Mercy Hospital of Valley City
Mercy Hospital of Valley City in Valley City, ND publishes cash prices for 182 common procedures listed here, from its own machine-readable price file updated Feb 28, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the North Dakota median for 147 of 179 procedures and above it for 29. By typical cash price it ranks #6 of 22 North Dakota hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
570 Chautauqua Boulevard, Valley City, ND 58072 Collected Sep 27, 2026 Source price file (701) 845-6400
Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 5 of 5 CCN 351324 · 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 1 action for a hospital named Mercy Hospital of Valley City in Valley City, ND:
- May 15, 2025 Met requirements
Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.
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 North Dakota | Off list |
|---|---|---|---|---|---|
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 CV ANKLE BRACHIAL INDEX (ABI) | $276.00 | $460.00 | $164.22–$446.20 | at median | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 CV ANKLE BRACHIAL INDEX (ABI) | $276.00 | $460.00 | $335.80–$446.20 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS | $341.40 | $569.00 | $203.14–$551.93 | 10% below | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS | $341.40 | $569.00 | $415.37–$551.93 | — | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN WHOLE BODY | $1,274.40 | $2,124.00 | $758.27–$2,060.28 | 26% above | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE SCAN WHOLE BODY | $1,274.40 | $2,124.00 | $1,550.52–$2,060.28 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 ANG CHEST | $1,770.60 | $2,951.00 | $1,053.51–$2,862.47 | 17% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 ANG CHEST | $1,770.60 | $2,951.00 | $2,154.23–$2,862.47 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 ABDOMEN PELVIS WO CONT | $1,147.80 | $1,913.00 | $682.95–$1,855.61 | 13% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 ABDOMEN PELVIS WO CONT | $1,147.80 | $1,913.00 | $1,396.49–$1,855.61 | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 ABDOMEN PELVIS CT W CONT | $2,013.60 | $3,356.00 | $1,198.10–$3,255.32 | 17% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 ABDOMEN PELVIS CT W CONT | $2,013.60 | $3,356.00 | $2,449.88–$3,255.32 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CTA ABD PELV W WO CONT | $2,497.20 | $4,162.00 | $1,485.84–$4,037.14 | 13% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CTA ABD PELV W WO CONT | $2,497.20 | $4,162.00 | $3,038.26–$4,037.14 | — | 40% |
| CT scan of the abdomen with contrast CPT 74160 ABDOMEN W CONT | $1,481.40 | $2,469.00 | $881.44–$2,394.93 | 6% below | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 ABDOMEN W CONT | $1,481.40 | $2,469.00 | $1,802.37–$2,394.93 | — | 40% |
| CT scan of the abdomen without contrast CPT 74150 ABDOMEN WO CONT | $778.20 | $1,297.00 | $463.03–$1,258.09 | 30% below | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 ABDOMEN WO CONT | $778.20 | $1,297.00 | $946.81–$1,258.09 | — | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 MAX FACIAL SINUS WO CONT | $959.40 | $1,599.00 | $570.85–$1,551.03 | 10% below | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 MAX FACIAL SINUS WO CONT | $959.40 | $1,599.00 | $1,167.27–$1,551.03 | — | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 HEAD WO CONT | $789.60 | $1,316.00 | $469.82–$1,276.52 | 17% below | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HEAD WO CONT | $789.60 | $1,316.00 | $960.68–$1,276.52 | — | 40% |
| CT scan of the head with contrast CPT 70460 HEAD W CONT | $1,105.20 | $1,842.00 | $657.60–$1,786.74 | 13% below | 40% |
| CT scan of the head with contrast inpatient CPT 70460 HEAD W CONT | $1,105.20 | $1,842.00 | $1,344.66–$1,786.74 | — | 40% |
| CT scan of the head without and with contrast CPT 70470 HEAD W WO CONT | $1,207.20 | $2,012.00 | $718.29–$1,951.64 | 16% below | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 HEAD W WO CONT | $1,207.20 | $2,012.00 | $1,468.76–$1,951.64 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 LUMBAR SPINE WO CONT | $1,173.60 | $1,956.00 | $698.30–$1,897.32 | 9% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 LUMBAR SPINE WO CONT | $1,173.60 | $1,956.00 | $1,427.88–$1,897.32 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CERVICAL SPINE WO CONT | $1,155.60 | $1,926.00 | $687.59–$1,868.22 | 12% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CERVICAL SPINE WO CONT | $1,155.60 | $1,926.00 | $1,405.98–$1,868.22 | — | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 PELVIS W CONT | $1,709.40 | $2,849.00 | $1,017.10–$2,763.53 | 9% above | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 PELVIS W CONT | $1,709.40 | $2,849.00 | $2,079.77–$2,763.53 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID COMP | $600.00 | $1,000.00 | $357.00–$970.00 | 5% below | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID COMP | $600.00 | $1,000.00 | $730.00–$970.00 | — | 40% |
| Chest X-ray, 2 views both sides CPT 71046 CHEST DECUBITUS BI | $217.20 | $362.00 | $129.24–$351.14 | — | 40% |
| Chest X-ray, 2 views CPT 71046 CHEST 2V | $146.40 | $244.00 | $87.11–$236.68 | 7% below | 40% |
| Chest X-ray, 2 views inpatient both sides CPT 71046 CHEST DECUBITUS BI | $217.20 | $362.00 | $264.26–$351.14 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST 2V | $146.40 | $244.00 | $178.12–$236.68 | — | 40% |
| Chest X-ray, single view CPT 71045 CHEST 1V FRONTAL | $118.20 | $197.00 | $70.33–$191.09 | 11% below | 40% |
| Chest X-ray, single view inpatient CPT 71045 CHEST 1V FRONTAL | $118.20 | $197.00 | $143.81–$191.09 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 AORTA COMP DUPLEX | $359.40 | $599.00 | $213.85–$581.03 | 11% below | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 AORTA COMP DUPLEX | $359.40 | $599.00 | $437.27–$581.03 | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA BONE DENSITY BODY | $267.60 | $446.00 | $159.23–$432.62 | at median | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA BONE DENSITY BODY | $267.60 | $446.00 | $325.58–$432.62 | — | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA BONE DENSITY PERIPHERAL | $82.80 | $138.00 | $49.27–$133.86 | 19% below | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA BONE DENSITY PERIPHERAL | $82.80 | $138.00 | $100.74–$133.86 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CHEST WO CONT | $993.00 | $1,655.00 | $590.84–$1,605.35 | 15% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CHEST WO CONT | $993.00 | $1,655.00 | $1,208.15–$1,605.35 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CHEST CT W CONT | $1,273.20 | $2,122.00 | $757.56–$2,058.34 | 10% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CHEST CT W CONT | $1,273.20 | $2,122.00 | $1,549.06–$2,058.34 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC DIGITAL BI | $565.80 | $943.00 | $336.66–$914.71 | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC DIGITAL BI | $565.80 | $943.00 | $688.39–$914.71 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 CV ARTERIAL DUPLEX LEGS BI | $807.00 | $1,345.00 | $480.17–$1,304.65 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 ARTERIAL DUPLEX LWR EXT BIL | $807.00 | $1,345.00 | $480.17–$1,304.65 | 5% below | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 CV ARTERIAL DUPLEX LEGS BI | $807.00 | $1,345.00 | $981.85–$1,304.65 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 ARTERIAL DUPLEX LWR EXT BIL | $807.00 | $1,345.00 | $981.85–$1,304.65 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 CV VENOUS DUPLEX ARMS BI | $1,128.00 | $1,880.00 | $671.16–$1,823.60 | — | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 VL DUPLEX LWR EXT VEINS COMP | $564.00 | $940.00 | $335.58–$911.80 | 4% below | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 CV VENOUS DUPLEX ARMS BI | $1,128.00 | $1,880.00 | $1,372.40–$1,823.60 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VL DUPLEX LWR EXT VEINS COMP | $564.00 | $940.00 | $686.20–$911.80 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMP WO CONT | $592.80 | $988.00 | $352.72–$958.36 | 28% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO COMP WO CONT | $592.80 | $988.00 | $721.24–$958.36 | — | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 CHOLESCINTIGRAPHY | $1,481.40 | $2,469.00 | $881.44–$2,394.93 | 37% above | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 CHOLESCINTIGRAPHY | $1,481.40 | $2,469.00 | $1,802.37–$2,394.93 | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY W CPAP LTD | $1,866.60 | $3,111.00 | $1,110.63–$3,017.67 | 19% below | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY W BIPAP OR CPAP | $1,866.60 | $3,111.00 | $1,110.63–$3,017.67 | 19% below | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY W CPAP LTD | $1,866.60 | $3,111.00 | $2,271.03–$3,017.67 | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY W BIPAP OR CPAP | $1,866.60 | $3,111.00 | $2,271.03–$3,017.67 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ABDOMEN LTD | $297.00 | $495.00 | $176.72–$480.15 | 21% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ABDOMEN LTD | $297.00 | $495.00 | $361.35–$480.15 | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LUNG SCREEN PROTOCOL | $738.60 | $1,231.00 | $439.47–$1,194.07 | 13% above | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LUNG SCREEN PROTOCOL | $738.60 | $1,231.00 | $898.63–$1,194.07 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 LWR EXT JOINT WO CONT BI | $2,196.00 | $3,660.00 | $1,306.62–$3,550.20 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 LWR EXT JOINT WO CONT BI | $2,196.00 | $3,660.00 | $2,671.80–$3,550.20 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 ACHILLES W WO CONT LT | $3,030.60 | $5,051.00 | $1,803.21–$4,899.47 | 6% above | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 ACHILLES W WO CONT LT | $3,030.60 | $5,051.00 | $3,687.23–$4,899.47 | — | 40% |
| MRI of the abdomen without contrast CPT 74181 ABDOMEN WO CONT | $1,736.40 | $2,894.00 | $1,033.16–$2,807.18 | 9% below | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 ABDOMEN WO CONT | $1,736.40 | $2,894.00 | $2,112.62–$2,807.18 | — | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 ABDOMEN W WO CONT | $2,517.00 | $4,195.00 | $1,497.62–$4,069.15 | 22% below | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 ABDOMEN W WO CONT | $2,517.00 | $4,195.00 | $3,062.35–$4,069.15 | — | 40% |
| MRI of the brain, no contrast dye CPT 70551 BRAIN WO CONT | $2,146.80 | $3,578.00 | $1,277.35–$3,470.66 | 31% above | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN WO CONT | $2,146.80 | $3,578.00 | $2,611.94–$3,470.66 | — | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 BRAIN W WO CONT | $2,683.80 | $4,473.00 | $1,596.87–$4,338.81 | 6% below | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN W WO CONT | $2,683.80 | $4,473.00 | $3,265.29–$4,338.81 | — | 40% |
| MRI of the lower back, no contrast dye CPT 72148 LUMBAR SPINE COMP WO CONT | $1,839.00 | $3,065.00 | $1,094.21–$2,973.05 | at median | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 LUMBAR SPINE COMP WO CONT | $1,839.00 | $3,065.00 | $2,237.45–$2,973.05 | — | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 LUMBAR SPINE COMP W WO CONT | $2,372.40 | $3,954.00 | $1,411.58–$3,835.38 | 28% below | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 LUMBAR SPINE COMP W WO CONT | $2,372.40 | $3,954.00 | $2,886.42–$3,835.38 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 THORACIC SPINE COMP WO CONT | $1,569.60 | $2,616.00 | $933.92–$2,537.52 | 20% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 THORACIC SPINE LTD WO CONT | $1,569.60 | $2,616.00 | $933.92–$2,537.52 | 20% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 THORACIC SPINE LTD WO CONT | $1,569.60 | $2,616.00 | $1,909.68–$2,537.52 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 THORACIC SPINE COMP WO CONT | $1,569.60 | $2,616.00 | $1,909.68–$2,537.52 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 CERVICAL SPINE COMP W WO CONT | $2,225.40 | $3,709.00 | $1,324.12–$3,597.73 | 28% below | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 CERVICAL SPINE COMP W WO CONT | $2,225.40 | $3,709.00 | $2,707.57–$3,597.73 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 CERVICAL SPINE COMP WO CONT | $1,725.00 | $2,875.00 | $1,026.38–$2,788.75 | 7% below | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 CERVICAL SPINE COMP WO CONT | $1,725.00 | $2,875.00 | $2,098.75–$2,788.75 | — | 40% |
| MRI of the pelvis without and with contrast CPT 72197 PELVIS W WO CONT | $2,499.60 | $4,166.00 | $1,487.27–$4,041.02 | 19% below | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 PELVIS W WO CONT | $2,499.60 | $4,166.00 | $3,041.18–$4,041.02 | — | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 PELVIS WO CONT | $2,004.00 | $3,340.00 | $1,192.38–$3,239.80 | 2% below | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 PELVIS WO CONT | $2,004.00 | $3,340.00 | $2,438.20–$3,239.80 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 UPR EXT JOINT WO CONT BI | $2,011.80 | $3,353.00 | $1,197.03–$3,252.41 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 UPR EXT JOINT WO CONT LT | $2,056.20 | $3,427.00 | $1,223.44–$3,324.19 | 6% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 UPR EXT JOINT WO CONT BI | $2,011.80 | $3,353.00 | $2,447.69–$3,252.41 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 UPR EXT JOINT WO CONT LT | $2,056.20 | $3,427.00 | $2,501.71–$3,324.19 | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL PERF SPECT MULTI | $1,866.60 | $3,111.00 | $1,110.63–$3,017.67 | 4% below | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL PERF SPECT MULTI | $1,866.60 | $3,111.00 | $2,271.03–$3,017.67 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIS NON OB LTD | $111.00 | $185.00 | $66.05–$179.45 | 65% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIS NON OB LTD | $111.00 | $185.00 | $135.05–$179.45 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIS NON OB COMP | $359.40 | $599.00 | $213.85–$581.03 | 8% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIS NON OB COMP | $359.40 | $599.00 | $437.27–$581.03 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB 2 OR 3 TRI SGL 1ST GEST | $435.00 | $725.00 | $258.83–$703.25 | 5% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB 2 OR 3 TRI SGL 1ST GEST | $435.00 | $725.00 | $529.25–$703.25 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB 1ST TRI SGL 1ST GEST | $352.20 | $587.00 | $209.56–$569.39 | 6% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB 1ST TRI SGL 1ST GEST | $352.20 | $587.00 | $428.51–$569.39 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB LTD 1 OR MORE FETUS | $249.00 | $415.00 | $148.16–$402.55 | 10% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB LTD 1 OR MORE FETUS | $249.00 | $415.00 | $302.95–$402.55 | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 SCREENING DIGITAL BI | $469.20 | $782.00 | $91.23–$758.54 | — | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING DIGITAL BI | $469.20 | $782.00 | $570.86–$758.54 | — | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY | $1,790.40 | $2,984.00 | $1,065.29–$2,894.48 | 20% below | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY | $1,790.40 | $2,984.00 | $2,178.32–$2,894.48 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNCTION W VIDEO | $459.60 | $766.00 | $273.47–$743.02 | 8% below | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOWING FUNCTION W VIDEO | $459.60 | $766.00 | $559.18–$743.02 | — | 40% |
| Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL NON OB | $414.00 | $690.00 | $246.33–$669.30 | 9% below | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL NON OB | $414.00 | $690.00 | $503.70–$669.30 | — | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 OB TRANSVAGINAL | $283.80 | $473.00 | $168.87–$458.81 | 4% below | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 OB TRANSVAGINAL | $283.80 | $473.00 | $345.29–$458.81 | — | 40% |
| Ultrasound of the abdomen, complete CPT 76700 ABDOMEN COMP | $386.40 | $644.00 | $229.91–$624.68 | 24% below | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMEN COMP | $386.40 | $644.00 | $470.12–$624.68 | — | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 SCROTUM AND CONTENTS | $172.80 | $288.00 | $102.82–$279.36 | 55% below | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 SCROTUM AND CONTENTS | $172.80 | $288.00 | $210.24–$279.36 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HEAD NECK SOFT TISSUE | $331.20 | $552.00 | $197.07–$535.44 | 27% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HEAD NECK SOFT TISSUE | $331.20 | $552.00 | $402.96–$535.44 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI WO KUB | $365.40 | $609.00 | $217.42–$590.73 | 13% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI | $386.40 | $644.00 | $229.91–$624.68 | 8% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI WO KUB | $365.40 | $609.00 | $444.57–$590.73 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI | $386.40 | $644.00 | $470.12–$624.68 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 CV VENOUS DUPLEX UNI | $338.40 | $564.00 | $201.35–$547.08 | 40% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 CV VENOUS DUPLEX UNI | $338.40 | $564.00 | $411.72–$547.08 | — | 40% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1V DECUBITIS | $83.40 | $139.00 | $49.63–$134.83 | 27% below | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1V DECUBITIS | $83.40 | $139.00 | $101.47–$134.83 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2 OR 3V | $111.00 | $185.00 | $66.05–$179.45 | 35% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 2 OR 3V | $111.00 | $185.00 | $135.05–$179.45 | — | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE MIN 4V | $153.00 | $255.00 | $91.04–$247.35 | 34% below | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE MIN 4V | $153.00 | $255.00 | $186.15–$247.35 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2V | $103.80 | $173.00 | $61.77–$167.81 | 28% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2V | $103.80 | $173.00 | $126.29–$167.81 | — | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONE MIN 3V | $111.00 | $185.00 | $66.05–$179.45 | 25% below | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONE MIN 3V | $111.00 | $185.00 | $135.05–$179.45 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 2V OR 3V | $103.80 | $173.00 | $61.77–$167.81 | 34% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE 2V OR 3V | $103.80 | $173.00 | $126.29–$167.81 | — | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1V OR 2V | $133.80 | $223.00 | $79.62–$216.31 | 10% below | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1V OR 2V | $133.80 | $223.00 | $162.79–$216.31 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM | $90.60 | $151.00 | $53.91–$146.47 | 38% below | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM | $90.60 | $151.00 | $110.23–$146.47 | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs North Dakota | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT | $33.60 | $56.00 | $5.30–$54.32 | 17% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT | $33.60 | $56.00 | $40.88–$54.32 | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST | $35.40 | $59.00 | $5.18–$57.23 | 21% below | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST | $35.40 | $59.00 | $43.07–$57.23 | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE W HCV NAA RFL | $85.74 | $142.89 | $47.63–$138.61 | 61% below | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE | $280.80 | $468.00 | $47.63–$453.96 | 29% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE W HCV NAA RFL | $85.74 | $142.89 | $104.31–$138.61 | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE | $280.80 | $468.00 | $341.64–$453.96 | — | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENASPER.FUMIGATUS | $7.92 | $13.20 | $5.22–$12.81 | 45% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD GLUTEN | $9.40 | $15.66 | $5.22–$15.20 | 35% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COWS MILK IGE | $34.20 | $57.00 | $5.22–$55.29 | 138% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN D. PTERONYSSINUS | $40.20 | $67.00 | $5.22–$64.99 | 179% above | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENASPER.FUMIGATUS | $7.92 | $13.20 | $9.64–$12.81 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FOOD GLUTEN | $9.40 | $15.66 | $11.44–$15.20 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COWS MILK IGE | $34.20 | $57.00 | $41.61–$55.29 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN D. PTERONYSSINUS | $40.20 | $67.00 | $48.91–$64.99 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRUL PEPTIDE CCP IGG | $23.31 | $38.85 | $12.95–$37.69 | 59% below | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDEAB | $83.40 | $139.00 | $12.95–$134.83 | 47% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRUL PEPTIDE CCP IGG | $23.31 | $38.85 | $28.37–$37.69 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDEAB | $83.40 | $139.00 | $101.47–$134.83 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY ELISA IGG W/RFLX IFA | $21.77 | $36.27 | $12.09–$35.19 | 62% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA WITH REFLEX TO EIGHT AUTOA | $74.40 | $124.00 | $12.09–$120.28 | 31% above | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY ELISA IGG W/RFLX IFA | $21.77 | $36.27 | $26.48–$35.19 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA WITH REFLEX TO EIGHT AUTOA | $74.40 | $124.00 | $90.52–$120.28 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PEPTIDE (BN | $180.60 | $301.00 | $39.26–$291.97 | 15% below | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP | $207.00 | $345.00 | $39.26–$334.65 | 3% below | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC PEPTIDE (BN | $180.60 | $301.00 | $219.73–$291.97 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP | $207.00 | $345.00 | $251.85–$334.65 | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $49.20 | $82.00 | $8.46–$79.54 | 34% below | 40% |
| Basic metabolic panel (blood test) CPT 80048 BMP | $71.40 | $119.00 | $8.46–$115.43 | 4% below | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $49.20 | $82.00 | $59.86–$79.54 | — | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BMP | $71.40 | $119.00 | $86.87–$115.43 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST | $92.94 | $154.89 | $55.30–$150.25 | 18% below | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH GROSS/MICRO L4 | $220.20 | $367.00 | $131.02–$355.99 | 95% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM BY PATHOLOGIST | $92.94 | $154.89 | $113.07–$150.25 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH GROSS/MICRO L4 | $220.20 | $367.00 | $267.91–$355.99 | — | 40% |
| Blood culture for bacteria CPT 87040 CULT BLOOD AEROBIC | $94.80 | $158.00 | $10.32–$153.26 | 25% above | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULT BLOOD AEROBIC | $94.80 | $158.00 | $115.34–$153.26 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $19.80 | $33.00 | $8.83–$32.01 | 15% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $19.80 | $33.00 | $24.09–$32.01 | — | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOMETER NOVA | $24.00 | $40.00 | $3.93–$38.80 | 7% below | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $24.60 | $41.00 | $3.93–$39.77 | 5% below | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOMETER NOVA | $24.00 | $40.00 | $29.20–$38.80 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE | $24.60 | $41.00 | $29.93–$39.77 | — | 40% |
| Blood lead test CPT 83655 LEAD BLOOD VENOUS | $21.80 | $36.33 | $12.11–$35.25 | 26% below | 40% |
| Blood lead test CPT 83655 LEAD | $74.40 | $124.00 | $12.11–$120.28 | 151% above | 40% |
| Blood lead test inpatient CPT 83655 LEAD BLOOD VENOUS | $21.80 | $36.33 | $26.53–$35.25 | — | 40% |
| Blood lead test inpatient CPT 83655 LEAD | $74.40 | $124.00 | $90.52–$120.28 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG BETA SUBUNIT QUAL | $40.20 | $67.00 | $7.52–$64.99 | 41% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL. SERUM | $49.80 | $83.00 | $7.52–$80.51 | 27% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG BETA SUBUNIT QUAL | $40.20 | $67.00 | $48.91–$64.99 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL. SERUM | $49.80 | $83.00 | $60.59–$80.51 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO | $24.60 | $41.00 | $2.99–$39.77 | 37% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO | $24.60 | $41.00 | $29.93–$39.77 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $9.33 | $15.54 | $5.18–$15.08 | 62% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP | $39.60 | $66.00 | $5.18–$64.02 | 60% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN | $9.33 | $15.54 | $11.35–$15.08 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP | $39.60 | $66.00 | $48.18–$64.02 | — | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOXIN B GENE TCDBRTPCR | $67.09 | $111.81 | $37.27–$108.46 | 64% below | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE TOXIN | $214.20 | $357.00 | $37.27–$346.29 | 16% above | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF TOXIN B GENE TCDBRTPCR | $67.09 | $111.81 | $81.63–$108.46 | — | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE TOXIN | $214.20 | $357.00 | $260.61–$346.29 | — | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CANCER ANTIGEN GI (19-9) | $37.46 | $62.43 | $20.81–$60.56 | 63% below | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $131.40 | $219.00 | $20.81–$212.43 | 29% above | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CANCER ANTIGEN GI (19-9) | $37.46 | $62.43 | $45.58–$60.56 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $131.40 | $219.00 | $159.87–$212.43 | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125 | $37.46 | $62.43 | $20.81–$60.56 | 65% below | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $131.40 | $219.00 | $20.81–$212.43 | 24% above | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125 | $37.46 | $62.43 | $45.58–$60.56 | — | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 | $131.40 | $219.00 | $159.87–$212.43 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2/2019-NCOV INHOUSE C | $41.40 | $69.00 | $29.67–$66.93 | 66% below | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2/2019-NCOV INHOUSE C | $41.40 | $69.00 | $50.37–$66.93 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS BY TMA | $63.00 | $105.00 | $35.09–$101.85 | 45% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. TRACHOMATIS BY TMA | $63.17 | $105.27 | $35.09–$102.12 | 45% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA PROBE | $214.20 | $357.00 | $35.09–$346.29 | 87% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C TRACHOMATIS BY TMA | $63.00 | $105.00 | $76.65–$101.85 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. TRACHOMATIS BY TMA | $63.17 | $105.27 | $76.85–$102.12 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA PROBE | $214.20 | $357.00 | $260.61–$346.29 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PNL | $36.60 | $61.00 | $13.39–$59.17 | 46% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $77.40 | $129.00 | $13.39–$125.13 | 14% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE | $85.20 | $142.00 | $13.39–$137.74 | 25% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PNL | $36.60 | $61.00 | $44.53–$59.17 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $77.40 | $129.00 | $94.17–$125.13 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE | $85.20 | $142.00 | $103.66–$137.74 | — | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC WITH AUTO DIFF | $42.60 | $71.00 | $7.77–$68.87 | 27% below | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/MANUAL DIFF | $58.20 | $97.00 | $7.77–$94.09 | at median | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH AUTO DIFF | $42.60 | $71.00 | $51.83–$68.87 | — | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/MANUAL DIFF | $58.20 | $97.00 | $70.81–$94.09 | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFF | $41.40 | $69.00 | $6.47–$66.93 | 9% below | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFF | $41.40 | $69.00 | $50.37–$66.93 | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $60.60 | $101.00 | $10.56–$97.97 | 36% below | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP | $105.60 | $176.00 | $10.56–$170.72 | 11% above | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $60.60 | $101.00 | $73.73–$97.97 | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP | $105.60 | $176.00 | $128.48–$170.72 | — | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT | $62.40 | $104.00 | $10.18–$100.88 | 17% below | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANT | $62.40 | $104.00 | $75.92–$100.88 | — | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE SULFATE | $40.02 | $66.69 | $22.23–$64.69 | 58% below | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SO4 | $102.00 | $170.00 | $22.23–$164.90 | 8% above | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE SULFATE | $40.02 | $66.69 | $48.69–$64.69 | — | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SO4 | $102.00 | $170.00 | $124.10–$164.90 | — | 40% |
| Estradiol blood test CPT 82670 ESTRADIOL BY IMMUNOASSAY | $50.30 | $83.82 | $27.94–$81.31 | 37% below | 40% |
| Estradiol blood test CPT 82670 ESTRADIOL | $127.80 | $213.00 | $27.94–$206.61 | 60% above | 40% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL BY IMMUNOASSAY | $50.30 | $83.82 | $61.19–$81.31 | — | 40% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL | $127.80 | $213.00 | $155.49–$206.61 | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE | $33.45 | $55.74 | $18.58–$54.07 | 66% below | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE | $33.45 | $55.74 | $40.70–$54.07 | — | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL | $35.34 | $58.89 | $19.63–$57.13 | 70% below | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL | $35.34 | $58.89 | $42.99–$57.13 | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $24.54 | $40.89 | $13.63–$39.67 | 66% below | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $24.54 | $40.89 | $29.85–$39.67 | — | 40% |
| Folate (folic acid) blood test CPT 82746 FOLATESERUM | $26.46 | $44.10 | $14.70–$42.78 | 68% below | 40% |
| Folate (folic acid) blood test CPT 82746 FOLATE SERUM | $90.60 | $151.00 | $14.70–$146.47 | 10% above | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATESERUM | $26.46 | $44.10 | $32.20–$42.78 | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM | $90.60 | $151.00 | $110.23–$146.47 | — | 40% |
| Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINEFREE FREE T3 | $30.50 | $50.82 | $16.94–$49.30 | 64% below | 40% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $103.80 | $173.00 | $16.94–$167.81 | 21% above | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINEFREE FREE T3 | $30.50 | $50.82 | $37.10–$49.30 | — | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE | $103.80 | $173.00 | $126.29–$167.81 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE | $16.24 | $27.06 | $9.02–$26.25 | 53% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE | $55.80 | $93.00 | $9.02–$90.21 | 60% above | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE | $16.24 | $27.06 | $19.76–$26.25 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE | $55.80 | $93.00 | $67.89–$90.21 | — | 40% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $45.85 | $76.41 | $25.47–$74.12 | 24% below | 40% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE | $45.85 | $76.41 | $55.78–$74.12 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHOEAE BY TMA | $63.17 | $105.27 | $35.09–$102.12 | 27% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC PROBE | $214.20 | $357.00 | $35.09–$346.29 | 148% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHOEAE BY TMA | $63.17 | $105.27 | $76.85–$102.12 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC PROBE | $214.20 | $357.00 | $260.61–$346.29 | — | 40% |
| H. pylori antibody blood test CPT 86677 H. PYLORI IGG | $74.40 | $124.00 | $16.85–$120.28 | 12% below | 40% |
| H. pylori antibody blood test inpatient CPT 86677 H. PYLORI IGG | $74.40 | $124.00 | $90.52–$120.28 | — | 40% |
| H. pylori stool antigen test CPT 87338 HELICOBACT PYLORI AGFECAL EIA | $25.89 | $43.14 | $14.38–$41.85 | 74% below | 40% |
| H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI STOOL ANTI | $90.60 | $151.00 | $14.38–$146.47 | 7% below | 40% |
| H. pylori stool antigen test inpatient CPT 87338 HELICOBACT PYLORI AGFECAL EIA | $25.89 | $43.14 | $31.50–$41.85 | — | 40% |
| H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI STOOL ANTI | $90.60 | $151.00 | $110.23–$146.47 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QNT BY NAAT | $153.18 | $255.30 | $85.10–$247.65 | 27% below | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 ULTRASENSITIVE RNA (PCR) | $294.00 | $490.00 | $85.10–$475.30 | 39% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QNT BY NAAT | $153.18 | $255.30 | $186.37–$247.65 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 ULTRASENSITIVE RNA (PCR) | $294.00 | $490.00 | $357.70–$475.30 | — | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV RAPID | $83.40 | $139.00 | $13.71–$134.83 | 10% above | 40% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV RAPID | $83.40 | $139.00 | $101.47–$134.83 | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 12 COMBO AG/AB CIA W/RFLX | $43.35 | $72.24 | $24.08–$70.08 | 58% below | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 AG/AB COMBO | $141.00 | $235.00 | $24.08–$227.95 | 36% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 12 COMBO AG/AB CIA W/RFLX | $43.35 | $72.24 | $52.74–$70.08 | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 AG/AB COMBO | $141.00 | $235.00 | $171.55–$227.95 | — | 40% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV NUCLEIC ACID AMPLIFICATION | $63.17 | $105.27 | $35.09–$102.12 | 35% below | 40% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV NUCLEIC ACID AMPLIFICATION | $63.17 | $105.27 | $76.85–$102.12 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLOBIN (HA1C) | $50.40 | $84.00 | $9.71–$81.48 | 28% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCO HGB | $60.60 | $101.00 | $9.71–$97.97 | 13% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HEMOGLOBIN (HA1C) | $50.40 | $84.00 | $61.32–$81.48 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCO HGB | $60.60 | $101.00 | $73.73–$97.97 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY | $19.34 | $32.22 | $10.74–$31.26 | 44% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIB QUAL | $70.20 | $117.00 | $10.74–$113.49 | 105% above | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY | $19.34 | $32.22 | $23.53–$31.26 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIB QUAL | $70.20 | $117.00 | $85.41–$113.49 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG W/RFLX | $18.60 | $30.99 | $10.33–$30.07 | 63% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN | $62.40 | $104.00 | $10.33–$100.88 | 24% above | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG W/RFLX | $18.60 | $30.99 | $22.63–$30.07 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN | $62.40 | $104.00 | $75.92–$100.88 | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C VIRUS ANTIBODY CIA | $25.69 | $42.81 | $14.27–$41.53 | 43% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $90.60 | $151.00 | $14.27–$146.47 | 102% above | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIRUS ANTIBODY CIA | $25.69 | $42.81 | $31.26–$41.53 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY | $90.60 | $151.00 | $110.23–$146.47 | — | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV QNT BY NAAT | $77.12 | $128.52 | $42.84–$124.67 | 40% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QUANT BY PCR | $262.80 | $438.00 | $42.84–$424.86 | 103% above | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV QNT BY NAAT | $77.12 | $128.52 | $93.82–$124.67 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QUANT BY PCR | $262.80 | $438.00 | $319.74–$424.86 | — | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV1-GLYCO-G ABIGGBYCIA | $23.75 | $39.57 | $13.19–$38.39 | 29% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 G SPECIFIC IGG | $24.00 | $40.00 | $13.19–$38.80 | 28% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 H SIMPLEX IGG | $80.40 | $134.00 | $13.19–$129.98 | 142% above | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV1-GLYCO-G ABIGGBYCIA | $23.75 | $39.57 | $28.89–$38.39 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1 G SPECIFIC IGG | $24.00 | $40.00 | $29.20–$38.80 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 H SIMPLEX IGG | $80.40 | $134.00 | $97.82–$129.98 | — | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 G SPECIFIC IGG | $34.80 | $58.00 | $19.35–$56.26 | 28% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV2-GLYCO-G ABIGGBYCIA | $34.83 | $58.05 | $19.35–$56.31 | 28% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX VIRUS 2 IGG | $114.60 | $191.00 | $19.35–$185.27 | 138% above | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 G SPECIFIC IGG | $34.80 | $58.00 | $42.34–$56.26 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV2-GLYCO-G ABIGGBYCIA | $34.83 | $58.05 | $42.38–$56.31 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX VIRUS 2 IGG | $114.60 | $191.00 | $139.43–$185.27 | — | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRPHIGH SENSITIVITY | $23.31 | $38.85 | $12.95–$37.69 | 66% below | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENSIT | $61.80 | $103.00 | $12.95–$99.91 | 10% below | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-HS | $83.40 | $139.00 | $12.95–$134.83 | 22% above | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRPHIGH SENSITIVITY | $23.31 | $38.85 | $28.37–$37.69 | — | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HIGH SENSIT | $61.80 | $103.00 | $75.19–$99.91 | — | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP-HS | $83.40 | $139.00 | $101.47–$134.83 | — | 40% |
| Homocysteine blood test CPT 83090 HOMOCYSTINE TOTAL | $32.26 | $53.76 | $17.92–$52.15 | 46% below | 40% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE CARDIAC RISK | $103.80 | $173.00 | $17.92–$167.81 | 75% above | 40% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE TOTAL | $32.26 | $53.76 | $39.25–$52.15 | — | 40% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE CARDIAC RISK | $103.80 | $173.00 | $126.29–$167.81 | — | 40% |
| Insulin blood test CPT 83525 INSULIN | $20.58 | $34.29 | $11.43–$33.27 | 64% below | 40% |
| Insulin blood test CPT 83525 INSULIN TOTAL | $43.20 | $72.00 | $11.43–$69.84 | 25% below | 40% |
| Insulin blood test CPT 83525 INSULIN ASSAY | $70.20 | $117.00 | $11.43–$113.49 | 22% above | 40% |
| Insulin blood test inpatient CPT 83525 INSULIN | $20.58 | $34.29 | $25.04–$33.27 | — | 40% |
| Insulin blood test inpatient CPT 83525 INSULIN TOTAL | $43.20 | $72.00 | $52.56–$69.84 | — | 40% |
| Insulin blood test inpatient CPT 83525 INSULIN ASSAY | $70.20 | $117.00 | $85.41–$113.49 | — | 40% |
| Iron blood test (serum iron) CPT 83540 IRONPLASMA OR SERUM | $11.65 | $19.41 | $6.47–$18.83 | 64% below | 40% |
| Iron blood test (serum iron) CPT 83540 IRON | $29.40 | $49.00 | $6.47–$47.53 | 8% below | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 IRONPLASMA OR SERUM | $11.65 | $19.41 | $14.17–$18.83 | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $29.40 | $49.00 | $35.77–$47.53 | — | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY TOTAL | $15.74 | $26.22 | $8.74–$25.44 | 66% below | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 TIBC | $39.60 | $66.00 | $8.74–$64.02 | 15% below | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING CAPACITY | $51.60 | $86.00 | $8.74–$83.42 | 11% above | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY TOTAL | $15.74 | $26.22 | $19.15–$25.44 | — | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC | $39.60 | $66.00 | $48.18–$64.02 | — | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING CAPACITY | $51.60 | $86.00 | $62.78–$83.42 | — | 40% |
| Kidney function blood test panel CPT 80069 RENAL PROFILE | $51.60 | $86.00 | $8.68–$83.42 | 23% below | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL PROFILE | $51.60 | $86.00 | $62.78–$83.42 | — | 40% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONESERUM | $33.34 | $55.56 | $18.52–$53.90 | 66% below | 40% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE | $111.00 | $185.00 | $18.52–$179.45 | 12% above | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONESERUM | $33.34 | $55.56 | $40.56–$53.90 | — | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE | $111.00 | $185.00 | $135.05–$179.45 | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE SERUM OR PLASMA | $12.41 | $20.67 | $6.89–$20.05 | 75% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $42.00 | $70.00 | $6.89–$67.90 | 17% below | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE SERUM OR PLASMA | $12.41 | $20.67 | $15.09–$20.05 | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $42.00 | $70.00 | $51.10–$67.90 | — | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION | $45.60 | $76.00 | $8.17–$73.72 | 37% below | 40% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION | $45.60 | $76.00 | $55.48–$73.72 | — | 40% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ACUTE REFLEXIVE | $30.66 | $51.09 | $17.03–$49.56 | 23% below | 40% |
| Lyme disease antibody test CPT 86618 LYME IGG CIA | $78.00 | $130.00 | $17.03–$126.10 | 95% above | 40% |
| Lyme disease antibody test CPT 86618 LYME(B BURGDORFERI) AB IGG/IGM | $103.80 | $173.00 | $17.03–$167.81 | 160% above | 40% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ACUTE REFLEXIVE | $30.66 | $51.09 | $37.30–$49.56 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 LYME IGG CIA | $78.00 | $130.00 | $94.90–$126.10 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 LYME(B BURGDORFERI) AB IGG/IGM | $103.80 | $173.00 | $126.29–$167.81 | — | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE | $8.40 | $14.00 | $6.02–$13.58 | 59% below | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM RBC | $12.06 | $20.10 | $6.70–$19.50 | 41% below | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM | $63.60 | $106.00 | $6.70–$102.82 | 212% above | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE | $8.40 | $14.00 | $10.22–$13.58 | — | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC | $12.06 | $20.10 | $14.68–$19.50 | — | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $63.60 | $106.00 | $77.38–$102.82 | — | 40% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA (MEASLES) AB IGG | $23.19 | $38.64 | $12.88–$37.49 | 58% below | 40% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY | $23.40 | $39.00 | $12.88–$37.83 | 58% below | 40% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA (MEASLES) ANTIBODY IGG | $76.80 | $128.00 | $12.88–$124.16 | 39% above | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA (MEASLES) AB IGG | $23.19 | $38.64 | $28.21–$37.49 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY | $23.40 | $39.00 | $28.47–$37.83 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA (MEASLES) ANTIBODY IGG | $76.80 | $128.00 | $93.44–$124.16 | — | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST | $34.20 | $57.00 | $5.18–$55.29 | 10% below | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST | $34.20 | $57.00 | $41.61–$55.29 | — | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $33.11 | $55.17 | $18.39–$53.52 | 46% below | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA | $111.00 | $185.00 | $18.39–$179.45 | 81% above | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE | $33.11 | $55.17 | $40.28–$53.52 | — | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA | $111.00 | $185.00 | $135.05–$179.45 | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN | $33.11 | $55.17 | $18.39–$53.52 | 49% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC | $111.00 | $185.00 | $18.39–$179.45 | 71% above | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN | $33.11 | $55.17 | $40.28–$53.52 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC | $111.00 | $185.00 | $135.05–$179.45 | — | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOLOGYTHINPREP PAP W/ HPV | $36.47 | $60.78 | $20.26–$58.96 | 60% below | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOLOGYTHINPREP PAP W/ HPV | $36.47 | $60.78 | $44.37–$58.96 | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTACT | $74.31 | $123.84 | $41.28–$120.13 | 64% below | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE INTACT | $74.31 | $123.84 | $90.41–$120.13 | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA SCREEN (PTT-D) | $10.82 | $18.03 | $6.01–$17.49 | 66% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $39.60 | $66.00 | $6.01–$64.02 | 26% above | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA SCREEN (PTT-D) | $10.82 | $18.03 | $13.17–$17.49 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $39.60 | $66.00 | $48.18–$64.02 | — | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 NON INV PRENATAL SCREENING | $1,366.29 | $2,277.15 | $759.05–$2,208.84 | 11% above | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 NON INV PRENATAL SCREENING | $1,366.29 | $2,277.15 | $1,662.32–$2,208.84 | — | 40% |
| Progesterone blood test CPT 84144 PROGESTERONE QUANTSER/PLAS | $37.55 | $62.58 | $20.86–$60.71 | 66% below | 40% |
| Progesterone blood test CPT 84144 PROGESTERONE | $131.40 | $219.00 | $20.86–$212.43 | 20% above | 40% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE QUANTSER/PLAS | $37.55 | $62.58 | $45.69–$60.71 | — | 40% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $131.40 | $219.00 | $159.87–$212.43 | — | 40% |
| Prolactin blood test CPT 84146 PROLACTIN | $34.89 | $58.14 | $19.38–$56.40 | 29% below | 40% |
| Prolactin blood test CPT 84146 MONOMERIC PROLACTIN | $35.40 | $59.00 | $19.38–$57.23 | 27% below | 40% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $34.89 | $58.14 | $42.45–$56.40 | — | 40% |
| Prolactin blood test inpatient CPT 84146 MONOMERIC PROLACTIN | $35.40 | $59.00 | $43.07–$57.23 | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $7.73 | $12.87 | $4.29–$12.49 | 61% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME (INR) | $21.60 | $36.00 | $4.29–$34.92 | 8% above | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME/INR | $54.00 | $90.00 | $4.29–$87.30 | 170% above | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $7.73 | $12.87 | $9.40–$12.49 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME (INR) | $21.60 | $36.00 | $26.28–$34.92 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME/INR | $54.00 | $90.00 | $65.70–$87.30 | — | 40% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A AG | $80.40 | $134.00 | $16.55–$129.98 | 4% below | 40% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A AG SOFIA | $83.40 | $139.00 | $16.55–$134.83 | 1% below | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A AG | $80.40 | $134.00 | $97.82–$129.98 | — | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A AG SOFIA | $83.40 | $139.00 | $101.47–$134.83 | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP GROUP A RAPID SCREEN | $83.40 | $139.00 | $16.53–$134.83 | 2% above | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP GROUP A RAPID SCREEN | $83.40 | $139.00 | $101.47–$134.83 | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR | $10.21 | $17.01 | $5.67–$16.50 | 72% below | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR | $10.21 | $17.01 | $12.42–$16.50 | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODYIGG | $25.91 | $43.17 | $14.39–$41.88 | 42% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $26.40 | $44.00 | $14.39–$42.68 | 41% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IGG | $87.60 | $146.00 | $14.39–$141.62 | 96% above | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODYIGG | $25.91 | $43.17 | $31.52–$41.88 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY | $26.40 | $44.00 | $32.12–$42.68 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY IGG | $87.60 | $146.00 | $106.58–$141.62 | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR AUTO | $18.00 | $30.00 | $2.70–$29.10 | 34% below | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR AUTO | $18.00 | $30.00 | $21.90–$29.10 | — | 40% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS | $16.02 | $26.70 | $8.90–$25.90 | 67% below | 40% |
| Stool ova and parasites exam CPT 87177 O&P SMEAR | $55.80 | $93.00 | $8.90–$90.21 | 15% above | 40% |
| Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES SMEARS | $16.02 | $26.70 | $19.50–$25.90 | — | 40% |
| Stool ova and parasites exam inpatient CPT 87177 O&P SMEAR | $55.80 | $93.00 | $67.89–$90.21 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN | $20.40 | $34.00 | $4.38–$32.98 | 25% below | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREEN | $20.40 | $34.00 | $24.82–$32.98 | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL OCCULT BLOOD BY IA | $28.66 | $47.76 | $15.92–$46.33 | 50% below | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLD IMMUNOASSAY-DIAG. | $90.00 | $150.00 | $15.92–$145.50 | 56% above | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL OCCULT BLOOD BY IA | $28.66 | $47.76 | $34.87–$46.33 | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLD IMMUNOASSAY-DIAG. | $90.00 | $150.00 | $109.50–$145.50 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR WITH REFLEX TO TITER | $7.69 | $12.81 | $4.27–$12.43 | 67% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 CSF VDRL | $24.00 | $40.00 | $4.27–$38.80 | 3% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR (SYPHILLUS SEROLOGY) | $27.60 | $46.00 | $4.27–$44.62 | 19% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR WITH REFLEX TO TITER | $7.69 | $12.81 | $9.36–$12.43 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 CSF VDRL | $24.00 | $40.00 | $29.20–$38.80 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR (SYPHILLUS SEROLOGY) | $27.60 | $46.00 | $33.58–$44.62 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD PLUS4TUBE | $111.57 | $185.94 | $61.98–$180.37 | at median | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON GOLD | $351.00 | $585.00 | $61.98–$567.45 | 215% above | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD PLUS4TUBE | $111.57 | $185.94 | $135.74–$180.37 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON GOLD | $351.00 | $585.00 | $427.05–$567.45 | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTO ADULT MALE | $46.46 | $77.43 | $25.81–$75.11 | 24% below | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $159.60 | $266.00 | $25.81–$258.02 | 162% above | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTO ADULT MALE | $46.46 | $77.43 | $56.53–$75.11 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL | $159.60 | $266.00 | $194.18–$258.02 | — | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY (TPO) | $26.19 | $43.65 | $14.55–$42.35 | 53% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODY | $87.60 | $146.00 | $14.55–$141.62 | 59% above | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY (TPO) | $26.19 | $43.65 | $31.87–$42.35 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODY | $87.60 | $146.00 | $106.58–$141.62 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE | $30.24 | $50.40 | $16.80–$48.89 | 66% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 CONG HYPOTHYROIDISM | $100.80 | $168.00 | $16.80–$162.96 | 15% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE | $30.24 | $50.40 | $36.80–$48.89 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CONG HYPOTHYROIDISM | $100.80 | $168.00 | $122.64–$162.96 | — | 40% |
| Trichomonas test (NAAT) CPT 87661 T. VAGINALIS BY TMA | $63.17 | $105.27 | $35.09–$102.12 | 5% below | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 T. VAGINALIS BY TMA | $63.17 | $105.27 | $76.85–$102.12 | — | 40% |
| Uric acid blood test CPT 84550 URIC ACID | $28.80 | $48.00 | $4.52–$46.56 | 22% below | 40% |
| Uric acid blood test inpatient CPT 84550 URIC ACID | $28.80 | $48.00 | $35.04–$46.56 | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICROSCOPIC | $34.20 | $57.00 | $3.17–$55.29 | 5% below | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICROSCOPIC | $34.20 | $57.00 | $41.61–$55.29 | — | 40% |
| Urinalysis with microscope exam, manual CPT 81000 URINE DIPSTICK W/MICROSCOPIC | $20.40 | $34.00 | $4.02–$32.98 | 23% below | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINE DIPSTICK W/MICROSCOPIC | $20.40 | $34.00 | $24.82–$32.98 | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA W/O MICROSCOPIC | $15.60 | $26.00 | $2.25–$25.22 | 10% below | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA W/O MICROSCOPIC | $15.60 | $26.00 | $18.98–$25.22 | — | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK | $20.40 | $34.00 | $3.48–$32.98 | 14% above | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK | $20.40 | $34.00 | $24.82–$32.98 | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 CULT URINE | $49.80 | $83.00 | $8.07–$80.51 | 23% below | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE | $49.80 | $83.00 | $60.59–$80.51 | — | 40% |
| Urine pregnancy test, read by color change CPT 81025 HCG QUAL URINE | $40.20 | $67.00 | $8.61–$64.99 | 28% below | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG QUAL URINE | $40.20 | $67.00 | $48.91–$64.99 | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $27.15 | $45.24 | $15.08–$43.89 | 66% below | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 | $27.15 | $45.24 | $33.03–$43.89 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D25-HYDROXY | $53.28 | $88.80 | $29.60–$86.14 | 45% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D2 D3 25-HYDROXY | $174.60 | $291.00 | $29.60–$282.27 | 80% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D25-HYDROXY | $53.28 | $88.80 | $64.83–$86.14 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D2 D3 25-HYDROXY | $174.60 | $291.00 | $212.43–$282.27 | — | 40% |
| Zinc blood test CPT 84630 ZINC | $20.51 | $34.17 | $11.39–$33.15 | 22% below | 40% |
| Zinc blood test inpatient CPT 84630 ZINC | $20.51 | $34.17 | $24.95–$33.15 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TUMOR MARKER | $27.09 | $45.15 | $15.05–$43.80 | 63% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT SERUM | $90.60 | $151.00 | $15.05–$146.47 | 24% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG TUMOR MARKER | $27.09 | $45.15 | $32.96–$43.80 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT SERUM | $90.60 | $151.00 | $110.23–$146.47 | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs North Dakota | Off list |
|---|---|---|---|---|---|
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ SNGL FACET LUMBAR | $1,491.60 | $2,486.00 | $887.51–$2,411.42 | 15% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ SNGL FACET LUMBAR | $1,491.60 | $2,486.00 | $1,814.78–$2,411.42 | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs North Dakota | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION | $765.60 | $1,276.00 | $455.54–$1,237.72 | 2% above | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION | $765.60 | $1,276.00 | $931.48–$1,237.72 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD TRACE | $123.60 | $206.00 | $73.55–$199.82 | 3% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD TRACE | $123.60 | $206.00 | $150.38–$199.82 | — | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE TEST - TREADMILL | $150.60 | $251.00 | $89.61–$243.47 | 61% below | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EXERCISE TEST - TREADMILL | $150.60 | $251.00 | $183.23–$243.47 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPUTIC PHLEBOTOMY | $351.00 | $585.00 | $208.85–$567.45 | 33% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPUTIC PHLEBOTOMY | $351.00 | $585.00 | $427.05–$567.45 | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs North Dakota | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FL FLUAD TRI 24-25 (65UP) 0.5M | $184.56 | $307.59 | $78.86–$298.37 | 43% above | 40% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FL FLUAD TRI 24-25 (65UP) 0.5M | $184.56 | $307.59 | $224.55–$298.37 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUARIX TRIV24-25 6M+ 0.5M SY | $49.41 | $82.34 | $21.21–$79.87 | 46% above | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUARIX TRIV24-25 6M+ 0.5M SY | $49.41 | $82.34 | $60.11–$79.87 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VACC ADULT 10MCG/1ML | $142.93 | $238.21 | $73.97–$231.07 | 79% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VIRUS VAC PF 20 MCG/ML | $150.14 | $250.22 | $73.97–$242.72 | 88% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VACC ADULT 10MCG/1ML | $142.93 | $238.21 | $173.90–$231.07 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VIRUS VAC PF 20 MCG/ML | $150.14 | $250.22 | $182.67–$242.72 | — | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES MU & RUB VAC.5 ML | $195.20 | $325.33 | $102.34–$315.58 | 44% above | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES MU & RUB VAC.5 ML | $195.20 | $325.33 | $237.50–$315.58 | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOL 20-VAL CONJUG 0.5 ML | $593.17 | $988.61 | $352.94–$958.96 | 69% above | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOL 20-VAL CONJUG 0.5 ML | $593.17 | $988.61 | $721.69–$958.96 | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEU 23-VAL P-SAC VAC 0.5ML | $245.87 | $409.78 | $125.86–$397.49 | 63% above | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEU 23-VAL P-SAC VAC 0.5ML | $245.87 | $409.78 | $299.14–$397.49 | — | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML S | $1,309.77 | $2,182.95 | $779.32–$2,117.47 | 46% above | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML S | $1,309.77 | $2,182.95 | $1,593.56–$2,117.47 | — | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACC AB/PF 120 MCG/0.5 ML | $644.28 | $1,073.80 | $383.35–$1,041.59 | 11% above | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACC AB/PF 120 MCG/0.5 ML | $644.28 | $1,073.80 | $783.88–$1,041.59 | — | 40% |
| Rabies vaccine, one dose CPT 90675 RABIES VAC HUM DIPLOID PF2.5 | $911.01 | $1,518.34 | $344.65–$1,472.79 | 42% above | 40% |
| Rabies vaccine, one dose CPT 90675 RABIES VAC (AVIAN) 1 ML | $1,043.06 | $1,738.42 | $344.65–$1,686.27 | 62% above | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC HUM DIPLOID PF2.5 | $911.01 | $1,518.34 | $1,108.39–$1,472.79 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC (AVIAN) 1 ML | $1,043.06 | $1,738.42 | $1,269.05–$1,686.27 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TET/DIP TOXOIDS ADULT TD .5ML | $81.51 | $135.84 | $36.84–$131.77 | 46% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TET/DIP TOXOIDS ADULT TD0.5ML | $92.87 | $154.77 | $36.84–$150.13 | 67% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TET/DIP TOXOIDS ADULT TD .5ML | $81.51 | $135.84 | $99.17–$131.77 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TET/DIP TOXOIDS ADULT TD0.5ML | $92.87 | $154.77 | $112.99–$150.13 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP 10+YRS 0.5ML SYRNG | $115.17 | $191.94 | $42.39–$186.19 | 65% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP 10+YRS 0.5ML SYRNG | $115.17 | $191.94 | $140.12–$186.19 | — | 40% |
Source file: https://www.mercyhospitalvalleycity.org/450226553-1477549111_mercy-hospital-of-valley-city_standardcharges.json