Hospital Jackson, MS

Merit Health Central

Listed in its price file as “Jackson HMA LLC”.

Merit Health Central in Jackson, MS publishes cash prices for 234 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Mississippi median for 192 of 229 procedures and below it for 36. By typical cash price it ranks #30 of 36 Mississippi hospitals and #6 of 9 hospitals in the Jackson, MS area, cheapest first. Click a procedure to compare it with other hospitals nearby.

1850 Chadwick Dr Jackson, MS 39204 Collected Sep 27, 2026 Source price file (601) 376-1000

Acute care hospital Emergency department CMS star rating 3 of 5 CCN 250072 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete Min 3 V Bilateral DR	$354.75	$2,365.00	$22.64–$2,365.00	—	85%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Right DR	$202.05	$1,347.00	$22.64–$1,347.00	67% above	85%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Left DR	$202.05	$1,347.00	$22.64–$1,347.00	67% above	85%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle Complete Min 3 V Bilateral DR	$709.50	$2,365.00	$243.60–$2,128.50	—	70%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Left DR	$404.10	$1,347.00	$138.74–$1,212.30	—	70%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Right DR	$404.10	$1,347.00	$138.74–$1,212.30	—	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US LE Arterial Doppler Single Lvl Bilat	$801.00	$5,340.00	$98.23–$5,340.00	—	85%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US LE Arterial Doppler Single Lvl Bilat	$1,602.00	$5,340.00	$550.02–$4,806.00	—	70%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RF Esophagus Gastrografin	$395.55	$2,637.00	$54.76–$2,637.00	96% above	85%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RF Esophagus Barium	$395.55	$2,637.00	$54.76–$2,637.00	96% above	85%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RF Esophagus Barium	$791.10	$2,637.00	$271.61–$2,373.30	—	70%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RF Esophagus Gastrografin	$791.10	$2,637.00	$271.61–$2,373.30	—	70%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone and or Joint Whole Body Scan 1 - NM Bone	$1,308.00	$8,720.00	$216.37–$8,512.68	103% above	85%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone and or Joint Whole Body Scan 1 - NM Bone	$2,616.00	$8,720.00	$898.16–$7,848.00	—	70%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right	$354.15	$2,361.00	$81.04–$2,361.00	90% above	85%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left	$354.15	$2,361.00	$81.04–$2,361.00	90% above	85%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left	$708.30	$2,361.00	$243.18–$2,124.90	—	70%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right	$708.30	$2,361.00	$243.18–$2,124.90	—	70%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right	$354.15	$2,361.00	$67.09–$2,361.00	82% above	85%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right CM	$354.15	$2,361.00	$67.09–$2,361.00	82% above	85%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left CM	$354.15	$2,361.00	$67.09–$2,361.00	82% above	85%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left	$354.15	$2,361.00	$67.09–$2,361.00	82% above	85%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left	$708.30	$2,361.00	$243.18–$2,124.90	—	70%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right CM	$708.30	$2,361.00	$243.18–$2,124.90	—	70%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left CM	$708.30	$2,361.00	$243.18–$2,124.90	—	70%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right	$708.30	$2,361.00	$243.18–$2,124.90	—	70%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest for PE	$1,864.95	$12,433.00	$135.66–$11,189.70	63% above	85%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest	$1,864.95	$12,433.00	$135.66–$11,189.70	63% above	85%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest for PE	$3,729.90	$12,433.00	$1,280.60–$11,189.70	—	70%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest	$3,729.90	$12,433.00	$1,280.60–$11,189.70	—	70%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart WO	$76.20	$508.00	$52.32–$508.00	4% below	85%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart WO	$152.40	$508.00	$52.32–$457.20	—	70%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis Stone Protocol	$2,849.70	$18,998.00	$156.35–$17,098.20	106% above	85%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis WO	$2,849.70	$18,998.00	$156.35–$17,098.20	106% above	85%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis WO	$5,699.40	$18,998.00	$1,956.79–$17,098.20	—	70%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis Stone Protocol	$5,699.40	$18,998.00	$1,956.79–$17,098.20	—	70%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis W	$3,130.20	$20,868.00	$253.72–$18,781.20	81% above	85%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis W	$6,260.40	$20,868.00	$2,149.40–$18,781.20	—	70%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen Pelvis WWO	$3,531.15	$23,541.00	$272.15–$21,186.90	88% above	85%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen Pelvis WWO	$7,062.30	$23,541.00	$2,424.72–$21,186.90	—	70%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W	$1,799.70	$11,998.00	$135.66–$10,798.20	87% above	85%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W	$3,599.40	$11,998.00	$1,235.79–$10,798.20	—	70%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen WO	$1,641.75	$10,945.00	$81.04–$9,850.50	93% above	85%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen WO	$3,283.50	$10,945.00	$1,127.34–$9,850.50	—	70%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus WO	$773.25	$5,155.00	$81.04–$5,155.00	10% above	85%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial WO	$773.25	$5,155.00	$81.04–$5,155.00	10% above	85%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial WO	$1,546.50	$5,155.00	$530.96–$4,639.50	—	70%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus WO	$1,546.50	$5,155.00	$530.96–$4,639.50	—	70%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain WO	$1,197.30	$7,982.00	$81.04–$7,982.00	60% above	85%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head Stroke Alert	$1,197.30	$7,982.00	$81.04–$7,982.00	60% above	85%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain WO	$2,394.60	$7,982.00	$822.15–$7,183.80	—	70%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Stroke Alert	$2,394.60	$7,982.00	$822.15–$7,183.80	—	70%
CT scan of the head with contrast CPT 70460 CT Head or Brain W	$1,180.50	$7,870.00	$125.54–$7,870.00	30% above	85%
CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain W	$2,361.00	$7,870.00	$810.61–$7,083.00	—	70%
CT scan of the head without and with contrast CPT 70470 CT Head or Brain WWO	$1,543.50	$10,290.00	$135.66–$9,261.00	48% above	85%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain WWO	$3,087.00	$10,290.00	$1,059.87–$9,261.00	—	70%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar WO	$2,088.45	$13,923.00	$81.04–$12,530.70	135% above	85%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar WO	$4,176.90	$13,923.00	$1,434.07–$12,530.70	—	70%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical WO	$2,121.15	$14,141.00	$81.04–$12,726.90	139% above	85%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical WO	$4,242.30	$14,141.00	$1,456.52–$12,726.90	—	70%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W	$1,496.55	$9,977.00	$135.66–$8,979.30	53% above	85%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W	$2,993.10	$9,977.00	$1,027.63–$8,979.30	—	70%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral	$304.35	$2,029.00	$184.20–$2,029.00	—	85%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral	$608.70	$2,029.00	$208.99–$1,826.10	—	70%
Chest X-ray, 2 views CPT 71046 XR Chest 2 V DR	$244.65	$1,631.00	$27.93–$1,631.00	83% above	85%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 V DR	$489.30	$1,631.00	$167.99–$1,467.90	—	70%
Chest X-ray, single view CPT 71045 XR Chest 1 V Portable CR	$150.30	$1,002.00	$21.60–$1,002.00	42% above	85%
Chest X-ray, single view CPT 71045 XR Chest 1 V Portable DR	$150.30	$1,002.00	$21.60–$1,002.00	42% above	85%
Chest X-ray, single view CPT 71045 XR Chest 1 V Frontal DR	$150.30	$1,002.00	$21.60–$1,002.00	42% above	85%
Chest X-ray, single view CPT 71045 XR Chest 1 V Frontal CR	$150.30	$1,002.00	$21.60–$1,002.00	42% above	85%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Frontal CR	$300.60	$1,002.00	$103.21–$901.80	—	70%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Portable DR	$300.60	$1,002.00	$103.21–$901.80	—	70%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Frontal DR	$300.60	$1,002.00	$103.21–$901.80	—	70%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Portable CR	$300.60	$1,002.00	$103.21–$901.80	—	70%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete	$496.05	$3,307.00	$81.04–$3,307.00	46% above	85%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete	$992.10	$3,307.00	$340.62–$2,976.30	—	70%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton	$336.75	$2,245.00	$52.36–$2,245.00	41% above	85%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton	$673.50	$2,245.00	$231.24–$2,020.50	—	70%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Pregnancy Complete w Detail	$582.75	$3,885.00	$115.00–$3,885.00	24% above	85%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Pregnancy Complete w Detail	$1,165.50	$3,885.00	$400.16–$3,496.50	—	70%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest Diagnostic WO	$1,484.85	$9,899.00	$81.04–$8,909.10	77% above	85%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest Diagnostic WO	$2,969.70	$9,899.00	$1,019.60–$8,909.10	—	70%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest Diagnostic W	$1,793.85	$11,959.00	$135.66–$10,763.10	80% above	85%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest Diagnostic W	$3,587.70	$11,959.00	$1,231.78–$10,763.10	—	70%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD CM	$248.55	$1,657.00	$65.00–$1,657.00	—	85%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD CM	$497.10	$1,657.00	$170.67–$1,491.30	—	70%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right WWO CAD CM	$204.15	$1,361.00	$65.00–$1,361.00	57% above	85%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left WWO CAD CM	$204.15	$1,361.00	$65.00–$1,361.00	57% above	85%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left WWO CAD CM	$408.30	$1,361.00	$140.18–$1,224.90	—	70%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right WWO CAD CM	$408.30	$1,361.00	$140.18–$1,224.90	—	70%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Bypass Grafts Comp Bilat	$1,019.10	$6,794.00	$184.20–$6,794.00	—	85%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Duplex Bilateral	$1,019.10	$6,794.00	$184.20–$6,794.00	—	85%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE Arterial Duplex Bilateral	$2,038.20	$6,794.00	$699.78–$6,114.60	—	70%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE Arterial Bypass Grafts Comp Bilat	$2,038.20	$6,794.00	$699.78–$6,114.60	—	70%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Duplex Bilateral	$911.55	$6,077.00	$151.35–$6,077.00	—	85%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LE Venous Duplex Bilateral	$1,823.10	$6,077.00	$625.93–$5,469.30	—	70%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Transthoracic Echo 2D Doppler Comp	$1,137.60	$7,584.00	$161.44–$7,584.00	20% above	85%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 NI Echo TTE 2D Complete w Color Doppler	$1,137.60	$7,584.00	$161.44–$7,584.00	20% above	85%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 NI Echo TTE 2D Complete w Color Doppler	$2,275.20	$7,584.00	$781.15–$6,825.60	—	70%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Transthoracic Echo 2D Doppler Comp	$2,275.20	$7,584.00	$781.15–$6,825.60	—	70%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary System Scan 1	$1,207.95	$8,053.00	$237.02–$8,053.00	87% above	85%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary System Scan 1	$2,415.90	$8,053.00	$829.46–$7,247.70	—	70%
Knee X-ray, 3 views both sides CPT 73562 XR Knee 3 V Bilateral DR	$391.35	$2,609.00	$25.61–$2,609.00	—	85%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Right DR	$196.80	$1,312.00	$25.61–$1,312.00	64% above	85%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Left DR	$196.80	$1,312.00	$25.61–$1,312.00	64% above	85%
Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee 3 V Bilateral DR	$782.70	$2,609.00	$268.73–$2,348.10	—	70%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Left DR	$393.60	$1,312.00	$135.14–$1,180.80	—	70%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Right DR	$393.60	$1,312.00	$135.14–$1,180.80	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen	$377.40	$2,516.00	$72.01–$2,516.00	41% above	85%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$377.40	$2,516.00	$72.01–$2,516.00	41% above	85%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pylorus	$377.40	$2,516.00	$72.01–$2,516.00	41% above	85%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder	$377.40	$2,516.00	$72.01–$2,516.00	41% above	85%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver	$377.40	$2,516.00	$72.01–$2,516.00	41% above	85%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas	$377.40	$2,516.00	$72.01–$2,516.00	41% above	85%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder	$754.80	$2,516.00	$259.15–$2,264.40	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas	$754.80	$2,516.00	$259.15–$2,264.40	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pylorus	$754.80	$2,516.00	$259.15–$2,264.40	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen	$754.80	$2,516.00	$259.15–$2,264.40	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver	$754.80	$2,516.00	$259.15–$2,264.40	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$754.80	$2,516.00	$259.15–$2,264.40	—	70%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Low Dose Cncr Scrn Rtn Annual WO	$66.60	$444.00	$45.73–$444.00	11% below	85%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Low Dose Cancer Screening WO	$66.60	$444.00	$45.73–$444.00	11% below	85%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Low Dose Cncr Scrn Rtn Annual WO	$133.20	$444.00	$45.73–$399.60	—	70%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Low Dose Cancer Screening WO	$133.20	$444.00	$45.73–$399.60	—	70%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Left WO	$1,237.20	$8,248.00	$171.28–$8,248.00	at median	85%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Left WO	$1,237.20	$8,248.00	$171.28–$8,248.00	at median	85%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Right WO	$1,237.20	$8,248.00	$171.28–$8,248.00	at median	85%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Right WO	$1,237.20	$8,248.00	$171.28–$8,248.00	at median	85%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Left WO	$1,237.20	$8,248.00	$171.28–$8,248.00	at median	85%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Right WO	$1,237.20	$8,248.00	$171.28–$8,248.00	at median	85%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Left WO	$2,474.40	$8,248.00	$849.54–$7,423.20	—	70%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Left WO	$2,474.40	$8,248.00	$849.54–$7,423.20	—	70%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Right WO	$2,474.40	$8,248.00	$849.54–$7,423.20	—	70%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Right WO	$2,474.40	$8,248.00	$849.54–$7,423.20	—	70%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Left WO	$2,474.40	$8,248.00	$849.54–$7,423.20	—	70%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Right WO	$2,474.40	$8,248.00	$849.54–$7,423.20	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Left WWO	$2,496.75	$16,645.00	$272.15–$14,980.50	56% above	85%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Left WWO	$2,496.75	$16,645.00	$272.15–$14,980.50	56% above	85%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Right WWO	$2,496.75	$16,645.00	$272.15–$14,980.50	56% above	85%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Right WWO	$2,496.75	$16,645.00	$272.15–$14,980.50	56% above	85%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Left WWO	$2,496.75	$16,645.00	$272.15–$14,980.50	56% above	85%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Right WWO	$2,496.75	$16,645.00	$272.15–$14,980.50	56% above	85%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Right WWO	$4,993.50	$16,645.00	$1,714.44–$14,980.50	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Left WWO	$4,993.50	$16,645.00	$1,714.44–$14,980.50	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Right WWO	$4,993.50	$16,645.00	$1,714.44–$14,980.50	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Left WWO	$4,993.50	$16,645.00	$1,714.44–$14,980.50	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Right WWO	$4,993.50	$16,645.00	$1,714.44–$14,980.50	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Left WWO	$4,993.50	$16,645.00	$1,714.44–$14,980.50	—	70%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen WO	$2,040.30	$13,602.00	$165.17–$12,241.80	81% above	85%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen WO	$4,080.60	$13,602.00	$1,401.01–$12,241.80	—	70%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen WWO	$3,396.45	$22,643.00	$272.15–$20,378.70	94% above	85%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen WWO	$6,792.90	$22,643.00	$2,332.23–$20,378.70	—	70%
MRI of the brain, no contrast dye CPT 70551 MRI Brain WO	$1,996.35	$13,309.00	$166.04–$11,978.10	101% above	85%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO	$3,992.70	$13,309.00	$1,370.83–$11,978.10	—	70%
MRI of the brain, with and without contrast dye CPT 70553 MRI IAC WWO	$2,998.65	$19,991.00	$269.20–$17,991.90	54% above	85%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain WWO	$2,998.65	$19,991.00	$269.20–$17,991.90	54% above	85%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain WWO	$5,997.30	$19,991.00	$2,059.07–$17,991.90	—	70%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC WWO	$5,997.30	$19,991.00	$2,059.07–$17,991.90	—	70%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar WO	$2,210.55	$14,737.00	$161.72–$13,263.30	86% above	85%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar WO	$4,421.10	$14,737.00	$1,517.91–$13,263.30	—	70%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar WWO	$3,358.80	$22,392.00	$269.47–$20,152.80	64% above	85%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar WWO	$6,717.60	$22,392.00	$2,306.38–$20,152.80	—	70%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic WO	$2,215.35	$14,769.00	$161.45–$13,292.10	81% above	85%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic WO	$4,430.70	$14,769.00	$1,521.21–$13,292.10	—	70%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical WWO	$2,925.75	$19,505.00	$270.01–$17,554.50	51% above	85%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical WWO	$5,851.50	$19,505.00	$2,009.02–$17,554.50	—	70%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical WO	$2,458.95	$16,393.00	$161.19–$14,753.70	119% above	85%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical WO	$4,917.90	$16,393.00	$1,688.48–$14,753.70	—	70%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis WWO	$2,891.55	$19,277.00	$272.15–$17,349.30	68% above	85%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis WWO	$5,783.10	$19,277.00	$1,985.53–$17,349.30	—	70%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis WO	$2,124.15	$14,161.00	$184.20–$12,744.90	96% above	85%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis WO	$4,248.30	$14,161.00	$1,458.58–$12,744.90	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow Right WO	$1,377.60	$9,184.00	$171.55–$8,512.68	22% above	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder Right WO	$1,377.60	$9,184.00	$171.55–$8,512.68	22% above	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder Left WO	$1,377.60	$9,184.00	$171.55–$8,512.68	22% above	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist Right WO	$1,377.60	$9,184.00	$171.55–$8,512.68	22% above	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow Left WO	$1,377.60	$9,184.00	$171.55–$8,512.68	22% above	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist Left WO	$1,377.60	$9,184.00	$171.55–$8,512.68	22% above	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow Right WO	$2,755.20	$9,184.00	$945.95–$8,265.60	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder Right WO	$2,755.20	$9,184.00	$945.95–$8,265.60	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist Right WO	$2,755.20	$9,184.00	$945.95–$8,265.60	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist Left WO	$2,755.20	$9,184.00	$945.95–$8,265.60	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder Left WO	$2,755.20	$9,184.00	$945.95–$8,265.60	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow Left WO	$2,755.20	$9,184.00	$945.95–$8,265.60	—	70%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion RestStr Mult Sc1 - NM Myoc	$3,293.85	$21,959.00	$346.15–$19,763.10	70% above	85%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Rest Multi 1	$3,293.85	$21,959.00	$346.15–$19,763.10	70% above	85%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Stress Multi 1	$3,293.85	$21,959.00	$346.15–$19,763.10	70% above	85%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Stress Multi 1	$6,587.70	$21,959.00	$2,261.78–$19,763.10	—	70%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion RestStr Mult Sc1 - NM Myoc	$6,587.70	$21,959.00	$2,261.78–$19,763.10	—	70%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Rest Multi 1	$6,587.70	$21,959.00	$2,261.78–$19,763.10	—	70%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non OB FU	$345.75	$2,305.00	$42.06–$2,305.00	66% above	85%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non OB FU	$691.50	$2,305.00	$237.42–$2,074.50	—	70%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 76856 US-PELVIS NON OB	$545.25	$3,635.00	$81.04–$3,635.00	104% above	85%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non OB Complete	$545.25	$3,635.00	$81.04–$3,635.00	104% above	85%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non OB Complete	$1,090.50	$3,635.00	$374.40–$3,271.50	—	70%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 76856 US-PELVIS NON OB	$1,090.50	$3,635.00	$374.40–$3,271.50	—	70%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnancy After 1st Trimester Transabdominal	$579.75	$3,865.00	$81.04–$3,865.00	68% above	85%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Pregnancy After 1st Trimester Transabdominal	$1,159.50	$3,865.00	$398.10–$3,478.50	—	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnancy 1st Trimester Transabdominal	$411.45	$2,743.00	$81.04–$2,743.00	38% above	85%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pregnancy 1st Trimester Transabdominal	$822.90	$2,743.00	$282.53–$2,468.70	—	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited	$175.50	$1,170.00	$67.35–$1,170.00	13% below	85%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited	$351.00	$1,170.00	$120.51–$1,053.00	—	70%
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD CM	$163.95	$1,093.00	$65.00–$1,093.00	—	85%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Right WWO CAD CM	$163.95	$1,093.00	$65.00–$1,093.00	22% below	85%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Left WWO CAD CM	$163.95	$1,093.00	$65.00–$1,093.00	22% below	85%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD CM	$327.90	$1,093.00	$112.58–$983.70	—	70%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Left WWO CAD CM	$327.90	$1,093.00	$112.58–$983.70	—	70%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Right WWO CAD CM	$327.90	$1,093.00	$112.58–$983.70	—	70%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Comp Min 2 V Bilateral DR	$354.75	$2,365.00	$20.75–$2,365.00	—	85%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Right DR	$181.65	$1,211.00	$20.75–$1,211.00	44% above	85%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Left DR	$181.65	$1,211.00	$20.75–$1,211.00	44% above	85%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Comp Min 2 V Bilateral DR	$709.50	$2,365.00	$243.60–$2,128.50	—	70%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Right DR	$363.30	$1,211.00	$124.73–$1,089.90	—	70%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Left DR	$363.30	$1,211.00	$124.73–$1,089.90	—	70%
Swallow study (modified barium swallow, video X-ray) CPT 74230 RF Modified Barium Swallow	$524.25	$3,495.00	$78.23–$3,495.00	125% above	85%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RF Modified Barium Swallow	$1,048.50	$3,495.00	$359.98–$3,145.50	—	70%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB	$544.65	$3,631.00	$81.04–$3,631.00	81% above	85%
Transvaginal pelvic ultrasound CPT 76830 76830 US-TRANSVAGINAL	$544.65	$3,631.00	$81.04–$3,631.00	81% above	85%
Transvaginal pelvic ultrasound inpatient CPT 76830 76830 US-TRANSVAGINAL	$1,089.30	$3,631.00	$373.99–$3,267.90	—	70%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB	$1,089.30	$3,631.00	$373.99–$3,267.90	—	70%
Transvaginal ultrasound during pregnancy CPT 76817 US Pregnancy Transvaginal	$534.60	$3,564.00	$76.59–$3,564.00	83% above	85%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pregnancy Transvaginal	$1,069.20	$3,564.00	$367.09–$3,207.60	—	70%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$691.65	$4,611.00	$81.04–$4,611.00	92% above	85%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$1,383.30	$4,611.00	$474.93–$4,149.90	—	70%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum Contents	$586.35	$3,909.00	$81.04–$3,909.00	119% above	85%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum Contents	$1,172.70	$3,909.00	$402.63–$3,518.10	—	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$453.45	$3,023.00	$81.04–$3,023.00	69% above	85%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head Neck Soft Tissue	$453.45	$3,023.00	$81.04–$3,023.00	69% above	85%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head Neck Soft Tissue	$906.90	$3,023.00	$311.37–$2,720.70	—	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$906.90	$3,023.00	$311.37–$2,720.70	—	70%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI w or wo KUB Gastrografin	$634.95	$4,233.00	$66.90–$4,233.00	122% above	85%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI w or wo KUB Barium	$634.95	$4,233.00	$66.90–$4,233.00	122% above	85%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 74240 FL-UPPER GI SINGLE	$634.95	$4,233.00	$66.90–$4,233.00	122% above	85%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 74240 FL-UPPER GI SINGLE	$1,269.90	$4,233.00	$436.00–$3,809.70	—	70%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI w or wo KUB Gastrografin	$1,269.90	$4,233.00	$436.00–$3,809.70	—	70%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI w or wo KUB Barium	$1,269.90	$4,233.00	$436.00–$3,809.70	—	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Right	$906.15	$6,041.00	$81.04–$6,041.00	211% above	85%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Right	$906.15	$6,041.00	$81.04–$6,041.00	211% above	85%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Left	$906.15	$6,041.00	$81.04–$6,041.00	211% above	85%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Left	$906.15	$6,041.00	$81.04–$6,041.00	211% above	85%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Left	$1,812.30	$6,041.00	$622.22–$5,436.90	—	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Right	$1,812.30	$6,041.00	$622.22–$5,436.90	—	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Right	$1,812.30	$6,041.00	$622.22–$5,436.90	—	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Left	$1,812.30	$6,041.00	$622.22–$5,436.90	—	70%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete Min 3 V Bilateral DR	$354.75	$2,365.00	$26.69–$2,365.00	—	85%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Left DR	$181.35	$1,209.00	$26.69–$1,209.00	50% above	85%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Right DR	$181.35	$1,209.00	$26.69–$1,209.00	50% above	85%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete Min 3 V Bilateral DR	$709.50	$2,365.00	$243.60–$2,128.50	—	70%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Left DR	$362.70	$1,209.00	$124.53–$1,088.10	—	70%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Right DR	$362.70	$1,209.00	$124.53–$1,088.10	—	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right w Pelvis 2 or 3 Views DR	$249.45	$1,663.00	$29.93–$1,663.00	102% above	85%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left w Pelvis 2 or 3 Views DR	$249.45	$1,663.00	$29.93–$1,663.00	102% above	85%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right w Pelvis 2 or 3 Views DR	$498.90	$1,663.00	$171.29–$1,496.70	—	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left w Pelvis 2 or 3 Views DR	$498.90	$1,663.00	$171.29–$1,496.70	—	70%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP KUB DR	$311.85	$2,079.00	$17.25–$2,079.00	164% above	85%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen AP KUB DR	$623.70	$2,079.00	$214.14–$1,871.10	—	70%
X-ray of the ankle, 2 views both sides CPT 73600 XR Ankle 2 V Bilateral DR	$334.50	$2,230.00	$19.68–$2,230.00	—	85%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Left DR	$171.30	$1,142.00	$19.68–$1,142.00	84% above	85%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Right DR	$171.30	$1,142.00	$19.68–$1,142.00	84% above	85%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR Ankle 2 V Bilateral DR	$669.00	$2,230.00	$229.69–$2,007.00	—	70%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Left DR	$342.60	$1,142.00	$117.63–$1,027.80	—	70%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Right DR	$342.60	$1,142.00	$117.63–$1,027.80	—	70%
X-ray of the finger(s), 2 or more views both sides CPT 73140 XR Finger Min 2 V Thumb Bilateral DR	$306.15	$2,041.00	$25.61–$2,041.00	—	85%
X-ray of the finger(s), 2 or more views both sides CPT 73140 XR Finger Min 2 V 5th Digit Bilateral DR	$306.15	$2,041.00	$25.61–$2,041.00	—	85%
X-ray of the finger(s), 2 or more views both sides CPT 73140 XR Finger Min 2 V 4th Digit Bilateral DR	$306.15	$2,041.00	$25.61–$2,041.00	—	85%
X-ray of the finger(s), 2 or more views both sides CPT 73140 XR Finger Min 2 V 2nd Digit Bilateral DR	$306.15	$2,041.00	$25.61–$2,041.00	—	85%
X-ray of the finger(s), 2 or more views both sides CPT 73140 XR Finger Min 2 V 3rd Digit Bilateral DR	$306.15	$2,041.00	$25.61–$2,041.00	—	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Right DR	$175.50	$1,170.00	$25.61–$1,170.00	66% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Left DR	$175.50	$1,170.00	$25.61–$1,170.00	66% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Right DR	$175.50	$1,170.00	$25.61–$1,170.00	66% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Left DR	$175.50	$1,170.00	$25.61–$1,170.00	66% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Right DR	$175.50	$1,170.00	$25.61–$1,170.00	66% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Left DR	$175.50	$1,170.00	$25.61–$1,170.00	66% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Right DR	$175.50	$1,170.00	$25.61–$1,170.00	66% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Left DR	$175.50	$1,170.00	$25.61–$1,170.00	66% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Right DR	$175.50	$1,170.00	$25.61–$1,170.00	66% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Left DR	$175.50	$1,170.00	$25.61–$1,170.00	66% above	85%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 XR Finger Min 2 V 2nd Digit Bilateral DR	$612.30	$2,041.00	$210.22–$1,836.90	—	70%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 XR Finger Min 2 V Thumb Bilateral DR	$612.30	$2,041.00	$210.22–$1,836.90	—	70%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 XR Finger Min 2 V 4th Digit Bilateral DR	$612.30	$2,041.00	$210.22–$1,836.90	—	70%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 XR Finger Min 2 V 3rd Digit Bilateral DR	$612.30	$2,041.00	$210.22–$1,836.90	—	70%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 XR Finger Min 2 V 5th Digit Bilateral DR	$612.30	$2,041.00	$210.22–$1,836.90	—	70%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Right DR	$351.00	$1,170.00	$120.51–$1,053.00	—	70%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Left DR	$351.00	$1,170.00	$120.51–$1,053.00	—	70%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Left DR	$351.00	$1,170.00	$120.51–$1,053.00	—	70%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Right DR	$351.00	$1,170.00	$120.51–$1,053.00	—	70%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Left DR	$351.00	$1,170.00	$120.51–$1,053.00	—	70%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Left DR	$351.00	$1,170.00	$120.51–$1,053.00	—	70%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Left DR	$351.00	$1,170.00	$120.51–$1,053.00	—	70%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Right DR	$351.00	$1,170.00	$120.51–$1,053.00	—	70%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Right DR	$351.00	$1,170.00	$120.51–$1,053.00	—	70%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Right DR	$351.00	$1,170.00	$120.51–$1,053.00	—	70%
X-ray of the foot, 2 views both sides CPT 73620 XR Foot 2 V Bilateral DR	$322.50	$2,150.00	$16.98–$2,150.00	—	85%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Left DR	$161.25	$1,075.00	$16.98–$1,075.00	54% above	85%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Right DR	$161.25	$1,075.00	$16.98–$1,075.00	54% above	85%
X-ray of the foot, 2 views inpatient both sides CPT 73620 XR Foot 2 V Bilateral DR	$645.00	$2,150.00	$221.45–$1,935.00	—	70%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Right DR	$322.50	$1,075.00	$110.72–$967.50	—	70%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Left DR	$322.50	$1,075.00	$110.72–$967.50	—	70%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot Complete Min 3 V Bilateral DR	$354.75	$2,365.00	$21.02–$2,365.00	—	85%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Left DR	$201.45	$1,343.00	$21.02–$1,343.00	72% above	85%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Right DR	$201.45	$1,343.00	$21.02–$1,343.00	72% above	85%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR Foot Complete Min 3 V Bilateral DR	$709.50	$2,365.00	$243.60–$2,128.50	—	70%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Right DR	$402.90	$1,343.00	$138.33–$1,208.70	—	70%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Left DR	$402.90	$1,343.00	$138.33–$1,208.70	—	70%
X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete Min 3 V Bilateral DR	$402.00	$2,680.00	$23.45–$2,680.00	—	85%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Left DR	$206.10	$1,374.00	$23.45–$1,374.00	68% above	85%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Right DR	$206.10	$1,374.00	$23.45–$1,374.00	68% above	85%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete Min 3 V Bilateral DR	$804.00	$2,680.00	$276.04–$2,412.00	—	70%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Right DR	$412.20	$1,374.00	$141.52–$1,236.60	—	70%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Left DR	$412.20	$1,374.00	$141.52–$1,236.60	—	70%
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 V Bilateral DR	$354.75	$2,365.00	$21.02–$2,365.00	—	85%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Left DR	$181.35	$1,209.00	$21.02–$1,209.00	50% above	85%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Right DR	$181.35	$1,209.00	$21.02–$1,209.00	50% above	85%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 V Bilateral DR	$709.50	$2,365.00	$243.60–$2,128.50	—	70%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Right DR	$362.70	$1,209.00	$124.53–$1,088.10	—	70%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Left DR	$362.70	$1,209.00	$124.53–$1,088.10	—	70%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 V DR	$174.15	$1,161.00	$23.45–$1,161.00	32% above	85%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 V DR	$348.30	$1,161.00	$119.58–$1,044.90	—	70%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 V DR	$342.45	$2,283.00	$31.82–$2,283.00	86% above	85%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 V DR	$684.90	$2,283.00	$235.15–$2,054.70	—	70%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 V DR	$204.90	$1,366.00	$18.87–$1,366.00	65% above	85%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 V DR	$409.80	$1,366.00	$140.70–$1,229.40	—	70%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Comp Minimum 3 V DR	$170.40	$1,136.00	$23.72–$1,136.00	28% above	85%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Comp Minimum 3 V DR	$340.80	$1,136.00	$117.01–$1,022.40	—	70%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 V DR	$226.05	$1,507.00	$23.45–$1,507.00	71% above	85%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 V DR	$452.10	$1,507.00	$155.22–$1,356.30	—	70%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 V DR	$153.30	$1,022.00	$15.90–$1,022.00	24% above	85%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 V DR	$306.60	$1,022.00	$105.27–$919.80	—	70%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum Coccyx Minimum 2 V DR	$177.30	$1,182.00	$19.68–$1,182.00	44% above	85%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum Coccyx Minimum 2 V DR	$354.60	$1,182.00	$121.75–$1,063.80	—	70%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase	$81.15	$541.00	$4.51–$541.00	115% above	85%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase	$162.30	$541.00	$55.72–$486.90	—	70%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase	$81.15	$541.00	$4.40–$541.00	121% above	85%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase	$162.30	$541.00	$55.72–$486.90	—	70%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute	$346.50	$2,310.00	$40.49–$2,310.00	122% above	85%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel Acute	$693.00	$2,310.00	$237.93–$2,079.00	—	70%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L673100 ALG IGE QT	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat LC	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgE Soybean LC	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 F013-IgE Peanut LC	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk (Cow) LC	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 F001-IgE Egg White LC	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 F075-IgE Egg (Yolk) LC	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L600919 ALG IGE QT	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L601013 ALG IGE QT	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L62448 ALG IGE QT	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L602633 ALG IGE QT	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L62695 ALG IGE QT	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L674010 ALG IGE QT	$6.00	$40.00	$4.12–$500.00	62% below	85%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L62695 ALG IGE QT	$12.00	$40.00	$4.12–$36.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L601013 ALG IGE QT	$12.00	$40.00	$4.12–$36.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L673100 ALG IGE QT	$12.00	$40.00	$4.12–$36.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F014-IgE Soybean LC	$12.00	$40.00	$4.12–$36.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L62448 ALG IGE QT	$12.00	$40.00	$4.12–$36.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F013-IgE Peanut LC	$12.00	$40.00	$4.12–$36.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L674010 ALG IGE QT	$12.00	$40.00	$4.12–$36.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F002-IgE Milk (Cow) LC	$12.00	$40.00	$4.12–$36.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L602633 ALG IGE QT	$12.00	$40.00	$4.12–$36.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F001-IgE Egg White LC	$12.00	$40.00	$4.12–$36.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F075-IgE Egg (Yolk) LC	$12.00	$40.00	$4.12–$36.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F004-IgE Wheat LC	$12.00	$40.00	$4.12–$36.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L600919 ALG IGE QT	$12.00	$40.00	$4.12–$36.00	—	70%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab IgG IgA (LC)	$39.15	$261.00	$11.01–$500.00	16% below	85%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab IgG IgA (LC)	$78.30	$261.00	$26.88–$234.90	—	70%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex if Positive (LC)	$98.55	$657.00	$10.28–$657.00	36% above	85%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Anti Nuclear Antibody IFA (LC)	$98.55	$657.00	$10.28–$657.00	36% above	85%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Anti Nuclear Antibodies Direct (LC)	$98.55	$657.00	$10.28–$657.00	36% above	85%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex if Positive (LC)	$197.10	$657.00	$67.67–$591.30	—	70%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Anti Nuclear Antibody IFA (LC)	$197.10	$657.00	$67.67–$591.30	—	70%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Anti Nuclear Antibodies Direct (LC)	$197.10	$657.00	$67.67–$591.30	—	70%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide Prohormone	$72.60	$484.00	$33.37–$500.00	48% below	85%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide	$72.60	$484.00	$33.37–$500.00	48% below	85%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptide	$145.20	$484.00	$49.85–$435.60	—	70%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptide Prohormone	$145.20	$484.00	$49.85–$435.60	—	70%
Basic metabolic panel (blood test) CPT 80048 BMPWTCA	$134.10	$894.00	$7.19–$894.00	82% above	85%
Basic metabolic panel (blood test) inpatient CPT 80048 BMPWTCA	$268.20	$894.00	$92.08–$804.60	—	70%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 $APRL 88305 Bill Surg Path Gross Lvl4	$23.10	$154.00	$15.86–$500.00	65% below	85%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 $APRL 88305 Bill Surg Path Gross Lvl4	$46.20	$154.00	$15.86–$138.60	—	70%
Blood culture for bacteria CPT 87040 Blood Culture	$240.30	$1,602.00	$8.77–$1,602.00	173% above	85%
Blood culture for bacteria inpatient CPT 87040 Blood Culture	$480.60	$1,602.00	$165.01–$1,441.80	—	70%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Chg BCE	$26.70	$178.00	$2.70–$178.00	181% above	85%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Chg	$26.70	$178.00	$2.70–$178.00	181% above	85%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 $ Contract Collection Charge Blood	$3.00	$10.00	$1.03–$9.00	—	70%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Chg	$53.40	$178.00	$18.33–$160.20	—	70%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Chg BCE	$53.40	$178.00	$18.33–$160.20	—	70%
Blood glucose (sugar) test CPT 82947 .Glucose POC	$52.20	$348.00	$3.34–$500.00	62% above	85%
Blood glucose (sugar) test CPT 82947 .Glucose Fasting	$52.20	$348.00	$3.34–$500.00	62% above	85%
Blood glucose (sugar) test CPT 82947 82947 GLUCOSE,SER PL OR WB	$52.20	$348.00	$3.34–$500.00	62% above	85%
Blood glucose (sugar) test CPT 82947 Glucose 4 Hour Postprandial	$52.20	$348.00	$3.34–$500.00	62% above	85%
Blood glucose (sugar) test CPT 82947 Glucose Level	$52.20	$348.00	$3.34–$500.00	62% above	85%
Blood glucose (sugar) test CPT 82947 Glucose 3 Hour Postprandial	$52.20	$348.00	$3.34–$500.00	62% above	85%
Blood glucose (sugar) test CPT 82947 .GTT 2nd Hr OB	$52.20	$348.00	$3.34–$500.00	62% above	85%
Blood glucose (sugar) test inpatient CPT 82947 .Glucose Fasting	$104.40	$348.00	$35.84–$313.20	—	70%
Blood glucose (sugar) test inpatient CPT 82947 .Glucose POC	$104.40	$348.00	$35.84–$313.20	—	70%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 4 Hour Postprandial	$104.40	$348.00	$35.84–$313.20	—	70%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 3 Hour Postprandial	$104.40	$348.00	$35.84–$313.20	—	70%
Blood glucose (sugar) test inpatient CPT 82947 .GTT 2nd Hr OB	$104.40	$348.00	$35.84–$313.20	—	70%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$104.40	$348.00	$35.84–$313.20	—	70%
Blood glucose (sugar) test inpatient CPT 82947 82947 GLUCOSE,SER PL OR WB	$104.40	$348.00	$35.84–$313.20	—	70%
Blood lead test CPT 83655 Lead Blood Pediatric (LC)	$48.90	$326.00	$10.29–$500.00	3% below	85%
Blood lead test CPT 83655 83655 L42580 LEAD	$48.90	$326.00	$10.29–$500.00	3% below	85%
Blood lead test CPT 83655 Lead Blood Adult (LC)	$48.90	$326.00	$10.29–$500.00	3% below	85%
Blood lead test CPT 83655 83655 L7046 LEAD	$48.90	$326.00	$10.29–$500.00	3% below	85%
Blood lead test inpatient CPT 83655 83655 L42580 LEAD	$97.80	$326.00	$33.58–$293.40	—	70%
Blood lead test inpatient CPT 83655 83655 L7046 LEAD	$97.80	$326.00	$33.58–$293.40	—	70%
Blood lead test inpatient CPT 83655 Lead Blood Pediatric (LC)	$97.80	$326.00	$33.58–$293.40	—	70%
Blood lead test inpatient CPT 83655 Lead Blood Adult (LC)	$97.80	$326.00	$33.58–$293.40	—	70%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCGQLS	$58.20	$388.00	$6.39–$500.00	21% above	85%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 hCG Qual, Urine CQ	$58.20	$388.00	$6.39–$500.00	21% above	85%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 hCG Qual, Urine CQ	$116.40	$388.00	$39.96–$349.20	—	70%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCGQLS	$116.40	$388.00	$39.96–$349.20	—	70%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO Forward	$39.45	$263.00	$2.54–$500.00	16% below	85%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 86900 BLOOD TYPING ABO	$39.45	$263.00	$2.54–$500.00	16% below	85%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO Reverse	$39.45	$263.00	$2.54–$500.00	16% below	85%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO	$39.45	$263.00	$2.54–$500.00	16% below	85%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO	$78.90	$263.00	$27.09–$236.70	—	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO Reverse	$78.90	$263.00	$27.09–$236.70	—	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO Forward	$78.90	$263.00	$27.09–$236.70	—	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 86900 BLOOD TYPING ABO	$78.90	$263.00	$27.09–$236.70	—	70%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein	$86.40	$576.00	$4.40–$576.00	159% above	85%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein	$172.80	$576.00	$59.33–$518.40	—	70%
C. difficile toxin gene test (stool PCR) CPT 87493 C diff AB PCR	$52.05	$347.00	$31.68–$500.00	31% below	85%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLI PROBE - BCE	$52.05	$347.00	$31.68–$500.00	31% below	85%
C. difficile toxin gene test (stool PCR) CPT 87493 C difficile NAA w/reflex Toxin Confirmation	$52.05	$347.00	$31.68–$500.00	31% below	85%
C. difficile toxin gene test (stool PCR) CPT 87493 C difficile PCR w/reflex Toxin Confirmation	$52.05	$347.00	$31.68–$500.00	31% below	85%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLI PROBE - BCE	$104.10	$347.00	$35.74–$312.30	—	70%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile PCR w/reflex Toxin Confirmation	$104.10	$347.00	$35.74–$312.30	—	70%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C diff AB PCR	$104.10	$347.00	$35.74–$312.30	—	70%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile NAA w/reflex Toxin Confirmation	$104.10	$347.00	$35.74–$312.30	—	70%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 LC	$103.80	$692.00	$17.69–$692.00	22% above	85%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 LC	$207.60	$692.00	$71.28–$622.80	—	70%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 LC	$109.80	$732.00	$17.69–$732.00	1% below	85%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125 LC	$219.60	$732.00	$75.40–$658.80	—	70%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 NAA (LC)	$25.65	$171.00	$17.61–$171.00	59% below	85%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 PCR	$25.65	$171.00	$17.61–$171.00	59% below	85%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 PCR	$51.30	$171.00	$17.61–$153.90	—	70%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 NAA (LC)	$51.30	$171.00	$17.61–$153.90	—	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia DNA Amplified Probe	$91.20	$608.00	$29.83–$608.00	18% above	85%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 L183194CHLMYD TRACH	$91.20	$608.00	$29.83–$608.00	18% above	85%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 CHLMYD TRACH DNA AMP	$91.20	$608.00	$29.83–$608.00	18% above	85%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia DNA Amplified Probe	$182.40	$608.00	$62.62–$547.20	—	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 L183194CHLMYD TRACH	$182.40	$608.00	$62.62–$547.20	—	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 CHLMYD TRACH DNA AMP	$182.40	$608.00	$62.62–$547.20	—	70%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID	$154.20	$1,028.00	$11.38–$1,028.00	109% above	85%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID	$308.40	$1,028.00	$105.88–$925.20	—	70%
Complete blood count (CBC) with differential CPT 85025 CBCADIFF	$91.95	$613.00	$6.60–$613.00	121% above	85%
Complete blood count (CBC) with differential inpatient CPT 85025 CBCADIFF	$183.90	$613.00	$63.14–$551.70	—	70%
Complete blood count (CBC), no differential CPT 85027 CBC	$33.45	$223.00	$5.50–$500.00	5% below	85%
Complete blood count (CBC), no differential CPT 85027 85027 CBC W-PLT	$33.45	$223.00	$5.50–$500.00	5% below	85%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC	$66.90	$223.00	$22.97–$200.70	—	70%
Complete blood count (CBC), no differential inpatient CPT 85027 85027 CBC W-PLT	$66.90	$223.00	$22.97–$200.70	—	70%
Comprehensive metabolic panel (blood test) CPT 80053 CMP	$232.35	$1,549.00	$8.98–$1,549.00	121% above	85%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP	$464.70	$1,549.00	$159.55–$1,394.10	—	70%
D-dimer blood test (blood clot marker) CPT 85379 D Dimer Quant	$77.40	$516.00	$8.65–$516.00	at median	85%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer Quant	$154.80	$516.00	$53.15–$464.40	—	70%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate (LC)	$300.00	$2,000.00	$18.90–$2,000.00	210% above	85%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate (LC)	$600.00	$2,000.00	$206.00–$1,800.00	—	70%
Estradiol blood test CPT 82670 Estradiol Sendout to LabCorp	$22.20	$148.00	$15.24–$500.00	78% below	85%
Estradiol blood test inpatient CPT 82670 Estradiol Sendout to LabCorp	$44.40	$148.00	$15.24–$133.20	—	70%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Serum	$158.55	$1,057.00	$15.79–$1,057.00	52% above	85%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone (LC)	$158.55	$1,057.00	$15.79–$1,057.00	52% above	85%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone (LC)	$317.10	$1,057.00	$108.87–$951.30	—	70%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone Serum	$317.10	$1,057.00	$108.87–$951.30	—	70%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$100.20	$668.00	$11.59–$668.00	30% above	85%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$200.40	$668.00	$68.80–$601.20	—	70%
Folate (folic acid) blood test CPT 82746 Folate Level	$106.05	$707.00	$12.50–$707.00	48% above	85%
Folate (folic acid) blood test CPT 82746 Folate (Folic Acid) Serum Sendout to LabCorp	$106.05	$707.00	$12.50–$707.00	48% above	85%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$212.10	$707.00	$72.82–$636.30	—	70%
Folate (folic acid) blood test inpatient CPT 82746 Folate (Folic Acid) Serum Sendout to LabCorp	$212.10	$707.00	$72.82–$636.30	—	70%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine 3 Free Serum (LC)	$173.70	$1,158.00	$12.02–$1,158.00	89% above	85%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine 3 Free Serum (LC)	$347.40	$1,158.00	$119.27–$1,042.20	—	70%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine 4 Free	$84.15	$561.00	$7.67–$561.00	68% above	85%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine 4 Free	$168.30	$561.00	$57.78–$504.90	—	70%
Free testosterone test CPT 84402 Testosterone Free Direct LC	$168.75	$1,125.00	$21.65–$1,125.00	106% above	85%
Free testosterone test inpatient CPT 84402 Testosterone Free Direct LC	$337.50	$1,125.00	$115.88–$1,012.50	—	70%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hour Postprandial	$45.45	$303.00	$4.04–$500.00	18% above	85%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hour Postprandial	$90.90	$303.00	$31.21–$272.70	—	70%
Glucose tolerance test, 3 samples CPT 82951 .GTT Fasting	$147.60	$984.00	$10.94–$984.00	100% above	85%
Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT Fasting	$295.20	$984.00	$101.35–$885.60	—	70%
H. pylori antibody blood test CPT 86677 Heliobacter pylori Ab IgG (LC)	$217.20	$1,448.00	$14.15–$1,448.00	283% above	85%
H. pylori antibody blood test CPT 86677 Heliobacter pylori Ab IgM (LC)	$217.20	$1,448.00	$14.15–$1,448.00	283% above	85%
H. pylori antibody blood test inpatient CPT 86677 Heliobacter pylori Ab IgM (LC)	$434.40	$1,448.00	$149.14–$1,303.20	—	70%
H. pylori antibody blood test inpatient CPT 86677 Heliobacter pylori Ab IgG (LC)	$434.40	$1,448.00	$149.14–$1,303.20	—	70%
H. pylori stool antigen test CPT 87338 Heliobacter pylori Stool Ag EIA (LC)	$331.50	$2,210.00	$6.46–$2,210.00	194% above	85%
H. pylori stool antigen test inpatient CPT 87338 Heliobacter pylori Stool Ag EIA (LC)	$663.00	$2,210.00	$227.63–$1,989.00	—	70%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA Real Time PCR (Graph) LC	$307.20	$2,048.00	$72.33–$2,048.00	46% above	85%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 .GenoSure PRIme(R) Quant RNA PCR (LC)	$307.20	$2,048.00	$72.33–$2,048.00	46% above	85%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA Real Time PCR (Non-Graph) Sendout to LabCorp	$307.20	$2,048.00	$72.33–$2,048.00	46% above	85%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA Real Time PCR (Non-Graph) Sendout to LabCorp	$614.40	$2,048.00	$210.94–$1,843.20	—	70%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 .GenoSure PRIme(R) Quant RNA PCR (LC)	$614.40	$2,048.00	$210.94–$1,843.20	—	70%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA Real Time PCR (Graph) LC	$614.40	$2,048.00	$210.94–$1,843.20	—	70%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Ab/p24 Ag w/Reflex (LC)	$32.25	$215.00	$20.47–$500.00	36% below	85%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Ab/p24 Ag w/Reflex (LC)	$64.50	$215.00	$22.15–$193.50	—	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgb A1c with eAG Estimation (LC)	$73.20	$488.00	$8.25–$500.00	36% above	85%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$73.20	$488.00	$8.25–$500.00	36% above	85%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hgb A1c with eAG Estimation (LC)	$146.40	$488.00	$50.26–$439.20	—	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$146.40	$488.00	$50.26–$439.20	—	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody w/Interp	$83.55	$557.00	$9.13–$557.00	48% above	85%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB - BCE	$83.55	$557.00	$9.13–$557.00	48% above	85%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab (LC)	$83.55	$557.00	$9.13–$557.00	48% above	85%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF AB - BCE	$167.10	$557.00	$57.37–$501.30	—	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab (LC)	$167.10	$557.00	$57.37–$501.30	—	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody w/Interp	$167.10	$557.00	$57.37–$501.30	—	70%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG- BCE	$62.40	$416.00	$8.78–$500.00	24% above	85%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag w/Interp	$62.40	$416.00	$8.78–$500.00	24% above	85%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAG- BCE	$124.80	$416.00	$42.85–$374.40	—	70%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag w/Interp	$124.80	$416.00	$42.85–$374.40	—	70%
Hepatitis C antibody blood test (screening) CPT 86803 HCAB2	$90.45	$603.00	$12.13–$603.00	31% above	85%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCAB2	$180.90	$603.00	$62.11–$542.70	—	70%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno. (LC)	$489.30	$3,262.00	$36.41–$3,262.00	184% above	85%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 Hepatitis C Virus RT PCR Quant Non-Graph (LC)	$489.30	$3,262.00	$36.41–$3,262.00	184% above	85%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno. (LC)	$978.60	$3,262.00	$335.99–$2,935.80	—	70%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 Hepatitis C Virus RT PCR Quant Non-Graph (LC)	$978.60	$3,262.00	$335.99–$2,935.80	—	70%
Herpes blood test, HSV-1 antibody CPT 86695 86695 L164922 HSV1	$21.00	$140.00	$11.21–$500.00	45% below	85%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Virus 1 Specific Antibody IgG (LC)	$21.00	$140.00	$11.21–$500.00	45% below	85%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IgG, Type Spec LC	$21.00	$140.00	$11.21–$500.00	45% below	85%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 L164922 HSV1	$42.00	$140.00	$14.42–$126.00	—	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IgG, Type Spec LC	$42.00	$140.00	$14.42–$126.00	—	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Virus 1 Specific Antibody IgG (LC)	$42.00	$140.00	$14.42–$126.00	—	70%
Herpes blood test, HSV-2 antibody CPT 86696 86696 L164922 HSV2	$21.00	$140.00	$14.42–$500.00	55% below	85%
Herpes blood test, HSV-2 antibody CPT 86696 .HSV2 IgG Supplemental (LC)	$21.00	$140.00	$14.42–$500.00	55% below	85%
Herpes blood test, HSV-2 antibody CPT 86696 HSV Type 2, Type-specific Antibodies, IgG LC	$21.00	$140.00	$14.42–$500.00	55% below	85%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV Type 2, Type-specific Antibodies, IgG LC	$42.00	$140.00	$14.42–$126.00	—	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 L164922 HSV2	$42.00	$140.00	$14.42–$126.00	—	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 .HSV2 IgG Supplemental (LC)	$42.00	$140.00	$14.42–$126.00	—	70%
High-sensitivity CRP (hs-CRP) test CPT 86141 C Reactive Protein Cardiac (LC)	$179.70	$1,198.00	$11.01–$1,198.00	353% above	85%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C Reactive Protein Cardiac (LC)	$359.40	$1,198.00	$123.39–$1,078.20	—	70%
Homocysteine blood test CPT 83090 Homocyst(e)ine Plasma LC	$108.90	$726.00	$15.23–$726.00	34% above	85%
Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine Plasma LC	$217.80	$726.00	$74.78–$653.40	—	70%
Insulin blood test CPT 83525 83525 L501561 INSULIN TOT	$89.25	$595.00	$9.72–$595.00	64% above	85%
Insulin blood test CPT 83525 Insulin LC	$89.25	$595.00	$9.72–$595.00	64% above	85%
Insulin blood test inpatient CPT 83525 Insulin LC	$178.50	$595.00	$61.28–$535.50	—	70%
Insulin blood test inpatient CPT 83525 83525 L501561 INSULIN TOT	$178.50	$595.00	$61.28–$535.50	—	70%
Iron blood test (serum iron) CPT 83540 83540 L1321 IRON	$49.20	$328.00	$5.50–$500.00	30% above	85%
Iron blood test (serum iron) CPT 83540 83540 IRON	$49.20	$328.00	$5.50–$500.00	30% above	85%
Iron blood test (serum iron) CPT 83540 IRON	$49.20	$328.00	$5.50–$500.00	30% above	85%
Iron blood test (serum iron) inpatient CPT 83540 83540 IRON	$98.40	$328.00	$33.78–$295.20	—	70%
Iron blood test (serum iron) inpatient CPT 83540 83540 L1321 IRON	$98.40	$328.00	$33.78–$295.20	—	70%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$98.40	$328.00	$33.78–$295.20	—	70%
Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity DM	$112.50	$750.00	$7.43–$750.00	156% above	85%
Iron-binding capacity (TIBC) test CPT 83550 83550 IRON BINDING CAPACIT	$112.50	$750.00	$7.43–$750.00	156% above	85%
Iron-binding capacity (TIBC) test CPT 83550 83550 L1321 IRON BIND CAP	$112.50	$750.00	$7.43–$750.00	156% above	85%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity DM	$225.00	$750.00	$77.25–$675.00	—	70%
Iron-binding capacity (TIBC) test inpatient CPT 83550 83550 L1321 IRON BIND CAP	$225.00	$750.00	$77.25–$675.00	—	70%
Iron-binding capacity (TIBC) test inpatient CPT 83550 83550 IRON BINDING CAPACIT	$225.00	$750.00	$77.25–$675.00	—	70%
Kidney function blood test panel CPT 80069 RFP	$169.80	$1,132.00	$7.38–$1,132.00	117% above	85%
Kidney function blood test panel inpatient CPT 80069 RFP	$339.60	$1,132.00	$116.60–$1,018.80	—	70%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone S (LC)	$140.70	$938.00	$15.74–$938.00	51% above	85%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$140.70	$938.00	$15.74–$938.00	51% above	85%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$281.40	$938.00	$96.61–$844.20	—	70%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone S (LC)	$281.40	$938.00	$96.61–$844.20	—	70%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$90.45	$603.00	$5.86–$603.00	125% above	85%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase, Body Fluid Sendout to LabCorp	$90.45	$603.00	$5.86–$603.00	125% above	85%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase, Body Fluid Sendout to LabCorp	$180.90	$603.00	$62.11–$542.70	—	70%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$180.90	$603.00	$62.11–$542.70	—	70%
Liver function blood test panel CPT 80076 HFP	$162.90	$1,086.00	$6.94–$1,086.00	98% above	85%
Liver function blood test panel inpatient CPT 80076 HFP	$325.80	$1,086.00	$111.86–$977.40	—	70%
Lyme disease antibody test CPT 86618 Lyme Disease Total Ab Rfx Immunoassay LC	$67.20	$448.00	$14.48–$500.00	15% below	85%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Total Ab Rfx Immunoassay LC	$134.40	$448.00	$46.14–$403.20	—	70%
Magnesium blood test CPT 83735 Magnesium Serum	$66.75	$445.00	$5.70–$500.00	96% above	85%
Magnesium blood test inpatient CPT 83735 Magnesium Serum	$133.50	$445.00	$45.84–$400.50	—	70%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Antibodies, IgG (LC)	$99.45	$663.00	$10.95–$663.00	138% above	85%
Measles (rubeola) antibody test CPT 86765 86765 L58495 RUBEOLA AB	$99.45	$663.00	$10.95–$663.00	138% above	85%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Antibodies, IgG (LC)	$198.90	$663.00	$68.29–$596.70	—	70%
Measles (rubeola) antibody test inpatient CPT 86765 86765 L58495 RUBEOLA AB	$198.90	$663.00	$68.29–$596.70	—	70%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen	$74.85	$499.00	$4.40–$500.00	100% above	85%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen	$149.70	$499.00	$51.40–$449.10	—	70%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Ag Total	$144.45	$963.00	$15.63–$963.00	68% above	85%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Ag Total	$288.90	$963.00	$99.19–$866.70	—	70%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact (LC)	$55.65	$371.00	$35.09–$500.00	65% below	85%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact (LC)	$111.30	$371.00	$38.21–$333.90	—	70%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$52.35	$349.00	$5.11–$500.00	33% above	85%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$104.70	$349.00	$35.95–$314.10	—	70%
Progesterone blood test CPT 84144 Progesterone Sendout to LabCorp	$144.75	$965.00	$17.73–$965.00	57% above	85%
Progesterone blood test inpatient CPT 84144 Progesterone Sendout to LabCorp	$289.50	$965.00	$99.40–$868.50	—	70%
Prolactin blood test CPT 84146 Prolactin (LC)	$209.25	$1,395.00	$16.47–$1,395.00	89% above	85%
Prolactin blood test inpatient CPT 84146 Prolactin (LC)	$418.50	$1,395.00	$143.68–$1,255.50	—	70%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time w/INR	$52.35	$349.00	$3.65–$500.00	48% above	85%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time w/INR	$104.70	$349.00	$35.95–$314.10	—	70%
Rapid flu test (influenza antigen) CPT 87804 87804 INFLUENZA ASSAY W-OP	$49.35	$329.00	$14.07–$500.00	15% above	85%
Rapid flu test (influenza antigen) CPT 87804 Influenza A Antigen Result	$49.35	$329.00	$14.07–$500.00	15% above	85%
Rapid flu test (influenza antigen) CPT 87804 Influenza B Antigen Result	$49.35	$329.00	$14.07–$500.00	15% above	85%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza B Antigen Result	$98.70	$329.00	$33.89–$296.10	—	70%
Rapid flu test (influenza antigen) inpatient CPT 87804 87804 INFLUENZA ASSAY W-OP	$98.70	$329.00	$33.89–$296.10	—	70%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A Antigen Result	$98.70	$329.00	$33.89–$296.10	—	70%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep A FIA	$73.20	$488.00	$14.05–$500.00	42% above	85%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep A FIA	$146.40	$488.00	$50.26–$439.20	—	70%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor (LC)	$10.35	$69.00	$4.82–$500.00	74% below	85%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Arthritis Factor (LC)	$20.70	$69.00	$7.11–$62.10	—	70%
Rubella antibody test (immunity check) CPT 86762 86762 L58495 RUBELLA AB	$73.05	$487.00	$12.23–$500.00	45% above	85%
Rubella antibody test (immunity check) CPT 86762 86762 L211581 RUBELLA AB	$73.05	$487.00	$12.23–$500.00	45% above	85%
Rubella antibody test (immunity check) CPT 86762 Rubella Ab IgG Auto w/Interp	$73.05	$487.00	$12.23–$500.00	45% above	85%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies IgG LC	$73.05	$487.00	$12.23–$500.00	45% above	85%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies IgM Sendout to LabCorp	$73.05	$487.00	$12.23–$500.00	45% above	85%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies IgG LC	$146.10	$487.00	$50.16–$438.30	—	70%
Rubella antibody test (immunity check) inpatient CPT 86762 86762 L211581 RUBELLA AB	$146.10	$487.00	$50.16–$438.30	—	70%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab IgG Auto w/Interp	$146.10	$487.00	$50.16–$438.30	—	70%
Rubella antibody test (immunity check) inpatient CPT 86762 86762 L58495 RUBELLA AB	$146.10	$487.00	$50.16–$438.30	—	70%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies IgM Sendout to LabCorp	$146.10	$487.00	$50.16–$438.30	—	70%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESRA	$38.55	$257.00	$2.30–$500.00	1% below	85%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESRA	$77.10	$257.00	$26.47–$231.30	—	70%
Stool ova and parasites exam CPT 87177 87177 L8623 OVA-PARASITES SMEARS	$109.50	$730.00	$7.57–$730.00	113% above	85%
Stool ova and parasites exam inpatient CPT 87177 87177 L8623 OVA-PARASITES SMEARS	$219.00	$730.00	$75.19–$657.00	—	70%
Stool test for hidden blood (guaiac FOBT) CPT 82270 FOBT	$30.75	$205.00	$3.23–$500.00	70% above	85%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 FOBT	$61.50	$205.00	$21.12–$184.50	—	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Qual	$105.45	$703.00	$3.63–$703.00	310% above	85%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF LC	$105.45	$703.00	$3.63–$703.00	310% above	85%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Qual w/Reflex Quant	$105.45	$703.00	$3.63–$703.00	310% above	85%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Qual	$210.90	$703.00	$72.41–$632.70	—	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF LC	$210.90	$703.00	$72.41–$632.70	—	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Qual w/Reflex Quant	$210.90	$703.00	$72.41–$632.70	—	70%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus (Client Incubated) LC	$120.00	$800.00	$52.68–$800.00	11% below	85%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus (Client Incubated) LC	$240.00	$800.00	$82.40–$720.00	—	70%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Level (LC)	$168.75	$1,125.00	$21.94–$1,125.00	42% above	85%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Level (LC)	$337.50	$1,125.00	$115.88–$1,012.50	—	70%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Antibody (LC)	$111.60	$744.00	$12.37–$744.00	217% above	85%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsomal Ab LC	$111.60	$744.00	$12.37–$744.00	217% above	85%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Antibody (LC)	$223.20	$744.00	$76.63–$669.60	—	70%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsomal Ab LC	$223.20	$744.00	$76.63–$669.60	—	70%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$93.00	$620.00	$14.28–$620.00	30% above	85%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4	$93.00	$620.00	$14.28–$620.00	30% above	85%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$186.00	$620.00	$63.86–$558.00	—	70%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4	$186.00	$620.00	$63.86–$558.00	—	70%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis, NAA (LC)	$56.70	$378.00	$29.83–$500.00	18% above	85%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis, NAA (LC)	$113.40	$378.00	$38.93–$340.20	—	70%
Uric acid blood test CPT 84550 Uric Acid Level	$49.20	$328.00	$3.84–$500.00	41% above	85%
Uric acid blood test inpatient CPT 84550 Uric Acid Level	$98.40	$328.00	$33.78–$295.20	—	70%
Urinalysis with microscope exam, automated CPT 81001 .Bill Only DS Auto/MSc Reqd	$60.30	$402.00	$2.69–$500.00	79% above	85%
Urinalysis with microscope exam, automated CPT 81001 Perform Microscopic - Yes	$60.30	$402.00	$2.69–$500.00	79% above	85%
Urinalysis with microscope exam, automated inpatient CPT 81001 Perform Microscopic - Yes	$120.60	$402.00	$41.41–$361.80	—	70%
Urinalysis with microscope exam, automated inpatient CPT 81001 .Bill Only DS Auto/MSc Reqd	$120.60	$402.00	$41.41–$361.80	—	70%
Urinalysis with microscope exam, manual CPT 81000 .Bill Only DS Man/MSc Reqd	$73.35	$489.00	$3.42–$500.00	102% above	85%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis w/Microscopic Manual	$73.35	$489.00	$3.42–$500.00	102% above	85%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis w/Microscopic Manual	$146.70	$489.00	$50.37–$440.10	—	70%
Urinalysis with microscope exam, manual inpatient CPT 81000 .Bill Only DS Man/MSc Reqd	$146.70	$489.00	$50.37–$440.10	—	70%
Urinalysis without microscope exam, automated CPT 81003 Dipstick Type? - Auto	$28.35	$189.00	$1.91–$500.00	88% above	85%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis w/o Microscopic Automated	$28.35	$189.00	$1.91–$500.00	88% above	85%
Urinalysis without microscope exam, automated CPT 81003 Perform Microscopic - No	$28.35	$189.00	$1.91–$500.00	88% above	85%
Urinalysis without microscope exam, automated CPT 81003 Urine Color Urine Dipstick	$28.35	$189.00	$1.91–$500.00	88% above	85%
Urinalysis without microscope exam, automated CPT 81003 .Bill Only DS Auto/No MSc	$28.35	$189.00	$1.91–$500.00	88% above	85%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Color Urine Dipstick	$56.70	$189.00	$19.47–$170.10	—	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 .Bill Only DS Auto/No MSc	$56.70	$189.00	$19.47–$170.10	—	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis w/o Microscopic Automated	$56.70	$189.00	$19.47–$170.10	—	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 Perform Microscopic - No	$56.70	$189.00	$19.47–$170.10	—	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 Dipstick Type? - Auto	$56.70	$189.00	$19.47–$170.10	—	70%
Urinalysis without microscope exam, manual CPT 81002 .Bill Only DS Man/No MSc	$55.95	$373.00	$2.96–$500.00	296% above	85%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis w/o Microscopic Manual	$55.95	$373.00	$2.96–$500.00	296% above	85%
Urinalysis without microscope exam, manual CPT 81002 Ketones Ur Ql	$55.95	$373.00	$2.96–$500.00	296% above	85%
Urinalysis without microscope exam, manual inpatient CPT 81002 .Bill Only DS Man/No MSc	$111.90	$373.00	$38.42–$335.70	—	70%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis w/o Microscopic Manual	$111.90	$373.00	$38.42–$335.70	—	70%
Urinalysis without microscope exam, manual inpatient CPT 81002 Ketones Ur Ql	$111.90	$373.00	$38.42–$335.70	—	70%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture Qn	$144.30	$962.00	$6.86–$962.00	214% above	85%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture Qn	$288.60	$962.00	$99.09–$865.80	—	70%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result - Negative	$57.00	$380.00	$7.32–$500.00	44% above	85%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result	$57.00	$380.00	$7.32–$500.00	44% above	85%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result - Positive	$57.00	$380.00	$7.32–$500.00	44% above	85%
Urine pregnancy test, read by color change CPT 81025 Human Chorionic Gonadotropin Urine Qual Manual	$57.00	$380.00	$7.32–$500.00	44% above	85%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result - Negative	$114.00	$380.00	$39.14–$342.00	—	70%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result	$114.00	$380.00	$39.14–$342.00	—	70%
Urine pregnancy test, read by color change inpatient CPT 81025 Human Chorionic Gonadotropin Urine Qual Manual	$114.00	$380.00	$39.14–$342.00	—	70%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result - Positive	$114.00	$380.00	$39.14–$342.00	—	70%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12	$63.75	$425.00	$12.82–$500.00	23% below	85%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12	$127.50	$425.00	$43.78–$382.50	—	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 hydroxy	$204.15	$1,361.00	$25.16–$1,361.00	120% above	85%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 hydroxy	$408.30	$1,361.00	$140.18–$1,224.90	—	70%
Zinc blood test CPT 84630 Zinc Plasma or Serum (LC)	$60.90	$406.00	$9.68–$500.00	10% below	85%
Zinc blood test CPT 84630 Zinc, Whole Blood (LC)	$60.90	$406.00	$9.68–$500.00	10% below	85%
Zinc blood test inpatient CPT 84630 Zinc Plasma or Serum (LC)	$121.80	$406.00	$41.82–$365.40	—	70%
Zinc blood test inpatient CPT 84630 Zinc, Whole Blood (LC)	$121.80	$406.00	$41.82–$365.40	—	70%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Human Chorionic Gonadotropin Beta Sub unit Quant (	$118.50	$790.00	$12.79–$790.00	45% above	85%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Human Chorionic Gonadotropin Quant	$118.50	$790.00	$12.79–$790.00	45% above	85%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Human Chorionic Gonadotropin Quant	$237.00	$790.00	$81.37–$711.00	—	70%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Human Chorionic Gonadotropin Beta Sub unit Quant (	$237.00	$790.00	$81.37–$711.00	—	70%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w Loc w Stereo 1 Lsn Lt	$2,042.10	$13,614.00	$402.98–$12,252.60	16% above	85%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w Loc w Stereo 1 Lsn Rt	$2,042.10	$13,614.00	$402.98–$12,252.60	16% above	85%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w Loc w Stereo 1 Lsn Lt	$4,084.20	$13,614.00	$1,402.24–$12,252.60	—	70%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w Loc w Stereo 1 Lsn Rt	$4,084.20	$13,614.00	$1,402.24–$12,252.60	—	70%
Cardiac catheterization with coronary angiogram CPT 93458 EP-EVALUATION AICD, DFT TESTING WITH AN EXTERNAL A	$1,061.25	$7,075.00	$583.84–$9,410.00	79% below	85%
Cardiac catheterization with coronary angiogram one side CPT 93458 CC-CORONARY W LEFT HEART CATH[MSMH]	$3,364.05	$22,427.00	$583.84–$22,427.00	34% below	85%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 EP-EVALUATION AICD, DFT TESTING WITH AN EXTERNAL A	$2,122.50	$7,075.00	$728.72–$6,367.50	—	70%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 CC-CORONARY W LEFT HEART CATH[MSMH]	$6,728.10	$22,427.00	$2,309.98–$20,184.30	—	70%
Cardioversion, elective (restoring heart rhythm) CPT 92960 $ED Cardioversion/Defibrillation	$523.05	$3,487.00	$135.36–$3,487.00	37% above	85%
Cardioversion, elective (restoring heart rhythm) CPT 92960 NI-CARDIOVERSION [MSMH]	$759.00	$5,060.00	$135.36–$5,060.00	99% above	85%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 $ED Cardioversion/Defibrillation	$1,046.10	$3,487.00	$359.16–$3,138.30	—	70%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 NI-CARDIOVERSION [MSMH]	$1,518.00	$5,060.00	$521.18–$4,554.00	—	70%
Coronary stent placement, one artery CPT 92928 IC-PRQ CRD STN W-ANG[MSMH]	$12,567.00	$83,780.00	$520.11–$75,402.00	64% above	85%
Coronary stent placement, one artery CPT 92928 PRQ TCAT PLMT NTRAC ST 1 LES	$32,060.52	$213,736.78	$520.11–$192,363.10	317% above	85%
Coronary stent placement, one artery inpatient CPT 92928 IC-PRQ CRD STN W-ANG[MSMH]	$25,134.00	$83,780.00	$8,629.34–$75,402.00	—	70%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$399.88	$2,665.84	$12.93–$2,665.84	807% above	85%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX	$384.66	$2,564.41	$42.42–$2,564.41	501% above	85%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 S-INJ CATH HYSTERSO	$727.20	$4,848.00	$196.17–$4,848.00	119% above	85%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 S-INJ CATH HYSTERSO	$1,454.40	$4,848.00	$499.34–$4,363.20	—	70%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS	$816.39	$5,442.62	$111.31–$5,442.62	515% above	85%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJECT, JOINT/BURSA	$1,047.11	$6,980.74	$57.44–$6,980.74	563% above	85%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJECT, JOINT/BURSA	$915.16	$6,101.08	$48.51–$6,101.08	609% above	85%
Left heart catheterization, diagnostic one side CPT 93452 IC-LEFT HRT CATH W/VENTRICLGRPHY [MSMH]	$4,133.85	$27,559.00	$517.18–$27,559.00	2% below	85%
Left heart catheterization, diagnostic inpatient one side CPT 93452 IC-LEFT HRT CATH W/VENTRICLGRPHY [MSMH]	$8,267.70	$27,559.00	$2,838.58–$24,803.10	—	70%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$993.34	$6,622.25	$99.06–$6,622.25	653% above	85%
Pacemaker implant (dual chamber) CPT 33208 INSERTION OF HEART PACEMAKER	$22,993.72	$153,291.49	$457.25–$137,962.34	94% above	85%
Paracentesis with imaging guidance CPT 49083 US Paracentesis Abd w Image	$1,310.70	$8,738.00	$245.21–$8,512.68	189% above	85%
Paracentesis with imaging guidance CPT 49083 IR Abdominal Paracentesis w Imaging	$2,043.60	$13,624.00	$245.21–$12,261.60	350% above	85%
Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis Abd w Image	$2,621.40	$8,738.00	$900.01–$7,864.20	—	70%
Paracentesis with imaging guidance inpatient CPT 49083 IR Abdominal Paracentesis w Imaging	$4,087.20	$13,624.00	$1,403.27–$12,261.60	—	70%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$261.98	$1,746.54	$139.49–$1,746.54	11% below	85%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY	$865.89	$5,772.59	$130.83–$5,772.59	367% above	85%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$1,005.88	$6,705.88	$59.50–$6,705.88	1130% above	85%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$1,289.09	$8,593.95	$65.45–$8,512.68	1164% above	85%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SUPERFICIAL WOUND(S)	$885.88	$5,905.84	$81.30–$5,905.84	447% above	85%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SUPERFICIAL WOUND(S)	$1,100.65	$7,337.67	$99.39–$7,337.67	576% above	85%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR SUPERFICIAL WOUND(S)	$1,495.13	$9,967.52	$97.43–$8,970.77	823% above	85%
Thoracentesis with imaging guidance CPT 32555 CT Thoracentesis w Imaging Guidance	$1,694.85	$11,299.00	$254.99–$10,169.10	163% above	85%
Thoracentesis with imaging guidance CPT 32555 IR Thoracentesis w Imging Guidance	$2,607.75	$17,385.00	$254.99–$15,646.50	305% above	85%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$5,083.79	$33,891.94	$263.57–$30,502.75	690% above	85%
Thoracentesis with imaging guidance inpatient CPT 32555 CT Thoracentesis w Imaging Guidance	$3,389.70	$11,299.00	$1,163.80–$10,169.10	—	70%
Thoracentesis with imaging guidance inpatient CPT 32555 IR Thoracentesis w Imging Guidance	$5,215.50	$17,385.00	$1,790.66–$15,646.50	—	70%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Right	$1,546.35	$10,309.00	$398.11–$9,278.10	6% below	85%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Left	$1,546.35	$10,309.00	$398.11–$9,278.10	6% below	85%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Right	$3,092.70	$10,309.00	$1,061.83–$9,278.10	—	70%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Left	$3,092.70	$10,309.00	$1,061.83–$9,278.10	—	70%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Blood transfusion (giving blood or blood components) CPT 36430 $ED Transfusion >2 yrs	$450.75	$3,005.00	$35.47–$3,005.00	2% above	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Verified with Pt Information: - Transfu	$450.75	$3,005.00	$35.47–$3,005.00	2% above	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood transfusions	$605.55	$4,037.00	$35.47–$4,037.00	36% above	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Whole blood	$605.55	$4,037.00	$35.47–$4,037.00	36% above	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Red blood cells (preoperativ	$605.55	$4,037.00	$35.47–$4,037.00	36% above	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Red blood cells (postoperati	$605.55	$4,037.00	$35.47–$4,037.00	36% above	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Platelets (single donor)	$605.55	$4,037.00	$35.47–$4,037.00	36% above	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Platelets (random donor)	$605.55	$4,037.00	$35.47–$4,037.00	36% above	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Packed red blood cells	$605.55	$4,037.00	$35.47–$4,037.00	36% above	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Fresh frozen plasma	$605.55	$4,037.00	$35.47–$4,037.00	36% above	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Cryoprecipitate	$605.55	$4,037.00	$35.47–$4,037.00	36% above	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Fee	$605.55	$4,037.00	$35.47–$4,037.00	36% above	85%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 $ED Transfusion >2 yrs	$901.50	$3,005.00	$309.52–$2,704.50	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Verified with Pt Information: - Transfu	$901.50	$3,005.00	$309.52–$2,704.50	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Fresh frozen plasma	$1,211.10	$4,037.00	$415.81–$3,633.30	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Whole blood	$1,211.10	$4,037.00	$415.81–$3,633.30	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Red blood cells (postoperati	$1,211.10	$4,037.00	$415.81–$3,633.30	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Platelets (single donor)	$1,211.10	$4,037.00	$415.81–$3,633.30	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Red blood cells (preoperativ	$1,211.10	$4,037.00	$415.81–$3,633.30	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Cryoprecipitate	$1,211.10	$4,037.00	$415.81–$3,633.30	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Platelets (random donor)	$1,211.10	$4,037.00	$415.81–$3,633.30	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Packed red blood cells	$1,211.10	$4,037.00	$415.81–$3,633.30	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood transfusions	$1,211.10	$4,037.00	$415.81–$3,633.30	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Fee	$1,211.10	$4,037.00	$415.81–$3,633.30	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPPB Initial	$200.25	$1,335.00	$6.45–$1,335.00	226% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPV Initial	$200.25	$1,335.00	$6.45–$1,335.00	226% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPV Subsequent	$200.25	$1,335.00	$6.45–$1,335.00	226% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Charge - Initial	$200.25	$1,335.00	$6.45–$1,335.00	226% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Charge - Subsequent	$200.25	$1,335.00	$6.45–$1,335.00	226% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - Initial	$200.25	$1,335.00	$6.45–$1,335.00	226% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - Subsequent	$200.25	$1,335.00	$6.45–$1,335.00	226% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPPB Subsequent	$200.25	$1,335.00	$6.45–$1,335.00	226% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$892.34	$5,948.91	$6.59–$5,948.91	1351% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPV Subsequent	$400.50	$1,335.00	$137.51–$1,201.50	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPV Initial	$400.50	$1,335.00	$137.51–$1,201.50	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - Initial	$400.50	$1,335.00	$137.51–$1,201.50	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler Charge - Subsequent	$400.50	$1,335.00	$137.51–$1,201.50	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPPB Subsequent	$400.50	$1,335.00	$137.51–$1,201.50	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - Subsequent	$400.50	$1,335.00	$137.51–$1,201.50	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler Charge - Initial	$400.50	$1,335.00	$137.51–$1,201.50	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPPB Initial	$400.50	$1,335.00	$137.51–$1,201.50	—	70%
Chemotherapy IV infusion, first hour CPT 96413 CHRG - CHEMO IV INFU 1ST HR	$357.60	$2,384.00	$102.87–$2,384.00	2% below	85%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHRG - CHEMO IV INFU 1ST HR	$715.20	$2,384.00	$245.55–$2,145.60	—	70%
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care	$1,583.70	$10,558.00	$246.61–$9,502.20	163% above	85%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care	$3,167.40	$10,558.00	$1,087.47–$9,502.20	—	70%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Including Recording Awake and Drowsy	$584.10	$3,894.00	$185.20–$3,894.00	107% above	85%
EEG (brain wave test), awake and drowsy, routine CPT 95816 CHRG - EEG AWAKE DROWSY	$584.10	$3,894.00	$185.20–$3,894.00	107% above	85%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 CHRG - EEG AWAKE DROWSY	$1,168.20	$3,894.00	$401.08–$3,504.60	—	70%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Including Recording Awake and Drowsy	$1,168.20	$3,894.00	$401.08–$3,504.60	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG BCE	$272.55	$1,817.00	$5.10–$1,817.00	248% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Series 3 Hours	$272.55	$1,817.00	$5.10–$1,817.00	248% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead Series Now	$272.55	$1,817.00	$5.10–$1,817.00	248% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 6 Hours	$272.55	$1,817.00	$5.10–$1,817.00	248% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG 12 Lead Series Now	$272.55	$1,817.00	$5.10–$1,817.00	248% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Series 1 Hour	$272.55	$1,817.00	$5.10–$1,817.00	248% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 1 Hour	$272.55	$1,817.00	$5.10–$1,817.00	248% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 3 Hours	$272.55	$1,817.00	$5.10–$1,817.00	248% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Is the patient scheduled for a Cath Lab procedure	$272.55	$1,817.00	$5.10–$1,817.00	248% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Start Time	$272.55	$1,817.00	$5.10–$1,817.00	248% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Series 1 Hour	$545.10	$1,817.00	$187.15–$1,635.30	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Start Time	$545.10	$1,817.00	$187.15–$1,635.30	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 1 Hour	$545.10	$1,817.00	$187.15–$1,635.30	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG 12 Lead Series Now	$545.10	$1,817.00	$187.15–$1,635.30	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Is the patient scheduled for a Cath Lab procedure	$545.10	$1,817.00	$187.15–$1,635.30	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG BCE	$545.10	$1,817.00	$187.15–$1,635.30	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead Series Now	$545.10	$1,817.00	$187.15–$1,635.30	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Series 3 Hours	$545.10	$1,817.00	$187.15–$1,635.30	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 3 Hours	$545.10	$1,817.00	$187.15–$1,635.30	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 6 Hours	$545.10	$1,817.00	$187.15–$1,635.30	—	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1	$161.85	$1,079.00	$10.49–$1,100.00	80% above	85%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1	$323.70	$1,079.00	$111.14–$971.10	—	70%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$304.80	$2,032.00	$38.63–$2,032.00	150% above	85%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$609.60	$2,032.00	$209.30–$1,828.80	—	70%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$558.45	$3,723.00	$65.37–$3,723.00	176% above	85%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$1,116.90	$3,723.00	$383.47–$3,350.70	—	70%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$1,003.20	$6,688.00	$111.54–$6,688.00	245% above	85%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$2,006.40	$6,688.00	$688.86–$6,019.20	—	70%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Trauma Notification Level - No Prior Notification	$1,008.75	$6,725.00	$161.84–$6,725.00	96% above	85%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Trauma Team Alert/Notification Level^ - No Prior N	$1,008.75	$6,725.00	$161.84–$6,725.00	96% above	85%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$1,096.35	$7,309.00	$161.84–$7,309.00	113% above	85%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Trauma Notification Level - No Prior Notification	$2,017.50	$6,725.00	$692.68–$6,052.50	—	70%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Trauma Team Alert/Notification Level^ - No Prior N	$2,017.50	$6,725.00	$692.68–$6,052.50	—	70%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$2,192.70	$7,309.00	$752.83–$6,578.10	—	70%
Exercise stress test, tracing only, the hospital charge CPT 93017 NM Stress Test	$440.40	$2,936.00	$30.99–$2,936.00	18% above	85%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiac Stress Test	$440.40	$2,936.00	$30.99–$2,936.00	18% above	85%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiac Stress Test	$880.80	$2,936.00	$302.41–$2,642.40	—	70%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NM Stress Test	$880.80	$2,936.00	$302.41–$2,642.40	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CHRG - Inf/Inj/Hydration - IV HYDRATION 1 HR	$509.25	$3,395.00	$26.42–$3,395.00	163% above	85%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration therapy 1st hour	$509.25	$3,395.00	$26.42–$3,395.00	163% above	85%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OB CHRG - Inf/Inj/Hydration Once - IV HYDRATION 1	$509.25	$3,395.00	$26.42–$3,395.00	163% above	85%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour	$509.25	$3,395.00	$26.42–$3,395.00	163% above	85%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 CHRG - Inf/Inj/Hydration - IV HYDRATION 1 HR	$1,018.50	$3,395.00	$349.68–$3,055.50	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration therapy 1st hour	$1,018.50	$3,395.00	$349.68–$3,055.50	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OB CHRG - Inf/Inj/Hydration Once - IV HYDRATION 1	$1,018.50	$3,395.00	$349.68–$3,055.50	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour	$1,018.50	$3,395.00	$349.68–$3,055.50	—	70%
IV infusion of a medicine, first hour CPT 96365 96365 - IV tx, first hour	$418.20	$2,788.00	$50.23–$2,788.00	86% above	85%
IV infusion of a medicine, first hour CPT 96365 OB CHRG - Inf/Inj/Hydration Once - IV THERAPY DX 1	$418.20	$2,788.00	$50.23–$2,788.00	86% above	85%
IV infusion of a medicine, first hour CPT 96365 CHRG - Inf/Inj/Hydration - IV THERAPY DX 1 HR	$418.20	$2,788.00	$50.23–$2,788.00	86% above	85%
IV infusion of a medicine, first hour CPT 96365 Infusion 1st hour	$418.20	$2,788.00	$50.23–$2,788.00	86% above	85%
IV infusion of a medicine, first hour inpatient CPT 96365 CHRG - Inf/Inj/Hydration - IV THERAPY DX 1 HR	$836.40	$2,788.00	$287.16–$2,509.20	—	70%
IV infusion of a medicine, first hour inpatient CPT 96365 OB CHRG - Inf/Inj/Hydration Once - IV THERAPY DX 1	$836.40	$2,788.00	$287.16–$2,509.20	—	70%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 - IV tx, first hour	$836.40	$2,788.00	$287.16–$2,509.20	—	70%
IV infusion of a medicine, first hour inpatient CPT 96365 Infusion 1st hour	$836.40	$2,788.00	$287.16–$2,509.20	—	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OB CHRG - THERAPEUTIC DX SQ IM	$155.55	$1,037.00	$12.64–$1,037.00	164% above	85%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CHRG - THERAPEUTIC DX SQ IM	$155.55	$1,037.00	$12.64–$1,037.00	164% above	85%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM Injection	$155.55	$1,037.00	$12.64–$1,037.00	164% above	85%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 - Subq/IM Injection	$155.55	$1,037.00	$12.64–$1,037.00	164% above	85%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OB CHRG - THERAPEUTIC DX SQ IM	$311.10	$1,037.00	$106.81–$933.30	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 - Subq/IM Injection	$311.10	$1,037.00	$106.81–$933.30	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM Injection	$311.10	$1,037.00	$106.81–$933.30	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CHRG - THERAPEUTIC DX SQ IM	$311.10	$1,037.00	$106.81–$933.30	—	70%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA - Redoc 1	$78.45	$523.00	$26.69–$523.00	50% above	85%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducatn Assist Charge	$78.45	$523.00	$26.69–$523.00	50% above	85%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units	$78.45	$523.00	$26.69–$523.00	50% above	85%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 185	$78.45	$523.00	$26.69–$523.00	50% above	85%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 181	$78.45	$523.00	$26.69–$523.00	50% above	85%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Charges	$78.45	$523.00	$26.69–$523.00	50% above	85%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Charges	$78.45	$523.00	$26.69–$523.00	50% above	85%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Units	$78.45	$523.00	$26.69–$523.00	50% above	85%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Charges	$156.90	$523.00	$53.87–$470.70	—	70%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 185	$156.90	$523.00	$53.87–$470.70	—	70%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Units	$156.90	$523.00	$53.87–$470.70	—	70%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 181	$156.90	$523.00	$53.87–$470.70	—	70%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA - Redoc 1	$156.90	$523.00	$53.87–$470.70	—	70%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Charges	$156.90	$523.00	$53.87–$470.70	—	70%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units	$156.90	$523.00	$53.87–$470.70	—	70%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducatn Assist Charge	$156.90	$523.00	$53.87–$470.70	—	70%
New patient office visit, about 45 minutes CPT 99204 CHRG - WOUND CARE LEVEL 4 NEW PT	$300.00	$2,000.00	$56.77–$2,000.00	109% above	85%
New patient office visit, about 45 minutes inpatient CPT 99204 CHRG - WOUND CARE LEVEL 4 NEW PT	$600.00	$2,000.00	$206.00–$1,800.00	—	70%
New patient office visit, about 60 minutes CPT 99205 CHRG - WOUND CARE LEVEL 5 NEW PT	$312.45	$2,083.00	$56.77–$2,083.00	76% above	85%
New patient office visit, about 60 minutes inpatient CPT 99205 CHRG - WOUND CARE LEVEL 5 NEW PT	$624.90	$2,083.00	$214.55–$1,874.70	—	70%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW Unit - Yes	$204.75	$1,365.00	$65.24–$1,365.00	49% above	85%
Occupational therapy evaluation, low complexity CPT 97165 IRF OT EVAL LOW	$204.75	$1,365.00	$65.24–$1,365.00	49% above	85%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL- LOW COMP - REDOC 185	$204.75	$1,365.00	$65.24–$1,365.00	49% above	85%
Occupational therapy evaluation, low complexity CPT 97165 OT Eval Low Assistant Unit - Yes	$204.75	$1,365.00	$65.24–$1,365.00	49% above	85%
Occupational therapy evaluation, low complexity CPT 97165 OCCUPAT THERAPY EVAL LOW COMPLEXITY COTA - Redoc 1	$204.75	$1,365.00	$65.24–$1,365.00	49% above	85%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OCCUPAT THERAPY EVAL LOW COMPLEXITY COTA - Redoc 1	$409.50	$1,365.00	$140.60–$1,228.50	—	70%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW Unit - Yes	$409.50	$1,365.00	$140.60–$1,228.50	—	70%
Occupational therapy evaluation, low complexity inpatient CPT 97165 IRF OT EVAL LOW	$409.50	$1,365.00	$140.60–$1,228.50	—	70%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL- LOW COMP - REDOC 185	$409.50	$1,365.00	$140.60–$1,228.50	—	70%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Eval Low Assistant Unit - Yes	$409.50	$1,365.00	$140.60–$1,228.50	—	70%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH Unit - Yes	$226.05	$1,507.00	$45.00–$1,507.00	54% above	85%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH COMP - REDOC 181	$226.05	$1,507.00	$45.00–$1,507.00	54% above	85%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 IRF PT EVAL HIGH	$226.05	$1,507.00	$45.00–$1,507.00	54% above	85%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH Unit - Yes	$452.10	$1,507.00	$155.22–$1,356.30	—	70%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 IRF PT EVAL HIGH	$452.10	$1,507.00	$155.22–$1,356.30	—	70%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH COMP - REDOC 181	$452.10	$1,507.00	$155.22–$1,356.30	—	70%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW COMP - REDOC 181	$189.60	$1,264.00	$45.00–$1,264.00	49% above	85%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW Unit - Yes	$189.60	$1,264.00	$45.00–$1,264.00	49% above	85%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 IRF PT EVAL LOW	$189.60	$1,264.00	$45.00–$1,264.00	49% above	85%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 IRF PT EVAL LOW	$379.20	$1,264.00	$130.19–$1,137.60	—	70%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW COMP - REDOC 181	$379.20	$1,264.00	$130.19–$1,137.60	—	70%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW Unit - Yes	$379.20	$1,264.00	$130.19–$1,137.60	—	70%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD COMP - REDOC 181	$214.20	$1,428.00	$45.00–$1,428.00	56% above	85%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 IRF PT EVAL MOD	$214.20	$1,428.00	$45.00–$1,428.00	56% above	85%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD Unit - Yes	$214.20	$1,428.00	$45.00–$1,428.00	56% above	85%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD Unit - Yes	$428.40	$1,428.00	$147.08–$1,285.20	—	70%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 IRF PT EVAL MOD	$428.40	$1,428.00	$147.08–$1,285.20	—	70%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD COMP - REDOC 181	$428.40	$1,428.00	$147.08–$1,285.20	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Assistant Charges	$67.50	$450.00	$22.66–$450.00	19% above	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Assistant Charges	$67.50	$450.00	$22.66–$450.00	19% above	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 181	$67.50	$450.00	$22.66–$450.00	19% above	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 185	$67.50	$450.00	$22.66–$450.00	19% above	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 185	$67.50	$450.00	$22.66–$450.00	19% above	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 181	$67.50	$450.00	$22.66–$450.00	19% above	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units	$67.50	$450.00	$22.66–$450.00	19% above	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Charges	$67.50	$450.00	$22.66–$450.00	19% above	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Charges	$67.50	$450.00	$22.66–$450.00	19% above	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units	$67.50	$450.00	$22.66–$450.00	19% above	85%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Assistant Charges	$135.00	$450.00	$46.35–$405.00	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units	$135.00	$450.00	$46.35–$405.00	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units	$135.00	$450.00	$46.35–$405.00	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Charges	$135.00	$450.00	$46.35–$405.00	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Charges	$135.00	$450.00	$46.35–$405.00	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 181	$135.00	$450.00	$46.35–$405.00	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 185	$135.00	$450.00	$46.35–$405.00	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Assistant Charges	$135.00	$450.00	$46.35–$405.00	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 181	$135.00	$450.00	$46.35–$405.00	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 185	$135.00	$450.00	$46.35–$405.00	—	70%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Charge	$94.05	$627.00	$10.96–$627.00	71% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Charges	$94.05	$627.00	$10.96–$627.00	71% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$94.05	$627.00	$10.96–$627.00	71% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181	$94.05	$627.00	$10.96–$627.00	71% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 185	$94.05	$627.00	$10.96–$627.00	71% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185	$94.05	$627.00	$10.96–$627.00	71% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units	$94.05	$627.00	$10.96–$627.00	71% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges	$94.05	$627.00	$10.96–$627.00	71% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Charge	$94.05	$627.00	$10.96–$627.00	71% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 181	$94.05	$627.00	$10.96–$627.00	71% above	85%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Charges	$188.10	$627.00	$64.58–$564.30	—	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Charges	$188.10	$627.00	$64.58–$564.30	—	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 185	$188.10	$627.00	$64.58–$564.30	—	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Charge	$188.10	$627.00	$64.58–$564.30	—	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Charge	$188.10	$627.00	$64.58–$564.30	—	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181	$188.10	$627.00	$64.58–$564.30	—	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185	$188.10	$627.00	$64.58–$564.30	—	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 181	$188.10	$627.00	$64.58–$564.30	—	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units	$188.10	$627.00	$64.58–$564.30	—	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units	$188.10	$627.00	$64.58–$564.30	—	70%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco counseling Charge - 3-10 minutes	$29.25	$195.00	$12.35–$326.00	11% below	85%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Behavior change Smoke Charge - 1-10 minutes	$29.25	$195.00	$12.35–$326.00	11% below	85%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco counseling Charge - 3-10 minutes	$58.50	$195.00	$20.08–$175.50	—	70%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Behavior change Smoke Charge - 1-10 minutes	$58.50	$195.00	$20.08–$175.50	—	70%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CHRG - WOUND CARE LEVEL 4 EST PT	$422.70	$2,818.00	$56.77–$2,818.00	324% above	85%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CHRG - WOUND CARE LEVEL 4 EST PT	$845.40	$2,818.00	$290.25–$2,536.20	—	70%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CHRG - WOUND CARE LEVEL 2 EST PT	$274.65	$1,831.00	$28.94–$1,831.00	284% above	85%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CHRG - WOUND CARE LEVEL 2 EST PT	$549.30	$1,831.00	$188.59–$1,647.90	—	70%
Speech and language evaluation CPT 92523 Speech Evaluation with Language Units	$142.05	$947.00	$97.54–$947.00	20% below	85%
Speech and language evaluation CPT 92523 Speech Evaluation with Language Charge	$142.05	$947.00	$97.54–$947.00	20% below	85%
Speech and language evaluation CPT 92523 SLP Eval Lang Comprehension,Express Unit	$142.05	$947.00	$97.54–$947.00	20% below	85%
Speech and language evaluation CPT 92523 SP SOUND LANG COMP - REDOC 187	$142.05	$947.00	$97.54–$947.00	20% below	85%
Speech and language evaluation inpatient CPT 92523 SLP Eval Lang Comprehension,Express Unit	$284.10	$947.00	$97.54–$852.30	—	70%
Speech and language evaluation inpatient CPT 92523 Speech Evaluation with Language Units	$284.10	$947.00	$97.54–$852.30	—	70%
Speech and language evaluation inpatient CPT 92523 SP SOUND LANG COMP - REDOC 187	$284.10	$947.00	$97.54–$852.30	—	70%
Speech and language evaluation inpatient CPT 92523 Speech Evaluation with Language Charge	$284.10	$947.00	$97.54–$852.30	—	70%
Speech therapy session, individual CPT 92507 Speech Treatment Charge	$138.00	$920.00	$32.79–$920.00	12% below	85%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 187	$138.00	$920.00	$32.79–$920.00	12% below	85%
Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units	$138.00	$920.00	$32.79–$920.00	12% below	85%
Speech therapy session, individual CPT 92507 Speech Treatment Charge - Yes	$138.00	$920.00	$32.79–$920.00	12% below	85%
Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units	$276.00	$920.00	$94.76–$828.00	—	70%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Charge	$276.00	$920.00	$94.76–$828.00	—	70%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 187	$276.00	$920.00	$94.76–$828.00	—	70%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Charge - Yes	$276.00	$920.00	$94.76–$828.00	—	70%
Spirometry (breathing test) CPT 94010 Pulmonary Function Test Charge - spirometry	$366.30	$2,442.00	$22.64–$2,442.00	191% above	85%
Spirometry (breathing test) inpatient CPT 94010 Pulmonary Function Test Charge - spirometry	$732.60	$2,442.00	$251.53–$2,197.80	—	70%
Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Test Charge - Pre and post bron	$336.60	$2,244.00	$32.25–$2,244.00	26% above	85%
Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Test Charge - Pre and post bron	$673.20	$2,244.00	$231.13–$2,019.60	—	70%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA - Redoc 1	$89.10	$594.00	$8.76–$594.00	78% above	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA - Redoc 1	$89.10	$594.00	$8.76–$594.00	78% above	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Assist Charges	$89.10	$594.00	$8.76–$594.00	78% above	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities Assist Charge	$89.10	$594.00	$8.76–$594.00	78% above	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 185	$89.10	$594.00	$8.76–$594.00	78% above	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 181	$89.10	$594.00	$8.76–$594.00	78% above	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities Charge	$89.10	$594.00	$8.76–$594.00	78% above	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Charges	$89.10	$594.00	$8.76–$594.00	78% above	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units	$89.10	$594.00	$8.76–$594.00	78% above	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Units	$89.10	$594.00	$8.76–$594.00	78% above	85%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA - Redoc 1	$178.20	$594.00	$61.18–$534.60	—	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units	$178.20	$594.00	$61.18–$534.60	—	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Charges	$178.20	$594.00	$61.18–$534.60	—	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities Charge	$178.20	$594.00	$61.18–$534.60	—	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 181	$178.20	$594.00	$61.18–$534.60	—	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 185	$178.20	$594.00	$61.18–$534.60	—	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities Assist Charge	$178.20	$594.00	$61.18–$534.60	—	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Assist Charges	$178.20	$594.00	$61.18–$534.60	—	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Units	$178.20	$594.00	$61.18–$534.60	—	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA - Redoc 1	$178.20	$594.00	$61.18–$534.60	—	70%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 08213-1000-37 - Collagen Matrix 21 cm2 Misc	$71.58	$477.23	$33.92–$477.23	58% below	85%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 08213-1000-37 - Collagen Matrix 21 cm2 Misc	$143.17	$477.23	$49.15–$429.51	—	70%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 08213-1000-33 - Collagen Matrix 10.5 cm2 Misc	$35.79	$238.62	$24.58–$238.62	81% below	85%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 08213-1000-33 - Collagen Matrix 10.5 cm2 Misc	$71.59	$238.62	$24.58–$214.76	—	70%
Rabies vaccine, one dose CPT 90675 61958-2902-01 - remdesivir 100 mg / 20 mL Soln-IV	$99.94	$666.25	$68.62–$666.25	83% below	85%
Rabies vaccine, one dose inpatient CPT 90675 61958-2902-01 - remdesivir 100 mg / 20 mL Soln-IV	$199.88	$666.25	$68.62–$599.62	—	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$407.13	$2,714.22	$47.88–$2,714.22	327% above	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - OB/Nursery	$66.45	$443.00	$17.87–$443.00	39% above	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - In House/Observati	$155.55	$1,037.00	$17.87–$1,037.00	226% above	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM 1ST VACCINE - BCE	$155.55	$1,037.00	$17.87–$1,037.00	226% above	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 $ED Admin Vaccine	$155.55	$1,037.00	$17.87–$1,037.00	226% above	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Infusion Center	$155.55	$1,037.00	$17.87–$1,037.00	226% above	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM 1ST VACCINE - BCE 191	$155.55	$1,037.00	$17.87–$1,037.00	226% above	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Emergency Departme	$155.55	$1,037.00	$17.87–$1,037.00	226% above	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$335.56	$2,237.04	$17.87–$2,237.04	603% above	85%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - OB/Nursery	$132.90	$443.00	$45.63–$398.70	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM 1ST VACCINE - BCE	$311.10	$1,037.00	$106.81–$933.30	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM 1ST VACCINE - BCE 191	$311.10	$1,037.00	$106.81–$933.30	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Infusion Center	$311.10	$1,037.00	$106.81–$933.30	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - In House/Observati	$311.10	$1,037.00	$106.81–$933.30	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Emergency Departme	$311.10	$1,037.00	$106.81–$933.30	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 $ED Admin Vaccine	$311.10	$1,037.00	$106.81–$933.30	—	70%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pt. Location - Vaccine Charge - ED Additional	$66.45	$443.00	$12.82–$443.00	120% above	85%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Pt. Location - Vaccine Charge - ED Additional	$132.90	$443.00	$45.63–$398.70	—	70%

Source file: https://www.merithealthcentral.com/Uploads/Public/Documents/charge-masters/charge-masters-2024/640907122_merit-health-central_standardcharges.csv