267.95	$377.40	$186.53–$366.08	1% below	29%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMPL RPR SUPFC	$252.55	$355.70	$45.28–$345.03	—	29%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPAIR SUPERFICIAL WOUND	$267.95	$377.40	$186.53–$366.08	—	29%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPAIR SUPERFICIAL WOUND SNHF	$267.95	$377.40	$186.53–$366.08	—	29%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN SINGLE	$261.56	$368.40	$182.08–$357.35	9% below	29%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$400.09	$563.50	$278.51–$546.60	39% above	29%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$400.09	$563.50	$278.51–$546.60	—	29%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SK TGS MLT	$150.45	$211.90	$104.74–$205.54	23% below	29%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS	$150.45	$211.90	$104.74–$205.54	23% below	29%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SK TGS MLT FIBRQ TAGS	$169.62	$238.90	$77.10–$231.73	13% below	29%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SK TGS MLT	$150.45	$211.90	$104.74–$205.54	—	29%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS	$150.45	$211.90	$104.74–$205.54	—	29%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SK TGS MLT FIBRQ TAGS	$169.62	$238.90	$77.10–$231.73	—	29%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DIAGNOSTIC	$277.47	$390.80	$58.88–$379.08	62% below	29%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP	$562.82	$792.70	$391.80–$768.92	22% below	29%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP	$562.82	$792.70	$391.80–$768.92	22% below	29%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL FLUID TAP DIAGNOSTIC	$277.47	$390.80	$58.88–$379.08	—	29%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL FLUID TAP	$562.82	$792.70	$391.80–$768.92	—	29%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REPAIR	$305.02	$429.60	$58.78–$416.71	1% below	29%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR	$413.43	$582.30	$287.81–$564.83	35% above	29%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR	$413.43	$582.30	$287.81–$564.83	35% above	29%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL REPAIR	$305.02	$429.60	$58.78–$416.71	—	29%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR	$413.43	$582.30	$287.81–$564.83	—	29%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 WOUND REPAIR TO FACE < 2.5CM	$294.93	$415.40	$205.31–$402.94	8% above	29%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR	$294.93	$415.40	$205.31–$402.94	8% above	29%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR SUPERFICAIL WOUND FACE	$294.93	$415.40	$205.31–$402.94	8% above	29%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMPL RPR SUPFC	$305.02	$429.60	$55.65–$416.71	12% above	29%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR	$294.93	$415.40	$205.31–$402.94	—	29%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPAIR SUPERFICAIL WOUND FACE	$294.93	$415.40	$205.31–$402.94	—	29%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SMPL RPR SUPFC	$305.02	$429.60	$55.65–$416.71	—	29%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN	$269.52	$379.60	$187.61–$368.21	7% above	29%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN	$369.13	$519.90	$256.96–$504.30	46% above	29%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN	$369.13	$519.90	$256.96–$504.30	—	29%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE	$592.21	$834.10	$412.26–$809.08	34% below	29%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE	$592.21	$834.10	$412.26–$809.08	—	29%
Tonsil and adenoid removal, age 12 or older CPT 42821 TONSILLECTOMY & ADENO	$3,464.94	$4,880.20	$2,412.06–$4,733.79	299% above	29%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 TONSILLECTOMY & ADENO	$3,464.94	$4,880.20	$2,412.06–$4,733.79	—	29%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY ONE-HALF	$2,830.49	$3,986.60	$1,970.40–$3,867.00	290% above	29%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY ONE-HALF	$2,830.49	$3,986.60	$1,970.40–$3,867.00	—	29%
Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY	$9,633.85	$13,568.80	$6,706.44–$13,161.74	147% above	29%
Total hip replacement inpatient CPT 27130 TOTAL HIP ARTHROPLASTY	$9,633.85	$13,568.80	$6,706.44–$13,161.74	—	29%
Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY	$9,510.38	$13,394.90	$6,620.49–$12,993.05	154% above	29%
Total knee replacement inpatient CPT 27447 TOTAL KNEE ARTHROPLASTY	$9,510.38	$13,394.90	$6,620.49–$12,993.05	—	29%
Total shoulder replacement CPT 23472 RECONSTRUCT SHOULDER JOINT	$12,288.47	$17,307.70	$8,554.41–$16,788.47	201% above	29%
Total shoulder replacement inpatient CPT 23472 RECONSTRUCT SHOULDER JOINT	$12,288.47	$17,307.70	$8,554.41–$16,788.47	—	29%
Trigger finger release surgery CPT 26055 FINGER TRIGGER INCISION	$1,879.94	$2,647.80	$1,308.69–$2,568.37	45% above	29%
Trigger finger release surgery inpatient CPT 26055 FINGER TRIGGER INCISION	$1,879.94	$2,647.80	$1,308.69–$2,568.37	—	29%
Trigger point injections, 1 or 2 muscles CPT 20552 NJX 1/MLT TRIGGER POINT 1/2 MU	$120.77	$170.10	$38.82–$165.00	61% below	29%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJECTION	$124.39	$175.20	$38.82–$169.94	60% below	29%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MLT TRIGGER	$294.93	$415.40	$205.31–$402.94	5% below	29%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION TRIGGER POINT	$294.93	$415.40	$205.31–$402.94	5% below	29%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 NJX 1/MLT TRIGGER POINT 1/2 MU	$120.77	$170.10	$38.82–$165.00	—	29%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJECTION	$124.39	$175.20	$38.82–$169.94	—	29%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION TRIGGER POINT	$294.93	$415.40	$205.31–$402.94	—	29%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BX 1ST LESION US IMAG	$1,097.31	$1,545.50	$763.87–$1,499.14	33% below	29%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BX 1ST LESION US IMAG	$1,097.31	$1,545.50	$763.87–$1,499.14	—	29%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER STOMACH-INTESTINE SCOPE	$1,122.30	$1,580.70	$133.33–$1,533.28	6% above	29%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY BIOPSY	$1,814.19	$2,555.20	$1,262.93–$2,478.54	72% above	29%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER STOMACH-INTESTINE SCOPE	$1,122.30	$1,580.70	$133.33–$1,533.28	—	29%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDOSCOPY BIOPSY	$1,814.19	$2,555.20	$1,262.93–$2,478.54	—	29%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UPR GI NDSC RMVL TUM P	$1,452.38	$2,045.60	$186.19–$1,984.23	18% below	29%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UPR GI NDSC RMVL TUM POLYP	$1,632.57	$2,299.40	$1,136.49–$2,230.42	8% below	29%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 UPR GI NDSC RMVL TUM P	$1,452.38	$2,045.60	$186.19–$1,984.23	—	29%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 UPR GI NDSC RMVL TUM POLYP	$1,632.57	$2,299.40	$1,136.49–$2,230.42	—	29%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPER STOMACH INTESTINE SCOPE	$968.58	$1,364.20	$119.36–$1,323.27	1% above	29%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDOSCOPY DIAGNOSIS	$1,653.95	$2,329.50	$1,151.39–$2,259.62	72% above	29%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER STOMACH INTESTINE SCOPE	$968.58	$1,364.20	$119.36–$1,323.27	—	29%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER GI ENDOSCOPY DIAGNOSIS	$1,653.95	$2,329.50	$1,151.39–$2,259.62	—	29%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECT UNI/BI SPX	$804.43	$1,133.00	$237.75–$1,099.01	—	29%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 SPERM DUCT REMOVAL VASECTOMY	$1,425.96	$2,008.40	$992.65–$1,948.15	7% below	29%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 SPERM DUCT REMOVAL / VASECTOMY	$1,425.96	$2,008.40	$992.65–$1,948.15	7% below	29%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECT UNI/BI SPX	$804.43	$1,133.00	$237.75–$1,099.01	—	29%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 SPERM DUCT REMOVAL VASECTOMY	$1,425.96	$2,008.40	$992.65–$1,948.15	—	29%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 SPERM DUCT REMOVAL / VASECTOMY	$1,425.96	$2,008.40	$992.65–$1,948.15	—	29%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION LESION	$140.01	$197.20	$97.47–$191.28	29% below	29%
Wart removal, up to 14 warts CPT 17110 DSTRJ SKIN TAGS	$196.67	$277.00	$69.77–$268.69	at median	29%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION LESION	$140.01	$197.20	$97.47–$191.28	—	29%
Wart removal, up to 14 warts inpatient CPT 17110 DSTRJ SKIN TAGS	$196.67	$277.00	$69.77–$268.69	—	29%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF DAMAGED SKIN	$428.34	$603.30	$298.17–$585.20	4% below	29%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF DAMAGED SKIN	$428.34	$603.30	$298.17–$585.20	4% below	29%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 REMOVAL OF DAMAGED SKIN	$428.34	$603.30	$298.17–$585.20	—	29%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPTX DSTL RADL X-ARTIC FX	$4,879.62	$6,872.70	$3,396.87–$6,666.52	105% above	29%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 OPTX DSTL RADL X-ARTIC FX	$4,879.62	$6,872.70	$3,396.87–$6,666.52	—	29%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRA < 2 HOURS	$741.52	$1,044.40	$516.18–$1,013.07	4% above	29%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRA > 2 HOURS	$926.12	$1,304.40	$644.71–$1,265.27	30% above	29%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRA < 2 HOURS	$741.52	$1,044.40	$516.18–$1,013.07	—	29%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRA > 2 HOURS	$926.12	$1,304.40	$644.71–$1,265.27	—	29%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT	$147.18	$207.30	$102.45–$201.08	26% above	29%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT	$147.18	$207.30	$102.45–$201.08	—	29%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST 30-74 MIN	$1,842.88	$2,595.60	$1,282.89–$2,517.73	19% above	29%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$179.99	$253.50	$125.30–$245.90	4% above	29%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG BY RN	$179.99	$253.50	$125.30–$245.90	4% above	29%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG BY RN	$179.99	$253.50	$125.30–$245.90	—	29%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$179.99	$253.50	$125.30–$245.90	—	29%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM VISIT LEVEL 1	$171.75	$241.90	$119.55–$234.64	11% below	29%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMER DEPT LOW TO MODER	$160.60	$226.20	$42.82–$219.41	35% below	29%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMER DEPT LOW TO MODER	$160.60	$226.20	$42.82–$219.41	35% below	29%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY ROOM VISIT LEVEL 2	$335.62	$472.70	$233.65–$458.52	35% above	29%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMER DEPT LOW TO MODER	$160.60	$226.20	$42.82–$219.41	—	29%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMER DEPT MODERATE SEVERITY	$241.12	$339.60	$73.30–$329.41	42% below	29%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM VISIT LEVEL 3	$477.40	$672.40	$332.34–$652.23	14% above	29%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT	$360.68	$508.00	$124.48–$492.76	43% below	29%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM VISIT LEVEL 4	$825.73	$1,163.00	$574.82–$1,128.11	30% above	29%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM VISIT LEVEL 5	$1,104.62	$1,555.80	$768.97–$1,509.13	17% above	29%
Family therapy with the patient, 50 minutes CPT 90847 PSYCHOTHERAPY FAMILY W/PATIENT	$196.39	$276.60	$115.63–$268.30	1% above	29%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY WITH PT	$599.95	$845.00	$417.64–$819.65	209% above	29%
Family therapy with the patient, 50 minutes inpatient CPT 90847 PSYCHOTHERAPY FAMILY W/PATIENT	$196.39	$276.60	$115.63–$268.30	—	29%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PT	$571.55	$805.00	$397.87–$780.85	212% above	29%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY	$521.85	$735.00	$363.27–$712.95	568% above	29%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL TO 1 HR	$344.92	$485.80	$240.10–$471.23	27% above	29%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL TO 1 HR	$345.63	$486.80	$240.59–$472.20	27% above	29%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL TO 1 HR	$345.63	$486.80	$240.59–$472.20	—	29%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY INITIAL TO 1 HOUR	$311.55	$438.80	$216.88–$425.64	5% below	29%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY INITIAL TO 1 HOUR	$312.47	$440.10	$217.52–$426.90	5% below	29%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY INITIAL TO 1 HOUR	$312.47	$440.10	$217.52–$426.90	—	29%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SQ / IM	$77.18	$108.70	$53.72–$105.44	at median	29%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUBCU OR IM	$77.60	$109.30	$54.03–$106.02	at median	29%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SQ / IM	$77.60	$109.30	$54.03–$106.02	at median	29%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SQ / IM	$77.60	$109.30	$54.03–$106.02	—	29%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUBCU OR IM	$77.60	$109.30	$54.03–$106.02	—	29%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$302.46	$426.00	$154.46–$413.22	18% above	29%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$302.46	$426.00	$154.46–$413.22	—	29%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC RE-EDU	$40.00	$56.34	$27.84–$54.65	45% below	29%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC RE-EDU	$40.00	$56.34	$27.84–$54.65	—	29%
New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPATIENT VISIT	$77.60	$109.30	$54.03–$106.02	34% below	29%
New patient office visit, about 30 minutes CPT 99203 DETAILED NEW PATIENT	$184.74	$260.20	$76.72–$252.39	58% above	29%
New patient office visit, about 30 minutes inpatient CPT 99203 DETAILED NEW PATIENT	$184.74	$260.20	$76.72–$252.39	—	29%
New patient office visit, about 45 minutes CPT 99204 COMPREHENSIVE NEW PATIENT	$262.84	$370.20	$126.12–$359.09	53% above	29%
New patient office visit, about 45 minutes inpatient CPT 99204 COMPREHENSIVE NEW PATIENT	$262.84	$370.20	$126.12–$359.09	—	29%
New patient office visit, about 60 minutes CPT 99205 COMPREHENSIVE NEW PT HIGH	$100.00	$140.85	$69.63–$172.18	57% below	29%
New patient office visit, about 60 minutes CPT 99205 OFFICE OUT PT NEW	$355.57	$500.80	$172.18–$485.78	51% above	29%
New patient office visit, about 60 minutes inpatient CPT 99205 COMPREHENSIVE NEW PT HIGH	$100.00	$140.85	$69.63–$172.18	—	29%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE OUT PT NEW	$355.57	$500.80	$172.18–$485.78	—	29%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 EXPANDED NEW PATIENT	$141.57	$199.40	$44.70–$193.42	86% above	29%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 EXPANDED NEW PATIENT	$145.83	$205.40	$44.70–$199.24	92% above	29%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 EXPANDED NEW PATIENT	$141.57	$199.40	$44.70–$193.42	—	29%
Psychotherapy session, 30 minutes CPT 90832 PSYCH PT / FAMILY 30 MIN	$106.43	$149.90	$74.09–$145.40	7% below	29%
Psychotherapy session, 30 minutes CPT 90832 16-37 MINS - INDIVIDUAL PSYCH	$433.10	$610.00	$301.50–$591.70	279% above	29%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCH PT / FAMILY 30 MIN	$106.43	$149.90	$74.09–$145.40	—	29%
Psychotherapy session, 45 minutes CPT 90834 PSYCH PT / FAMILY 45 MIN	$146.90	$206.90	$102.26–$200.69	2% below	29%
Psychotherapy session, 45 minutes CPT 90834 38-52 MINS - INDIVIDUAL PSYCH	$536.05	$755.00	$373.16–$732.35	259% above	29%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCH PT / FAMILY 45 MIN	$146.90	$206.90	$102.26–$200.69	—	29%
Psychotherapy session, 60 minutes CPT 90837 THERAPY PT&/OR FAMILY 60 MIN	$217.90	$306.90	$151.70–$297.69	20% above	29%
Psychotherapy session, 60 minutes CPT 90837 53-67 MINS - INDIVIDUAL PSYCH	$546.70	$770.00	$380.57–$746.90	202% above	29%
Psychotherapy session, 60 minutes inpatient CPT 90837 THERAPY PT&/OR FAMILY 60 MIN	$217.90	$306.90	$151.70–$297.69	—	29%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 COMPLEX EST PAT	$80.00	$112.68	$55.70–$136.80	53% below	29%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 COMPREHENSIVE ESTABLISH PT	$294.51	$414.80	$136.80–$402.36	74% above	29%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 COMPLEX EST PAT	$80.00	$112.68	$55.70–$136.80	—	29%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 COMPREHENSIVE ESTABLISH PT	$294.51	$414.80	$136.80–$402.36	—	29%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE OUTPT EST	$50.98	$71.80	$35.48–$69.65	46% below	29%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EXPANDED EST PAT	$60.00	$84.50	$41.77–$81.96	36% below	29%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE OUTPT EST 15	$127.16	$179.10	$62.72–$173.73	35% above	29%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EXPANDED ESTABLISHED PATIENT	$131.00	$184.50	$62.72–$178.96	39% above	29%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EXPANDED EST PAT	$60.00	$84.50	$41.77–$81.96	—	29%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE OUTPT EST 15	$127.16	$179.10	$62.72–$173.73	—	29%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 DETAILED EST PAT	$70.01	$98.60	$48.74–$95.64	42% below	29%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE OUT PATIENT	$77.60	$109.30	$54.03–$106.02	35% below	29%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE OUTPT EST 25 MIN	$184.74	$260.20	$92.04–$252.39	54% above	29%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 DETAILED EST PAT	$70.01	$98.60	$48.74–$95.64	—	29%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE OUTPT EST 25 MIN	$184.74	$260.20	$92.04–$252.39	—	29%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 FOCUSED EST PAT	$40.00	$56.34	$27.84–$54.65	52% below	29%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OUT PT VISIT	$77.60	$109.30	$54.03–$106.02	7% below	29%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OUTPT EST 10 MIN	$100.18	$141.10	$33.60–$136.87	20% above	29%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OUTPATIENT VISIT	$119.92	$168.90	$83.48–$163.83	44% above	29%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 FOCUSED EST PAT	$40.00	$56.34	$27.84–$54.65	—	29%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE OUTPT EST 10 MIN	$100.18	$141.10	$33.60–$136.87	—	29%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OUTPATIENT VISIT	$119.92	$168.90	$83.48–$163.83	—	29%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT	$257.52	$362.70	$179.27–$351.82	38% above	29%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT	$265.26	$373.60	$184.65–$362.39	43% above	29%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE CONSULT	$257.52	$362.70	$179.27–$351.82	—	29%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULT 60 MIN	$336.82	$474.40	$234.46–$460.17	53% above	29%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE CONSULT 60 MIN	$336.82	$474.40	$234.46–$460.17	—	29%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERA.PHLEBOTOMY	$268.95	$378.80	$187.22–$367.44	27% above	29%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERA.PHLEBOTOMY	$268.95	$378.80	$187.22–$367.44	—	29%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA TRIVALENT VACCINE	$15.10	$21.27	$10.51–$20.63	32% below	29%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA TRIVALENT VACCINE	$15.10	$21.27	$10.51–$20.63	—	29%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS 9 VAC	$218.03	$307.08	$151.77–$297.87	43% below	29%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS 9 VAC	$218.03	$307.08	$151.77–$297.87	—	29%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A HAVRIX	$66.54	$93.72	$46.32–$90.91	36% below	29%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A HAVRIX	$66.54	$93.72	$46.32–$90.91	—	29%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B HEPATITIIS B ADULT	$67.90	$95.64	$47.28–$92.77	39% below	29%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B HEPATITIIS B ADULT	$67.90	$95.64	$47.28–$92.77	—	29%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA TRIVALENT HIGH DOSE	$42.18	$59.41	$29.36–$57.63	44% below	29%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA TRIVALENT HIGH DOSE	$42.18	$59.41	$29.36–$57.63	—	29%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R VACCINE	$80.85	$113.88	$56.30–$110.46	35% below	29%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R VACCINE	$80.85	$113.88	$56.30–$110.46	—	29%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACCINE	$118.89	$167.45	$82.76–$162.43	39% below	29%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACCINE	$118.89	$167.45	$82.76–$162.43	—	29%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VACCINE	$153.99	$216.89	$107.20–$210.38	49% below	29%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VACCINE	$153.99	$216.89	$107.20–$210.38	—	29%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUG	$264.57	$372.64	$184.17–$361.46	34% below	29%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUG	$264.57	$372.64	$184.17–$361.46	—	29%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE 23 VALENT	$116.13	$163.57	$80.86–$158.66	12% below	29%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE 23 VALENT	$116.13	$163.57	$80.86–$158.66	—	29%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS, DIPTHERIA SYRINGE	$33.63	$47.36	$23.40–$45.94	46% below	29%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS, DIPTHERIA SYRINGE	$33.63	$47.36	$23.40–$45.94	—	29%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX VACCINE	$37.91	$53.40	$26.39–$51.80	52% below	29%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHERIA/TETANUS/ACEL0.5MLVL	$49.16	$69.24	$34.23–$67.16	37% below	29%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX VACCINE	$37.91	$53.40	$26.39–$51.80	—	29%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTHERIA/TETANUS/ACEL0.5MLVL	$49.16	$69.24	$34.23–$67.16	—	29%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$50.55	$71.20	$35.18–$69.06	24% above	29%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$50.55	$71.20	$35.18–$69.06	—	29%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN IMMUNIZATION ADDL VACCN	$34.51	$48.60	$24.02–$47.14	37% above	29%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN IMMUNIZATION ADDL VACCN	$34.51	$48.60	$24.02–$47.14	—	29%

Source file: https://www.bigforkvalley.org/wp-content/uploads/2026/09/411242647_northern-itsaca-hospital-district_standardcharges-1.csv