Hospital Grand Junction, CO

Family Health West Hospital

Family Health West Hospital in Fruita, CO publishes cash prices for 330 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Colorado median for 256 of 326 procedures and above it for 65. By typical cash price it ranks #20 of 50 Colorado hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

300 W Ottley Ave, Fruita, CO 81521 Collected Sep 28, 2026 Source price file Check a bill from this hospital (970) 858-9871

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 061302 · CMS hospital register NPI 1861496697

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Family Health West Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

State law

This state limits hospital bills for lower-income patients

Colorado's Hospital Discounted Care law (HB21-1198): for qualifying patients with household income at or below 250% of the federal poverty level, hospitals and the clinicians who work in them may charge no more than the greater of the Medicare rate or the Medicaid base rate, and monthly payments are capped. That can be less than the cash prices below; ask the hospital to screen you for discounted care. Other states' laws.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Family Health West Hospital in Fruita, CO:

Nov 5, 2024 Corrective action plan requested
Feb 26, 2025 Case closed

Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Colorado	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W/WO CONTRAST	$2,142.70	$3,061.00	—	6% below	30%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W/WO CONTRAST	$2,142.70	$3,061.00	—	—	30%
Abdominal X-ray, 2 views CPT 74019 HC DI ABDOMEN 2 VIEWS	$272.30	$389.00	—	21% below	30%
Abdominal X-ray, 2 views inpatient CPT 74019 HC DI ABDOMEN 2 VIEWS	$272.30	$389.00	—	—	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC DI ANKLE MIN 3 VIEW UNILATERAL	$272.30	$389.00	—	18% below	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC DI ANKLE MIN 3 VIEW UNILATERAL	$272.30	$389.00	—	—	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC UPR/L EXTREMITY ART 1-2 LEVELS BILATERAL	$630.70	$901.00	—	—	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 HC UPR/L EXTREMITY ART 1-2 LEVELS UNILATERAL	$630.70	$901.00	—	5% above	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC UPR/L EXTREMITY ART 1-2 LEVELS BILATERAL	$630.70	$901.00	—	—	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 HC UPR/L EXTREMITY ART 1-2 LEVELS UNILATERAL	$630.70	$901.00	—	—	30%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY W/O CONTRAST	$1,250.90	$1,787.00	—	26% below	30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY W/O CONTRAST	$1,250.90	$1,787.00	—	—	30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC DI ESOPHAGRAM	$589.40	$842.00	—	8% below	30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC DI ESOPHAGRAM	$589.40	$842.00	—	—	30%
Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST UNILATERAL COMPLETE INCL AXILLA - 4 QUADRANTS	$602.00	$860.00	—	39% above	30%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US BREAST UNILATERAL COMPLETE INCL AXILLA - 4 QUADRANTS	$602.00	$860.00	—	—	30%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC US BREAST BILATERAL LIMITED INCL AXILLA - 1 OR MORE ELEMENTS	$602.00	$860.00	—	—	30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US BREAST UNILATERAL LIMITED INCL AXILLA - 1 OR MORE ELEMENTS	$301.00	$430.00	—	30% below	30%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 HC US BREAST BILATERAL LIMITED INCL AXILLA - 1 OR MORE ELEMENTS	$602.00	$860.00	—	—	30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC US BREAST UNILATERAL LIMITED INCL AXILLA - 1 OR MORE ELEMENTS	$301.00	$430.00	—	—	30%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN AND PELVIS	$2,142.70	$3,061.00	—	25% below	30%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABDOMEN AND PELVIS	$2,142.70	$3,061.00	—	—	30%
CT angiography (CTA) of the head CPT 70496 HC CTA HEAD W/WO CONTRAST	$2,142.70	$3,061.00	—	9% below	30%
CT angiography (CTA) of the head inpatient CPT 70496 HC CTA HEAD W/WO CONTRAST	$2,142.70	$3,061.00	—	—	30%
CT angiography (CTA) of the neck CPT 70498 HC CTA NECK W/WO CONTRAST	$2,142.70	$3,061.00	—	8% below	30%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CTA NECK W/WO CONTRAST	$2,142.70	$3,061.00	—	—	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA PULMONARY W/WO CONTRAST	$2,142.70	$3,061.00	—	11% below	30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CTA PULMONARY W/WO CONTRAST	$2,142.70	$3,061.00	—	—	30%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HEART QUAN CALCIUM W/O CONTRAST	$638.40	$912.00	—	82% above	30%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HEART QUAN CALCIUM W/O CONTRAST	$638.40	$912.00	—	—	30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS W/O CONTRAST	$2,011.80	$2,874.00	—	6% below	30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS W/O CONTRAST	$2,011.80	$2,874.00	—	—	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W/CONTRAST	$2,455.60	$3,508.00	—	6% below	30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W/CONTRAST	$2,455.60	$3,508.00	—	—	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD & PELVIS W/WO CONTRAST	$3,462.90	$4,947.00	—	1% below	30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD & PELVIS W/WO CONTRAST	$3,462.90	$4,947.00	—	—	30%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/CONTRAST	$1,518.30	$2,169.00	—	28% below	30%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W/CONTRAST	$1,518.30	$2,169.00	—	—	30%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O CONTRAST	$1,250.90	$1,787.00	—	12% below	30%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O CONTRAST	$1,250.90	$1,787.00	—	—	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O CONTRAST	$1,250.90	$1,787.00	—	6% below	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL W/O CONTRAST	$1,250.90	$1,787.00	—	—	30%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST	$1,250.90	$1,787.00	—	10% below	30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST	$1,250.90	$1,787.00	—	—	30%
CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W/CONTRAST	$1,518.30	$2,169.00	—	13% below	30%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD/BRAIN W/CONTRAST	$1,518.30	$2,169.00	—	—	30%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W/WO CONTRAST	$2,142.70	$3,061.00	—	4% above	30%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD/BRAIN W/WO CONTRAST	$2,142.70	$3,061.00	—	—	30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE W/O CONTRAST	$1,250.90	$1,787.00	—	23% below	30%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE W/O CONTRAST	$1,250.90	$1,787.00	—	—	30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST	$1,250.90	$1,787.00	—	18% below	30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST	$1,250.90	$1,787.00	—	—	30%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/CONTRAST	$1,518.30	$2,169.00	—	27% below	30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/CONTRAST	$1,518.30	$2,169.00	—	—	30%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC US DUPLEX SCAN CAROTID BILATERAL S&I	$1,661.80	$2,374.00	—	—	30%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC US DUPLEX SCAN CAROTID BILATERAL S&I	$1,661.80	$2,374.00	—	—	30%
Chest X-ray, 2 views CPT 71046 HC DI CHEST 2 VIEWS	$272.30	$389.00	—	10% below	30%
Chest X-ray, 2 views inpatient CPT 71046 HC DI CHEST 2 VIEWS	$272.30	$389.00	—	—	30%
Chest X-ray, single view CPT 71045 HC DI CHEST 1 VIEW	$226.80	$324.00	—	14% below	30%
Chest X-ray, single view inpatient CPT 71045 HC DI CHEST 1 VIEW	$226.80	$324.00	—	—	30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 HC CLAVICLE COMPLETE UNILATERAL	$249.90	$357.00	—	16% below	30%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC CLAVICLE COMPLETE UNILATERAL	$249.90	$357.00	—	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$534.10	$763.00	—	21% below	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE	$534.10	$763.00	—	—	30%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL 1+ SITES	$323.40	$462.00	—	38% below	30%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA BONE DENSITY AXIAL 1+ SITES	$323.40	$462.00	—	—	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA BONE DENSITY/PERIPHERAL	$176.40	$252.00	—	54% below	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC DXA BONE DENSITY/PERIPHERAL	$176.40	$252.00	—	—	30%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US OB COMPLETE SINGLE GESTATION	$1,099.00	$1,570.00	—	3% above	30%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US OB COMPLETE SINGLE GESTATION	$1,099.00	$1,570.00	—	—	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX DX W/O CONTRAST	$1,250.90	$1,787.00	—	17% below	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX DX W/O CONTRAST	$1,250.90	$1,787.00	—	—	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX DX W/CONTRAST	$1,518.30	$2,169.00	—	19% below	30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX DX W/CONTRAST	$1,518.30	$2,169.00	—	—	30%
Diagnostic mammogram, both breasts both sides CPT 77066 HC DIAG MAMMO, BILATERAL INCL CAD WHEN PERFORMED	$348.60	$498.00	—	—	30%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DIAG MAMMO, BILATERAL INCL CAD WHEN PERFORMED	$348.60	$498.00	—	—	30%
Diagnostic mammogram, one breast one side CPT 77065 HC DIAG MAMMO, UNILATERAL INCL CAD WHEN PERFORMED	$185.50	$265.00	—	34% below	30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DIAG MAMMO, UNILATERAL INCL CAD WHEN PERFORMED	$185.50	$265.00	—	—	30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DOPPLER LOWER EXTREMTIY BILATERAL	$1,346.80	$1,924.00	—	—	30%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DOPPLER LOWER EXTREMTIY BILATERAL	$1,346.80	$1,924.00	—	—	30%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DOPPLER EXTREM COMPLETE BILATERAL	$1,346.80	$1,924.00	—	—	30%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DOPPLER EXTREM COMPLETE BILATERAL	$1,346.80	$1,924.00	—	—	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE COMP W/DPLR & COLOR W/O CONTRAST	$1,374.80	$1,964.00	—	36% below	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE COMP W/DPLR & COLOR W/CONTRAST	$1,374.80	$1,964.00	—	36% below	30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE COMP W/DPLR & COLOR W/CONTRAST	$1,374.80	$1,964.00	—	—	30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE COMP W/DPLR & COLOR W/O CONTRAST	$1,374.80	$1,964.00	—	—	30%
Elbow X-ray, 2 views one side CPT 73070 HC DI ELBOW 2 VIEW UNILATERAL	$249.90	$357.00	—	16% below	30%
Elbow X-ray, 2 views inpatient one side CPT 73070 HC DI ELBOW 2 VIEW UNILATERAL	$249.90	$357.00	—	—	30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC DI ELBOW 3 VIEW UNILATERAL	$272.30	$389.00	—	10% below	30%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC DI ELBOW 3 VIEW UNILATERAL	$272.30	$389.00	—	—	30%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/SELLA/IAC W/O CONTRAST	$1,250.90	$1,787.00	—	24% below	30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT/SELLA/IAC W/O CONTRAST	$1,250.90	$1,787.00	—	—	30%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC DI FACIAL BONES MIN 3 VIEWS	$294.00	$420.00	—	19% below	30%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC DI FACIAL BONES MIN 3 VIEWS	$294.00	$420.00	—	—	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC DI FOREARM MIN 2 VIEW UNILATERAL	$249.90	$357.00	—	15% below	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC DI FOREARM MIN 2 VIEW UNILATERAL	$249.90	$357.00	—	—	30%
Hand X-ray, 2 views one side CPT 73120 HC DI HAND 2 VIEW UNILATERAL	$249.90	$357.00	—	17% below	30%
Hand X-ray, 2 views inpatient one side CPT 73120 HC DI HAND 2 VIEW UNILATERAL	$249.90	$357.00	—	—	30%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC DI OS CALCIS MIN 2 VIEW UNILATERAL	$249.90	$357.00	—	9% below	30%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC DI OS CALCIS MIN 2 VIEW UNILATERAL	$249.90	$357.00	—	—	30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STUDY UNATTENDED	$565.60	$808.00	—	1% above	30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STUDY UNATTENDED	$565.60	$808.00	—	—	30%
Knee X-ray, 3 views one side CPT 73562 HC DI KNEE 3 VIEWS UNILATERAL	$272.30	$389.00	—	21% below	30%
Knee X-ray, 3 views inpatient one side CPT 73562 HC DI KNEE 3 VIEWS UNILATERAL	$272.30	$389.00	—	—	30%
Knee X-ray, complete, 4 or more views one side CPT 73564 HC DI KNEE MIN 4 VIEW UNILATERAL	$294.00	$420.00	—	29% below	30%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC DI KNEE MIN 4 VIEW UNILATERAL	$294.00	$420.00	—	—	30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT LOWER EXTREMITY W/O CONTRAST UNILATERAL	$1,250.90	$1,787.00	—	15% below	30%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT LOWER EXTREMITY W/O CONTRAST UNILATERAL	$1,250.90	$1,787.00	—	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC ULTRASOUND ABDOMEN LIMITED	$490.00	$700.00	—	16% below	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC ULTRASOUND ABDOMEN LIMITED	$490.00	$700.00	—	—	30%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US LIMITED JOINT OR NONVASC EXTREM UNILATERAL	$490.00	$700.00	—	4% above	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC US LIMITED JOINT OR NONVASC EXTREM UNILATERAL	$490.00	$700.00	—	—	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT LOW DOSE LUNG CA SCREEN W/O	$459.90	$657.00	—	20% above	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT LOW DOSE LUNG CA SCREEN W/O	$459.90	$657.00	—	—	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC DI TIBIA/FIBULA 2 VIEW UNILATERAL	$272.30	$389.00	—	10% below	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC DI TIBIA/FIBULA 2 VIEW UNILATERAL	$272.30	$389.00	—	—	30%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD W/O CONTRAST	$1,974.70	$2,821.00	—	12% below	30%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD W/O CONTRAST	$1,974.70	$2,821.00	—	—	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI LOWER JOINT UNILATERAL W/O CONTRAST	$1,974.70	$2,821.00	—	5% below	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI LOWER JOINT UNILATERAL W/O CONTRAST	$1,974.70	$2,821.00	—	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI LOWER JOINT UNILATERAL W/WO CONTRAST	$3,161.90	$4,517.00	—	5% below	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI LOWER JOINT UNILATERAL W/WO CONTRAST	$3,161.90	$4,517.00	—	—	30%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O CONTRAST	$1,974.70	$2,821.00	—	13% below	30%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN W/O CONTRAST	$1,974.70	$2,821.00	—	—	30%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W/WO CONTRAST	$3,161.90	$4,517.00	—	4% below	30%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN W/WO CONTRAST	$3,161.90	$4,517.00	—	—	30%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST	$1,974.70	$2,821.00	—	14% below	30%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST	$1,974.70	$2,821.00	—	—	30%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/WO CONTRAST	$3,161.90	$4,517.00	—	1% below	30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W/WO CONTRAST	$3,161.90	$4,517.00	—	—	30%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST	$1,974.70	$2,821.00	—	9% below	30%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST	$1,974.70	$2,821.00	—	—	30%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/WO CONTRAST	$3,161.90	$4,517.00	—	2% below	30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W/WO CONTRAST	$3,161.90	$4,517.00	—	—	30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O CONTRAST	$1,974.70	$2,821.00	—	16% below	30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O CONTRAST	$1,974.70	$2,821.00	—	—	30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/WO CONTRAST	$3,161.90	$4,517.00	—	2% below	30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE W/WO CONTRAST	$3,161.90	$4,517.00	—	—	30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O CONTRAST	$1,974.70	$2,821.00	—	14% below	30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O CONTRAST	$1,974.70	$2,821.00	—	—	30%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W/WO CONTRAST	$3,161.90	$4,517.00	—	7% below	30%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS W/WO CONTRAST	$3,161.90	$4,517.00	—	—	30%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O CONTRAST	$1,974.70	$2,821.00	—	15% below	30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS W/O CONTRAST	$1,974.70	$2,821.00	—	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREM 1 JOINT W/O CONTRAST	$1,974.70	$2,821.00	—	6% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTREM 1 JOINT W/O CONTRAST	$1,974.70	$2,821.00	—	—	30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC DI CERVICAL SPINE 4 OR 5 VIEWS	$316.40	$452.00	—	34% below	30%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC DI CERVICAL SPINE 4 OR 5 VIEWS	$316.40	$452.00	—	—	30%
Neck soft tissue CT scan with contrast CPT 70491 HC CT NECK SOFT TISSUE W/CONTRAST	$1,518.30	$2,169.00	—	22% below	30%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT NECK SOFT TISSUE W/CONTRAST	$1,518.30	$2,169.00	—	—	30%
Neck soft tissue CT scan without contrast CPT 70490 HC CT NECK SOFT TISSUE W/O CONTRAST	$1,250.90	$1,787.00	—	20% below	30%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT NECK SOFT TISSUE W/O CONTRAST	$1,250.90	$1,787.00	—	—	30%
Neck soft tissue X-ray CPT 70360 HC DI NECK SOFT TISSUE	$226.80	$324.00	—	25% below	30%
Neck soft tissue X-ray inpatient CPT 70360 HC DI NECK SOFT TISSUE	$226.80	$324.00	—	—	30%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS W/O CONTRAST	$1,250.90	$1,787.00	—	22% below	30%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS W/O CONTRAST	$1,250.90	$1,787.00	—	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM, PELVIC, LIMITED	$403.90	$577.00	—	12% below	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM, PELVIC, LIMITED	$403.90	$577.00	—	—	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC NON-OB S&I	$628.60	$898.00	—	8% below	30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC NON-OB S&I	$628.60	$898.00	—	—	30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREG 2ND/3RD TRIMESTER	$690.90	$987.00	—	1% below	30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREG 2ND/3RD TRIMESTER	$690.90	$987.00	—	—	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US, OB < 14 WKS, SINGLE FETUS	$602.00	$860.00	—	2% above	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US, OB < 14 WKS, SINGLE FETUS	$602.00	$860.00	—	—	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC ULTRASOUND OB LIMITED	$490.00	$700.00	—	6% above	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC ULTRASOUND OB LIMITED	$490.00	$700.00	—	—	30%
Rib X-ray, one side, 2 views one side CPT 71100 HC DI RIBS 2 VIEWS UNILATERAL	$249.90	$357.00	—	26% below	30%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC DI RIBS 2 VIEWS UNILATERAL	$249.90	$357.00	—	—	30%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC DI X-RAY EXAM OF RIBS/CHEST	$375.20	$536.00	—	3% below	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC DI X-RAY EXAM OF RIBS/CHEST	$375.20	$536.00	—	—	30%
Screening mammogram, both breasts both sides CPT 77067 HC SCREEN MAMMO, BILATERAL INCL CAD WHEN PERFORMED	$245.70	$351.00	—	—	30%
Screening mammogram, both breasts one side CPT 77067 HC SCREEN MAMMO, UNILATERAL INCL CAD WHEN PERFORMED	$195.30	$279.00	—	3% above	30%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCREEN MAMMO, BILATERAL INCL CAD WHEN PERFORMED	$245.70	$351.00	—	—	30%
Screening mammogram, both breasts inpatient one side CPT 77067 HC SCREEN MAMMO, UNILATERAL INCL CAD WHEN PERFORMED	$195.30	$279.00	—	—	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC DI SHOULDER MIN 2 VIEWS UNILATERAL	$272.30	$389.00	—	13% below	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC DI SHOULDER MIN 2 VIEWS UNILATERAL	$272.30	$389.00	—	—	30%
Sinus X-ray, complete, 3 or more views CPT 70220 HC DI SINUSES COMPLETE 3 OR MORE VIEWS	$294.00	$420.00	—	15% below	30%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC DI SINUSES COMPLETE 3 OR MORE VIEWS	$294.00	$420.00	—	—	30%
Skull X-ray, fewer than 4 views CPT 70250 HC DI SKULL <4 VIEWS	$272.30	$389.00	—	16% below	30%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC DI SKULL <4 VIEWS	$272.30	$389.00	—	—	30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC DI SWALLOWING EVAL W/VIDEO	$541.80	$774.00	—	11% below	30%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC DI SWALLOWING EVAL W/VIDEO	$541.80	$774.00	—	—	30%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC DI FEMUR MIN 2 VIEW UNILATERAL	$316.40	$452.00	—	5% above	30%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC DI FEMUR MIN 2 VIEW UNILATERAL	$316.40	$452.00	—	—	30%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SPINE W/O CONTRAST	$1,250.90	$1,787.00	—	16% below	30%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT THORACIC SPINE W/O CONTRAST	$1,250.90	$1,787.00	—	—	30%
Toe X-ray, 2 or more views CPT 73660 HC DI TOES MIN 2 VIEWS UNLATERAL	$272.30	$389.00	—	3% below	30%
Toe X-ray, 2 or more views inpatient CPT 73660 HC DI TOES MIN 2 VIEWS UNLATERAL	$272.30	$389.00	—	—	30%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON-OB S&I	$599.90	$857.00	—	3% below	30%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON-OB S&I	$599.90	$857.00	—	—	30%
Transvaginal ultrasound during pregnancy CPT 76817 HC TRANSVAGINAL ULTRASOUND PREGNANCY	$490.00	$700.00	—	20% below	30%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC TRANSVAGINAL ULTRASOUND PREGNANCY	$490.00	$700.00	—	—	30%
Ultrasound of the abdomen, complete CPT 76700 HC ULTRASOUND ABDOMEN COMPLETE	$602.00	$860.00	—	17% below	30%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC ULTRASOUND ABDOMEN COMPLETE	$602.00	$860.00	—	—	30%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM AND CONTENTS	$602.70	$861.00	—	10% below	30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM AND CONTENTS	$602.70	$861.00	—	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US HEAD/NECK SOFT TISSUE	$602.00	$860.00	—	4% below	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US HEAD/NECK SOFT TISSUE	$602.00	$860.00	—	—	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC DI X-RAY UPPER GI DELAY W/KUB	$511.70	$731.00	—	40% below	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC DI X-RAY UPPER GI DELAY W/KUB	$511.70	$731.00	—	—	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC DI HUMERUS MIN 2 VIEWS UNILATERAL	$249.90	$357.00	—	16% below	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC DI HUMERUS MIN 2 VIEWS UNILATERAL	$249.90	$357.00	—	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DOPPLER EXTREMITY VEINS UNILATERAL	$898.10	$1,283.00	—	61% above	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DOPPLER EXTREMITY VEINS UNILATERAL	$898.10	$1,283.00	—	—	30%
Wrist X-ray, 2 views one side CPT 73100 HC DI WRIST 2 VIEW UNILATERAL	$249.90	$357.00	—	17% below	30%
Wrist X-ray, 2 views inpatient one side CPT 73100 HC DI WRIST 2 VIEW UNILATERAL	$249.90	$357.00	—	—	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC DI WRIST MIN 3 VIEW UNILAT	$272.30	$389.00	—	10% below	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC DI WRIST MIN 3 VIEW UNILAT	$272.30	$389.00	—	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC DI HIP UNILATERAL +/- PELVIS 2 OR 3 VIEW	$272.30	$389.00	—	15% below	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC DI HIP UNILATERAL +/- PELVIS 2 OR 3 VIEW	$272.30	$389.00	—	—	30%
X-ray of the abdomen, 1 view CPT 74018 HC ABDOMEN 1 VIEW	$226.80	$324.00	—	19% below	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC ABDOMEN 1 VIEW	$226.80	$324.00	—	—	30%
X-ray of the ankle, 2 views one side CPT 73600 HC DI ANKLE 2 VIEW UNILATERAL	$249.90	$357.00	—	17% below	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC DI ANKLE 2 VIEW UNILATERAL	$249.90	$357.00	—	—	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC DI FINGERS MIN 2 VIEWS UNILATERAL	$272.30	$389.00	—	10% below	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC DI FINGERS MIN 2 VIEWS UNILATERAL	$272.30	$389.00	—	—	30%
X-ray of the foot, 2 views one side CPT 73620 HC DI FOOT 2 VIEW UNILATERAL	$249.90	$357.00	—	13% below	30%
X-ray of the foot, 2 views inpatient one side CPT 73620 HC DI FOOT 2 VIEW UNILATERAL	$249.90	$357.00	—	—	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC DI FOOT MIN 3 VIEW UNILATERAL	$272.30	$389.00	—	12% below	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC DI FOOT MIN 3 VIEW UNILATERAL	$272.30	$389.00	—	—	30%
X-ray of the hand, 3 or more views one side CPT 73130 HC DI HAND MIN 3 VIEW UNILATERAL	$272.30	$389.00	—	13% below	30%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC DI HAND MIN 3 VIEW UNILATERAL	$272.30	$389.00	—	—	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC DI KNEE 1-2 VIEWS UNILATERAL	$249.90	$357.00	—	17% below	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC DI KNEE 1-2 VIEWS UNILATERAL	$249.90	$357.00	—	—	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC DI LUMBAR SPINE 2 OR 3 VIEWS	$294.00	$420.00	—	19% below	30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC DI LUMBAR SPINE 2 OR 3 VIEWS	$294.00	$420.00	—	—	30%
X-ray of the lower back, 4 or more views CPT 72110 HC DI L SPINE AP/LAT/OBL/OR FLEX/EXT	$316.40	$452.00	—	34% below	30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC DI L SPINE AP/LAT/OBL/OR FLEX/EXT	$316.40	$452.00	—	—	30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC DI THORACIC SPINE 2 VIEWS	$249.90	$357.00	—	20% below	30%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC DI THORACIC SPINE 2 VIEWS	$249.90	$357.00	—	—	30%
X-ray of the nasal bones, 3 or more views CPT 70160 HC DI NASAL BONES MIN 3 VIEWS	$272.30	$389.00	—	14% below	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC DI NASAL BONES MIN 3 VIEWS	$272.30	$389.00	—	—	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC DI CERVICAL SPINE 2 OR 3 VIEWS	$272.30	$389.00	—	13% below	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC DI CERVICAL SPINE 2 OR 3 VIEWS	$272.30	$389.00	—	—	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC DI PELVIS 1 OR 2 VIEWS	$249.90	$357.00	—	17% below	30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC DI PELVIS 1 OR 2 VIEWS	$249.90	$357.00	—	—	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC DI SACRUM/COCCYX MIN 2 VIEWS	$249.90	$357.00	—	17% below	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC DI SACRUM/COCCYX MIN 2 VIEWS	$249.90	$357.00	—	—	30%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Colorado	Off list
ACTH blood test CPT 82024 HC ACTH HORMONE	$105.70	$151.00	—	54% below	30%
ACTH blood test inpatient CPT 82024 HC ACTH HORMONE	$105.70	$151.00	—	—	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSAMINASE ALT/SGPT	$36.40	$52.00	—	39% below	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSAMINASE ALT/SGPT	$36.40	$52.00	—	—	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSAMINASE AST/SGOT	$34.30	$49.00	—	43% below	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSAMINASE AST/SGOT	$34.30	$49.00	—	—	30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS ACUTE PROFILE	$225.40	$322.00	—	45% below	30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS ACUTE PROFILE	$225.40	$322.00	—	—	30%
Albumin blood test CPT 82040 HC ALBUMIN SERUM	$23.80	$34.00	—	58% below	30%
Albumin blood test inpatient CPT 82040 HC ALBUMIN SERUM	$23.80	$34.00	—	—	30%
Aldosterone blood test CPT 82088 HC ALDOSTERONE; SERUM	$52.50	$75.00	—	80% below	30%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE; SERUM	$52.50	$75.00	—	—	30%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOSPHATASE SERUM	$24.50	$35.00	—	56% below	30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOSPHATASE SERUM	$24.50	$35.00	—	—	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN; SERUM	$107.80	$154.00	—	20% below	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN; SERUM	$107.80	$154.00	—	—	30%
Ammonia blood test CPT 82140 HC AMMONIA	$102.90	$147.00	—	44% below	30%
Ammonia blood test inpatient CPT 82140 HC AMMONIA	$102.90	$147.00	—	—	30%
Amylase blood test CPT 82150 HC AMYLASE	$44.10	$63.00	—	55% below	30%
Amylase blood test inpatient CPT 82150 HC AMYLASE	$44.10	$63.00	—	—	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CITRULLINATED PEPTIDE IGGCCP ANTIBODY	$91.00	$130.00	—	18% below	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CITRULLINATED PEPTIDE IGGCCP ANTIBODY	$91.00	$130.00	—	—	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTI-NUCLEAR ANTIBODIES	$65.80	$94.00	—	27% below	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTI-NUCLEAR ANTIBODIES	$65.80	$94.00	—	—	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE	$218.40	$312.00	—	22% below	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE	$218.40	$312.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE TISSUE	$58.80	$84.00	—	46% below	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC RESPIRATORY CULTURE	$58.80	$84.00	—	46% below	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC WOUND CULTURE	$58.80	$84.00	—	46% below	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, BACTERIAL, OTHER SOURCE	$58.80	$84.00	—	46% below	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CSF CULTURE AND GRAM STAIN	$58.80	$84.00	—	46% below	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC WOUND CULTURE	$58.80	$84.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CSF CULTURE AND GRAM STAIN	$58.80	$84.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC RESPIRATORY CULTURE	$58.80	$84.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE TISSUE	$58.80	$84.00	—	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, BACTERIAL, OTHER SOURCE	$58.80	$84.00	—	—	30%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL	$44.80	$64.00	—	67% below	30%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL	$44.80	$64.00	—	—	30%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL	$35.00	$50.00	—	40% below	30%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL	$35.00	$50.00	—	—	30%
Blood culture for bacteria CPT 87040 HC CULTURE BLOOD	$72.80	$104.00	—	65% below	30%
Blood culture for bacteria inpatient CPT 87040 HC CULTURE BLOOD	$72.80	$104.00	—	—	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE	$27.30	$39.00	—	10% below	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC VENIPUNCTURE	$27.30	$39.00	—	—	30%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE; QUAN BLOOD	$26.60	$38.00	—	56% below	30%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE; QUAN BLOOD	$26.60	$38.00	—	—	30%
Blood lead test CPT 83655 HC LEAD	$52.50	$75.00	—	52% below	30%
Blood lead test inpatient CPT 83655 HC LEAD	$52.50	$75.00	—	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC PREGNANCY TEST QUALITATIVE	$47.60	$68.00	—	56% below	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC PREGNANCY TEST QUALITATIVE	$47.60	$68.00	—	—	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING, SEROLOGIC; ABO	$37.80	$54.00	—	64% below	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING, SEROLOGIC; ABO	$37.80	$54.00	—	—	30%
Blood urea nitrogen (BUN) test CPT 84520 HC UREA NITROGEN QUANT	$26.60	$38.00	—	57% below	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC UREA NITROGEN QUANT	$26.60	$38.00	—	—	30%
C-peptide blood test CPT 84681 HC C-PEPTIDE	$67.90	$97.00	—	59% below	30%
C-peptide blood test inpatient CPT 84681 HC C-PEPTIDE	$67.90	$97.00	—	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN	$35.70	$51.00	—	62% below	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN	$35.70	$51.00	—	—	30%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFF AMPLIFIED PROBE	$113.40	$162.00	—	61% below	30%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFF AMPLIFIED PROBE	$113.40	$162.00	—	—	30%
CA 19-9 blood test (tumor marker) CPT 86301 HC CANCER ANTIGEN 19-9	$67.90	$97.00	—	62% below	30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC CANCER ANTIGEN 19-9	$67.90	$97.00	—	—	30%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC CANCER ANTIGEN 125	$133.00	$190.00	—	26% below	30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC CANCER ANTIGEN 125	$133.00	$190.00	—	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID-19/SARS-COV-2 CPT 87635 INF AGENT DET W/WO RESP CDC SITE U0001	$119.70	$171.00	—	1% above	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC COVID-19/SARS-COV-2 CPT 87635 INF AGENT DET W/WO RESP CDC SITE U0001	$119.70	$171.00	—	—	30%
Calcium blood test, total CPT 82310 HC CALCIUM; TOTAL	$27.30	$39.00	—	58% below	30%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM; TOTAL	$27.30	$39.00	—	—	30%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRONIC ANTIGEN (CEA)	$67.90	$97.00	—	61% below	30%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRONIC ANTIGEN (CEA)	$67.90	$97.00	—	—	30%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER ANTIBODY	$77.70	$111.00	—	30% below	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER ANTIBODY	$77.70	$111.00	—	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACH BY AMP DNA	$121.10	$173.00	—	27% below	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACH BY AMP DNA	$121.10	$173.00	—	—	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$45.50	$65.00	—	63% below	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL	$45.50	$65.00	—	—	30%
Complete blood count (CBC) with differential CPT 85025 HC CBC/PLT AUTO DIFFERENTIAL	$25.20	$36.00	—	68% below	30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC/PLT AUTO DIFFERENTIAL	$25.20	$36.00	—	—	30%
Complete blood count (CBC), no differential CPT 85027 HC CBC W/O DIFFERENTIAL	$22.40	$32.00	—	72% below	30%
Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC W/O DIFFERENTIAL	$22.40	$32.00	—	—	30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL	$57.40	$82.00	—	68% below	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL	$57.40	$82.00	—	—	30%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL	$67.90	$97.00	—	52% below	30%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL	$67.90	$97.00	—	—	30%
Creatine kinase (CK) blood test, total CPT 82550 HC CPK CREATINE PHOSPHOKINASE	$42.70	$61.00	—	51% below	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CPK CREATINE PHOSPHOKINASE	$42.70	$61.00	—	—	30%
Creatinine blood test CPT 82565 HC CREATININE BLOOD	$25.20	$36.00	—	54% below	30%
Creatinine blood test inpatient CPT 82565 HC CREATININE BLOOD	$25.20	$36.00	—	—	30%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CYTOMEGALOVIRUS ANTIOBYD	$108.50	$155.00	—	12% below	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CYTOMEGALOVIRUS ANTIOBYD	$108.50	$155.00	—	—	30%
D-dimer blood test (blood clot marker) CPT 85379 HC D DIMER QUAN	$55.30	$79.00	—	62% below	30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D DIMER QUAN	$55.30	$79.00	—	—	30%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DHEA SULFATE	$67.90	$97.00	—	65% below	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DHEA SULFATE	$67.90	$97.00	—	—	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN PRESMPTV,ANY NO. BY INSTR CHEM ANAL	$22.40	$32.00	—	87% below	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN PRESMPTV,ANY NO. BY INSTR CHEM ANAL	$22.40	$32.00	—	—	30%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL	$48.30	$69.00	—	61% below	30%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL	$48.30	$69.00	—	—	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC ANTIBODY; EPSTEIN-BARR, VIRAL CAPSID, EACH (A/G/M)	$101.50	$145.00	—	at median	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC ANTIBODY; EPSTEIN-BARR, VIRAL CAPSID, EACH (A/G/M)	$101.50	$145.00	—	—	30%
Estradiol blood test CPT 82670 HC ESTRADIOL	$123.90	$177.00	—	49% below	30%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL	$123.90	$177.00	—	—	30%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FSH	$119.70	$171.00	—	25% below	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FSH	$119.70	$171.00	—	—	30%
Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY FOR CALPROTECTIN FECAL	$249.90	$357.00	—	1% below	30%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY FOR CALPROTECTIN FECAL	$249.90	$357.00	—	—	30%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN	$150.50	$215.00	—	29% above	30%
Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN	$150.50	$215.00	—	—	30%
Folate (folic acid) blood test CPT 82746 HC FOLIC ACID; SERUM	$67.90	$97.00	—	46% below	30%
Folate (folic acid) blood test inpatient CPT 82746 HC FOLIC ACID; SERUM	$67.90	$97.00	—	—	30%
Free T3 thyroid hormone test CPT 84481 HC TRIIODOTHYRONINE T3 FREE	$113.40	$162.00	—	30% below	30%
Free T3 thyroid hormone test inpatient CPT 84481 HC TRIIODOTHYRONINE T3 FREE	$113.40	$162.00	—	—	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC FREE THYROXINE	$52.50	$75.00	—	50% below	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC FREE THYROXINE	$52.50	$75.00	—	—	30%
Free testosterone test CPT 84402 HC TESTOSTERONE FREE	$86.80	$124.00	—	48% below	30%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE FREE	$86.80	$124.00	—	—	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GAMMA GLUTAMYL TRANSFERASE	$52.50	$75.00	—	31% below	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GAMMA GLUTAMYL TRANSFERASE	$52.50	$75.00	—	—	30%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL	$137.90	$197.00	—	66% below	30%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL	$137.90	$197.00	—	—	30%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE 3 SPEC	$42.70	$61.00	—	62% below	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE 3 SPEC	$42.70	$61.00	—	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N. GONORRHOEAE (GC) BY AMP DNA	$121.10	$173.00	—	26% below	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N. GONORRHOEAE (GC) BY AMP DNA	$121.10	$173.00	—	—	30%
H. pylori stool antigen test CPT 87338 HC H PYLORI STOOL	$134.40	$192.00	—	14% below	30%
H. pylori stool antigen test inpatient CPT 87338 HC H PYLORI STOOL	$134.40	$192.00	—	—	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV 1 RNA BY PCR	$149.10	$213.00	—	65% below	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRP J	$155.40	$222.00	—	64% below	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV 1 RNA BY PCR	$149.10	$213.00	—	—	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRP J	$155.40	$222.00	—	—	30%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/2 ANTIBODY DIAGNOSTIC	$86.10	$123.00	—	32% below	30%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV-1/2 ANTIBODY DIAGNOSTIC	$86.10	$123.00	—	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB; SINGLE	$95.20	$136.00	—	4% below	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB; SINGLE	$95.20	$136.00	—	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN A1C	$60.20	$86.00	—	39% below	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN A1C	$60.20	$86.00	—	—	30%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN	$11.20	$16.00	—	70% below	30%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN	$11.20	$16.00	—	—	30%
Hepatitis B core antibody test (total) CPT 86704 HC AB; HBCAB - TOTAL	$52.50	$75.00	—	52% below	30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC AB; HBCAB - TOTAL	$52.50	$75.00	—	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE ANTIBODY	$156.80	$224.00	—	67% above	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURFACE ANTIBODY	$156.80	$224.00	—	—	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE AG EIA	$126.00	$180.00	—	18% above	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEPATITIS B SURFACE AG EIA	$126.00	$180.00	—	—	30%
Hepatitis C antibody blood test (screening) CPT 86803 HC HCV TEST	$141.40	$202.00	—	15% above	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HCV TEST	$141.40	$202.00	—	—	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C RNA QUANTITATIVE	$143.50	$205.00	—	52% below	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEPATITIS C RNA QUANTITATIVE	$143.50	$205.00	—	—	30%
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES TYPE I AB IGG	$107.80	$154.00	—	37% above	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES TYPE I AB IGG	$107.80	$154.00	—	—	30%
Herpes blood test, HSV-2 antibody CPT 86696 HC AB HSV TYPE 2	$108.50	$155.00	—	13% below	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC AB HSV TYPE 2	$108.50	$155.00	—	—	30%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC CRP-HIGH SENSITIVITY	$86.80	$124.00	—	28% below	30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC CRP-HIGH SENSITIVITY	$86.80	$124.00	—	—	30%
Homocysteine blood test CPT 83090 HC HOMOCYSTEINE	$67.90	$97.00	—	62% below	30%
Homocysteine blood test inpatient CPT 83090 HC HOMOCYSTEINE	$67.90	$97.00	—	—	30%
Insulin blood test CPT 83525 HC INSULIN; TOTAL	$52.50	$75.00	—	47% below	30%
Insulin blood test inpatient CPT 83525 HC INSULIN; TOTAL	$52.50	$75.00	—	—	30%
Iron blood test (serum iron) CPT 83540 HC IRON	$52.50	$75.00	—	17% below	30%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON	$52.50	$75.00	—	—	30%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY	$67.90	$97.00	—	15% below	30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY	$67.90	$97.00	—	—	30%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL	$59.50	$85.00	—	68% below	30%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL	$59.50	$85.00	—	—	30%
LH (luteinizing hormone) test CPT 83002 HC LEUTENIZINE HORMONE-LH	$118.30	$169.00	—	24% below	30%
LH (luteinizing hormone) test inpatient CPT 83002 HC LEUTENIZINE HORMONE-LH	$118.30	$169.00	—	—	30%
Lactate (lactic acid) blood test CPT 83605 HC LACTIC ACID	$67.20	$96.00	—	45% below	30%
Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTIC ACID	$67.20	$96.00	—	—	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE	$51.80	$74.00	—	25% below	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE	$51.80	$74.00	—	—	30%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE	$52.50	$75.00	—	55% below	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE	$52.50	$75.00	—	—	30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL	$54.60	$78.00	—	75% below	30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL	$54.60	$78.00	—	—	30%
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY	$119.70	$171.00	—	18% below	30%
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY	$119.70	$171.00	—	—	30%
Magnesium blood test CPT 83735 HC MAGNESIUM, BLOOD	$45.50	$65.00	—	23% below	30%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM, BLOOD	$45.50	$65.00	—	—	30%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA ANTIBODIES IGM	$67.90	$97.00	—	39% below	30%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA IGG ANTIBODY	$67.90	$97.00	—	39% below	30%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA ANTIBODIES IGM	$67.90	$97.00	—	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA IGG ANTIBODY	$67.90	$97.00	—	—	30%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE SCREEN	$37.10	$53.00	—	55% below	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE SCREEN	$37.10	$53.00	—	—	30%
Mumps immunity blood test CPT 86735 HC MUMPS IGG ANTIBODY	$52.50	$75.00	—	52% below	30%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS IGG ANTIBODY	$52.50	$75.00	—	—	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE	$112.00	$160.00	—	27% below	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE	$112.00	$160.00	—	—	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATIC SPECIFIC ANTIGEN TOTAL	$57.40	$82.00	—	64% below	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATIC SPECIFIC ANTIGEN TOTAL	$57.40	$82.00	—	—	30%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE; PTH	$67.90	$97.00	—	74% below	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE; PTH	$67.90	$97.00	—	—	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PARTIAL THROMBOPLASTIN TIME	$40.60	$58.00	—	38% below	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PARTIAL THROMBOPLASTIN TIME	$40.60	$58.00	—	—	30%
Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHORUS	$16.80	$24.00	—	72% below	30%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHORUS	$16.80	$24.00	—	—	30%
Potassium blood test CPT 84132 HC POTASSIUM; SERUM	$31.50	$45.00	—	49% below	30%
Potassium blood test inpatient CPT 84132 HC POTASSIUM; SERUM	$31.50	$45.00	—	—	30%
Progesterone blood test CPT 84144 HC PROGESTERONE	$98.00	$140.00	—	38% below	30%
Progesterone blood test inpatient CPT 84144 HC PROGESTERONE	$98.00	$140.00	—	—	30%
Prolactin blood test CPT 84146 HC PROLACTIN	$121.80	$174.00	—	27% below	30%
Prolactin blood test inpatient CPT 84146 HC PROLACTIN	$121.80	$174.00	—	—	30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME	$27.30	$39.00	—	42% below	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME	$27.30	$39.00	—	—	30%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA A/B ANTIGEN	$81.20	$116.00	—	33% below	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA A/B ANTIGEN	$81.20	$116.00	—	—	30%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY W/OPTIC	$53.90	$77.00	—	62% below	30%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP A ASSAY W/OPTIC	$53.90	$77.00	—	—	30%
Renin blood test CPT 84244 HC RENIN	$67.90	$97.00	—	64% below	30%
Renin blood test inpatient CPT 84244 HC RENIN	$67.90	$97.00	—	—	30%
Rh blood typing CPT 86901 HC BLOOD TYPING; SEROLOGIC; RH D	$37.10	$53.00	—	44% below	30%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING; SEROLOGIC; RH D	$37.10	$53.00	—	—	30%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANT	$52.50	$75.00	—	1% below	30%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANT	$52.50	$75.00	—	—	30%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY	$52.50	$75.00	—	51% below	30%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY	$52.50	$75.00	—	—	30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC AUTOM ERYTHROCYTE SED RATE	$18.90	$27.00	—	68% below	30%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC AUTOM ERYTHROCYTE SED RATE	$18.90	$27.00	—	—	30%
Sodium blood test CPT 84295 HC SODIUM; SERUM	$32.90	$47.00	—	45% below	30%
Sodium blood test inpatient CPT 84295 HC SODIUM; SERUM	$32.90	$47.00	—	—	30%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITE EXAM	$90.30	$129.00	—	1% above	30%
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITE EXAM	$90.30	$129.00	—	—	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD SCREENING	$28.70	$41.00	—	24% below	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC OCCULT BLOOD SCREENING	$28.70	$41.00	—	—	30%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC OCCULT BLD FHG QUAL 1-3	$109.20	$156.00	—	14% above	30%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC OCCULT BLD FHG QUAL 1-3	$109.20	$156.00	—	—	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM	$60.20	$86.00	—	17% below	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM	$60.20	$86.00	—	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILLIS NON-TREPONEMAL	$67.90	$97.00	—	9% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILLIS NON-TREPONEMAL	$67.90	$97.00	—	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB TEST, CELL IMMUN MEASURE RL	$143.50	$205.00	—	46% below	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB TEST, CELL IMMUN MEASURE RL	$143.50	$205.00	—	—	30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL	$168.00	$240.00	—	17% below	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL	$168.00	$240.00	—	—	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC THYROID PEROXIDASE ANTIBODY	$55.30	$79.00	—	54% below	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC THYROID PEROXIDASE ANTIBODY	$55.30	$79.00	—	—	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE	$55.30	$79.00	—	62% below	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE	$55.30	$79.00	—	—	30%
Total IgE blood test CPT 82785 HC IMMUNOGLOBULIN E	$67.90	$97.00	—	42% below	30%
Total IgE blood test inpatient CPT 82785 HC IMMUNOGLOBULIN E	$67.90	$97.00	—	—	30%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL	$27.30	$39.00	—	54% below	30%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL	$27.30	$39.00	—	—	30%
Total thyroxine (T4) blood test CPT 84436 HC THYROXINE TOTAL T4	$52.50	$75.00	—	33% below	30%
Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE TOTAL T4	$52.50	$75.00	—	—	30%
Total triiodothyronine (T3) blood test CPT 84480 HC TRIIODOTHYRONINE TOTAL	$52.50	$75.00	—	57% below	30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC TRIIODOTHYRONINE TOTAL	$52.50	$75.00	—	—	30%
Transferrin blood test CPT 84466 HC TRANSFERRIN LEVEL	$52.50	$75.00	—	61% below	30%
Transferrin blood test inpatient CPT 84466 HC TRANSFERRIN LEVEL	$52.50	$75.00	—	—	30%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES	$39.90	$57.00	—	41% below	30%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES	$39.90	$57.00	—	—	30%
Troponin test, quantitative CPT 84484 HC TROPONIN QUANTITATIVE	$67.90	$97.00	—	57% below	30%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN QUANTITATIVE	$67.90	$97.00	—	—	30%
Uric acid blood test CPT 84550 HC URIC ACID BLOOD	$31.50	$45.00	—	51% below	30%
Uric acid blood test inpatient CPT 84550 HC URIC ACID BLOOD	$31.50	$45.00	—	—	30%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS W/O MICRO AUTOMATED	$12.60	$18.00	—	71% below	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS W/O MICRO AUTOMATED	$12.60	$18.00	—	—	30%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE URINE	$60.20	$86.00	—	41% below	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE URINE	$60.20	$86.00	—	—	30%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN, URINE, QUANT	$52.50	$75.00	—	44% below	30%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN, URINE, QUANT	$52.50	$75.00	—	—	30%
Urine pregnancy test, read by color change CPT 81025 HC PREGNANCY TEST URINE	$45.50	$65.00	—	37% below	30%
Urine pregnancy test, read by color change inpatient CPT 81025 HC PREGNANCY TEST URINE	$45.50	$65.00	—	—	30%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12	$107.80	$154.00	—	17% below	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12	$107.80	$154.00	—	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D 25 HYDROXY	$151.90	$217.00	—	16% below	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D 25 HYDROXY	$151.90	$217.00	—	—	30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VITAMIN D 1 25 INCLDNG FRACTN	$134.40	$192.00	—	51% below	30%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VITAMIN D 1 25 INCLDNG FRACTN	$134.40	$192.00	—	—	30%
Zinc blood test CPT 84630 HC ZINC	$67.90	$97.00	—	27% below	30%
Zinc blood test inpatient CPT 84630 HC ZINC	$67.90	$97.00	—	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HUMAN CHORIONIC GONADOTROPIN QUANT	$78.40	$112.00	—	49% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HUMAN CHORIONIC GONADOTROPIN QUANT	$78.40	$112.00	—	—	30%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Colorado	Off list
Botox injections for chronic migraine CPT 64615 HC CHEMODENERV MUSC MIGRAINE	$1,022.70	$1,461.00	—	at median	30%
Botox injections for chronic migraine inpatient CPT 64615 HC CHEMODENERV MUSC MIGRAINE	$1,022.70	$1,461.00	—	—	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST 1ST LESION STEREO	$3,691.10	$5,273.00	—	39% above	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST 1ST LESION STEREO	$3,691.10	$5,273.00	—	—	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$1,411.20	$2,016.00	—	143% above	30%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$1,411.20	$2,016.00	—	—	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXTERNAL	$644.70	$921.00	—	59% below	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXTERNAL	$644.70	$921.00	—	—	30%
Carpal tunnel release, open surgery CPT 64721 HC NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$2,484.30	$3,549.00	—	53% below	30%
Carpal tunnel release, open surgery inpatient CPT 64721 HC NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$2,484.30	$3,549.00	—	—	30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$856.10	$1,223.00	—	29% above	30%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$856.10	$1,223.00	—	—	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX INTERLAMINAR CRV/THRC	$1,762.60	$2,518.00	—	9% above	30%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC NJX INTERLAMINAR CRV/THRC	$1,762.60	$2,518.00	—	—	30%
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV BILATERAL	$3,018.40	$4,312.00	—	—	30%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV UNILAT	$2,307.90	$3,297.00	—	94% above	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient both sides CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV BILATERAL	$3,018.40	$4,312.00	—	—	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV UNILAT	$2,307.90	$3,297.00	—	—	30%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSCESS SIMPLE OR SINGLE	$671.30	$959.00	—	92% above	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D ABSCESS SIMPLE OR SINGLE	$671.30	$959.00	—	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ SGL TENDON SHTH OR LIGAMENT	$242.20	$346.00	—	36% below	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJ SGL TENDON SHTH OR LIGAMENT	$242.20	$346.00	—	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 HC MAJOR JOINT ASPRTN/INJ BILATERAL W/O US GUIDE	$520.80	$744.00	—	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HC MAJOR JOINT ASPRTN/INJ UNILATERAL W/O US GUIDE	$408.10	$583.00	—	19% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 HC MAJOR JOINT ASPRTN/INJ BILATERAL W/O US GUIDE	$520.80	$744.00	—	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 HC MAJOR JOINT ASPRTN/INJ UNILATERAL W/O US GUIDE	$408.10	$583.00	—	—	30%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT	$552.30	$789.00	—	63% above	30%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT	$552.30	$789.00	—	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 HC MEDIUM JOINT ASPIRTN/INJECT UNILATERAL W/O US GUIDE	$408.10	$583.00	—	9% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 HC MEDIUM JOINT ASPIRTN/INJECT UNILATERAL W/O US GUIDE	$408.10	$583.00	—	—	30%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 HC SMALL JOINT ASPRNT/INJECT UNILATERAL W/O US GUIDE	$408.10	$583.00	—	5% above	30%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 HC SMALL JOINT ASPRNT/INJECT UNILATERAL W/O US GUIDE	$408.10	$583.00	—	—	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC REPR INTMD WOUND SCALP <2.5 CM	$1,015.70	$1,451.00	—	81% above	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC REPR INTMD WOUND SCALP <2.5 CM	$1,015.70	$1,451.00	—	—	30%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ DX/THER INTRALAMINAR LUMBAR/SACRAL W/IMAGING	$1,762.60	$2,518.00	—	19% above	30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ DX/THER INTRALAMINAR LUMBAR/SACRAL W/IMAGING	$1,762.60	$2,518.00	—	—	30%
Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$1,762.60	$2,518.00	—	44% above	30%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$1,762.60	$2,518.00	—	—	30%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 HC INJ ANES/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL BILAT	$2,019.50	$2,885.00	—	—	30%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ ANES/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL	$1,192.80	$1,704.00	—	19% below	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 HC INJ ANES/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL BILAT	$2,019.50	$2,885.00	—	—	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ ANES/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL	$1,192.80	$1,704.00	—	—	30%
Nail removal (partial or complete), one nail CPT 11730 HC AVLSION NAIL PLATE PARTL/COMPL SGL	$242.20	$346.00	—	22% below	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVLSION NAIL PLATE PARTL/COMPL SGL	$242.20	$346.00	—	—	30%
Occipital nerve block (injection for headaches) both sides CPT 64405 HC INJECTION, GREATER OCCIPITAL NERVE BILATERAL	$1,491.70	$2,131.00	—	—	30%
Occipital nerve block (injection for headaches) one side CPT 64405 HC INJECTION, GREATER OCCIPITAL NERVE UNILATERAL	$1,192.80	$1,704.00	—	69% above	30%
Occipital nerve block (injection for headaches) inpatient both sides CPT 64405 HC INJECTION, GREATER OCCIPITAL NERVE BILATERAL	$1,491.70	$2,131.00	—	—	30%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 HC INJECTION, GREATER OCCIPITAL NERVE UNILATERAL	$1,192.80	$1,704.00	—	—	30%
Paracentesis with imaging guidance CPT 49083 HC PARACENTESIS WITH IMAGING	$1,406.30	$2,009.00	—	8% below	30%
Paracentesis with imaging guidance inpatient CPT 49083 HC PARACENTESIS WITH IMAGING	$1,406.30	$2,009.00	—	—	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL NAILBED PARTL/COMPLETE	$614.60	$878.00	—	14% below	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVAL NAILBED PARTL/COMPLETE	$614.60	$878.00	—	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 HC CT FACET RHIZOTOMY L OR SACRAL SPINE BILATERAL SINGLE LEVEL	$4,553.50	$6,505.00	—	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 HC CT FACET RHIZOTOMY L OR SACRAL SPINE UNILATERAL SINGLE LEVEL	$3,030.30	$4,329.00	—	2% above	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient both sides CPT 64635 HC CT FACET RHIZOTOMY L OR SACRAL SPINE BILATERAL SINGLE LEVEL	$4,553.50	$6,505.00	—	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 HC CT FACET RHIZOTOMY L OR SACRAL SPINE UNILATERAL SINGLE LEVEL	$3,030.30	$4,329.00	—	—	30%
Removal of a foreign object under the skin, simple CPT 10120 HC INC & REM FB, SQ; SMPL	$1,024.80	$1,464.00	—	68% above	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC INC & REM FB, SQ; SMPL	$1,024.80	$1,464.00	—	—	30%
Short arm splint (forearm and hand) CPT 29125 HC APPLY FOREARM SPLINT STATIC	$438.90	$627.00	—	59% above	30%
Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY FOREARM SPLINT STATIC	$438.90	$627.00	—	—	30%
Short leg splint (calf to foot) CPT 29515 HC APPLY LOWER LEG SPLINT	$294.70	$421.00	—	37% above	30%
Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY LOWER LEG SPLINT	$294.70	$421.00	—	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC REPAIR SIMPLE S/N/A/G/TR/E TO 2.5CM	$249.90	$357.00	—	40% below	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC REPAIR SIMPLE S/N/A/G/TR/E TO 2.5CM	$249.90	$357.00	—	—	30%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BX SKIN; SINGLE LESION	$329.70	$471.00	—	46% below	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BX SKIN; SINGLE LESION	$329.70	$471.00	—	—	30%
Skin tag removal, up to 15 tags CPT 11200 HC SKIN TAG REMOVAL UP TO 15 LESIONS	$597.10	$853.00	—	108% above	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC SKIN TAG REMOVAL UP TO 15 LESIONS	$597.10	$853.00	—	—	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC	$366.10	$523.00	—	60% below	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC	$366.10	$523.00	—	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC REPAIR SIMP 2.6-7.5CM (SUPERFICIAL) S/N/A/G/TR/E	$363.30	$519.00	—	2% below	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC REPAIR SIMP 2.6-7.5CM (SUPERFICIAL) S/N/A/G/TR/E	$363.30	$519.00	—	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC REPAIR SIMP WOUND <=2.5CM FACE	$361.90	$517.00	—	at median	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC REPAIR SIMP WOUND <=2.5CM FACE	$361.90	$517.00	—	—	30%
Thoracentesis with imaging guidance one side CPT 32555 HC THORACENTESIS/ASPIRATION WITH IMAGING UNILATERAL	$1,316.00	$1,880.00	—	5% above	30%
Thoracentesis with imaging guidance inpatient one side CPT 32555 HC THORACENTESIS/ASPIRATION WITH IMAGING UNILATERAL	$1,316.00	$1,880.00	—	—	30%
Trigger finger release surgery CPT 26055 HC INCISE FINGER TENDON SHEATH	$2,055.90	$2,937.00	—	48% below	30%
Trigger finger release surgery inpatient CPT 26055 HC INCISE FINGER TENDON SHEATH	$2,055.90	$2,937.00	—	—	30%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJECT TRIGGER POINT(S), 1 - 2 MUSCLE	$1,372.70	$1,961.00	—	185% above	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJECT TRIGGER POINT(S), 1 - 2 MUSCLE	$1,372.70	$1,961.00	—	—	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US GUIDE	$2,055.90	$2,937.00	—	5% below	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST 1ST LESION US GUIDE	$2,055.90	$2,937.00	—	—	30%
Wart removal, up to 14 warts CPT 17110 HC DESTRUCT BENIGN LESION 1-14	$377.30	$539.00	—	38% above	30%
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCT BENIGN LESION 1-14	$377.30	$539.00	—	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEB SUBQ TISSUE 20 SQ CM/<	$401.10	$573.00	—	32% below	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEB SUBQ TISSUE 20 SQ CM/<	$401.10	$573.00	—	—	30%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Colorado	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC ADMIN BLOOD TRANSFUSION DAILY	$1,442.70	$2,061.00	—	28% above	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC ADMIN BLOOD TRANSFUSION DAILY	$1,442.70	$2,061.00	—	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT	$129.50	$185.00	—	55% below	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AIRWAY INHALATION TREATMENT	$129.50	$185.00	—	—	30%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO INFUSION INITIAL 1ST HR	$280.00	$400.00	—	73% below	30%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO INFUSION INITIAL 1ST HR	$280.00	$400.00	—	—	30%
Critical care, first 30 to 74 minutes CPT 99291 HC ER CRITICAL CARE	$2,630.60	$3,758.00	—	26% below	30%
Critical care, first 30 to 74 minutes CPT 99291 HC ER CRITICAL CARE W/MOD	$2,630.60	$3,758.00	—	26% below	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ER CRITICAL CARE	$2,630.60	$3,758.00	—	—	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ER CRITICAL CARE W/MOD	$2,630.60	$3,758.00	—	—	30%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE/DROWSY	$957.60	$1,368.00	—	73% below	30%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE/DROWSY	$957.60	$1,368.00	—	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG 12 LEAD;TRACING ONLY W/O INTERP	$255.50	$365.00	—	4% above	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG 12 LEAD;TRACING ONLY W/O INTERP	$255.50	$365.00	—	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY ROOM - LEVEL 1 W/MOD	$385.70	$551.00	—	52% above	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY ROOM-LEVEL 1	$385.70	$551.00	—	52% above	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMERGENCY ROOM - LEVEL 1 W/MOD	$385.70	$551.00	—	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMERGENCY ROOM-LEVEL 1	$385.70	$551.00	—	—	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY ROOM-LEVEL 2	$541.80	$774.00	—	3% below	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY ROOM - LEVEL 2 W/MOD	$541.80	$774.00	—	3% below	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY ROOM - LEVEL 2 W/MOD	$541.80	$774.00	—	—	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY ROOM-LEVEL 2	$541.80	$774.00	—	—	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY ROOM - LEVEL 3 W/MOD	$1,040.90	$1,487.00	—	8% above	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY ROOM-LEVEL 3	$1,040.90	$1,487.00	—	8% above	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMERGENCY ROOM-LEVEL 3	$1,040.90	$1,487.00	—	—	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMERGENCY ROOM - LEVEL 3 W/MOD	$1,040.90	$1,487.00	—	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY ROOM-LEVEL 4	$1,632.40	$2,332.00	—	3% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY ROOM - LEVEL 4 W/MOD	$1,632.40	$2,332.00	—	3% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMERGENCY ROOM - LEVEL 4 W/MOD	$1,632.40	$2,332.00	—	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMERGENCY ROOM-LEVEL 4	$1,632.40	$2,332.00	—	—	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY ROOM - LEVEL 5 W/MOD	$2,405.90	$3,437.00	—	5% below	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY ROOM-LEVEL 5	$2,405.90	$3,437.00	—	5% below	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMERGENCY ROOM - LEVEL 5 W/MOD	$2,405.90	$3,437.00	—	—	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMERGENCY ROOM-LEVEL 5	$2,405.90	$3,437.00	—	—	30%
Group psychotherapy session CPT 90853 HC GROUP THERAPY	$308.00	$440.00	—	4% above	30%
Group psychotherapy session inpatient CPT 90853 HC GROUP THERAPY	$308.00	$440.00	—	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INFUSN HYDRATION INITIAL HR	$237.30	$339.00	—	42% below	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INFUSN HYDRATION INITIAL HR	$237.30	$339.00	—	—	30%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION THERAP INITIAL HR	$406.00	$580.00	—	24% below	30%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION THERAP INITIAL HR	$406.00	$580.00	—	—	30%
IV push of a medicine, first drug CPT 96374 HC IVP INITIAL THERAPEUTIC	$198.80	$284.00	—	39% below	30%
IV push of a medicine, first drug inpatient CPT 96374 HC IVP INITIAL THERAPEUTIC	$198.80	$284.00	—	—	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION IM/SC THERAPEUTIC	$237.30	$339.00	—	58% above	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION IM/SC THERAPEUTIC	$237.30	$339.00	—	—	30%
Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUS RE-ED PER 15 MIN	$84.00	$120.00	—	28% below	30%
Neuromuscular re-education, 15 minutes CPT 97112 HC OT NEUROMUS RE-ED PER 15 MIN	$84.00	$120.00	—	28% below	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT NEUROMUS RE-ED PER 15 MIN	$84.00	$120.00	—	—	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC OT NEUROMUS RE-ED PER 15 MIN	$84.00	$120.00	—	—	30%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEXITY	$160.30	$229.00	—	51% below	30%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEXITY	$160.30	$229.00	—	—	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEXITY	$245.00	$350.00	—	24% below	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEXITY	$245.00	$350.00	—	—	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEXITY	$160.30	$229.00	—	43% below	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEXITY	$160.30	$229.00	—	—	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MODERATE COMPLEXITY	$192.50	$275.00	—	35% below	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL MODERATE COMPLEXITY	$192.50	$275.00	—	—	30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT MANUAL THERAPY (SOFT TISSUE, MOB, MANIPULATION, TRACTION) PER 15 MIN	$75.60	$108.00	—	29% below	30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THERAPY (SOFT TISSUE, MOB, MANIPULATION, TRACTION) PER 15 MIN	$75.60	$108.00	—	29% below	30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC OT MANUAL THERAPY (SOFT TISSUE, MOB, MANIPULATION, TRACTION) PER 15 MIN	$75.60	$108.00	—	—	30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MANUAL THERAPY (SOFT TISSUE, MOB, MANIPULATION, TRACTION) PER 15 MIN	$75.60	$108.00	—	—	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EX PER 15 MIN	$80.50	$115.00	—	28% below	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EX PER 15 MIN	$80.50	$115.00	—	28% below	30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EX PER 15 MIN	$80.50	$115.00	—	—	30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EX PER 15 MIN	$80.50	$115.00	—	—	30%
Psychotherapy for crisis, first 60 minutes CPT 90839 HC PSYTX CRISIS INITIAL 60 MIN	$576.10	$823.00	—	6% above	30%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PSYTX CRISIS INITIAL 60 MIN	$576.10	$823.00	—	—	30%
Psychotherapy session, 30 minutes CPT 90832 HC PSYTX PT&/FAMILY 30 MINUTES	$314.30	$449.00	—	47% above	30%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYTX PT&/FAMILY 30 MINUTES	$314.30	$449.00	—	—	30%
Psychotherapy session, 45 minutes CPT 90834 HC PSYTX, 45 MIN WITH PATIENT	$338.10	$483.00	—	21% above	30%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYTX, 45 MIN WITH PATIENT	$338.10	$483.00	—	—	30%
Psychotherapy session, 60 minutes CPT 90837 HC PSYTX, 60 MIN WITH PATIENT	$345.80	$494.00	—	at median	30%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYTX, 60 MIN WITH PATIENT	$345.80	$494.00	—	—	30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC SMOKING CESSATION ASYMPTOMATIC >3 & UP TO 10 MIN	$69.30	$99.00	—	12% above	30%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC SMOKING CESSATION ASYMPTOMATIC >3 & UP TO 10 MIN	$69.30	$99.00	—	—	30%
Speech and language evaluation CPT 92523 HC ST EVAL ST SOUND PROD W/LANG COMP	$493.50	$705.00	—	6% above	30%
Speech and language evaluation inpatient CPT 92523 HC ST EVAL ST SOUND PROD W/LANG COMP	$493.50	$705.00	—	—	30%
Speech therapy session, individual CPT 92507 HC ST TRTMT SPEECH LANG VOICE INDIV	$306.60	$438.00	—	15% below	30%
Speech therapy session, individual inpatient CPT 92507 HC ST TRTMT SPEECH LANG VOICE INDIV	$306.60	$438.00	—	—	30%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY	$222.60	$318.00	—	27% below	30%
Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY	$222.60	$318.00	—	—	30%
Spirometry before and after a bronchodilator CPT 94060 HC SPIROMETRY BEFORE/AFTER B.D.	$403.20	$576.00	—	13% below	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC SPIROMETRY BEFORE/AFTER B.D.	$403.20	$576.00	—	—	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THERAPEUTIC ACTIVITY 15 MIN	$86.80	$124.00	—	34% below	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THERAPEUTIC ACTIVITY 15 MIN	$86.80	$124.00	—	34% below	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC OT THERAPEUTIC ACTIVITY 15 MIN	$86.80	$124.00	—	—	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THERAPEUTIC ACTIVITY 15 MIN	$86.80	$124.00	—	—	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERAPEUTIC	$231.00	$330.00	—	19% below	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY THERAPEUTIC	$231.00	$330.00	—	—	30%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Colorado	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLU VACC 2025-26(65YR UP)-MF59C(PF) 45 MCG(15 MCGX3)/0.5 ML IM SYRINGE	$299.18	$427.40	—	at median	30%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLU VACC 2025-26(65YR UP)-MF59C(PF) 45 MCG(15 MCGX3)/0.5 ML IM SYRINGE	$299.18	$427.40	—	—	30%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID VACC 2025-2026 (12 YRS UP) (PFIZER)(PF) 30 MCG/0.3 ML IM SYRINGE	$594.46	$849.23	—	48% above	30%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID VACC 2025-2026 (12 YRS UP) (PFIZER)(PF) 30 MCG/0.3 ML IM SYRINGE	$594.46	$849.23	—	—	30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE	$159.24	$227.48	—	26% above	30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE	$159.24	$227.48	—	—	30%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE	$464.72	$663.88	—	15% below	30%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$497.38	$710.54	—	9% below	30%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE	$464.72	$663.88	—	—	30%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$497.38	$710.54	—	—	30%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE	$221.36	$316.23	—	53% above	30%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE	$221.36	$316.23	—	—	30%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$536.14	$765.92	—	67% above	30%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$536.14	$765.92	—	—	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$1,077.58	$1,539.40	—	25% above	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$1,077.58	$1,539.40	—	—	30%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PNEUMOCOCCAL 21-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$1,054.73	$1,506.75	—	234% above	30%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 PNEUMOCOCCAL 21-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$1,054.73	$1,506.75	—	—	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION	$409.79	$585.41	—	16% above	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE	$409.79	$585.41	—	16% above	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION	$409.79	$585.41	—	—	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE	$409.79	$585.41	—	—	30%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$1,642.24	$2,346.05	—	27% above	30%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$1,642.24	$2,346.05	—	—	30%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT	$821.41	$1,173.44	—	156% above	30%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT	$821.41	$1,173.44	—	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE	$268.19	$383.13	—	29% above	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$273.45	$390.64	—	31% above	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE	$268.19	$383.13	—	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$273.45	$390.64	—	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN;ONE VACCINE	$35.00	$50.00	—	50% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VACCINE	$36.40	$52.00	—	47% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN HEPATITIS B VACCINE	$36.40	$52.00	—	47% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE	$36.40	$52.00	—	47% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMIN;ONE VACCINE	$35.00	$50.00	—	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN INFLUENZA VACCINE	$36.40	$52.00	—	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE	$36.40	$52.00	—	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN HEPATITIS B VACCINE	$36.40	$52.00	—	—	30%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://fhw.org/wp-content/uploads/2026/03/84-0447998_Family_Health_West_standardcharges.csv