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 (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Colorado median for 301 of 319 procedures and above it for 16. By typical cash price it ranks #7 of 37 Colorado hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

300 W Ottley Ave, Fruita, CO 81521 Collected Sep 27, 2026 Source price file (970) 858-9871

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

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
Ankle X-ray, complete, 3 or more views CPT 73610 CAH RADEX ANKLE COMPLETE MINIMUM 3 VIEWS	$52.50	$75.00	—	83% below	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC DI ANKLE MIN 3 VIEW UNILATERAL	$272.30	$389.00	—	10% below	30%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 CAH RADEX ANKLE COMPLETE MINIMUM 3 VIEWS	$52.50	$75.00	—	—	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	—	52% below	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%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC DI ESOPHAGRAM	$589.40	$842.00	—	24% 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 CPT 76641 CAH US BREAST UNI REAL TIME WITH IMAGE COMPLETE	$147.00	$210.00	—	66% below	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 CPT 76641 CAH US BREAST UNI REAL TIME WITH IMAGE COMPLETE	$147.00	$210.00	—	—	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) CPT 76642 CAH US BREAST UNI REAL TIME WITH IMAGE LIMITED	$121.10	$173.00	—	72% below	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 CPT 76642 CAH US BREAST UNI REAL TIME WITH IMAGE LIMITED	$121.10	$173.00	—	—	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 of the chest (CTA), for blood clots in the lungs CPT 71275 CAH CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST	$376.60	$538.00	—	86% below	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	—	22% below	30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CAH CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST	$376.60	$538.00	—	—	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 CAH CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM	$146.30	$209.00	—	54% below	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	—	100% above	30%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CAH CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM	$146.30	$209.00	—	—	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 CAH CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL	$266.70	$381.00	—	91% below	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	—	29% below	30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CAH CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL	$266.70	$381.00	—	—	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 CAH CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$445.90	$637.00	—	90% below	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W/CONTRAST	$2,455.60	$3,508.00	—	46% below	30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CAH CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$445.90	$637.00	—	—	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	—	28% 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 CAH CT ABDOMEN W/CONTRAST MATERIAL	$340.90	$487.00	—	87% below	30%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/CONTRAST	$1,518.30	$2,169.00	—	42% below	30%
CT scan of the abdomen with contrast inpatient CPT 74160 CAH CT ABDOMEN W/CONTRAST MATERIAL	$340.90	$487.00	—	—	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	—	38% 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	—	10% 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 CAH CT HEAD/BRAIN W/O CONTRAST MATERIAL	$155.40	$222.00	—	93% below	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	—	43% below	30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CAH CT HEAD/BRAIN W/O CONTRAST MATERIAL	$155.40	$222.00	—	—	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	—	29% 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 CAH CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL	$254.10	$363.00	—	93% below	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	—	38% below	30%
CT scan of the head without and with contrast inpatient CPT 70470 CAH CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL	$254.10	$363.00	—	—	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	—	32% 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 CAH CT CERVICAL SPINE W/O CONTRAST MATERIAL	$190.40	$272.00	—	90% below	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	—	34% below	30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CAH CT CERVICAL SPINE W/O CONTRAST MATERIAL	$190.40	$272.00	—	—	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	—	42% 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	—	17% 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	—	21% below	30%
Chest X-ray, single view inpatient CPT 71045 HC DI CHEST 1 VIEW	$226.80	$324.00	—	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$534.10	$763.00	—	33% 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	—	62% 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 CAH DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL	$45.50	$65.00	—	93% below	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA BONE DENSITY/PERIPHERAL	$176.40	$252.00	—	72% below	30%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 CAH DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL	$45.50	$65.00	—	—	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	—	5% below	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 CAH DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST	$194.60	$278.00	—	89% below	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	—	32% below	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CAH DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST	$194.60	$278.00	—	—	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 CAH DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST	$245.00	$350.00	—	90% below	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX DX W/CONTRAST	$1,518.30	$2,169.00	—	37% below	30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CAH DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST	$245.00	$350.00	—	—	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 CAH DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$226.80	$324.00	—	—	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 CAH DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$226.80	$324.00	—	—	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 CPT 77065 CAH DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$53.20	$76.00	—	85% below	30%
Diagnostic mammogram, one breast one side CPT 77065 HC DIAG MAMMO, UNILATERAL INCL CAD WHEN PERFORMED	$185.50	$265.00	—	49% below	30%
Diagnostic mammogram, one breast inpatient CPT 77065 CAH DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$53.20	$76.00	—	—	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	—	67% 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	—	67% 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%
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 CPT 73562 CAH RADIOLOGIC EXAMINATION KNEE 3 VIEWS	$58.80	$84.00	—	80% below	30%
Knee X-ray, 3 views one side CPT 73562 HC DI KNEE 3 VIEWS UNILATERAL	$272.30	$389.00	—	10% below	30%
Knee X-ray, 3 views inpatient CPT 73562 CAH RADIOLOGIC EXAMINATION KNEE 3 VIEWS	$58.80	$84.00	—	—	30%
Knee X-ray, 3 views inpatient one side CPT 73562 HC DI KNEE 3 VIEWS UNILATERAL	$272.30	$389.00	—	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC ULTRASOUND ABDOMEN LIMITED	$490.00	$700.00	—	29% 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%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CAH COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-	$70.70	$101.00	—	77% below	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	—	50% above	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CAH COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-	$70.70	$101.00	—	—	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%
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	—	39% above	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	—	78% above	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 CAH MRI ABDOMEN W/O CONTRAST MATERIAL	$287.70	$411.00	—	90% below	30%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O CONTRAST	$1,974.70	$2,821.00	—	33% below	30%
MRI of the abdomen without contrast inpatient CPT 74181 CAH MRI ABDOMEN W/O CONTRAST MATERIAL	$287.70	$411.00	—	—	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 CAH MRI ABDOMEN W/O & W/CONTRAST MATERIAL	$497.70	$711.00	—	88% below	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	—	24% below	30%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 CAH MRI ABDOMEN W/O & W/CONTRAST MATERIAL	$497.70	$711.00	—	—	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 CAH MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL	$287.70	$411.00	—	92% below	30%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST	$1,974.70	$2,821.00	—	46% below	30%
MRI of the brain, no contrast dye inpatient CPT 70551 CAH MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL	$287.70	$411.00	—	—	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 CAH MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$467.60	$668.00	—	89% below	30%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/WO CONTRAST	$3,161.90	$4,517.00	—	24% below	30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 CAH MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$467.60	$668.00	—	—	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 CAH MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$280.70	$401.00	—	91% below	30%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST	$1,974.70	$2,821.00	—	38% below	30%
MRI of the lower back, no contrast dye inpatient CPT 72148 CAH MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$280.70	$401.00	—	—	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	—	16% 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 CAH MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL	$279.30	$399.00	—	92% below	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	—	42% below	30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 CAH MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL	$279.30	$399.00	—	—	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 CAH MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL	$470.40	$672.00	—	87% below	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	—	12% below	30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 CAH MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL	$470.40	$672.00	—	—	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	—	43% 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	—	35% 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	—	46% 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 CAH MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL	$298.20	$426.00	—	71% below	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	—	95% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 CAH MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL	$298.20	$426.00	—	—	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%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 CAH US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U	$70.00	$100.00	—	92% below	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM, PELVIC, LIMITED	$403.90	$577.00	—	57% below	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 CAH US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U	$70.00	$100.00	—	—	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 CAH US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE	$150.50	$215.00	—	83% below	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC NON-OB S&I	$628.60	$898.00	—	27% below	30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 CAH US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE	$150.50	$215.00	—	—	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 CAH US CAHEG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$65.10	$93.00	—	93% below	30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREG 2ND/3RD TRIMESTER	$690.90	$987.00	—	25% below	30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 CAH US CAHEG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$65.10	$93.00	—	—	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 CAH US CAHEGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT	$64.40	$92.00	—	91% below	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US, OB < 14 WKS, SINGLE FETUS	$602.00	$860.00	—	13% below	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 CAH US CAHEGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT	$64.40	$92.00	—	—	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 CAH US CAHEGNANT UTERUS LIMITED 1/> FETUSES	$115.50	$165.00	—	73% below	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC ULTRASOUND OB LIMITED	$490.00	$700.00	—	13% above	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 CAH US CAHEGNANT UTERUS LIMITED 1/> FETUSES	$115.50	$165.00	—	—	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC ULTRASOUND OB LIMITED	$490.00	$700.00	—	—	30%
Screening mammogram, both breasts both sides CPT 77067 CAH SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$49.70	$71.00	—	—	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	—	39% above	30%
Screening mammogram, both breasts inpatient both sides CPT 77067 CAH SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$49.70	$71.00	—	—	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 CPT 73030 CAH RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS	$50.40	$72.00	—	83% below	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC DI SHOULDER MIN 2 VIEWS UNILATERAL	$272.30	$389.00	—	10% below	30%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 CAH RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS	$50.40	$72.00	—	—	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%
Swallow study (modified barium swallow, video X-ray) CPT 74230 CAH RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$179.20	$256.00	—	70% below	30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC DI SWALLOWING EVAL W/VIDEO	$541.80	$774.00	—	10% below	30%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 CAH RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$179.20	$256.00	—	—	30%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC DI SWALLOWING EVAL W/VIDEO	$541.80	$774.00	—	—	30%
Transvaginal pelvic ultrasound CPT 76830 CAH US TRANSVAGINAL	$170.80	$244.00	—	77% below	30%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON-OB S&I	$599.90	$857.00	—	19% below	30%
Transvaginal pelvic ultrasound inpatient CPT 76830 CAH US TRANSVAGINAL	$170.80	$244.00	—	—	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 CAH US CAHEG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG	$132.30	$189.00	—	83% below	30%
Transvaginal ultrasound during pregnancy CPT 76817 HC TRANSVAGINAL ULTRASOUND PREGNANCY	$490.00	$700.00	—	37% below	30%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 CAH US CAHEG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG	$132.30	$189.00	—	—	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	—	35% 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	—	23% 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 CAH US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM	$158.20	$226.00	—	80% below	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	—	25% below	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 CAH US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM	$158.20	$226.00	—	—	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 CAH RADIOLOGIC EXAM UCAH GI TRC SINGLE CONTRAST STUDY	$175.70	$251.00	—	82% below	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	—	46% below	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 CAH RADIOLOGIC EXAM UCAH GI TRC SINGLE CONTRAST STUDY	$175.70	$251.00	—	—	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%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CAH DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$170.80	$244.00	—	87% below	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	—	33% below	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CAH DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$170.80	$244.00	—	—	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, complete, 3 or more views CPT 73110 CAH RADEX WRIST COMPLETE MINIMUM 3 VIEWS	$59.50	$85.00	—	80% below	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 CPT 73110 CAH RADEX WRIST COMPLETE MINIMUM 3 VIEWS	$59.50	$85.00	—	—	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 CAH RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$68.60	$98.00	—	88% below	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	—	52% below	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 CAH RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$68.60	$98.00	—	—	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	—	21% 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 CPT 73600 CAH RADIOLOGIC EXAMINATION ANKLE 2 VIEWS	$46.20	$66.00	—	85% below	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 CPT 73600 CAH RADIOLOGIC EXAMINATION ANKLE 2 VIEWS	$46.20	$66.00	—	—	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 CPT 73140 CAH RADEX FINGR MINIMUM 2 VIEWS	$55.30	$79.00	—	80% below	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	—	2% below	30%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 CAH RADEX FINGR MINIMUM 2 VIEWS	$55.30	$79.00	—	—	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	—	17% 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 CPT 73630 CAH RADEX FOOT COMPLETE MINIMUM 3 VIEWS	$49.00	$70.00	—	84% below	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	—	10% below	30%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 CAH RADEX FOOT COMPLETE MINIMUM 3 VIEWS	$49.00	$70.00	—	—	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 CPT 73130 CAH RADEX HAND MINIMUM 3 VIEWS	$53.20	$76.00	—	82% below	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	—	10% below	30%
X-ray of the hand, 3 or more views inpatient CPT 73130 CAH RADEX HAND MINIMUM 3 VIEWS	$53.20	$76.00	—	—	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 CPT 73560 CAH RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS	$49.00	$70.00	—	84% below	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 CPT 73560 CAH RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS	$49.00	$70.00	—	—	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	—	49% 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	—	54% 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	—	34% 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 CAH RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS	$53.90	$77.00	—	82% below	30%
X-ray of the nasal bones, 3 or more views CPT 70160 HC DI NASAL BONES MIN 3 VIEWS	$272.30	$389.00	—	11% below	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 CAH RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS	$53.90	$77.00	—	—	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	—	45% 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	—	30% 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 CAH RADEX SACRUM & COCCYX MINIMUM 2 VIEWS	$46.90	$67.00	—	89% below	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	—	43% below	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 CAH RADEX SACRUM & COCCYX MINIMUM 2 VIEWS	$46.90	$67.00	—	—	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
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSAMINASE ALT/SGPT	$36.40	$52.00	—	66% 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	—	84% 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	—	70% below	30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS ACUTE PROFILE	$225.40	$322.00	—	—	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CITRULLINATED PEPTIDE IGGCCP ANTIBODY	$91.00	$130.00	—	58% 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	—	53% 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	—	65% below	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE	$218.40	$312.00	—	—	30%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL	$44.80	$64.00	—	84% below	30%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL	$44.80	$64.00	—	—	30%
Blood culture for bacteria CPT 87040 HC CULTURE BLOOD	$72.80	$104.00	—	78% 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 CAH COLLECTION VENOUS BLOOD VENIPUNCTURE	$11.90	$17.00	—	80% below	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE	$27.30	$39.00	—	54% below	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 CAH COLLECTION VENOUS BLOOD VENIPUNCTURE	$11.90	$17.00	—	—	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	—	85% 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	—	80% 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	—	79% 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	—	73% 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%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN	$35.70	$51.00	—	88% 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	—	79% 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	—	80% 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	—	60% 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	—	11% below	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%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACH BY AMP DNA	$121.10	$173.00	—	75% 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	—	77% 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	—	72% 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	—	89% 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	—	82% below	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL	$57.40	$82.00	—	—	30%
D-dimer blood test (blood clot marker) CPT 85379 HC D DIMER QUAN	$55.30	$79.00	—	87% 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	—	89% below	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DHEA SULFATE	$67.90	$97.00	—	—	30%
Estradiol blood test CPT 82670 HC ESTRADIOL	$123.90	$177.00	—	72% 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	—	60% 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	—	16% 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	—	31% below	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	—	71% 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	—	74% 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	—	67% 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	—	86% below	30%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE FREE	$86.80	$124.00	—	—	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	—	69% 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	—	65% 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	—	63% 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	—	82% below	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRP J	$155.40	$222.00	—	81% 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	—	74% 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	—	49% 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	—	61% below	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN A1C	$60.20	$86.00	—	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE ANTIBODY	$156.80	$224.00	—	9% below	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	—	21% below	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	—	31% below	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	—	53% 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	—	2% 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	—	18% 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	—	58% 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	—	75% 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	—	71% 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	—	77% 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	—	64% 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	—	85% 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	—	60% below	30%
LH (luteinizing hormone) test inpatient CPT 83002 HC LEUTENIZINE HORMONE-LH	$118.30	$169.00	—	—	30%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE	$52.50	$75.00	—	81% 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	—	81% 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	—	56% 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	—	58% below	30%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM, BLOOD	$45.50	$65.00	—	—	30%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA IGG ANTIBODY	$67.90	$97.00	—	55% below	30%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA ANTIBODIES IGM	$67.90	$97.00	—	55% below	30%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA IGG ANTIBODY	$67.90	$97.00	—	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA ANTIBODIES IGM	$67.90	$97.00	—	—	30%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE SCREEN	$37.10	$53.00	—	90% below	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE SCREEN	$37.10	$53.00	—	—	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE	$112.00	$160.00	—	62% 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	—	81% 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	—	89% 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	—	84% below	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PARTIAL THROMBOPLASTIN TIME	$40.60	$58.00	—	—	30%
Progesterone blood test CPT 84144 HC PROGESTERONE	$98.00	$140.00	—	61% 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	—	61% 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	—	66% 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	—	40% 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	—	65% 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%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANT	$52.50	$75.00	—	35% 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	—	77% 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	—	82% below	30%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC AUTOM ERYTHROCYTE SED RATE	$18.90	$27.00	—	—	30%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITE EXAM	$90.30	$129.00	—	75% below	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	—	50% 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	—	10% 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 screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILLIS NON-TREPONEMAL	$67.90	$97.00	—	46% below	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	—	75% 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	—	58% 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	—	69% 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	—	79% below	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE	$55.30	$79.00	—	—	30%
Uric acid blood test CPT 84550 HC URIC ACID BLOOD	$31.50	$45.00	—	70% 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	—	90% 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	—	67% below	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE URINE	$60.20	$86.00	—	—	30%
Urine pregnancy test, read by color change CPT 81025 HC PREGNANCY TEST URINE	$45.50	$65.00	—	55% 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	—	55% 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	—	28% 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%
Zinc blood test CPT 84630 HC ZINC	$67.90	$97.00	—	62% 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	—	83% 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
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 CAH ARTHRD ANT INTERBODY DECOMCAHESS CERVICAL BELW C2	$2,347.80	$3,354.00	—	—	30%
Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 CAH ARTHRD ANT INTERBODY DECOMCAHESS CERVICAL BELW C2	$2,347.80	$3,354.00	—	—	30%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 CAH ARTHRS AIDED ANT CRUCIATE LIGM RCAH/AGMNTJ/RCNSTJ	$1,362.20	$1,946.00	—	89% below	30%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 CAH ARTHRS AIDED ANT CRUCIATE LIGM RCAH/AGMNTJ/RCNSTJ	$1,362.20	$1,946.00	—	—	30%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 CAH SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RCAH	$1,493.10	$2,133.00	—	85% below	30%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 CAH SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RCAH	$1,493.10	$2,133.00	—	—	30%
Botox injections for chronic migraine CPT 64615 CAH CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$213.50	$305.00	—	77% below	30%
Botox injections for chronic migraine CPT 64615 HC CHEMODENERV MUSC MIGRAINE	$1,022.70	$1,461.00	—	9% above	30%
Botox injections for chronic migraine inpatient CPT 64615 CAH CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$213.50	$305.00	—	—	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 CAH BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID	$706.30	$1,009.00	—	93% below	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	—	63% below	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 CAH BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID	$706.30	$1,009.00	—	—	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 ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CAH CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$461.30	$659.00	—	16% below	30%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CAH CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$461.30	$659.00	—	—	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CAH CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$319.90	$457.00	—	47% below	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	—	134% above	30%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CAH CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$319.90	$457.00	—	—	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%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CAH CORRJ HALLUX VALGUS W/SESMDC W/DIST METAR OSTEOT	$1,255.10	$1,793.00	—	86% below	30%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CAH CORRJ HALLUX VALGUS W/SESMDC W/DIST METAR OSTEOT	$1,255.10	$1,793.00	—	—	30%
Bunion correction with removal of part of the big toe joint CPT 28292 CAH CORRJ HALLUX VALGUS W/SESMDC W/RESCJ CAHOX PHAL	$991.90	$1,417.00	—	89% below	30%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CAH CORRJ HALLUX VALGUS W/SESMDC W/RESCJ CAHOX PHAL	$991.90	$1,417.00	—	—	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CAH CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$215.60	$308.00	—	94% below	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXTERNAL	$644.70	$921.00	—	83% below	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CAH CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$215.60	$308.00	—	—	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 CAH NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$636.30	$909.00	—	88% below	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 CAH NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$636.30	$909.00	—	—	30%
Carpal tunnel release, open surgery inpatient CPT 64721 HC NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$2,484.30	$3,549.00	—	—	30%
Cervical biopsy CPT 57500 CAH BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX	$219.10	$313.00	—	80% below	30%
Cervical biopsy inpatient CPT 57500 CAH BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX	$219.10	$313.00	—	—	30%
Cesarean delivery, including prenatal and postpartum care CPT 59510 CAH OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$3,704.40	$5,292.00	—	—	30%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 CAH OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM	$3,704.40	$5,292.00	—	—	30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CAH CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$502.60	$718.00	—	33% below	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	—	15% above	30%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CAH CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$502.60	$718.00	—	—	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%
Colonoscopy with polyp removal CPT 45385 CAH COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$641.20	$916.00	—	73% below	30%
Colonoscopy with polyp removal inpatient CPT 45385 CAH COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$641.20	$916.00	—	—	30%
Colonoscopy with tissue sample CPT 45380 CAH COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$615.30	$879.00	—	73% below	30%
Colonoscopy with tissue sample inpatient CPT 45380 CAH COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$615.30	$879.00	—	—	30%
Colonoscopy, diagnostic CPT 45378 CAH COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$480.90	$687.00	—	75% below	30%
Colonoscopy, diagnostic inpatient CPT 45378 CAH COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$480.90	$687.00	—	—	30%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 CAH COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX	$445.20	$636.00	—	73% below	30%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 CAH COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX	$445.20	$636.00	—	—	30%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 CAH COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE	$237.30	$339.00	—	14% below	30%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 CAH COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE	$237.30	$339.00	—	—	30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CAH CYSTOURETHROSCOPY	$342.30	$489.00	—	73% below	30%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CAH CYSTOURETHROSCOPY	$342.30	$489.00	—	—	30%
D&C (dilation and curettage), not related to pregnancy CPT 58120 CAH DILATION & CURETTAGE DX&/THER NONOBSTETRIC	$422.10	$603.00	—	87% below	30%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 CAH DILATION & CURETTAGE DX&/THER NONOBSTETRIC	$422.10	$603.00	—	—	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 CAH DESTRUCTION CAHEMALIGNANT LESION 1ST	$96.60	$138.00	—	67% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 CAH DESTRUCTION CAHEMALIGNANT LESION 1ST	$96.60	$138.00	—	—	30%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 CAH REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$23.10	$33.00	—	81% below	30%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 CAH REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$23.10	$33.00	—	—	30%
Earwax removal with instruments, one ear one side CPT 69210 CAH REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$67.20	$96.00	—	63% below	30%
Earwax removal with instruments, one ear inpatient one side CPT 69210 CAH REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$67.20	$96.00	—	—	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 CAH ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX	$142.80	$204.00	—	56% below	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 CAH ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX	$142.80	$204.00	—	—	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CAH NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$375.20	$536.00	—	81% below	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX INTERLAMINAR CRV/THRC	$1,762.60	$2,518.00	—	12% below	30%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CAH NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$375.20	$536.00	—	—	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 CPT 64493 CAH NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$252.70	$361.00	—	92% below	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	—	27% below	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 CPT 64493 CAH NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$252.70	$361.00	—	—	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%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 CAH SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD	$266.70	$381.00	—	81% below	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 CAH SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD	$266.70	$381.00	—	—	30%
Gallbladder removal, laparoscopic CPT 47562 CAH LAPAROSCOPY SURG CHOLECYSTECTOMY	$912.80	$1,304.00	—	94% below	30%
Gallbladder removal, laparoscopic inpatient CPT 47562 CAH LAPAROSCOPY SURG CHOLECYSTECTOMY	$912.80	$1,304.00	—	—	30%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 CAH LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY	$991.20	$1,416.00	—	93% below	30%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 CAH LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY	$991.20	$1,416.00	—	—	30%
Hammertoe correction surgery CPT 28285 CAH CORRECTION HAMMERTOE	$765.80	$1,094.00	—	91% below	30%
Hammertoe correction surgery inpatient CPT 28285 CAH CORRECTION HAMMERTOE	$765.80	$1,094.00	—	—	30%
Hemorrhoidectomy (internal and external), one area CPT 46255 CAH HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP	$735.70	$1,051.00	—	78% below	30%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 CAH HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP	$735.70	$1,051.00	—	—	30%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 CAH CONV CAHEV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT	$2,313.50	$3,305.00	—	—	30%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 CAH CONV CAHEV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT	$2,313.50	$3,305.00	—	—	30%
Hysterectomy through an abdominal incision (total) CPT 58150 CAH TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY	$1,411.90	$2,017.00	—	53% below	30%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 CAH TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY	$1,411.90	$2,017.00	—	—	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CAH CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI	$347.20	$496.00	—	18% above	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CAH CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI	$347.20	$496.00	—	—	30%
Hysteroscopy with endometrial ablation CPT 58563 CAH HYSTEROSCOPY ENDOMETRIAL ABLATION	$3,007.90	$4,297.00	—	78% below	30%
Hysteroscopy with endometrial ablation inpatient CPT 58563 CAH HYSTEROSCOPY ENDOMETRIAL ABLATION	$3,007.90	$4,297.00	—	—	30%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 CAH HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$1,893.50	$2,705.00	—	77% below	30%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 CAH HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$1,893.50	$2,705.00	—	—	30%
IUD insertion (the device itself billed separately) CPT 58300 CAH INSERTION INTRAUTERINE DEVICE IUD	$187.60	$268.00	—	88% below	30%
IUD insertion (the device itself billed separately) inpatient CPT 58300 CAH INSERTION INTRAUTERINE DEVICE IUD	$187.60	$268.00	—	—	30%
Incision and drainage of a simple or single skin abscess CPT 10060 CAH INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$181.30	$259.00	—	38% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSCESS SIMPLE OR SINGLE	$671.30	$959.00	—	129% above	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 CAH INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$181.30	$259.00	—	—	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%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 CAH RCAH 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$726.60	$1,038.00	—	93% below	30%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 CAH RCAH 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$726.60	$1,038.00	—	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 CAH INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$81.20	$116.00	—	92% below	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	—	75% below	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 CAH INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$81.20	$116.00	—	—	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 CPT 20610 CAH ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$91.70	$131.00	—	90% below	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	—	56% below	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 CPT 20610 CAH ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$91.70	$131.00	—	—	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 CAH INSERTION DRUG DELIVERY IMPLANT	$141.40	$202.00	—	58% below	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 CAH INSERTION DRUG DELIVERY IMPLANT	$141.40	$202.00	—	—	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) CPT 20605 CAH ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$77.70	$111.00	—	90% below	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	—	48% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 CAH ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$77.70	$111.00	—	—	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) CPT 20600 CAH ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$75.60	$108.00	—	86% below	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	—	25% below	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 CAH ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$75.60	$108.00	—	—	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%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 CAH ARTHROSCOPY KNEE W/MENISCUS RCAH MEDIAL/LATERAL	$969.50	$1,385.00	—	85% below	30%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 CAH ARTHROSCOPY KNEE W/MENISCUS RCAH MEDIAL/LATERAL	$969.50	$1,385.00	—	—	30%
Knee arthroscopy with meniscus trim CPT 29881 CAH ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$767.20	$1,096.00	—	88% below	30%
Knee arthroscopy with meniscus trim inpatient CPT 29881 CAH ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$767.20	$1,096.00	—	—	30%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 CAH ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING	$795.90	$1,137.00	—	90% below	30%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 CAH ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING	$795.90	$1,137.00	—	—	30%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 CAH ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG	$877.80	$1,254.00	—	87% below	30%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 CAH ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG	$877.80	$1,254.00	—	—	30%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 CAH LAPAROSCOPIC APPENDECTOMY	$833.70	$1,191.00	—	84% below	30%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 CAH LAPAROSCOPIC APPENDECTOMY	$833.70	$1,191.00	—	—	30%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 CAH LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<	$1,124.90	$1,607.00	—	—	30%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 CAH LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<	$1,124.90	$1,607.00	—	—	30%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 CAH LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY	$1,267.00	$1,810.00	—	95% below	30%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 CAH LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY	$1,267.00	$1,810.00	—	—	30%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 CAH LAPAROSCOPY SURG RCAH INITIAL INGUINAL HERNIA	$603.40	$862.00	—	79% below	30%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 CAH LAPAROSCOPY SURG RCAH INITIAL INGUINAL HERNIA	$603.40	$862.00	—	—	30%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 CAH LAPS SURG RCAH RECURRENT INGUINAL HERNIA	$786.80	$1,124.00	—	—	30%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 CAH LAPS SURG RCAH RECURRENT INGUINAL HERNIA	$786.80	$1,124.00	—	—	30%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 CAH LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES	$905.10	$1,293.00	—	94% below	30%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 CAH LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES	$905.10	$1,293.00	—	—	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 CAH REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$375.20	$536.00	—	22% below	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	—	112% above	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 CAH REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$375.20	$536.00	—	—	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 CAH NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$368.90	$527.00	—	77% below	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	—	10% above	30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CAH NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$368.90	$527.00	—	—	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 CAH NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$191.10	$273.00	—	86% below	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	—	28% above	30%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 CAH NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$191.10	$273.00	—	—	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 CAH NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$351.40	$502.00	—	88% below	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	—	59% 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 CAH NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$351.40	$502.00	—	—	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%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 CAH LAMNOTMY INCL W/DCMCAHSN NRV ROOT 1 INTRSPC LUMBR	$1,278.90	$1,827.00	—	84% below	30%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 CAH LAMNOTMY INCL W/DCMCAHSN NRV ROOT 1 INTRSPC LUMBR	$1,278.90	$1,827.00	—	—	30%
Lumbar laminectomy (spinal decompression), one level CPT 63047 CAH LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR	$1,540.00	$2,200.00	—	80% below	30%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 CAH LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR	$1,540.00	$2,200.00	—	—	30%
Lumbar spinal fusion (posterior), one level CPT 22612 CAH ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR	$2,188.20	$3,126.00	—	—	30%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 CAH ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR	$2,188.20	$3,126.00	—	—	30%
Lumpectomy (partial mastectomy) CPT 19301 CAH MASTECTOMY PARTIAL	$914.90	$1,307.00	—	74% below	30%
Lumpectomy (partial mastectomy) inpatient CPT 19301 CAH MASTECTOMY PARTIAL	$914.90	$1,307.00	—	—	30%
Mastectomy (total removal of the breast) CPT 19303 CAH MASTECTOMY SIMPLE COMPLETE	$1,324.40	$1,892.00	—	75% below	30%
Mastectomy (total removal of the breast) inpatient CPT 19303 CAH MASTECTOMY SIMPLE COMPLETE	$1,324.40	$1,892.00	—	—	30%
Miscarriage treatment with D&C, first trimester CPT 59820 CAH TX MISSED ABORTION FIRST TRIMESTER SURGICAL	$620.20	$886.00	—	84% below	30%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 CAH TX MISSED ABORTION FIRST TRIMESTER SURGICAL	$620.20	$886.00	—	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 CAH EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$183.40	$262.00	—	85% below	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 CAH EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$183.40	$262.00	—	—	30%
Nail removal (partial or complete), one nail CPT 11730 CAH AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$163.80	$234.00	—	44% below	30%
Nail removal (partial or complete), one nail CPT 11730 HC AVLSION NAIL PLATE PARTL/COMPL SGL	$242.20	$346.00	—	17% below	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 CAH AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$163.80	$234.00	—	—	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) CPT 64405 CAH INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$105.70	$151.00	—	91% below	30%
Occipital nerve block (injection for headaches) one side CPT 64405 HC INJECTION, GREATER OCCIPITAL NERVE UNILATERAL	$1,192.80	$1,704.00	—	at median	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 CPT 64405 CAH INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$105.70	$151.00	—	—	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 CAH ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE	$414.40	$592.00	—	66% below	30%
Paracentesis with imaging guidance CPT 49083 HC PARACENTESIS WITH IMAGING	$1,406.30	$2,009.00	—	17% above	30%
Paracentesis with imaging guidance inpatient CPT 49083 CAH ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE	$414.40	$592.00	—	—	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 CAH EXCISION NAIL MATRIX PERMANENT REMOVAL	$228.90	$327.00	—	65% below	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL NAILBED PARTL/COMPLETE	$614.60	$878.00	—	7% below	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 CAH EXCISION NAIL MATRIX PERMANENT REMOVAL	$228.90	$327.00	—	—	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 CPT 64635 CAH DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$630.00	$900.00	—	88% below	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	—	40% below	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 CPT 64635 CAH DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$630.00	$900.00	—	—	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 breast lump, open surgery CPT 19120 CAH EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$732.20	$1,046.00	—	67% below	30%
Removal of a breast lump, open surgery inpatient CPT 19120 CAH EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$732.20	$1,046.00	—	—	30%
Removal of a foreign object under the skin, simple CPT 10120 CAH INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$217.70	$311.00	—	32% below	30%
Removal of a foreign object under the skin, simple CPT 10120 HC INC & REM FB, SQ; SMPL	$1,024.80	$1,464.00	—	218% above	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 CAH INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$217.70	$311.00	—	—	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%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 CAH TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY	$983.50	$1,405.00	—	77% below	30%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 CAH TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY	$983.50	$1,405.00	—	—	30%
Short arm cast (elbow to hand) CPT 29075 CAH APPLICATION CAST ELBOW FINGER SHORT ARM	$126.70	$181.00	—	72% below	30%
Short arm cast (elbow to hand) inpatient CPT 29075 CAH APPLICATION CAST ELBOW FINGER SHORT ARM	$126.70	$181.00	—	—	30%
Short arm splint (forearm and hand) CPT 29125 CAH APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$97.30	$139.00	—	80% below	30%
Short arm splint (forearm and hand) CPT 29125 HC APPLY FOREARM SPLINT STATIC	$438.90	$627.00	—	8% below	30%
Short arm splint (forearm and hand) inpatient CPT 29125 CAH APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$97.30	$139.00	—	—	30%
Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY FOREARM SPLINT STATIC	$438.90	$627.00	—	—	30%
Short leg cast (below the knee) CPT 29405 CAH APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$115.50	$165.00	—	70% below	30%
Short leg cast (below the knee) inpatient CPT 29405 CAH APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$115.50	$165.00	—	—	30%
Short leg splint (calf to foot) CPT 29515 CAH APPLICATION SHORT LEG SPLINT CALF FOOT	$104.30	$149.00	—	54% below	30%
Short leg splint (calf to foot) CPT 29515 HC APPLY LOWER LEG SPLINT	$294.70	$421.00	—	29% above	30%
Short leg splint (calf to foot) inpatient CPT 29515 CAH APPLICATION SHORT LEG SPLINT CALF FOOT	$104.30	$149.00	—	—	30%
Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY LOWER LEG SPLINT	$294.70	$421.00	—	—	30%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 CAH SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC	$956.90	$1,367.00	—	85% below	30%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 CAH SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC	$956.90	$1,367.00	—	—	30%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 CAH SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$233.80	$334.00	—	94% below	30%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 CAH SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$233.80	$334.00	—	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 CAH SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$133.70	$191.00	—	68% below	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 CAH SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$133.70	$191.00	—	—	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 CAH PUNCH BIOPSY SKIN SINGLE LESION	$178.50	$255.00	—	67% below	30%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BX SKIN; SINGLE LESION	$329.70	$471.00	—	39% below	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 CAH PUNCH BIOPSY SKIN SINGLE LESION	$178.50	$255.00	—	—	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BX SKIN; SINGLE LESION	$329.70	$471.00	—	—	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 CAH EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$281.40	$402.00	—	86% below	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 CAH EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$281.40	$402.00	—	—	30%
Skin tag removal, up to 15 tags CPT 11200 CAH REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15	$132.30	$189.00	—	54% below	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 CAH REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15	$132.30	$189.00	—	—	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 CAH DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$206.50	$295.00	—	78% below	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC	$366.10	$523.00	—	61% below	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 CAH DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$206.50	$295.00	—	—	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 CAH SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$161.70	$231.00	—	64% below	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	—	18% 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 CAH SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$161.70	$231.00	—	—	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 CAH SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<	$158.90	$227.00	—	59% below	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	—	6% below	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 CAH SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<	$158.90	$227.00	—	—	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%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 CAH TANGENTIAL BIOPSY SKIN SINGLE LESION	$143.50	$205.00	—	63% below	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 CAH TANGENTIAL BIOPSY SKIN SINGLE LESION	$143.50	$205.00	—	—	30%
Thoracentesis with imaging guidance CPT 32555 CAH THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$444.50	$635.00	—	69% below	30%
Thoracentesis with imaging guidance one side CPT 32555 HC THORACENTESIS/ASPIRATION WITH IMAGING UNILATERAL	$1,316.00	$1,880.00	—	8% below	30%
Thoracentesis with imaging guidance inpatient CPT 32555 CAH THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$444.50	$635.00	—	—	30%
Thoracentesis with imaging guidance inpatient one side CPT 32555 HC THORACENTESIS/ASPIRATION WITH IMAGING UNILATERAL	$1,316.00	$1,880.00	—	—	30%
Total hip replacement CPT 27130 CAH ARTHRP ACETBLR/CAHOX FEM CAHOSTC AGRFT/ALGRFT	$1,782.90	$2,547.00	—	86% below	30%
Total hip replacement inpatient CPT 27130 CAH ARTHRP ACETBLR/CAHOX FEM CAHOSTC AGRFT/ALGRFT	$1,782.90	$2,547.00	—	—	30%
Total knee replacement CPT 27447 CAH ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$1,809.50	$2,585.00	—	84% below	30%
Total knee replacement inpatient CPT 27447 CAH ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$1,809.50	$2,585.00	—	—	30%
Total shoulder replacement CPT 23472 CAH ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER	$2,005.50	$2,865.00	—	88% below	30%
Total shoulder replacement inpatient CPT 23472 CAH ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER	$2,005.50	$2,865.00	—	—	30%
Trigger finger release surgery CPT 26055 CAH TENDON SHEATH INCISION	$847.00	$1,210.00	—	80% below	30%
Trigger finger release surgery CPT 26055 HC INCISE FINGER TENDON SHEATH	$2,055.90	$2,937.00	—	51% below	30%
Trigger finger release surgery inpatient CPT 26055 CAH TENDON SHEATH INCISION	$847.00	$1,210.00	—	—	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 CAH INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$74.20	$106.00	—	81% below	30%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJECT TRIGGER POINT(S), 1 - 2 MUSCLE	$1,372.70	$1,961.00	—	245% above	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 CAH INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$74.20	$106.00	—	—	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 CAH BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID	$704.90	$1,007.00	—	87% below	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	—	62% below	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 CAH BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID	$704.90	$1,007.00	—	—	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%
Upper endoscopy (EGD) with biopsy CPT 43239 CAH EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$536.20	$766.00	—	72% below	30%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 CAH EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$536.20	$766.00	—	—	30%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 CAH EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH	$702.10	$1,003.00	—	76% below	30%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 CAH EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH	$702.10	$1,003.00	—	—	30%
Upper endoscopy (EGD), diagnostic CPT 43235 CAH ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$409.50	$585.00	—	79% below	30%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 CAH ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$409.50	$585.00	—	—	30%
Vaginal delivery, including prenatal and postpartum care CPT 59400 CAH OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$3,341.80	$4,774.00	—	—	30%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 CAH OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM	$3,341.80	$4,774.00	—	—	30%
Wart removal, up to 14 warts CPT 17110 CAH DESTRUCTION BENIGN LESIONS UP TO 14	$163.10	$233.00	—	40% below	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 CAH DESTRUCTION BENIGN LESIONS UP TO 14	$163.10	$233.00	—	—	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 CAH DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<	$184.80	$264.00	—	65% below	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	—	24% below	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 CAH DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<	$184.80	$264.00	—	—	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%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 CAH OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP	$1,052.10	$1,503.00	—	95% below	30%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 CAH OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP	$1,052.10	$1,503.00	—	—	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	—	17% below	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	—	75% 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	—	78% 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 CAH CRITICAL CARE E/M 30-103 MINUTES	$381.50	$545.00	—	98% below	30%
Critical care, first 30 to 74 minutes CPT 99291 HC ER CRITICAL CARE W/MOD	$2,630.60	$3,758.00	—	85% below	30%
Critical care, first 30 to 74 minutes CPT 99291 HC ER CRITICAL CARE	$2,630.60	$3,758.00	—	85% below	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CAH CRITICAL CARE E/M 30-103 MINUTES	$381.50	$545.00	—	—	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ER CRITICAL CARE W/MOD	$2,630.60	$3,758.00	—	—	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ER CRITICAL CARE	$2,630.60	$3,758.00	—	—	30%
EEG (brain wave test), awake and drowsy, routine CPT 95816 CAH ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY	$569.10	$813.00	—	84% below	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 CAH ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY	$569.10	$813.00	—	—	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	—	60% below	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	$385.70	$551.00	—	1% below	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	—	1% below	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 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 2 of 5, straightforward problem CPT 99282 CAH EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$56.70	$81.00	—	97% below	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY ROOM-LEVEL 2	$541.80	$774.00	—	70% below	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY ROOM - LEVEL 2 W/MOD	$541.80	$774.00	—	70% below	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 CAH EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$56.70	$81.00	—	—	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 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY ROOM - LEVEL 2 W/MOD	$541.80	$774.00	—	—	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 CAH EMERGENCY DEPARTMENT VISIT LOW MDM	$96.60	$138.00	—	97% below	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	—	67% below	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY ROOM-LEVEL 3	$1,040.90	$1,487.00	—	67% below	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 CAH EMERGENCY DEPARTMENT VISIT LOW MDM	$96.60	$138.00	—	—	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 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 4 of 5, moderate-complexity problem CPT 99284 CAH EMERGENCY DEPARTMENT VISIT MODERATE MDM	$164.50	$235.00	—	98% 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	—	79% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY ROOM-LEVEL 4	$1,632.40	$2,332.00	—	79% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 CAH EMERGENCY DEPARTMENT VISIT MODERATE MDM	$164.50	$235.00	—	—	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 CAH EMERGENCY DEPARTMENT VISIT HIGH MDM	$238.70	$341.00	—	98% below	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	—	85% 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	—	85% below	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 CAH EMERGENCY DEPARTMENT VISIT HIGH MDM	$238.70	$341.00	—	—	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	—	7% below	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	—	75% 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	—	55% below	30%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION THERAP INITIAL HR	$406.00	$580.00	—	—	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CAH THERAPEUTIC CAHOPHYLACTIC/DX INJECTION SUBQ/IM	$20.30	$29.00	—	90% below	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION IM/SC THERAPEUTIC	$237.30	$339.00	—	14% above	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CAH THERAPEUTIC CAHOPHYLACTIC/DX INJECTION SUBQ/IM	$20.30	$29.00	—	—	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%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 CAH PSYCHIATRIC DIAGNOSTIC EVALUATION	$240.80	$344.00	—	69% below	30%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 CAH PSYCHIATRIC DIAGNOSTIC EVALUATION	$240.80	$344.00	—	—	30%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 CAH NERVE CONDUCTION STUDIES 7-8 STUDIES	$248.50	$355.00	—	80% below	30%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 CAH NERVE CONDUCTION STUDIES 7-8 STUDIES	$248.50	$355.00	—	—	30%
Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUS RE-ED PER 15 MIN	$84.00	$120.00	—	33% below	30%
Neuromuscular re-education, 15 minutes CPT 97112 HC OT NEUROMUS RE-ED PER 15 MIN	$84.00	$120.00	—	33% 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%
New patient office visit, about 30 minutes CPT 99203 CAH OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES	$156.80	$224.00	—	56% below	30%
New patient office visit, about 30 minutes inpatient CPT 99203 CAH OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES	$156.80	$224.00	—	—	30%
New patient office visit, about 45 minutes CPT 99204 CAH OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES	$234.50	$335.00	—	48% below	30%
New patient office visit, about 45 minutes inpatient CPT 99204 CAH OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES	$234.50	$335.00	—	—	30%
New patient office visit, about 60 minutes CPT 99205 CAH OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES	$308.70	$441.00	—	48% below	30%
New patient office visit, about 60 minutes inpatient CPT 99205 CAH OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES	$308.70	$441.00	—	—	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 CAH OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES	$102.20	$146.00	—	75% below	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 CAH OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES	$102.20	$146.00	—	—	30%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEXITY	$160.30	$229.00	—	75% 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	—	62% 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	—	75% 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	—	70% 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	—	40% 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	—	40% 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 OT THERAPEUTIC EX PER 15 MIN	$80.50	$115.00	—	40% below	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EX PER 15 MIN	$80.50	$115.00	—	40% 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%
Preventive checkup, new patient aged 18–39 CPT 99385 CAH INITIAL CAHEVENTIVE MEDICINE NEW PT AGE 18-39YRS	$221.90	$317.00	—	29% above	30%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 CAH INITIAL CAHEVENTIVE MEDICINE NEW PT AGE 18-39YRS	$221.90	$317.00	—	—	30%
Preventive checkup, new patient aged 40–64 CPT 99386 CAH INITIAL CAHEVENTIVE MEDICINE NEW PATIENT 40-64YRS	$255.50	$365.00	—	26% above	30%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 CAH INITIAL CAHEVENTIVE MEDICINE NEW PATIENT 40-64YRS	$255.50	$365.00	—	—	30%
Preventive checkup, new patient aged 65 or older CPT 99387 CAH INITIAL CAHEVENTIVE MEDICINE NEW PATIENT 65YRS&>	$341.60	$488.00	—	56% above	30%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 CAH INITIAL CAHEVENTIVE MEDICINE NEW PATIENT 65YRS&>	$341.60	$488.00	—	—	30%
Psychotherapy for crisis, first 60 minutes CPT 90839 HC PSYTX CRISIS INITIAL 60 MIN	$576.10	$823.00	—	15% below	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 CAH PSYCHOTHERAPY W/PATIENT 45 MINUTES	$144.20	$206.00	—	48% below	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 CAH PSYCHOTHERAPY W/PATIENT 45 MINUTES	$144.20	$206.00	—	—	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 CAH PSYCHOTHERAPY W/PATIENT 60 MINUTES	$212.80	$304.00	—	32% below	30%
Psychotherapy session, 60 minutes CPT 90837 HC PSYTX, 60 MIN WITH PATIENT	$345.80	$494.00	—	10% above	30%
Psychotherapy session, 60 minutes inpatient CPT 90837 CAH PSYCHOTHERAPY W/PATIENT 60 MINUTES	$212.80	$304.00	—	—	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	—	3% 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%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CAH OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN	$253.40	$362.00	—	34% below	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CAH OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN	$253.40	$362.00	—	—	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CAH OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN	$128.10	$183.00	—	57% below	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CAH OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN	$128.10	$183.00	—	—	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CAH OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN	$180.60	$258.00	—	41% below	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CAH OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN	$180.60	$258.00	—	—	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CAH OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN	$79.80	$114.00	—	66% below	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CAH OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN	$79.80	$114.00	—	—	30%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CAH OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$210.00	$300.00	—	at median	30%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CAH OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES	$210.00	$300.00	—	—	30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CAH OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$301.00	$430.00	—	at median	30%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CAH OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$301.00	$430.00	—	—	30%
Speech and language evaluation CPT 92523 HC ST EVAL ST SOUND PROD W/LANG COMP	$493.50	$705.00	—	31% 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	—	28% 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	—	68% 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	—	15% 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	—	29% below	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THERAPEUTIC ACTIVITY 15 MIN	$86.80	$124.00	—	29% below	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THERAPEUTIC ACTIVITY 15 MIN	$86.80	$124.00	—	—	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC OT THERAPEUTIC ACTIVITY 15 MIN	$86.80	$124.00	—	—	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERAPEUTIC	$231.00	$330.00	—	74% 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	—	63% below	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	—	4% 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%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE	$464.72	$663.88	—	47% below	30%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$497.38	$710.54	—	43% 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%
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	—	21% below	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	—	15% 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, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE	$409.79	$585.41	—	14% below	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	—	14% below	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%
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%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$1,642.24	$2,346.05	—	21% below	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	—	122% 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	—	15% below	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	—	14% below	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	—	70% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VACCINE	$36.40	$52.00	—	69% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE	$36.40	$52.00	—	69% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN HEPATITIS B VACCINE	$36.40	$52.00	—	69% 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 HEPATITIS B VACCINE	$36.40	$52.00	—	—	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%

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