Hospital Dallas-Fort Worth-Arlington, TX

Methodist Hospitals of Dallas – Coppell

Listed in its price file as “Methodist Hospitals of Dallas”.

Methodist Hospitals of Dallas – Coppell in Coppell, TX publishes cash prices for 383 common procedures listed here, from its own machine-readable price file updated Mar 23, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Texas median for 243 of 380 procedures and above it for 120. By typical cash price it ranks #104 of 305 Texas hospitals and #14 of 82 hospitals in the Dallas, TX area, cheapest first. Click a procedure to compare it with other hospitals nearby.

330 S Denton Tap Rd, Coppell, TX 75019 Collected Sep 27, 2026 Source price file (878) 654-4400

Acute care hospital Emergency department CCN 670132 · CMS hospital register NPI 1568818417

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT Abdomen Wowc	$2,569.00	$5,138.00	$2,569.00–$5,138.00	11% below	50%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT Abdomen Wowc	$2,569.00	$5,138.00	$2,569.00–$5,138.00	—	50%
Abdominal X-ray, 2 views CPT 74019 HC Abdomen 2 Views	$391.00	$782.00	$391.00–$782.00	2% below	50%
Abdominal X-ray, 2 views inpatient CPT 74019 HC Abdomen 2 Views	$391.00	$782.00	$391.00–$782.00	—	50%
Ankle X-ray, complete, 3 or more views CPT 73610 HC Ankle Compl Min 3 Views	$377.50	$755.00	$377.50–$755.00	at median	50%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC Ankle Compl Min 3 Views	$377.50	$755.00	$377.50–$755.00	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Tcom Ltd Bil	$558.00	$1,116.00	$558.00–$1,116.00	8% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Abi Bil Single Level Ltd	$654.00	$1,308.00	$654.00–$1,308.00	8% above	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC Tcom Ltd Bil	$558.00	$1,116.00	$558.00–$1,116.00	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC Abi Bil Single Level Ltd	$654.00	$1,308.00	$654.00–$1,308.00	—	50%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT Upper Extr Woc	$1,675.00	$3,350.00	$1,675.00–$3,350.00	9% below	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT Upper Extr Woc	$1,675.00	$3,350.00	$1,675.00–$3,350.00	—	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Esophagram Ba Swallow Single Contrast Study	$442.50	$885.00	$442.50–$885.00	12% below	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC Esophagram Ba Swallow Single Contrast Study	$442.50	$885.00	$442.50–$885.00	—	50%
Bone scan, whole body (nuclear medicine) CPT 78306 HC Bone &/or Joint Imaging Wb	$1,213.00	$2,426.00	$1,213.00–$2,426.00	30% below	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC Bone &/or Joint Imaging Wb	$1,213.00	$2,426.00	$1,213.00–$2,426.00	—	50%
Breast ultrasound, complete, one breast both sides CPT 76641 HC US Breast Bilateral Complete	$499.50	$999.00	$499.50–$999.00	—	50%
Breast ultrasound, complete, one breast one side CPT 76641 HC US Breast Unilateral Complete	$277.50	$555.00	$277.50–$555.00	37% below	50%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 HC US Breast Bilateral Complete	$499.50	$999.00	$499.50–$999.00	—	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US Breast Unilateral Complete	$277.50	$555.00	$277.50–$555.00	—	50%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC US Breast Bilat Limited	$288.50	$577.00	$288.50–$577.00	—	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US Breast Uni Limited	$180.00	$360.00	$180.00–$360.00	52% below	50%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 HC US Breast Bilat Limited	$288.50	$577.00	$288.50–$577.00	—	50%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US Breast Uni Limited	$180.00	$360.00	$180.00–$360.00	—	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC Cta Abd Pelvis Wowc	$4,607.50	$9,215.00	$4,607.50–$9,215.00	5% above	50%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC Cta Abd Pelvis Wowc	$4,607.50	$9,215.00	$4,607.50–$9,215.00	—	50%
CT angiography (CTA) of the head CPT 70496 HC Cta Head WC/Noncontrast	$2,824.50	$5,649.00	$2,824.50–$5,649.00	at median	50%
CT angiography (CTA) of the head inpatient CPT 70496 HC Cta Head WC/Noncontrast	$2,824.50	$5,649.00	$2,824.50–$5,649.00	—	50%
CT angiography (CTA) of the neck CPT 70498 HC Cta Neck WC/Noncontrast	$2,883.00	$5,766.00	$2,883.00–$5,766.00	6% above	50%
CT angiography (CTA) of the neck inpatient CPT 70498 HC Cta Neck WC/Noncontrast	$2,883.00	$5,766.00	$2,883.00–$5,766.00	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC Cta Chest WC/Noncontrast	$2,835.50	$5,671.00	$2,835.50–$5,671.00	at median	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC Cta Chest WC/Noncontrast	$2,835.50	$5,671.00	$2,835.50–$5,671.00	—	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC Cta Hrt Cornry Art/Bypass Grfts WC 3d Post	$1,130.00	$2,260.00	$1,130.00–$2,260.00	32% below	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC Cta Hrt Cornry Art/Bypass Grfts WC 3d Post	$1,130.00	$2,260.00	$1,130.00–$2,260.00	—	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT Screen Heart Calcium Scoring	$129.00	$258.00	$129.00–$258.00	32% below	50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT Screen Heart Calcium Scoring	$129.00	$258.00	$129.00–$258.00	—	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abd Pelvis Woc	$3,769.50	$7,539.00	$3,769.50–$7,539.00	12% above	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT Abd Pelvis Woc	$3,769.50	$7,539.00	$3,769.50–$7,539.00	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abd Pelvis WC	$4,335.00	$8,670.00	$4,335.00–$8,670.00	11% above	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abd Pelvis WC	$4,335.00	$8,670.00	$4,335.00–$8,670.00	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abd Pelvis Wowc	$5,006.00	$10,012.00	$5,006.00–$10,012.00	20% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT Abd Pelvis Wowc	$5,006.00	$10,012.00	$5,006.00–$10,012.00	—	50%
CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen WC	$2,273.00	$4,546.00	$2,273.00–$4,546.00	13% below	50%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT Abdomen WC	$2,273.00	$4,546.00	$2,273.00–$4,546.00	—	50%
CT scan of the abdomen without contrast CPT 74150 HC CT Abdomen Woc	$1,977.00	$3,954.00	$1,977.00–$3,954.00	3% below	50%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT Abdomen Woc	$1,977.00	$3,954.00	$1,977.00–$3,954.00	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Maxillofacial Woc	$1,698.50	$3,397.00	$1,698.50–$3,397.00	2% above	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT Maxillofacial Woc	$1,698.50	$3,397.00	$1,698.50–$3,397.00	—	50%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head Brain Woc	$1,789.00	$3,578.00	$1,789.00–$3,578.00	6% below	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head Brain Woc	$1,789.00	$3,578.00	$1,789.00–$3,578.00	—	50%
CT scan of the head with contrast CPT 70460 HC CT Head Brain WC	$2,057.50	$4,115.00	$2,057.50–$4,115.00	17% above	50%
CT scan of the head with contrast inpatient CPT 70460 HC CT Head Brain WC	$2,057.50	$4,115.00	$2,057.50–$4,115.00	—	50%
CT scan of the head without and with contrast CPT 70470 HC CT Head Brain Wowc	$2,325.50	$4,651.00	$2,325.50–$4,651.00	1% above	50%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT Head Brain Wowc	$2,325.50	$4,651.00	$2,325.50–$4,651.00	—	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Lumbar Spine Woc	$2,263.00	$4,526.00	$2,263.00–$4,526.00	10% above	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT Lumbar Spine Woc	$2,263.00	$4,526.00	$2,263.00–$4,526.00	—	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Cervical Spine Woc	$2,112.50	$4,225.00	$2,112.50–$4,225.00	at median	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT Cervical Spine Woc	$2,112.50	$4,225.00	$2,112.50–$4,225.00	—	50%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis WC	$2,251.50	$4,503.00	$2,251.50–$4,503.00	2% above	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis WC	$2,251.50	$4,503.00	$2,251.50–$4,503.00	—	50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HC Doppler Carotids Bil	$1,476.00	$2,952.00	$1,476.00–$2,952.00	9% above	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 HC Doppler Carotids Bil	$1,476.00	$2,952.00	$1,476.00–$2,952.00	—	50%
Chest CT scan without and with contrast CPT 71270 HC CT Thorax Wowc	$2,547.50	$5,095.00	$2,547.50–$5,095.00	7% below	50%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT Thorax Wowc	$2,547.50	$5,095.00	$2,547.50–$5,095.00	—	50%
Chest X-ray, 2 views CPT 71046 HC Chest 2 Views	$324.50	$649.00	$324.50–$649.00	18% below	50%
Chest X-ray, 2 views inpatient CPT 71046 HC Chest 2 Views	$324.50	$649.00	$324.50–$649.00	—	50%
Chest X-ray, single view CPT 71045 HC Chest 1 View	$300.50	$601.00	$300.50–$601.00	7% below	50%
Chest X-ray, single view inpatient CPT 71045 HC Chest 1 View	$300.50	$601.00	$300.50–$601.00	—	50%
Collarbone (clavicle) X-ray, complete CPT 73000 HC Clavicle Compl	$269.00	$538.00	$269.00–$538.00	22% below	50%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC Clavicle Compl	$269.00	$538.00	$269.00–$538.00	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US Retroperitoneum Complete	$708.00	$1,416.00	$708.00–$1,416.00	4% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US Retroperitoneum Complete	$708.00	$1,416.00	$708.00–$1,416.00	—	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC Bone Density Axial Skeleton	$757.00	$1,514.00	$757.00–$1,514.00	82% above	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC Bone Density Axial Skeleton	$757.00	$1,514.00	$757.00–$1,514.00	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US Detailed Single Fetus, 1st Gestation	$1,023.00	$2,046.00	$1,023.00–$2,046.00	48% above	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US Detailed Single Fetus, 1st Gestation	$1,023.00	$2,046.00	$1,023.00–$2,046.00	—	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Thorax Woc	$1,959.50	$3,919.00	$1,959.50–$3,919.00	17% above	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Thorax Woc	$1,959.50	$3,919.00	$1,959.50–$3,919.00	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Thorax WC	$2,252.50	$4,505.00	$2,252.50–$4,505.00	4% above	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT Thorax WC	$2,252.50	$4,505.00	$2,252.50–$4,505.00	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 HC Diag Mammocomputer-Aided Detcj Bi	$580.00	$1,160.00	$580.00–$1,160.00	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Diag Mammocomputer-Aided Detcj Bi	$580.00	$1,160.00	$580.00–$1,160.00	—	50%
Diagnostic mammogram, one breast CPT 77065 HC Diag Mammoomputer-Aided Detcj Uni	$469.00	$938.00	$469.00–$938.00	72% above	50%
Diagnostic mammogram, one breast inpatient CPT 77065 HC Diag Mammoomputer-Aided Detcj Uni	$469.00	$938.00	$469.00–$938.00	—	50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 HC Doppler Lower Ext Artery Bil	$1,809.00	$3,618.00	$1,809.00–$3,618.00	at median	50%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC Doppler Lower Ext Artery Bil	$1,809.00	$3,618.00	$1,809.00–$3,618.00	—	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 HC Doppler Extremity Veins Bil	$1,714.00	$3,428.00	$1,714.00–$3,428.00	14% below	50%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC Doppler Extremity Veins Bil	$1,714.00	$3,428.00	$1,714.00–$3,428.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Echo W Doppler Colorflow Woc	$2,345.50	$4,691.00	$2,345.50–$4,691.00	at median	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Echo W Doppler Colorflow Woc (Cath)	$2,345.50	$4,691.00	$2,345.50–$4,691.00	at median	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Echo W Doppler Colorflow WC (Cath)	$2,564.00	$5,128.00	$2,564.00–$5,128.00	9% above	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Echo W Doppler Colorflow WC	$2,564.00	$5,128.00	$2,564.00–$5,128.00	9% above	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Echo W Doppler Colorflow Woc (Cath)	$2,345.50	$4,691.00	$2,345.50–$4,691.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Echo W Doppler Colorflow Woc	$2,345.50	$4,691.00	$2,345.50–$4,691.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Echo W Doppler Colorflow WC	$2,564.00	$5,128.00	$2,564.00–$5,128.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Echo W Doppler Colorflow WC (Cath)	$2,564.00	$5,128.00	$2,564.00–$5,128.00	—	50%
Elbow X-ray, 2 views CPT 73070 HC Elbow 2 Views	$324.00	$648.00	$324.00–$648.00	at median	50%
Elbow X-ray, 2 views inpatient CPT 73070 HC Elbow 2 Views	$324.00	$648.00	$324.00–$648.00	—	50%
Elbow X-ray, complete, 3 or more views CPT 73080 HC Elbow Complete Min 3 Views	$154.50	$309.00	$154.50–$309.00	60% below	50%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC Elbow Complete Min 3 Views	$154.50	$309.00	$154.50–$309.00	—	50%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Orb Sel P Fos Ear Woc	$1,782.00	$3,564.00	$1,782.00–$3,564.00	6% above	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT Orb Sel P Fos Ear Woc	$1,782.00	$3,564.00	$1,782.00–$3,564.00	—	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC Facial Bones Compl, Min 3 Views	$442.00	$884.00	$442.00–$884.00	4% above	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC Facial Bones Compl, Min 3 Views	$442.00	$884.00	$442.00–$884.00	—	50%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC Forearm 2 Views	$324.00	$648.00	$324.00–$648.00	14% below	50%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC Forearm 2 Views	$324.00	$648.00	$324.00–$648.00	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC Hepatobiliary Scan	$1,162.50	$2,325.00	$1,162.50–$2,325.00	27% below	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC Hepatobiliary Scan	$1,162.50	$2,325.00	$1,162.50–$2,325.00	—	50%
Hand X-ray, 2 views CPT 73120 HC Hand 2 Views	$277.00	$554.00	$277.00–$554.00	16% below	50%
Hand X-ray, 2 views inpatient CPT 73120 HC Hand 2 Views	$277.00	$554.00	$277.00–$554.00	—	50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC Calcaneus Min 2 Views	$258.50	$517.00	$258.50–$517.00	11% below	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC Calcaneus Min 2 Views	$258.50	$517.00	$258.50–$517.00	—	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC Home Sleep Test Type III	$359.00	$718.00	$359.00–$718.00	53% below	50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC Home Sleep Test Type III	$359.00	$718.00	$359.00–$718.00	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Polysom Split Study	$4,178.00	$8,356.00	$4,178.00–$8,356.00	5% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Sleep Polysomnagram W Cpap	$4,178.00	$8,356.00	$4,178.00–$8,356.00	5% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Npsg Study 6/> Yrs	$4,178.00	$8,356.00	$4,178.00–$8,356.00	5% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC Npsg Study 6/> Yrs	$4,178.00	$8,356.00	$4,178.00–$8,356.00	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC Polysom Split Study	$4,178.00	$8,356.00	$4,178.00–$8,356.00	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC Sleep Polysomnagram W Cpap	$4,178.00	$8,356.00	$4,178.00–$8,356.00	—	50%
Knee X-ray, 3 views CPT 73562 HC Knee 3 Views	$204.00	$408.00	$204.00–$408.00	50% below	50%
Knee X-ray, 3 views inpatient CPT 73562 HC Knee 3 Views	$204.00	$408.00	$204.00–$408.00	—	50%
Knee X-ray, complete, 4 or more views CPT 73564 HC Knee Complete 4/More Views	$242.50	$485.00	$242.50–$485.00	43% below	50%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC Knee Complete 4/More Views	$242.50	$485.00	$242.50–$485.00	—	50%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT Lower Extr Woc	$1,819.50	$3,639.00	$1,819.50–$3,639.00	3% above	50%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT Lower Extr Woc	$1,819.50	$3,639.00	$1,819.50–$3,639.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdomen Limited	$506.50	$1,013.00	$506.50–$1,013.00	20% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdomen Limited Q-Path	$506.50	$1,013.00	$506.50–$1,013.00	20% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Abdomen Limited	$506.50	$1,013.00	$506.50–$1,013.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Abdomen Limited Q-Path	$506.50	$1,013.00	$506.50–$1,013.00	—	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US Lmtd Joint/Oth Nonvasc Ext	$506.50	$1,013.00	$506.50–$1,013.00	7% above	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US Lmtd Joint/Oth Nonvasc Ext	$506.50	$1,013.00	$506.50–$1,013.00	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT Thorax Low Dose Lung Cancer Scr	$170.50	$341.00	$170.50–$341.00	29% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT Thorax Low Dose Lung Cancer Scr	$170.50	$341.00	$170.50–$341.00	—	50%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC Tibia Fibula 2 Views	$410.00	$820.00	$410.00–$820.00	19% above	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC Tibia Fibula 2 Views	$410.00	$820.00	$410.00–$820.00	—	50%
MR angiography (MRA) of the head without contrast CPT 70544 HC Mra Head Woc	$1,977.50	$3,955.00	$1,977.50–$3,955.00	7% below	50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC Mra Head Woc	$1,977.50	$3,955.00	$1,977.50–$3,955.00	—	50%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI Breast W/O & W Contrast W/Cad Bi	$1,880.00	$3,760.00	$1,880.00–$3,760.00	—	50%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MRI Breast W/O & W Contrast W/Cad Bi	$1,880.00	$3,760.00	$1,880.00–$3,760.00	—	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Extremity Lwr Joint Woc	$2,439.00	$4,878.00	$2,439.00–$4,878.00	9% above	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI Extremity Lwr Joint Woc	$2,439.00	$4,878.00	$2,439.00–$4,878.00	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Extremity Lwr Joint Wowc	$3,171.50	$6,343.00	$3,171.50–$6,343.00	at median	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI Extremity Lwr Joint Wowc	$3,171.50	$6,343.00	$3,171.50–$6,343.00	—	50%
MRI of the abdomen without contrast CPT 74181 HC MRI Abdomen Woc	$2,282.50	$4,565.00	$2,282.50–$4,565.00	3% above	50%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI Abdomen Woc	$2,282.50	$4,565.00	$2,282.50–$4,565.00	—	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI Abdomen Wowc	$2,967.00	$5,934.00	$2,967.00–$5,934.00	8% below	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI Abdomen Wowc	$2,967.00	$5,934.00	$2,967.00–$5,934.00	—	50%
MRI of the brain, no contrast dye CPT 70551 HC MRI Head Woc	$2,324.00	$4,648.00	$2,324.00–$4,648.00	6% above	50%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Head Woc	$2,324.00	$4,648.00	$2,324.00–$4,648.00	—	50%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI Head Wowc	$3,021.00	$6,042.00	$3,021.00–$6,042.00	at median	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Head Wowc	$3,021.00	$6,042.00	$3,021.00–$6,042.00	—	50%
MRI of the lower back, no contrast dye CPT 72148 HC MRI Spinal Canal Lumbar Woc	$2,455.00	$4,910.00	$2,455.00–$4,910.00	7% above	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI Spinal Canal Lumbar Woc	$2,455.00	$4,910.00	$2,455.00–$4,910.00	—	50%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI Spinal Canal Lumbar Wowc	$3,191.50	$6,383.00	$3,191.50–$6,383.00	at median	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI Spinal Canal Lumbar Wowc	$3,191.50	$6,383.00	$3,191.50–$6,383.00	—	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI Spinal Canal Thoraci Woc	$2,307.00	$4,614.00	$2,307.00–$4,614.00	8% above	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI Spinal Canal Thoraci Woc	$2,307.00	$4,614.00	$2,307.00–$4,614.00	—	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI Spinal Canal Cervical Wowc	$3,146.00	$6,292.00	$3,146.00–$6,292.00	4% below	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI Spinal Canal Cervical Wowc	$3,146.00	$6,292.00	$3,146.00–$6,292.00	—	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI Spinal Canal Cervical Woc	$2,419.00	$4,838.00	$2,419.00–$4,838.00	4% above	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI Spinal Canal Cervical Woc	$2,419.00	$4,838.00	$2,419.00–$4,838.00	—	50%
MRI of the pelvis without and with contrast CPT 72197 HC MRI Pelvis Wowc	$2,642.00	$5,284.00	$2,642.00–$5,284.00	22% below	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI Pelvis Wowc	$2,642.00	$5,284.00	$2,642.00–$5,284.00	—	50%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI Pelvis Woc	$2,032.50	$4,065.00	$2,032.50–$4,065.00	17% below	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI Pelvis Woc	$2,032.50	$4,065.00	$2,032.50–$4,065.00	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI Extremity Up Joint Woc	$2,392.00	$4,784.00	$2,392.00–$4,784.00	7% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI Extremity Up Joint Woc	$2,392.00	$4,784.00	$2,392.00–$4,784.00	—	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Spine Cervical Rout 4 or 5 Views	$706.00	$1,412.00	$706.00–$1,412.00	29% above	50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC Spine Cervical Rout 4 or 5 Views	$706.00	$1,412.00	$706.00–$1,412.00	—	50%
Neck soft tissue CT scan with contrast CPT 70491 HC CT Neck Soft Tissue WC	$2,257.00	$4,514.00	$2,257.00–$4,514.00	10% above	50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT Neck Soft Tissue WC	$2,257.00	$4,514.00	$2,257.00–$4,514.00	—	50%
Neck soft tissue CT scan without contrast CPT 70490 HC CT Neck Soft Tissue Woc	$1,962.50	$3,925.00	$1,962.50–$3,925.00	12% above	50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT Neck Soft Tissue Woc	$1,962.50	$3,925.00	$1,962.50–$3,925.00	—	50%
Neck soft tissue X-ray CPT 70360 HC Neck Soft Tissue	$187.00	$374.00	$187.00–$374.00	22% below	50%
Neck soft tissue X-ray inpatient CPT 70360 HC Neck Soft Tissue	$187.00	$374.00	$187.00–$374.00	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC Myocard Perf Mult Rst/Str Spec	$4,548.50	$9,097.00	$4,548.50–$9,097.00	5% above	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC Myocard Perf Mult Rst/Str Spec	$4,548.50	$9,097.00	$4,548.50–$9,097.00	—	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pet/CT Tumor Img Skul to Thigh	$7,898.00	$15,796.00	$7,898.00–$15,796.00	68% above	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Pet/CT Tumor Img Skul to Thigh	$7,898.00	$15,796.00	$7,898.00–$15,796.00	—	50%
Pelvic CT scan without contrast CPT 72192 HC CT Pelvis Woc	$1,958.00	$3,916.00	$1,958.00–$3,916.00	18% above	50%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT Pelvis Woc	$1,958.00	$3,916.00	$1,958.00–$3,916.00	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US Pelvic Limited	$330.50	$661.00	$330.50–$661.00	32% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US Pelvic Non OB Limited	$330.50	$661.00	$330.50–$661.00	32% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US Pelvic Non OB Limited	$330.50	$661.00	$330.50–$661.00	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US Pelvic Limited	$330.50	$661.00	$330.50–$661.00	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US Pelvic	$629.50	$1,259.00	$629.50–$1,259.00	27% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US Pelvic Non OB Complete	$629.50	$1,259.00	$629.50–$1,259.00	27% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US Pelvic Non OB Complete	$629.50	$1,259.00	$629.50–$1,259.00	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US Pelvic	$629.50	$1,259.00	$629.50–$1,259.00	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB >14 Wks Single Gestation	$567.00	$1,134.00	$567.00–$1,134.00	13% below	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB >14 Wks Single Gestation	$567.00	$1,134.00	$567.00–$1,134.00	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US OB <14 Wks Single Gestation	$531.50	$1,063.00	$531.50–$1,063.00	13% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US OB <14 Wks Single Gestation	$531.50	$1,063.00	$531.50–$1,063.00	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US Preg Uterus Limited, 1/> Fetuses	$478.50	$957.00	$478.50–$957.00	4% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US Preg Uterus Limited, 1/> Fetuses	$478.50	$957.00	$478.50–$957.00	—	50%
Rib X-ray, one side, 2 views one side CPT 71100 HC Ribs Unilateral, 2 Views	$334.50	$669.00	$334.50–$669.00	6% below	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC Ribs Unilateral, 2 Views	$334.50	$669.00	$334.50–$669.00	—	50%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC Ribs Uni W/Posteroant Ch Min 3 Views	$300.50	$601.00	$300.50–$601.00	24% below	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC Ribs Uni W/Posteroant Ch Min 3 Views	$300.50	$601.00	$300.50–$601.00	—	50%
Screening mammogram, both breasts both sides CPT 77067 HC Screening Mammo Bi 2-View Breast Inc Cad/Uni	$335.50	$671.00	$335.50–$671.00	—	50%
Screening mammogram, both breasts both sides CPT 77067 HC Screening Mammo Bi 2-View Breast Inc Cad	$381.00	$762.00	$381.00–$762.00	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC Screening Mammo Bi 2-View Breast Inc Cad/Uni	$335.50	$671.00	$335.50–$671.00	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC Screening Mammo Bi 2-View Breast Inc Cad	$381.00	$762.00	$381.00–$762.00	—	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC Shoulder Min 2 Views	$339.50	$679.00	$339.50–$679.00	1% below	50%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC Shoulder Min 2 Views	$339.50	$679.00	$339.50–$679.00	—	50%
Sinus X-ray, complete, 3 or more views CPT 70220 HC Sinuses Paranasal Compl, Min 3 Views	$422.00	$844.00	$422.00–$844.00	at median	50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC Sinuses Paranasal Compl, Min 3 Views	$422.00	$844.00	$422.00–$844.00	—	50%
Skull X-ray, fewer than 4 views CPT 70250 HC Skull Less Than 4 Views	$501.50	$1,003.00	$501.50–$1,003.00	43% above	50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC Skull Less Than 4 Views	$501.50	$1,003.00	$501.50–$1,003.00	—	50%
Sleep study in a lab (polysomnography) CPT 95810 HC Polysomnography	$3,734.50	$7,469.00	$3,734.50–$7,469.00	10% below	50%
Sleep study in a lab (polysomnography) CPT 95810 HC Sleep Polysomnagram	$3,734.50	$7,469.00	$3,734.50–$7,469.00	10% below	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Sleep Polysomnagram	$3,734.50	$7,469.00	$3,734.50–$7,469.00	—	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Polysomnography	$3,734.50	$7,469.00	$3,734.50–$7,469.00	—	50%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC Echo Stress W Cpl Cv Stress (Cath)	$3,013.50	$6,027.00	$3,013.50–$6,027.00	11% above	50%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC Echo Stress W Cpl Cv Stress	$3,013.50	$6,027.00	$3,013.50–$6,027.00	11% above	50%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC Echo Stress W Cpl Cv Stress (Cath)	$3,013.50	$6,027.00	$3,013.50–$6,027.00	—	50%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC Echo Stress W Cpl Cv Stress	$3,013.50	$6,027.00	$3,013.50–$6,027.00	—	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Modified Barium Swallow	$524.50	$1,049.00	$524.50–$1,049.00	13% below	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC Modified Barium Swallow	$524.50	$1,049.00	$524.50–$1,049.00	—	50%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC Femur 2v Min	$355.50	$711.00	$355.50–$711.00	1% above	50%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC Femur 2v Min	$355.50	$711.00	$355.50–$711.00	—	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT Thoracic Spine Woc	$2,240.50	$4,481.00	$2,240.50–$4,481.00	13% above	50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT Thoracic Spine Woc	$2,240.50	$4,481.00	$2,240.50–$4,481.00	—	50%
Toe X-ray, 2 or more views CPT 73660 HC Toes Min 2 Views	$258.50	$517.00	$258.50–$517.00	12% below	50%
Toe X-ray, 2 or more views inpatient CPT 73660 HC Toes Min 2 Views	$258.50	$517.00	$258.50–$517.00	—	50%
Transvaginal pelvic ultrasound CPT 76830 HC US Transvaginal	$661.50	$1,323.00	$661.50–$1,323.00	3% above	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US Transvaginal	$661.50	$1,323.00	$661.50–$1,323.00	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 HC US Preg Uterus Transvaginal	$414.50	$829.00	$414.50–$829.00	19% below	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US Preg Uterus Transvaginal	$414.50	$829.00	$414.50–$829.00	—	50%
Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Complete	$783.00	$1,566.00	$783.00–$1,566.00	9% below	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US Abdomen Complete	$783.00	$1,566.00	$783.00–$1,566.00	—	50%
Ultrasound of the scrotum and testicles CPT 76870 HC US Scrotum	$573.50	$1,147.00	$573.50–$1,147.00	6% below	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US Scrotum	$573.50	$1,147.00	$573.50–$1,147.00	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US Head Neck Tissues	$497.00	$994.00	$497.00–$994.00	21% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US Head Neck Tissues	$497.00	$994.00	$497.00–$994.00	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Upr GI Trc Single Contrast Study	$707.50	$1,415.00	$707.50–$1,415.00	4% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC Upr GI Trc Single Contrast Study	$707.50	$1,415.00	$707.50–$1,415.00	—	50%
Upper arm X-ray (humerus), 2 views CPT 73060 HC Humerus Min 2 Views	$283.50	$567.00	$283.50–$567.00	19% below	50%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC Humerus Min 2 Views	$283.50	$567.00	$283.50–$567.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC Doppler Extrem Veins Uni/Lmtd	$1,147.00	$2,294.00	$1,147.00–$2,294.00	43% above	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC Doppler Extrem Veins Uni/Lmtd	$1,147.00	$2,294.00	$1,147.00–$2,294.00	—	50%
Wrist X-ray, 2 views CPT 73100 HC Wrist 2 Views	$318.50	$637.00	$318.50–$637.00	at median	50%
Wrist X-ray, 2 views inpatient CPT 73100 HC Wrist 2 Views	$318.50	$637.00	$318.50–$637.00	—	50%
Wrist X-ray, complete, 3 or more views CPT 73110 HC Wrist Complete Minimum 3 Views	$311.00	$622.00	$311.00–$622.00	19% below	50%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC Wrist Complete Minimum 3 Views	$311.00	$622.00	$311.00–$622.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC Hip Uni V2-3 W Pelvis	$418.00	$836.00	$418.00–$836.00	3% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC Hip Uni V2-3 W Pelvis	$418.00	$836.00	$418.00–$836.00	—	50%
X-ray of the abdomen, 1 view CPT 74018 HC Abdomen 1 View	$303.50	$607.00	$303.50–$607.00	11% below	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC Abdomen 1 View	$303.50	$607.00	$303.50–$607.00	—	50%
X-ray of the ankle, 2 views CPT 73600 HC Ankle 2 Views	$282.50	$565.00	$282.50–$565.00	6% below	50%
X-ray of the ankle, 2 views inpatient CPT 73600 HC Ankle 2 Views	$282.50	$565.00	$282.50–$565.00	—	50%
X-ray of the finger(s), 2 or more views CPT 73140 HC Finger(S) Min 2 Views	$214.00	$428.00	$214.00–$428.00	19% below	50%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC Finger(S) Min 2 Views	$214.00	$428.00	$214.00–$428.00	—	50%
X-ray of the foot, 2 views CPT 73620 HC Foot 2 Views	$243.00	$486.00	$243.00–$486.00	27% below	50%
X-ray of the foot, 2 views inpatient CPT 73620 HC Foot 2 Views	$243.00	$486.00	$243.00–$486.00	—	50%
X-ray of the foot, complete, 3 or more views CPT 73630 HC Foot 3 Views	$324.00	$648.00	$324.00–$648.00	13% below	50%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC Foot 3 Views	$324.00	$648.00	$324.00–$648.00	—	50%
X-ray of the hand, 3 or more views CPT 73130 HC Hand Min 3 Views	$283.50	$567.00	$283.50–$567.00	27% below	50%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC Hand Min 3 Views	$283.50	$567.00	$283.50–$567.00	—	50%
X-ray of the knee, 1 or 2 views CPT 73560 HC Knee 1/2 Views	$135.00	$270.00	$135.00–$270.00	54% below	50%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC Knee 1/2 Views	$135.00	$270.00	$135.00–$270.00	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Spine Lumbosacral 2/3 Views	$467.00	$934.00	$467.00–$934.00	at median	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC Spine Lumbosacral 2/3 Views	$467.00	$934.00	$467.00–$934.00	—	50%
X-ray of the lower back, 4 or more views CPT 72110 HC Spinelumbosacral Minimum 4 Views	$531.00	$1,062.00	$531.00–$1,062.00	15% below	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Spinelumbosacral Minimum 4 Views	$531.00	$1,062.00	$531.00–$1,062.00	—	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Spine Thoracic 2 Views	$373.00	$746.00	$373.00–$746.00	7% below	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC Spine Thoracic 2 Views	$373.00	$746.00	$373.00–$746.00	—	50%
X-ray of the nasal bones, 3 or more views CPT 70160 HC Nasal Bones, Compl, Min 3 Views	$283.50	$567.00	$283.50–$567.00	3% below	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC Nasal Bones, Compl, Min 3 Views	$283.50	$567.00	$283.50–$567.00	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Spine Cervical 2 Views	$373.00	$746.00	$373.00–$746.00	at median	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Spine Cervical 3 Views	$467.00	$934.00	$467.00–$934.00	25% above	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Spine Cervical 2 Views	$373.00	$746.00	$373.00–$746.00	—	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Spine Cervical 3 Views	$467.00	$934.00	$467.00–$934.00	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC Pelvis 1/2 View	$334.00	$668.00	$334.00–$668.00	10% below	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC Pelvis 1/2 View	$334.00	$668.00	$334.00–$668.00	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Sacrum Coccyx Min 2 Views	$353.00	$706.00	$353.00–$706.00	8% above	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC Sacrum Coccyx Min 2 Views	$353.00	$706.00	$353.00–$706.00	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
ACTH blood test CPT 82024 HC Adrenal Cortical Throphic Acth	$16.00	$32.00	$16.00–$32.00	93% below	50%
ACTH blood test inpatient CPT 82024 HC Adrenal Cortical Throphic Acth	$16.00	$32.00	$16.00–$32.00	—	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Alt (Fibrometer)	$25.00	$50.00	$25.00–$50.00	57% below	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Alt (Sgpt)	$169.50	$339.00	$169.50–$339.00	188% above	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Alt (Fibrometer)	$25.00	$50.00	$25.00–$50.00	—	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Alt (Sgpt)	$169.50	$339.00	$169.50–$339.00	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC Ast (Fibrometer)	$25.00	$50.00	$25.00–$50.00	57% below	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC Ast (Sgot)	$176.00	$352.00	$176.00–$352.00	204% above	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Ast (Fibrometer)	$25.00	$50.00	$25.00–$50.00	—	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Ast (Sgot)	$176.00	$352.00	$176.00–$352.00	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC Acute Hepatitis Panel	$33.00	$66.00	$33.00–$66.00	91% below	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC Acute Hepatitis Panel	$33.00	$66.00	$33.00–$66.00	—	50%
Albumin blood test CPT 82040 HC Albumin Serum	$75.00	$150.00	$75.00–$150.00	102% above	50%
Albumin blood test inpatient CPT 82040 HC Albumin Serum	$75.00	$150.00	$75.00–$150.00	—	50%
Aldosterone blood test CPT 82088 HC Urine Aldosterone	$19.00	$38.00	$19.00–$38.00	87% below	50%
Aldosterone blood test CPT 82088 HC Aldosterone Blood	$28.00	$56.00	$28.00–$56.00	81% below	50%
Aldosterone blood test CPT 82088 HC Aldosterone Urine	$28.00	$56.00	$28.00–$56.00	81% below	50%
Aldosterone blood test CPT 82088 HC Aldosterone Serum	$103.00	$206.00	$103.00–$206.00	29% below	50%
Aldosterone blood test inpatient CPT 82088 HC Urine Aldosterone	$19.00	$38.00	$19.00–$38.00	—	50%
Aldosterone blood test inpatient CPT 82088 HC Aldosterone Blood	$28.00	$56.00	$28.00–$56.00	—	50%
Aldosterone blood test inpatient CPT 82088 HC Aldosterone Urine	$28.00	$56.00	$28.00–$56.00	—	50%
Aldosterone blood test inpatient CPT 82088 HC Aldosterone Serum	$103.00	$206.00	$103.00–$206.00	—	50%
Alkaline phosphatase (ALP) blood test CPT 84075 HC Bf Alkaline Phosphatase	$37.50	$75.00	$37.50–$75.00	36% below	50%
Alkaline phosphatase (ALP) blood test CPT 84075 HC Alkaline Phosphatase	$134.50	$269.00	$134.50–$269.00	130% above	50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC Bf Alkaline Phosphatase	$37.50	$75.00	$37.50–$75.00	—	50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC Alkaline Phosphatase	$134.50	$269.00	$134.50–$269.00	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Rast Ige	$4.00	$8.00	$4.00–$8.00	86% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Peanut Ige	$17.00	$34.00	$17.00–$34.00	39% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Aspergillus Ige Panel	$88.50	$177.00	$88.50–$177.00	219% above	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Rast Ige	$4.00	$8.00	$4.00–$8.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Peanut Ige	$17.00	$34.00	$17.00–$34.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Aspergillus Ige Panel	$88.50	$177.00	$88.50–$177.00	—	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha-Fetoprotein	$10.00	$20.00	$10.00–$20.00	92% below	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha Feto Protein Ria	$11.50	$23.00	$11.50–$23.00	91% below	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC Afp Tumor Marker	$199.00	$398.00	$199.00–$398.00	63% above	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Alpha-Fetoprotein	$10.00	$20.00	$10.00–$20.00	—	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Alpha Feto Protein Ria	$11.50	$23.00	$11.50–$23.00	—	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Afp Tumor Marker	$199.00	$398.00	$199.00–$398.00	—	50%
Ammonia blood test CPT 82140 HC Ammonia Blood	$188.00	$376.00	$188.00–$376.00	29% above	50%
Ammonia blood test inpatient CPT 82140 HC Ammonia Blood	$188.00	$376.00	$188.00–$376.00	—	50%
Amylase blood test CPT 82150 HC Amylase Urine	$127.00	$254.00	$127.00–$254.00	29% above	50%
Amylase blood test CPT 82150 HC Amylase Serum	$134.00	$268.00	$134.00–$268.00	37% above	50%
Amylase blood test inpatient CPT 82150 HC Amylase Urine	$127.00	$254.00	$127.00–$254.00	—	50%
Amylase blood test inpatient CPT 82150 HC Amylase Serum	$134.00	$268.00	$134.00–$268.00	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC Cyclic Peptide Igg Antibodies	$12.00	$24.00	$12.00–$24.00	80% below	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC Cyclic Peptide Igg Antibodies	$12.00	$24.00	$12.00–$24.00	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Antinuclear Ab	$61.00	$122.00	$61.00–$122.00	31% below	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC Antinuclear Ab	$61.00	$122.00	$61.00–$122.00	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Fluid Body Bnp	$45.00	$90.00	$45.00–$90.00	76% below	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Bnp Arup	$45.00	$90.00	$45.00–$90.00	76% below	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Natriurtic Peptide (POC)	$177.50	$355.00	$177.50–$355.00	5% below	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC B Type Natriuretic Peptide	$389.00	$778.00	$389.00–$778.00	109% above	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Bnp Arup	$45.00	$90.00	$45.00–$90.00	—	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Fluid Body Bnp	$45.00	$90.00	$45.00–$90.00	—	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Natriurtic Peptide (POC)	$177.50	$355.00	$177.50–$355.00	—	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC B Type Natriuretic Peptide	$389.00	$778.00	$389.00–$778.00	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Synovasure Culture Aerobic	$19.50	$39.00	$19.50–$39.00	72% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Nocardia Culture	$30.00	$60.00	$30.00–$60.00	57% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Helicobacter Pylori Culture	$35.50	$71.00	$35.50–$71.00	49% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Environmental	$39.00	$78.00	$39.00–$78.00	44% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Respiratory Culture	$195.50	$391.00	$195.50–$391.00	181% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Spinal Fluid Culture	$195.50	$391.00	$195.50–$391.00	181% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Any Other Source	$195.50	$391.00	$195.50–$391.00	181% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC C Gc Screen	$195.50	$391.00	$195.50–$391.00	181% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Respiratory	$195.50	$391.00	$195.50–$391.00	181% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Synovasure Culture Aerobic	$19.50	$39.00	$19.50–$39.00	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Nocardia Culture	$30.00	$60.00	$30.00–$60.00	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Helicobacter Pylori Culture	$35.50	$71.00	$35.50–$71.00	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Environmental	$39.00	$78.00	$39.00–$78.00	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Spinal Fluid Culture	$195.50	$391.00	$195.50–$391.00	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Respiratory Culture	$195.50	$391.00	$195.50–$391.00	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Respiratory	$195.50	$391.00	$195.50–$391.00	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC C Gc Screen	$195.50	$391.00	$195.50–$391.00	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Any Other Source	$195.50	$391.00	$195.50–$391.00	—	50%
Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel	$349.50	$699.00	$349.50–$699.00	45% above	50%
Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel	$349.50	$699.00	$349.50–$699.00	—	50%
Bilirubin blood test, total CPT 82247 HC Bilirubin Total	$134.50	$269.00	$134.50–$269.00	100% above	50%
Bilirubin blood test, total inpatient CPT 82247 HC Bilirubin Total	$134.50	$269.00	$134.50–$269.00	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Propath Bx Skin	$56.50	$113.00	$56.50–$113.00	81% below	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Light Microscopy	$176.50	$353.00	$176.50–$353.00	41% below	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Anatomic Pathology Level IV	$185.00	$370.00	$185.00–$370.00	38% below	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC Propath Bx Skin	$56.50	$113.00	$56.50–$113.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC Light Microscopy	$176.50	$353.00	$176.50–$353.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC Anatomic Pathology Level IV	$185.00	$370.00	$185.00–$370.00	—	50%
Blood culture for bacteria CPT 87040 HC Blood Culture	$259.50	$519.00	$259.50–$519.00	9% above	50%
Blood culture for bacteria inpatient CPT 87040 HC Blood Culture	$259.50	$519.00	$259.50–$519.00	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Sane Venipuncture	$5.00	$10.00	$5.00–$10.00	75% below	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Collection Venous Blood Venipuncture	$8.50	$17.00	$8.50–$17.00	57% below	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Sane Venipuncture	$5.00	$10.00	$5.00–$10.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Collection Venous Blood Venipuncture	$8.50	$17.00	$8.50–$17.00	—	50%
Blood glucose (sugar) test CPT 82947 HC Glucose (Fibrometer)	$23.00	$46.00	$23.00–$46.00	48% below	50%
Blood glucose (sugar) test CPT 82947 HC Glucose Level Serum	$106.00	$212.00	$106.00–$212.00	139% above	50%
Blood glucose (sugar) test inpatient CPT 82947 HC Glucose (Fibrometer)	$23.00	$46.00	$23.00–$46.00	—	50%
Blood glucose (sugar) test inpatient CPT 82947 HC Glucose Level Serum	$106.00	$212.00	$106.00–$212.00	—	50%
Blood lead test CPT 83655 HC Lead Blood	$8.50	$17.00	$8.50–$17.00	84% below	50%
Blood lead test CPT 83655 HC Lead Quantitive Urine	$9.00	$18.00	$9.00–$18.00	83% below	50%
Blood lead test inpatient CPT 83655 HC Lead Blood	$8.50	$17.00	$8.50–$17.00	—	50%
Blood lead test inpatient CPT 83655 HC Lead Quantitive Urine	$9.00	$18.00	$9.00–$18.00	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Urine Pregnancy Test	$28.00	$56.00	$28.00–$56.00	80% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC B Hcg Qual (Preg Test)	$264.50	$529.00	$264.50–$529.00	92% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC Urine Pregnancy Test	$28.00	$56.00	$28.00–$56.00	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC B Hcg Qual (Preg Test)	$264.50	$529.00	$264.50–$529.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Abo Descrepancy Cbc	$65.50	$131.00	$65.50–$131.00	26% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Abo Type	$76.50	$153.00	$76.50–$153.00	13% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Donor Unit Abo Type	$93.50	$187.00	$93.50–$187.00	6% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Abo Type Cbc	$118.50	$237.00	$118.50–$237.00	34% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Abo Descrepancy Cbc	$65.50	$131.00	$65.50–$131.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Abo Type	$76.50	$153.00	$76.50–$153.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Donor Unit Abo Type	$93.50	$187.00	$93.50–$187.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Abo Type Cbc	$118.50	$237.00	$118.50–$237.00	—	50%
Blood urea nitrogen (BUN) test CPT 84520 HC Body Fluid Urea Nitrogen	$4.50	$9.00	$4.50–$9.00	92% below	50%
Blood urea nitrogen (BUN) test CPT 84520 HC Bun (Fibrometer)	$25.00	$50.00	$25.00–$50.00	57% below	50%
Blood urea nitrogen (BUN) test CPT 84520 HC Blood Urea Nitrogen	$117.00	$234.00	$117.00–$234.00	99% above	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC Body Fluid Urea Nitrogen	$4.50	$9.00	$4.50–$9.00	—	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC Bun (Fibrometer)	$25.00	$50.00	$25.00–$50.00	—	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC Blood Urea Nitrogen	$117.00	$234.00	$117.00–$234.00	—	50%
C-peptide blood test CPT 84681 HC C Peptide	$37.50	$75.00	$37.50–$75.00	54% below	50%
C-peptide blood test CPT 84681 HC C Peptide Ultrasensitive	$71.00	$142.00	$71.00–$142.00	13% below	50%
C-peptide blood test inpatient CPT 84681 HC C Peptide	$37.50	$75.00	$37.50–$75.00	—	50%
C-peptide blood test inpatient CPT 84681 HC C Peptide Ultrasensitive	$71.00	$142.00	$71.00–$142.00	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC Synovasure Crp	$19.00	$38.00	$19.00–$38.00	67% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C Reactive Protein	$20.50	$41.00	$20.50–$41.00	65% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC High Sensitivity Crp	$46.00	$92.00	$46.00–$92.00	21% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC Synovasure Crp	$19.00	$38.00	$19.00–$38.00	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C Reactive Protein	$20.50	$41.00	$20.50–$41.00	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC High Sensitivity Crp	$46.00	$92.00	$46.00–$92.00	—	50%
C. difficile toxin gene test (stool PCR) CPT 87493 HC Clostridium Diff by Pcr	$292.50	$585.00	$292.50–$585.00	64% above	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC Clostridium Diff by Pcr	$292.50	$585.00	$292.50–$585.00	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 HC Ca 19 9 Carbohydrate Ag 19 9	$263.00	$526.00	$263.00–$526.00	94% above	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC Ca 19 9 Carbohydrate Ag 19 9	$263.00	$526.00	$263.00–$526.00	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC Cancer Antigen 125	$173.50	$347.00	$173.50–$347.00	8% above	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC Cancer Antigen 125	$173.50	$347.00	$173.50–$347.00	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Covid-19 Molecular Detection	$75.00	$150.00	$75.00–$150.00	16% below	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Sars-Cov-2 Covid-19 Amp Prb High Tech	$75.00	$150.00	$75.00–$150.00	16% below	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Covid-19 Pcr Molecular Detect	$106.00	$212.00	$106.00–$212.00	19% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Sar Cov-2 Rna Ddpcr, Qual, Ffpe	$450.00	$900.00	$450.00–$900.00	405% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC Covid-19 Molecular Detection	$75.00	$150.00	$75.00–$150.00	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC Sars-Cov-2 Covid-19 Amp Prb High Tech	$75.00	$150.00	$75.00–$150.00	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC Covid-19 Pcr Molecular Detect	$106.00	$212.00	$106.00–$212.00	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC Sar Cov-2 Rna Ddpcr, Qual, Ffpe	$450.00	$900.00	$450.00–$900.00	—	50%
Calcium blood test, total CPT 82310 HC Calcium Serum	$117.00	$234.00	$117.00–$234.00	86% above	50%
Calcium blood test, total inpatient CPT 82310 HC Calcium Serum	$117.00	$234.00	$117.00–$234.00	—	50%
Carcinoembryonic antigen (CEA) test CPT 82378 HC Carcinoembryonic Antigen (Cea)	$199.00	$398.00	$199.00–$398.00	24% above	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC Carcinoembryonic Antigen (Cea)	$199.00	$398.00	$199.00–$398.00	—	50%
Chickenpox (varicella) immunity blood test CPT 86787 HC Varicella-Zoster Antibody	$8.50	$17.00	$8.50–$17.00	87% below	50%
Chickenpox (varicella) immunity blood test CPT 86787 HC Varicella Zoster Ab Igm	$11.00	$22.00	$11.00–$22.00	83% below	50%
Chickenpox (varicella) immunity blood test CPT 86787 HC Vzv Ab Igg	$68.00	$136.00	$68.00–$136.00	8% above	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Varicella-Zoster Antibody	$8.50	$17.00	$8.50–$17.00	—	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Varicella Zoster Ab Igm	$11.00	$22.00	$11.00–$22.00	—	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Vzv Ab Igg	$68.00	$136.00	$68.00–$136.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chlamydia Trachomatis by Tma	$19.00	$38.00	$19.00–$38.00	85% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chlamydia Nucleic Acid Amplif	$22.50	$45.00	$22.50–$45.00	82% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chlamydia by Bd Max	$86.50	$173.00	$86.50–$173.00	31% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chlamydia Tma	$133.00	$266.00	$133.00–$266.00	6% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Chlamydia Trachomatis by Tma	$19.00	$38.00	$19.00–$38.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Chlamydia Nucleic Acid Amplif	$22.50	$45.00	$22.50–$45.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Chlamydia by Bd Max	$86.50	$173.00	$86.50–$173.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Chlamydia Tma	$133.00	$266.00	$133.00–$266.00	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel	$247.00	$494.00	$247.00–$494.00	27% above	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel	$247.00	$494.00	$247.00–$494.00	—	50%
Complete blood count (CBC) with differential CPT 85025 HC Complete Blood Count Cbc	$156.50	$313.00	$156.50–$313.00	71% above	50%
Complete blood count (CBC) with differential inpatient CPT 85025 HC Complete Blood Count Cbc	$156.50	$313.00	$156.50–$313.00	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel	$405.00	$810.00	$405.00–$810.00	36% above	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehensive Metabolic Panel	$405.00	$810.00	$405.00–$810.00	—	50%
Cortisol blood test, total CPT 82533 HC Urine Total Cortisol	$19.00	$38.00	$19.00–$38.00	79% below	50%
Cortisol blood test, total CPT 82533 HC Total Cortisol	$22.00	$44.00	$22.00–$44.00	76% below	50%
Cortisol blood test, total CPT 82533 HC Cortisol Serum	$103.00	$206.00	$103.00–$206.00	12% above	50%
Cortisol blood test, total inpatient CPT 82533 HC Urine Total Cortisol	$19.00	$38.00	$19.00–$38.00	—	50%
Cortisol blood test, total inpatient CPT 82533 HC Total Cortisol	$22.00	$44.00	$22.00–$44.00	—	50%
Cortisol blood test, total inpatient CPT 82533 HC Cortisol Serum	$103.00	$206.00	$103.00–$206.00	—	50%
Creatine kinase (CK) blood test, total CPT 82550 HC Creatine Kinase Serum Cpk	$176.00	$352.00	$176.00–$352.00	147% above	50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC Creatine Kinase Serum Cpk	$176.00	$352.00	$176.00–$352.00	—	50%
Creatinine blood test CPT 82565 HC Creatinine (Sendout)	$8.50	$17.00	$8.50–$17.00	86% below	50%
Creatinine blood test CPT 82565 HC Creatinine Serum	$117.00	$234.00	$117.00–$234.00	94% above	50%
Creatinine blood test inpatient CPT 82565 HC Creatinine (Sendout)	$8.50	$17.00	$8.50–$17.00	—	50%
Creatinine blood test inpatient CPT 82565 HC Creatinine Serum	$117.00	$234.00	$117.00–$234.00	—	50%
Cytomegalovirus (CMV) antibody test CPT 86644 HC Cmv Antibody	$8.50	$17.00	$8.50–$17.00	89% below	50%
Cytomegalovirus (CMV) antibody test CPT 86644 HC Cmv Ab Igg	$10.50	$21.00	$10.50–$21.00	86% below	50%
Cytomegalovirus (CMV) antibody test CPT 86644 HC Cmv Ab Igg CSF	$23.50	$47.00	$23.50–$47.00	69% below	50%
Cytomegalovirus (CMV) antibody test CPT 86644 HC Cmv Ab Neg Fee	$66.00	$132.00	$66.00–$132.00	14% below	50%
Cytomegalovirus (CMV) antibody test CPT 86644 HC Cytomegalovirus Antibody Igg	$73.50	$147.00	$73.50–$147.00	5% below	50%
Cytomegalovirus (CMV) antibody test CPT 86644 HC Cytomegalovirus Antibody Igg A	$103.00	$206.00	$103.00–$206.00	34% above	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cmv Antibody	$8.50	$17.00	$8.50–$17.00	—	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cmv Ab Igg	$10.50	$21.00	$10.50–$21.00	—	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cmv Ab Igg CSF	$23.50	$47.00	$23.50–$47.00	—	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cmv Ab Neg Fee	$66.00	$132.00	$66.00–$132.00	—	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cytomegalovirus Antibody Igg	$73.50	$147.00	$73.50–$147.00	—	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cytomegalovirus Antibody Igg A	$103.00	$206.00	$103.00–$206.00	—	50%
D-dimer blood test (blood clot marker) CPT 85379 HC Thrombotic Marker D-Dimer	$21.50	$43.00	$21.50–$43.00	88% below	50%
D-dimer blood test (blood clot marker) CPT 85379 HC D Dimer Quantitative	$235.00	$470.00	$235.00–$470.00	34% above	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC Thrombotic Marker D-Dimer	$21.50	$43.00	$21.50–$43.00	—	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D Dimer Quantitative	$235.00	$470.00	$235.00–$470.00	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC Dhea Sulfate	$16.50	$33.00	$16.50–$33.00	89% below	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC Dhea Sulfate	$16.50	$33.00	$16.50–$33.00	—	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Level Clonazepam	$21.50	$43.00	$21.50–$43.00	70% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Librium and Nordiazepam	$36.00	$72.00	$36.00–$72.00	50% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Panel Urine	$38.00	$76.00	$38.00–$76.00	47% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Tricyclic Antidepressant Scn	$38.00	$76.00	$38.00–$76.00	47% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Alcohol Ethanol Urine	$38.00	$76.00	$38.00–$76.00	47% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Panel 9a Blood	$40.50	$81.00	$40.50–$81.00	44% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drugs of Abuse Panel Meconium	$48.00	$96.00	$48.00–$96.00	33% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Comprehensive Drug Screen	$52.00	$104.00	$52.00–$104.00	28% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Level Lorazepam	$56.00	$112.00	$56.00–$112.00	22% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Oxycodone Urine Screen	$57.00	$114.00	$57.00–$114.00	21% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Fentanyl Screen	$57.00	$114.00	$57.00–$114.00	21% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Synth Cannab UR	$57.50	$115.00	$57.50–$115.00	20% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Level Benzo Confirmation	$58.00	$116.00	$58.00–$116.00	19% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Synthetc Cannabinoids Scr Urin	$64.00	$128.00	$64.00–$128.00	11% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Screen Lsd Urine	$76.00	$152.00	$76.00–$152.00	6% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Heroin Screen S/P	$86.50	$173.00	$86.50–$173.00	20% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Cotinine Screen Urine	$92.50	$185.00	$92.50–$185.00	28% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Benzodiazepine	$100.50	$201.00	$100.50–$201.00	40% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Test Prsmv Chem Anlyzr	$116.50	$233.00	$116.50–$233.00	62% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Gamma Hydroxybutyric Acid	$124.00	$248.00	$124.00–$248.00	72% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Flunitrazepam Screen	$129.00	$258.00	$129.00–$258.00	79% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine PCP Screen (in-House)	$173.50	$347.00	$173.50–$347.00	141% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drugs Abuse Scrn Body Fluids	$202.50	$405.00	$202.50–$405.00	181% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drugs of Abuse Screen	$722.00	$1,444.00	$722.00–$1,444.00	903% above	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Level Clonazepam	$21.50	$43.00	$21.50–$43.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Librium and Nordiazepam	$36.00	$72.00	$36.00–$72.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Panel Urine	$38.00	$76.00	$38.00–$76.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Tricyclic Antidepressant Scn	$38.00	$76.00	$38.00–$76.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Alcohol Ethanol Urine	$38.00	$76.00	$38.00–$76.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Panel 9a Blood	$40.50	$81.00	$40.50–$81.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drugs of Abuse Panel Meconium	$48.00	$96.00	$48.00–$96.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Comprehensive Drug Screen	$52.00	$104.00	$52.00–$104.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Level Lorazepam	$56.00	$112.00	$56.00–$112.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Fentanyl Screen	$57.00	$114.00	$57.00–$114.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Oxycodone Urine Screen	$57.00	$114.00	$57.00–$114.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Synth Cannab UR	$57.50	$115.00	$57.50–$115.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Level Benzo Confirmation	$58.00	$116.00	$58.00–$116.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Synthetc Cannabinoids Scr Urin	$64.00	$128.00	$64.00–$128.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Screen Lsd Urine	$76.00	$152.00	$76.00–$152.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Heroin Screen S/P	$86.50	$173.00	$86.50–$173.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Cotinine Screen Urine	$92.50	$185.00	$92.50–$185.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Benzodiazepine	$100.50	$201.00	$100.50–$201.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Test Prsmv Chem Anlyzr	$116.50	$233.00	$116.50–$233.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Gamma Hydroxybutyric Acid	$124.00	$248.00	$124.00–$248.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Flunitrazepam Screen	$129.00	$258.00	$129.00–$258.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine PCP Screen (in-House)	$173.50	$347.00	$173.50–$347.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drugs Abuse Scrn Body Fluids	$202.50	$405.00	$202.50–$405.00	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drugs of Abuse Screen	$722.00	$1,444.00	$722.00–$1,444.00	—	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC Electrolyte Panel	$247.00	$494.00	$247.00–$494.00	28% above	50%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC Electrolyte Panel	$247.00	$494.00	$247.00–$494.00	—	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC Ebv Vca Ab	$12.50	$25.00	$12.50–$25.00	87% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC Epstein-Barr Capsid Vca	$16.50	$33.00	$16.50–$33.00	83% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC Ebv Ab	$77.00	$154.00	$77.00–$154.00	20% below	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Ebv Vca Ab	$12.50	$25.00	$12.50–$25.00	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Epstein-Barr Capsid Vca	$16.50	$33.00	$16.50–$33.00	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Ebv Ab	$77.00	$154.00	$77.00–$154.00	—	50%
Estradiol blood test CPT 82670 HC Estradiol Female	$20.00	$40.00	$20.00–$40.00	86% below	50%
Estradiol blood test CPT 82670 HC Estradiol Male or Child	$25.00	$50.00	$25.00–$50.00	83% below	50%
Estradiol blood test inpatient CPT 82670 HC Estradiol Female	$20.00	$40.00	$20.00–$40.00	—	50%
Estradiol blood test inpatient CPT 82670 HC Estradiol Male or Child	$25.00	$50.00	$25.00–$50.00	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 HC Calprotectin	$134.50	$269.00	$134.50–$269.00	37% below	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC Calprotectin	$134.50	$269.00	$134.50–$269.00	—	50%
Ferritin blood test (iron stores) CPT 82728 HC Ferritin (Fibrometer)	$31.50	$63.00	$31.50–$63.00	70% below	50%
Ferritin blood test (iron stores) CPT 82728 HC Ferritin Ria	$182.00	$364.00	$182.00–$364.00	76% above	50%
Ferritin blood test (iron stores) inpatient CPT 82728 HC Ferritin (Fibrometer)	$31.50	$63.00	$31.50–$63.00	—	50%
Ferritin blood test (iron stores) inpatient CPT 82728 HC Ferritin Ria	$182.00	$364.00	$182.00–$364.00	—	50%
Fibrinogen blood test CPT 85384 HC Thromboelastograph	$147.00	$294.00	$147.00–$294.00	60% above	50%
Fibrinogen blood test CPT 85384 HC Fibrinogen	$147.00	$294.00	$147.00–$294.00	60% above	50%
Fibrinogen blood test inpatient CPT 85384 HC Thromboelastograph	$147.00	$294.00	$147.00–$294.00	—	50%
Fibrinogen blood test inpatient CPT 85384 HC Fibrinogen	$147.00	$294.00	$147.00–$294.00	—	50%
Folate (folic acid) blood test CPT 82746 HC Folate (Folic Acid) Serum	$208.00	$416.00	$208.00–$416.00	120% above	50%
Folate (folic acid) blood test inpatient CPT 82746 HC Folate (Folic Acid) Serum	$208.00	$416.00	$208.00–$416.00	—	50%
Free T3 thyroid hormone test CPT 84481 HC T3 Free	$188.00	$376.00	$188.00–$376.00	33% above	50%
Free T3 thyroid hormone test inpatient CPT 84481 HC T3 Free	$188.00	$376.00	$188.00–$376.00	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4 Free	$188.00	$376.00	$188.00–$376.00	113% above	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T4 Free	$188.00	$376.00	$188.00–$376.00	—	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Ggt (Fibrometer)	$25.00	$50.00	$25.00–$50.00	61% below	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Gamma Glutamyl Transpeptidase	$188.00	$376.00	$188.00–$376.00	194% above	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC Ggt (Fibrometer)	$25.00	$50.00	$25.00–$50.00	—	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC Gamma Glutamyl Transpeptidase	$188.00	$376.00	$188.00–$376.00	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose Tol 50g OB 1 Hr Total	$150.50	$301.00	$150.50–$301.00	64% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucose Tol 50g OB 1 Hr Total	$150.50	$301.00	$150.50–$301.00	—	50%
Glucose tolerance test, 3 samples CPT 82951 HC Glucose Tolerance 2 Hour	$280.50	$561.00	$280.50–$561.00	85% above	50%
Glucose tolerance test, 3 samples CPT 82951 HC Glucose Tolerance 3 Hour	$380.00	$760.00	$380.00–$760.00	150% above	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC Glucose Tolerance 2 Hour	$280.50	$561.00	$280.50–$561.00	—	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC Glucose Tolerance 3 Hour	$380.00	$760.00	$380.00–$760.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Neisseria Gonorrhoeae by Tma	$22.50	$45.00	$22.50–$45.00	84% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N Gonorrhoeae Dna Amp Probe	$24.00	$48.00	$24.00–$48.00	83% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Gonorrhea by Bd Max	$86.50	$173.00	$86.50–$173.00	39% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Gonorrhea Tma	$133.00	$266.00	$133.00–$266.00	6% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC Neisseria Gonorrhoeae by Tma	$22.50	$45.00	$22.50–$45.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N Gonorrhoeae Dna Amp Probe	$24.00	$48.00	$24.00–$48.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC Gonorrhea by Bd Max	$86.50	$173.00	$86.50–$173.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC Gonorrhea Tma	$133.00	$266.00	$133.00–$266.00	—	50%
H. pylori antibody blood test CPT 86677 HC Helicobacter Pylori Ab	$76.00	$152.00	$76.00–$152.00	42% below	50%
H. pylori antibody blood test inpatient CPT 86677 HC Helicobacter Pylori Ab	$76.00	$152.00	$76.00–$152.00	—	50%
H. pylori stool antigen test CPT 87338 HC Helicobacter Pylori Stool	$45.00	$90.00	$45.00–$90.00	55% below	50%
H. pylori stool antigen test CPT 87338 HC Helicobacter Pylori Stool Ag	$231.00	$462.00	$231.00–$462.00	132% above	50%
H. pylori stool antigen test inpatient CPT 87338 HC Helicobacter Pylori Stool	$45.00	$90.00	$45.00–$90.00	—	50%
H. pylori stool antigen test inpatient CPT 87338 HC Helicobacter Pylori Stool Ag	$231.00	$462.00	$231.00–$462.00	—	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Hiv 1 Rna Pcr	$60.00	$120.00	$60.00–$120.00	81% below	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC Hiv 1 Rna Pcr	$60.00	$120.00	$60.00–$120.00	—	50%
HIV-1 and HIV-2 antibody test CPT 86703 HC Hiv Screen	$66.50	$133.00	$66.50–$133.00	36% below	50%
HIV-1 and HIV-2 antibody test CPT 86703 HC Hiv 1/2 Ab	$172.00	$344.00	$172.00–$344.00	65% above	50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC Hiv Screen	$66.50	$133.00	$66.50–$133.00	—	50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC Hiv 1/2 Ab	$172.00	$344.00	$172.00–$344.00	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Hiv Antigen Ab Combo	$18.00	$36.00	$18.00–$36.00	87% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Hiv 1 & 2 Ag Ab Combo	$79.00	$158.00	$79.00–$158.00	44% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC Hiv Antigen Ab Combo	$18.00	$36.00	$18.00–$36.00	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC Hiv 1 & 2 Ag Ab Combo	$79.00	$158.00	$79.00–$158.00	—	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC Hpv Dna	$25.50	$51.00	$25.50–$51.00	64% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC Hpv Mrna E6 E7	$27.50	$55.00	$27.50–$55.00	61% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC Hpv W Geno 16 and 18 Pcr	$65.50	$131.00	$65.50–$131.00	8% below	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC Hpv Dna	$25.50	$51.00	$25.50–$51.00	—	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC Hpv Mrna E6 E7	$27.50	$55.00	$27.50–$55.00	—	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC Hpv W Geno 16 and 18 Pcr	$65.50	$131.00	$65.50–$131.00	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Hemoglobin A1c	$51.00	$102.00	$51.00–$102.00	45% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Glycosylated Hemoglobin	$79.00	$158.00	$79.00–$158.00	14% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Hemoglobin A1c	$51.00	$102.00	$51.00–$102.00	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Glycosylated Hemoglobin	$79.00	$158.00	$79.00–$158.00	—	50%
Hemoglobin blood test CPT 85018 HC Hemoglobin	$47.00	$94.00	$47.00–$94.00	at median	50%
Hemoglobin blood test inpatient CPT 85018 HC Hemoglobin	$47.00	$94.00	$47.00–$94.00	—	50%
Hepatitis B core antibody test (total) CPT 86704 HC Hepatitis B Core Ab	$263.00	$526.00	$263.00–$526.00	194% above	50%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC Hepatitis B Core Ab	$263.00	$526.00	$263.00–$526.00	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Hbsab Quant to Endpoint	$8.00	$16.00	$8.00–$16.00	88% below	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Hepatitis B Surface Ab	$173.50	$347.00	$173.50–$347.00	164% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC Hbsab Quant to Endpoint	$8.00	$16.00	$8.00–$16.00	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC Hepatitis B Surface Ab	$173.50	$347.00	$173.50–$347.00	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Hep B Core Ab Igm	$61.50	$123.00	$61.50–$123.00	21% below	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Hepatitis B Surface Antigen	$202.50	$405.00	$202.50–$405.00	160% above	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Hep B Core Ab Igm	$61.50	$123.00	$61.50–$123.00	—	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Hepatitis B Surface Antigen	$202.50	$405.00	$202.50–$405.00	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC Hcv Rna Qt Pcr Livinst	$76.00	$152.00	$76.00–$152.00	74% below	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC Hcv Rna Quant Pcr	$79.00	$158.00	$79.00–$158.00	73% below	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC Hcv Rna Qt Pcr Livinst	$76.00	$152.00	$76.00–$152.00	—	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC Hcv Rna Quant Pcr	$79.00	$158.00	$79.00–$158.00	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 HC Hsv 1 Glycoprotein G Ab Igg	$15.50	$31.00	$15.50–$31.00	80% below	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Hsv 1 Glycoprotein G Ab Igg	$15.50	$31.00	$15.50–$31.00	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 HC Hsv 2 Glycoprotein G Ab Igg	$15.50	$31.00	$15.50–$31.00	83% below	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Hsv 2 Glycoprotein G Ab Igg	$15.50	$31.00	$15.50–$31.00	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC Cardio Crp	$18.00	$36.00	$18.00–$36.00	77% below	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC Cardio Crp	$18.00	$36.00	$18.00–$36.00	—	50%
Homocysteine blood test CPT 83090 HC Homocystine Plasma	$24.50	$49.00	$24.50–$49.00	84% below	50%
Homocysteine blood test CPT 83090 HC Homocysteine	$452.00	$904.00	$452.00–$904.00	201% above	50%
Homocysteine blood test inpatient CPT 83090 HC Homocystine Plasma	$24.50	$49.00	$24.50–$49.00	—	50%
Homocysteine blood test inpatient CPT 83090 HC Homocysteine	$452.00	$904.00	$452.00–$904.00	—	50%
Insulin blood test CPT 83525 HC Insulin Assay I Specimen	$8.00	$16.00	$8.00–$16.00	90% below	50%
Insulin blood test inpatient CPT 83525 HC Insulin Assay I Specimen	$8.00	$16.00	$8.00–$16.00	—	50%
Iron blood test (serum iron) CPT 83540 HC Iron Level Serum	$176.00	$352.00	$176.00–$352.00	102% above	50%
Iron blood test (serum iron) inpatient CPT 83540 HC Iron Level Serum	$176.00	$352.00	$176.00–$352.00	—	50%
Iron-binding capacity (TIBC) test CPT 83550 HC Unbound Iron Binding Capacity	$176.00	$352.00	$176.00–$352.00	80% above	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC Unbound Iron Binding Capacity	$176.00	$352.00	$176.00–$352.00	—	50%
Kidney function blood test panel CPT 80069 HC Renal Function Panel	$387.00	$774.00	$387.00–$774.00	118% above	50%
Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel	$387.00	$774.00	$387.00–$774.00	—	50%
LH (luteinizing hormone) test CPT 83002 HC Lh Leutinizing Hormone Pedi	$41.50	$83.00	$41.50–$83.00	73% below	50%
LH (luteinizing hormone) test inpatient CPT 83002 HC Lh Leutinizing Hormone Pedi	$41.50	$83.00	$41.50–$83.00	—	50%
Lactate (lactic acid) blood test CPT 83605 HC Lactic Acid (Sendout)	$19.00	$38.00	$19.00–$38.00	81% below	50%
Lactate (lactic acid) blood test CPT 83605 HC Lactate CSF	$44.50	$89.00	$44.50–$89.00	55% below	50%
Lactate (lactic acid) blood test CPT 83605 HC Lactic Acid	$146.00	$292.00	$146.00–$292.00	49% above	50%
Lactate (lactic acid) blood test CPT 83605 HC D Lactate Plasma Mayo	$370.50	$741.00	$370.50–$741.00	278% above	50%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactic Acid (Sendout)	$19.00	$38.00	$19.00–$38.00	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactate CSF	$44.50	$89.00	$44.50–$89.00	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactic Acid	$146.00	$292.00	$146.00–$292.00	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 HC D Lactate Plasma Mayo	$370.50	$741.00	$370.50–$741.00	—	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC Lactate Dehydrogen Body Fluid	$5.50	$11.00	$5.50–$11.00	88% below	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC Lactate Dehydrogenase	$8.00	$16.00	$8.00–$16.00	83% below	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC Ldh (Lactate Dehydrogenase) Se	$176.00	$352.00	$176.00–$352.00	274% above	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Lactate Dehydrogen Body Fluid	$5.50	$11.00	$5.50–$11.00	—	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Lactate Dehydrogenase	$8.00	$16.00	$8.00–$16.00	—	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Ldh (Lactate Dehydrogenase) Se	$176.00	$352.00	$176.00–$352.00	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 HC Lipase Body Fluid	$9.00	$18.00	$9.00–$18.00	91% below	50%
Lipase blood test (pancreas enzyme) CPT 83690 HC Lipase Serum	$158.50	$317.00	$158.50–$317.00	67% above	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Lipase Body Fluid	$9.00	$18.00	$9.00–$18.00	—	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Lipase Serum	$158.50	$317.00	$158.50–$317.00	—	50%
Liver function blood test panel CPT 80076 HC Hepatic Function Panel	$288.00	$576.00	$288.00–$576.00	33% above	50%
Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel	$288.00	$576.00	$288.00–$576.00	—	50%
Lyme disease antibody test CPT 86618 HC Borrelia Ab Total	$11.50	$23.00	$11.50–$23.00	86% below	50%
Lyme disease antibody test CPT 86618 HC Lyme Ab 2nd Tier Testing	$19.00	$38.00	$19.00–$38.00	77% below	50%
Lyme disease antibody test inpatient CPT 86618 HC Borrelia Ab Total	$11.50	$23.00	$11.50–$23.00	—	50%
Lyme disease antibody test inpatient CPT 86618 HC Lyme Ab 2nd Tier Testing	$19.00	$38.00	$19.00–$38.00	—	50%
Magnesium blood test CPT 83735 HC Magnesium Urine	$7.50	$15.00	$7.50–$15.00	85% below	50%
Magnesium blood test CPT 83735 HC Magnesium Stool	$8.50	$17.00	$8.50–$17.00	83% below	50%
Magnesium blood test CPT 83735 HC Stone Risk Magnesium	$17.00	$34.00	$17.00–$34.00	66% below	50%
Magnesium blood test CPT 83735 HC Magnesium RBC	$40.50	$81.00	$40.50–$81.00	18% below	50%
Magnesium blood test CPT 83735 HC Magnesium Assay	$169.50	$339.00	$169.50–$339.00	242% above	50%
Magnesium blood test inpatient CPT 83735 HC Magnesium Urine	$7.50	$15.00	$7.50–$15.00	—	50%
Magnesium blood test inpatient CPT 83735 HC Magnesium Stool	$8.50	$17.00	$8.50–$17.00	—	50%
Magnesium blood test inpatient CPT 83735 HC Stone Risk Magnesium	$17.00	$34.00	$17.00–$34.00	—	50%
Magnesium blood test inpatient CPT 83735 HC Magnesium RBC	$40.50	$81.00	$40.50–$81.00	—	50%
Magnesium blood test inpatient CPT 83735 HC Magnesium Assay	$169.50	$339.00	$169.50–$339.00	—	50%
Measles (rubeola) antibody test CPT 86765 HC Rubeola Antibody	$8.00	$16.00	$8.00–$16.00	78% below	50%
Measles (rubeola) antibody test CPT 86765 HC Rubeola Ab Igm	$9.00	$18.00	$9.00–$18.00	76% below	50%
Measles (rubeola) antibody test CPT 86765 HC Measles Ab Igg	$63.50	$127.00	$63.50–$127.00	73% above	50%
Measles (rubeola) antibody test inpatient CPT 86765 HC Rubeola Antibody	$8.00	$16.00	$8.00–$16.00	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 HC Rubeola Ab Igm	$9.00	$18.00	$9.00–$18.00	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 HC Measles Ab Igg	$63.50	$127.00	$63.50–$127.00	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 HC Heterophile Antibodies Screen	$56.50	$113.00	$56.50–$113.00	34% below	50%
Mono test (heterophile antibody, Monospot) CPT 86308 HC Monospot	$84.00	$168.00	$84.00–$168.00	1% below	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC Heterophile Antibodies Screen	$56.50	$113.00	$56.50–$113.00	—	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC Monospot	$84.00	$168.00	$84.00–$168.00	—	50%
Mumps immunity blood test CPT 86735 HC Mumps Ab	$7.00	$14.00	$7.00–$14.00	89% below	50%
Mumps immunity blood test CPT 86735 HC Mumps Virus Ab Igm	$9.00	$18.00	$9.00–$18.00	85% below	50%
Mumps immunity blood test CPT 86735 HC Mumps Ab Igg	$54.50	$109.00	$54.50–$109.00	12% below	50%
Mumps immunity blood test inpatient CPT 86735 HC Mumps Ab	$7.00	$14.00	$7.00–$14.00	—	50%
Mumps immunity blood test inpatient CPT 86735 HC Mumps Virus Ab Igm	$9.00	$18.00	$9.00–$18.00	—	50%
Mumps immunity blood test inpatient CPT 86735 HC Mumps Ab Igg	$54.50	$109.00	$54.50–$109.00	—	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC Psa Free	$12.50	$25.00	$12.50–$25.00	89% below	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Psa Free	$12.50	$25.00	$12.50–$25.00	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Assay of Prostate Specific Antigen Total	$17.00	$34.00	$17.00–$34.00	81% below	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen	$166.00	$332.00	$166.00–$332.00	86% above	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Assay of Prostate Specific Antigen Total	$17.00	$34.00	$17.00–$34.00	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Prostate Specific Antigen	$166.00	$332.00	$166.00–$332.00	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 HC Pap Screening by Automated Sys	$24.50	$49.00	$24.50–$49.00	67% below	50%
Pap test (liquid-based, automated screening with review) CPT 88175 HC Pap Test Digital Imaging Review	$66.00	$132.00	$66.00–$132.00	10% below	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC Pap Screening by Automated Sys	$24.50	$49.00	$24.50–$49.00	—	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC Pap Test Digital Imaging Review	$66.00	$132.00	$66.00–$132.00	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Cytology Surepath Pap	$31.50	$63.00	$31.50–$63.00	65% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Cytology Thinprep Pap	$32.50	$65.00	$32.50–$65.00	64% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC Cytology Surepath Pap	$31.50	$63.00	$31.50–$63.00	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC Cytology Thinprep Pap	$32.50	$65.00	$32.50–$65.00	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 HC Intact Parathyroid Hormone	$28.50	$57.00	$28.50–$57.00	87% below	50%
Parathyroid hormone (PTH) blood test CPT 83970 HC Pth Intact Hormone	$174.50	$349.00	$174.50–$349.00	19% below	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Intact Parathyroid Hormone	$28.50	$57.00	$28.50–$57.00	—	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Pth Intact Hormone	$174.50	$349.00	$174.50–$349.00	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Lupus Anticoagulant Aptt	$8.50	$17.00	$8.50–$17.00	84% below	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Reflex Ptt 1 Hr Incubation	$10.50	$21.00	$10.50–$21.00	81% below	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Reflex Ptt	$14.50	$29.00	$14.50–$29.00	73% below	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Ptt Mixing Study (Utsw)	$19.00	$38.00	$19.00–$38.00	65% below	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Reflex Treated Ptt Ratio	$26.50	$53.00	$26.50–$53.00	51% below	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Factor Inhibitor Ptt	$31.50	$63.00	$31.50–$63.00	42% below	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Activated Part Thrombo Time	$117.00	$234.00	$117.00–$234.00	116% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Lupus Anticoagulant Aptt	$8.50	$17.00	$8.50–$17.00	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Reflex Ptt 1 Hr Incubation	$10.50	$21.00	$10.50–$21.00	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Reflex Ptt	$14.50	$29.00	$14.50–$29.00	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Ptt Mixing Study (Utsw)	$19.00	$38.00	$19.00–$38.00	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Reflex Treated Ptt Ratio	$26.50	$53.00	$26.50–$53.00	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Factor Inhibitor Ptt	$31.50	$63.00	$31.50–$63.00	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Activated Part Thrombo Time	$117.00	$234.00	$117.00–$234.00	—	50%
Phosphorus (phosphate) blood test CPT 84100 HC Phosphorus Serum	$108.00	$216.00	$108.00–$216.00	72% above	50%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC Phosphorus Serum	$108.00	$216.00	$108.00–$216.00	—	50%
Potassium blood test CPT 84132 HC Potassium Serum	$134.00	$268.00	$134.00–$268.00	105% above	50%
Potassium blood test inpatient CPT 84132 HC Potassium Serum	$134.00	$268.00	$134.00–$268.00	—	50%
Progesterone blood test CPT 84144 HC Progesterone Ria	$17.00	$34.00	$17.00–$34.00	85% below	50%
Progesterone blood test CPT 84144 HC Progesterone	$40.50	$81.00	$40.50–$81.00	65% below	50%
Progesterone blood test inpatient CPT 84144 HC Progesterone Ria	$17.00	$34.00	$17.00–$34.00	—	50%
Progesterone blood test inpatient CPT 84144 HC Progesterone	$40.50	$81.00	$40.50–$81.00	—	50%
Prolactin blood test CPT 84146 HC Prolactin	$13.50	$27.00	$13.50–$27.00	88% below	50%
Prolactin blood test inpatient CPT 84146 HC Prolactin	$13.50	$27.00	$13.50–$27.00	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Lupus Anticoagulant Inr Protim	$8.50	$17.00	$8.50–$17.00	82% below	50%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Pt W Inr	$32.00	$64.00	$32.00–$64.00	32% below	50%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time	$117.00	$234.00	$117.00–$234.00	148% above	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Lupus Anticoagulant Inr Protim	$8.50	$17.00	$8.50–$17.00	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Pt W Inr	$32.00	$64.00	$32.00–$64.00	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time	$117.00	$234.00	$117.00–$234.00	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC Drug Screen Urine Prsmv	$64.50	$129.00	$64.50–$129.00	47% below	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC Drug Screen Urine Prsmv	$64.50	$129.00	$64.50–$129.00	—	50%
Rapid flu test (influenza antigen) CPT 87804 HC Influenza Antigen Screen	$193.50	$387.00	$193.50–$387.00	103% above	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC Influenza Antigen Screen	$193.50	$387.00	$193.50–$387.00	—	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Strep a Assay W/Optic	$49.50	$99.00	$49.50–$99.00	50% below	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Rapid Strep Screen	$80.00	$160.00	$80.00–$160.00	20% below	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Rapid Strep Screen POC	$93.00	$186.00	$93.00–$186.00	7% below	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC Strep a Assay W/Optic	$49.50	$99.00	$49.50–$99.00	—	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC Rapid Strep Screen	$80.00	$160.00	$80.00–$160.00	—	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC Rapid Strep Screen POC	$93.00	$186.00	$93.00–$186.00	—	50%
Renin blood test CPT 84244 HC Renin	$15.00	$30.00	$15.00–$30.00	85% below	50%
Renin blood test inpatient CPT 84244 HC Renin	$15.00	$30.00	$15.00–$30.00	—	50%
Rh blood typing CPT 86901 HC Rh Discrepancy Cbc	$20.50	$41.00	$20.50–$41.00	68% below	50%
Rh blood typing CPT 86901 HC Rh Type Cbc	$36.00	$72.00	$36.00–$72.00	44% below	50%
Rh blood typing CPT 86901 HC Rh Type	$65.50	$131.00	$65.50–$131.00	2% above	50%
Rh blood typing CPT 86901 HC Donor Unit Rh Type	$67.50	$135.00	$67.50–$135.00	5% above	50%
Rh blood typing inpatient CPT 86901 HC Rh Discrepancy Cbc	$20.50	$41.00	$20.50–$41.00	—	50%
Rh blood typing inpatient CPT 86901 HC Rh Type Cbc	$36.00	$72.00	$36.00–$72.00	—	50%
Rh blood typing inpatient CPT 86901 HC Rh Type	$65.50	$131.00	$65.50–$131.00	—	50%
Rh blood typing inpatient CPT 86901 HC Donor Unit Rh Type	$67.50	$135.00	$67.50–$135.00	—	50%
Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor Body Fluid	$6.50	$13.00	$6.50–$13.00	88% below	50%
Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor	$8.00	$16.00	$8.00–$16.00	85% below	50%
Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor Titer	$250.50	$501.00	$250.50–$501.00	354% above	50%
Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor Body Fluid	$6.50	$13.00	$6.50–$13.00	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor	$8.00	$16.00	$8.00–$16.00	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor Titer	$250.50	$501.00	$250.50–$501.00	—	50%
Rubella antibody test (immunity check) CPT 86762 HC Rubella Ab Igm	$8.00	$16.00	$8.00–$16.00	84% below	50%
Rubella antibody test (immunity check) CPT 86762 HC Rubella Ab Igg	$10.50	$21.00	$10.50–$21.00	78% below	50%
Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella Ab Igm	$8.00	$16.00	$8.00–$16.00	—	50%
Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella Ab Igg	$10.50	$21.00	$10.50–$21.00	—	50%
Sodium blood test CPT 84295 HC Sodium Level Serum	$134.50	$269.00	$134.50–$269.00	117% above	50%
Sodium blood test inpatient CPT 84295 HC Sodium Level Serum	$134.50	$269.00	$134.50–$269.00	—	50%
Stool ova and parasites exam CPT 87177 HC Cyclospora Isospora Concentrat	$11.00	$22.00	$11.00–$22.00	88% below	50%
Stool ova and parasites exam CPT 87177 HC Ova Parasite Concentrate	$23.00	$46.00	$23.00–$46.00	74% below	50%
Stool ova and parasites exam inpatient CPT 87177 HC Cyclospora Isospora Concentrat	$11.00	$22.00	$11.00–$22.00	—	50%
Stool ova and parasites exam inpatient CPT 87177 HC Ova Parasite Concentrate	$23.00	$46.00	$23.00–$46.00	—	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC Fecal Occult Blood Test 5 Card	$19.00	$38.00	$19.00–$38.00	51% below	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC Fecal Occult Blood Test 5 Card	$19.00	$38.00	$19.00–$38.00	—	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Fecal Occult Blood	$63.50	$127.00	$63.50–$127.00	8% below	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Fecal Occult Blood	$63.50	$127.00	$63.50–$127.00	—	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC Treponema Pallidum Ab Ifa CSF	$8.00	$16.00	$8.00–$16.00	83% below	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC Treponema Pallidum Antibody	$180.00	$360.00	$180.00–$360.00	289% above	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Treponema Pallidum Ab Ifa CSF	$8.00	$16.00	$8.00–$16.00	—	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Treponema Pallidum Antibody	$180.00	$360.00	$180.00–$360.00	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Vdrl CSF	$5.50	$11.00	$5.50–$11.00	90% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Vdrl Serum	$6.00	$12.00	$6.00–$12.00	89% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Rapid Plasma Reagin	$60.00	$120.00	$60.00–$120.00	14% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Vdrl	$97.00	$194.00	$97.00–$194.00	85% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Vdrl CSF	$5.50	$11.00	$5.50–$11.00	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Vdrl Serum	$6.00	$12.00	$6.00–$12.00	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Rapid Plasma Reagin	$60.00	$120.00	$60.00–$120.00	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Vdrl	$97.00	$194.00	$97.00–$194.00	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC Quantiferon TB Gold	$35.50	$71.00	$35.50–$71.00	83% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB Quantiferon Gold Plus	$139.00	$278.00	$139.00–$278.00	32% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC Quantiferon TB Gold	$35.50	$71.00	$35.50–$71.00	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB Quantiferon Gold Plus	$139.00	$278.00	$139.00–$278.00	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Testosterone	$17.50	$35.00	$17.50–$35.00	83% below	50%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Total Testosterone	$23.50	$47.00	$23.50–$47.00	77% below	50%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Testosterone Female	$26.50	$53.00	$26.50–$53.00	74% below	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Testosterone	$17.50	$35.00	$17.50–$35.00	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Total Testosterone	$23.50	$47.00	$23.50–$47.00	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Testosterone Female	$26.50	$53.00	$26.50–$53.00	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC Liver Kidney Thyroid Microsome Ab	$11.00	$22.00	$11.00–$22.00	88% below	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Liver Kidney Thyroid Microsome Ab	$11.00	$22.00	$11.00–$22.00	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulatin Hormone-Tsh	$345.00	$690.00	$345.00–$690.00	180% above	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Thyroid Stimulatin Hormone-Tsh	$345.00	$690.00	$345.00–$690.00	—	50%
Total IgE blood test CPT 82785 HC Immunoglobulin E Quantitative	$11.50	$23.00	$11.50–$23.00	87% below	50%
Total IgE blood test inpatient CPT 82785 HC Immunoglobulin E Quantitative	$11.50	$23.00	$11.50–$23.00	—	50%
Total cholesterol blood test CPT 82465 HC Ldl Cholesterol	$22.50	$45.00	$22.50–$45.00	67% below	50%
Total cholesterol blood test CPT 82465 HC Level Cholesterol Serum	$134.00	$268.00	$134.00–$268.00	99% above	50%
Total cholesterol blood test inpatient CPT 82465 HC Ldl Cholesterol	$22.50	$45.00	$22.50–$45.00	—	50%
Total cholesterol blood test inpatient CPT 82465 HC Level Cholesterol Serum	$134.00	$268.00	$134.00–$268.00	—	50%
Total thyroxine (T4) blood test CPT 84436 HC Thyroxine T4	$6.00	$12.00	$6.00–$12.00	93% below	50%
Total thyroxine (T4) blood test CPT 84436 HC T4 Thyroxine True	$208.00	$416.00	$208.00–$416.00	158% above	50%
Total thyroxine (T4) blood test inpatient CPT 84436 HC Thyroxine T4	$6.00	$12.00	$6.00–$12.00	—	50%
Total thyroxine (T4) blood test inpatient CPT 84436 HC T4 Thyroxine True	$208.00	$416.00	$208.00–$416.00	—	50%
Total triiodothyronine (T3) blood test CPT 84480 HC Total T3	$208.00	$416.00	$208.00–$416.00	65% above	50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC Total T3	$208.00	$416.00	$208.00–$416.00	—	50%
Transferrin blood test CPT 84466 HC Transferrin	$211.00	$422.00	$211.00–$422.00	77% above	50%
Transferrin blood test inpatient CPT 84466 HC Transferrin	$211.00	$422.00	$211.00–$422.00	—	50%
Trichomonas test (NAAT) CPT 87661 HC Trichomonas Vaginalis Tma	$47.50	$95.00	$47.50–$95.00	46% below	50%
Trichomonas test (NAAT) CPT 87661 HC Trichomonas by Bd Max	$86.50	$173.00	$86.50–$173.00	1% below	50%
Trichomonas test (NAAT) inpatient CPT 87661 HC Trichomonas Vaginalis Tma	$47.50	$95.00	$47.50–$95.00	—	50%
Trichomonas test (NAAT) inpatient CPT 87661 HC Trichomonas by Bd Max	$86.50	$173.00	$86.50–$173.00	—	50%
Triglycerides blood test CPT 84478 HC Assay of Triglycerides	$6.50	$13.00	$6.50–$13.00	93% below	50%
Triglycerides blood test CPT 84478 HC Triglycerides Serum	$239.00	$478.00	$239.00–$478.00	172% above	50%
Triglycerides blood test inpatient CPT 84478 HC Assay of Triglycerides	$6.50	$13.00	$6.50–$13.00	—	50%
Triglycerides blood test inpatient CPT 84478 HC Triglycerides Serum	$239.00	$478.00	$239.00–$478.00	—	50%
Troponin test, quantitative CPT 84484 HC Troponin T	$26.00	$52.00	$26.00–$52.00	81% below	50%
Troponin test, quantitative CPT 84484 HC Troponin I Quantitative	$222.00	$444.00	$222.00–$444.00	64% above	50%
Troponin test, quantitative inpatient CPT 84484 HC Troponin T	$26.00	$52.00	$26.00–$52.00	—	50%
Troponin test, quantitative inpatient CPT 84484 HC Troponin I Quantitative	$222.00	$444.00	$222.00–$444.00	—	50%
Uric acid blood test CPT 84550 HC Uric Acid Serum	$108.00	$216.00	$108.00–$216.00	19% above	50%
Uric acid blood test inpatient CPT 84550 HC Uric Acid Serum	$108.00	$216.00	$108.00–$216.00	—	50%
Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis With Microscopy	$117.00	$234.00	$117.00–$234.00	8% above	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis With Microscopy	$117.00	$234.00	$117.00–$234.00	—	50%
Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Chemical	$47.00	$94.00	$47.00–$94.00	6% below	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis Chemical	$47.00	$94.00	$47.00–$94.00	—	50%
Urinalysis without microscope exam, manual CPT 81002 HC Ua Visual	$43.00	$86.00	$43.00–$86.00	20% above	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC Ua Visual	$43.00	$86.00	$43.00–$86.00	—	50%
Urine culture for bacteria, with colony count CPT 87086 HC Culture Colony Count-Urine	$201.00	$402.00	$201.00–$402.00	45% above	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC Culture Colony Count-Urine	$201.00	$402.00	$201.00–$402.00	—	50%
Urine microalbumin (albumin) test CPT 82043 HC Microalbumin Protein	$128.00	$256.00	$128.00–$256.00	151% above	50%
Urine microalbumin (albumin) test inpatient CPT 82043 HC Microalbumin Protein	$128.00	$256.00	$128.00–$256.00	—	50%
Urine pregnancy test, read by color change CPT 81025 HC Urine Pregnancy Test	$55.50	$111.00	$55.50–$111.00	35% below	50%
Urine pregnancy test, read by color change inpatient CPT 81025 HC Urine Pregnancy Test	$55.50	$111.00	$55.50–$111.00	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 HC Vitamin B12	$179.00	$358.00	$179.00–$358.00	97% above	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC Vitamin B12	$179.00	$358.00	$179.00–$358.00	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 Hydroxvitamin D2 D3	$29.50	$59.00	$29.50–$59.00	76% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Vitamin D 25 Oh	$146.00	$292.00	$146.00–$292.00	19% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 Hydroxvitamin D2 D3	$29.50	$59.00	$29.50–$59.00	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC Vitamin D 25 Oh	$146.00	$292.00	$146.00–$292.00	—	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC Vitamin D 1 25 Dioh	$27.50	$55.00	$27.50–$55.00	83% below	50%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC Vitamin D 1 25 Dioh	$27.50	$55.00	$27.50–$55.00	—	50%
Zinc blood test CPT 84630 HC Zinc Urine	$8.00	$16.00	$8.00–$16.00	88% below	50%
Zinc blood test CPT 84630 HC Zinc Blood	$16.00	$32.00	$16.00–$32.00	77% below	50%
Zinc blood test inpatient CPT 84630 HC Zinc Urine	$8.00	$16.00	$8.00–$16.00	—	50%
Zinc blood test inpatient CPT 84630 HC Zinc Blood	$16.00	$32.00	$16.00–$32.00	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Hcg Tumor Marker	$10.00	$20.00	$10.00–$20.00	91% below	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Hcg Quantative	$289.00	$578.00	$289.00–$578.00	158% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Hcg Tumor Marker	$10.00	$20.00	$10.00–$20.00	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Hcg Quantative	$289.00	$578.00	$289.00–$578.00	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC Breast Bx W Stereo Guide Init	$5,261.50	$10,523.00	$5,261.50–$10,523.00	50% above	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC Breast Bx W Stereo Guide Init	$5,261.50	$10,523.00	$5,261.50–$10,523.00	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC ED Treatment of Ankle Fracture	$232.00	$464.00	$232.00–$464.00	50% below	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC ED Treatment of Ankle Fracture	$232.00	$464.00	$232.00–$464.00	—	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC ED Cltx Metatarsal Fx WO Mnp Ea	$232.00	$464.00	$232.00–$464.00	17% below	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC ED Cltx Metatarsal Fx WO Mnp Ea	$232.00	$464.00	$232.00–$464.00	—	50%
Cardiac catheterization with coronary angiogram one side CPT 93458 HC Heart Cath Lt Cor W WO Lv	$10,693.00	$21,386.00	$10,693.00–$21,386.00	10% below	50%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 HC Heart Cath Lt Cor W WO Lv	$10,693.00	$21,386.00	$10,693.00–$21,386.00	—	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion	$1,249.50	$2,499.00	$1,249.50–$2,499.00	13% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion (Ep)	$1,249.50	$2,499.00	$1,249.50–$2,499.00	13% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC ED Cardioversion	$1,249.50	$2,499.00	$1,249.50–$2,499.00	13% below	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Cardioversion (Ep)	$1,249.50	$2,499.00	$1,249.50–$2,499.00	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Cardioversion	$1,249.50	$2,499.00	$1,249.50–$2,499.00	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC ED Cardioversion	$1,249.50	$2,499.00	$1,249.50–$2,499.00	—	50%
Carpal tunnel release, open surgery CPT 64721 HC Carpal Tunnel Surgery	$2,035.50	$4,071.00	$2,035.50–$4,071.00	39% below	50%
Carpal tunnel release, open surgery inpatient CPT 64721 HC Carpal Tunnel Surgery	$2,035.50	$4,071.00	$2,035.50–$4,071.00	—	50%
Catheter ablation for atrial fibrillation CPT 93656 HC Eps W Arrhy Afib Abl W Pvi	$27,791.00	$55,582.00	$27,791.00–$55,582.00	23% below	50%
Catheter ablation for atrial fibrillation inpatient CPT 93656 HC Eps W Arrhy Afib Abl W Pvi	$27,791.00	$55,582.00	$27,791.00–$55,582.00	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC ED Cltx Dst Rdl Fx/Ephys Sep WO	$232.00	$464.00	$232.00–$464.00	55% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC ED Cltx Dst Rdl Fx/Ephys Sep WO	$232.00	$464.00	$232.00–$464.00	—	50%
Coronary stent placement, one artery CPT 92928 HC Bm Stent Init	$9,866.50	$19,733.00	$9,866.50–$19,733.00	16% below	50%
Coronary stent placement, one artery CPT 92928 HC De Prq Trluml Coronary Stent W/Angio 1 Art/Brnch	$11,381.00	$22,762.00	$11,381.00–$22,762.00	3% below	50%
Coronary stent placement, one artery inpatient CPT 92928 HC Bm Stent Init	$9,866.50	$19,733.00	$9,866.50–$19,733.00	—	50%
Coronary stent placement, one artery inpatient CPT 92928 HC De Prq Trluml Coronary Stent W/Angio 1 Art/Brnch	$11,381.00	$22,762.00	$11,381.00–$22,762.00	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC ED Destruct Premalg Lesion	$188.50	$377.00	$188.50–$377.00	6% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC ED Destruct Premalg Lesion	$188.50	$377.00	$188.50–$377.00	—	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC Uc Remove Impacted Ear Wax Uni	$131.50	$263.00	$131.50–$263.00	8% above	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC ED Remove Impacted Ear Wax Uni	$131.50	$263.00	$131.50–$263.00	8% above	50%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC ED Remove Impacted Ear Wax Uni	$131.50	$263.00	$131.50–$263.00	—	50%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC Uc Remove Impacted Ear Wax Uni	$131.50	$263.00	$131.50–$263.00	—	50%
Earwax removal with instruments, one ear CPT 69210 HC ED Remove Impacted Ear Wax Uni	$172.00	$344.00	$172.00–$344.00	8% above	50%
Earwax removal with instruments, one ear CPT 69210 HC Clear/Clean Outer Ear Canal	$172.00	$344.00	$172.00–$344.00	8% above	50%
Earwax removal with instruments, one ear inpatient CPT 69210 HC ED Remove Impacted Ear Wax Uni	$172.00	$344.00	$172.00–$344.00	—	50%
Earwax removal with instruments, one ear inpatient CPT 69210 HC Clear/Clean Outer Ear Canal	$172.00	$344.00	$172.00–$344.00	—	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC Bx Endometrial Lining	$1,058.50	$2,117.00	$1,058.50–$2,117.00	187% above	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC Bx Endometrial Lining	$1,058.50	$2,117.00	$1,058.50–$2,117.00	—	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Inj Ther Dx Drug Cerv Thor Img	$1,107.50	$2,215.00	$1,107.50–$2,215.00	23% below	50%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC Inj Ther Dx Drug Cerv Thor Img	$1,107.50	$2,215.00	$1,107.50–$2,215.00	—	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Inj Paravert F Jnt L/S 1 Lev Uni	$1,113.50	$2,227.00	$1,113.50–$2,227.00	37% below	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Inj Paravert F Jnt L/S 1 Lev Bil	$1,782.00	$3,564.00	$1,782.00–$3,564.00	at median	50%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC Inj Paravert F Jnt L/S 1 Lev Uni	$1,113.50	$2,227.00	$1,113.50–$2,227.00	—	50%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC Inj Paravert F Jnt L/S 1 Lev Bil	$1,782.00	$3,564.00	$1,782.00–$3,564.00	—	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC Place Cath Hysterosonography	$359.50	$719.00	$359.50–$719.00	4% below	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC Place Cath Hysterosonography	$359.50	$719.00	$359.50–$719.00	—	50%
IUD insertion (the device itself billed separately) CPT 58300 HC Iud Insertion	$2,398.00	$4,796.00	$2,398.00–$4,796.00	533% above	50%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC Iud Insertion	$2,398.00	$4,796.00	$2,398.00–$4,796.00	—	50%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D Abscess Simple	$208.00	$416.00	$208.00–$416.00	56% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 HC ED Drainage of Skin Abscess Simple/Single	$208.00	$416.00	$208.00–$416.00	56% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 HC Uc Drainage of Skin Abscess	$208.00	$416.00	$208.00–$416.00	56% below	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC Uc Drainage of Skin Abscess	$208.00	$416.00	$208.00–$416.00	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D Abscess Simple	$208.00	$416.00	$208.00–$416.00	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC ED Drainage of Skin Abscess Simple/Single	$208.00	$416.00	$208.00–$416.00	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Inject Tendon or Ligament	$445.50	$891.00	$445.50–$891.00	1% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC ED Njx 1 Tendon Sheath/Ligament	$445.50	$891.00	$445.50–$891.00	1% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC ED Njx 1 Tendon Sheath/Ligament	$445.50	$891.00	$445.50–$891.00	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC Inject Tendon or Ligament	$445.50	$891.00	$445.50–$891.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 HC Drain/Inj Joint/Bursa Bilat W/O US	$891.00	$1,782.00	$891.00–$1,782.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Drain/Inj Joint/Bursa Uni W/O US	$445.50	$891.00	$445.50–$891.00	32% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ED Drain/Inj Joint/Bursa W/O US	$445.50	$891.00	$445.50–$891.00	32% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 HC Drain/Inj Joint/Bursa Bilat W/O US	$891.00	$1,782.00	$891.00–$1,782.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Drain/Inj Joint/Bursa Uni W/O US	$445.50	$891.00	$445.50–$891.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ED Drain/Inj Joint/Bursa W/O US	$445.50	$891.00	$445.50–$891.00	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 HC Drain/Inj Joint/Bursa Bilat W/O US	$663.00	$1,326.00	$663.00–$1,326.00	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ED Drain/Inj Joint/Bursa W/O US	$331.50	$663.00	$331.50–$663.00	44% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Drain/Inj Joint/Bursa Uni W/O US	$331.50	$663.00	$331.50–$663.00	44% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 HC Drain/Inj Joint/Bursa Bilat W/O US	$663.00	$1,326.00	$663.00–$1,326.00	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Drain/Inj Joint/Bursa Uni W/O US	$331.50	$663.00	$331.50–$663.00	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ED Drain/Inj Joint/Bursa W/O US	$331.50	$663.00	$331.50–$663.00	—	50%
Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 HC Drain/Inj Joint/Bursa Bilat W/O US	$650.50	$1,301.00	$650.50–$1,301.00	—	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Drain/Inj Joint/Bursa Uni W/O US	$325.00	$650.00	$325.00–$650.00	26% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ED Drain/Inj Joint/Bursa W/O US	$325.00	$650.00	$325.00–$650.00	26% below	50%
Joint injection or drainage, small joint (fingers, toes) inpatient both sides CPT 20600 HC Drain/Inj Joint/Bursa Bilat W/O US	$650.50	$1,301.00	$650.50–$1,301.00	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ED Drain/Inj Joint/Bursa W/O US	$325.00	$650.00	$325.00–$650.00	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Drain/Inj Joint/Bursa Uni W/O US	$325.00	$650.00	$325.00–$650.00	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Repair Wound Intermediate S/a/T/E 2.5 Cm/<	$460.00	$920.00	$460.00–$920.00	13% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC ED Repair Intmd S/a/T/E 2.5 Cm/<	$460.00	$920.00	$460.00–$920.00	13% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC Repair Wound Intermediate S/a/T/E 2.5 Cm/<	$460.00	$920.00	$460.00–$920.00	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC ED Repair Intmd S/a/T/E 2.5 Cm/<	$460.00	$920.00	$460.00–$920.00	—	50%
Left heart catheterization, diagnostic one side CPT 93452 HC Heart Cath Lt W Intra Inj	$8,694.00	$17,388.00	$8,694.00–$17,388.00	9% below	50%
Left heart catheterization, diagnostic inpatient one side CPT 93452 HC Heart Cath Lt W Intra Inj	$8,694.00	$17,388.00	$8,694.00–$17,388.00	—	50%
Lower-back epidural injection, with imaging guidance CPT 62323 HC Inj Ther Dx Drug Lumb Sacr Img	$1,107.50	$2,215.00	$1,107.50–$2,215.00	34% below	50%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Inj Ther Dx Drug Lumb Sacr Img	$1,107.50	$2,215.00	$1,107.50–$2,215.00	—	50%
Lower-back epidural injection, without imaging guidance CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn	$1,107.50	$2,215.00	$1,107.50–$2,215.00	12% below	50%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn	$1,107.50	$2,215.00	$1,107.50–$2,215.00	—	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Inj Tr Foram Epidur Lumbar	$1,113.50	$2,227.00	$1,113.50–$2,227.00	25% below	50%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC Inj Tr Foram Epidur Lumbar	$1,113.50	$2,227.00	$1,113.50–$2,227.00	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC ED Exc Tr-Ext B9+Marg 0.5 Cm<	$665.50	$1,331.00	$665.50–$1,331.00	17% below	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC ED Exc Tr-Ext B9+Marg 0.5 Cm<	$665.50	$1,331.00	$665.50–$1,331.00	—	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC ED Exc Face-Mm B9+Marg 0.5 Cm/<	$665.50	$1,331.00	$665.50–$1,331.00	25% below	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC ED Exc Face-Mm B9+Marg 0.5 Cm/<	$665.50	$1,331.00	$665.50–$1,331.00	—	50%
Nail removal (partial or complete), one nail CPT 11730 HC ED Avulsion Nail Plate Part/Comp/Simple	$282.50	$565.00	$282.50–$565.00	8% below	50%
Nail removal (partial or complete), one nail CPT 11730 HC Avulsion Nail Plate	$282.50	$565.00	$282.50–$565.00	8% below	50%
Nail removal (partial or complete), one nail CPT 11730 HC Uc Avulsion Nail Plate Part/Comp/Simple	$282.50	$565.00	$282.50–$565.00	8% below	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC ED Avulsion Nail Plate Part/Comp/Simple	$282.50	$565.00	$282.50–$565.00	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC Avulsion Nail Plate	$282.50	$565.00	$282.50–$565.00	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC Uc Avulsion Nail Plate Part/Comp/Simple	$282.50	$565.00	$282.50–$565.00	—	50%
Pacemaker implant (dual chamber) CPT 33208 HC Inst/Repl Ppm Gen & a/V Ld	$14,383.50	$28,767.00	$14,383.50–$28,767.00	24% below	50%
Pacemaker implant (dual chamber) CPT 33208 HC Pm Insert/Replace Gen & Av Lds	$14,383.50	$28,767.00	$14,383.50–$28,767.00	24% below	50%
Pacemaker implant (dual chamber) inpatient CPT 33208 HC Pm Insert/Replace Gen & Av Lds	$14,383.50	$28,767.00	$14,383.50–$28,767.00	—	50%
Pacemaker implant (dual chamber) inpatient CPT 33208 HC Inst/Repl Ppm Gen & a/V Ld	$14,383.50	$28,767.00	$14,383.50–$28,767.00	—	50%
Paracentesis with imaging guidance CPT 49083 HC Abd Paracentesis Guided US	$1,672.50	$3,345.00	$1,672.50–$3,345.00	3% above	50%
Paracentesis with imaging guidance CPT 49083 HC Abd Paracentesis Guided CT	$3,514.50	$7,029.00	$3,514.50–$7,029.00	116% above	50%
Paracentesis with imaging guidance inpatient CPT 49083 HC Abd Paracentesis Guided US	$1,672.50	$3,345.00	$1,672.50–$3,345.00	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 HC Abd Paracentesis Guided CT	$3,514.50	$7,029.00	$3,514.50–$7,029.00	—	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC ED Excision Nail&Nail Matrix	$382.00	$764.00	$382.00–$764.00	27% below	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Uc Excision Nail&Nail Matrix	$382.00	$764.00	$382.00–$764.00	27% below	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC Uc Excision Nail&Nail Matrix	$382.00	$764.00	$382.00–$764.00	—	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC ED Excision Nail&Nail Matrix	$382.00	$764.00	$382.00–$764.00	—	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC Destruction Pvf Lsp Inj Sgl	$2,377.00	$4,754.00	$2,377.00–$4,754.00	15% below	50%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC Destruction Pvf Lsp Inj Sgl	$2,377.00	$4,754.00	$2,377.00–$4,754.00	—	50%
Removal of a foreign object under the skin, simple CPT 10120 HC Remove FB Subcutaneous Other	$685.50	$1,371.00	$685.50–$1,371.00	29% above	50%
Removal of a foreign object under the skin, simple CPT 10120 HC ED Inc&Rmvl FB Subq Tiss Smpl	$685.50	$1,371.00	$685.50–$1,371.00	29% above	50%
Removal of a foreign object under the skin, simple CPT 10120 HC Uc Inc&Rmvl FB Subq Tiss Smpl	$685.50	$1,371.00	$685.50–$1,371.00	29% above	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC ED Inc&Rmvl FB Subq Tiss Smpl	$685.50	$1,371.00	$685.50–$1,371.00	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC Uc Inc&Rmvl FB Subq Tiss Smpl	$685.50	$1,371.00	$685.50–$1,371.00	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC Remove FB Subcutaneous Other	$685.50	$1,371.00	$685.50–$1,371.00	—	50%
Short arm splint (forearm and hand) CPT 29125 HC ED Apply Forearm Splint	$131.50	$263.00	$131.50–$263.00	44% below	50%
Short arm splint (forearm and hand) CPT 29125 HC Uc Apply Forearm Splint	$131.50	$263.00	$131.50–$263.00	44% below	50%
Short arm splint (forearm and hand) inpatient CPT 29125 HC Uc Apply Forearm Splint	$131.50	$263.00	$131.50–$263.00	—	50%
Short arm splint (forearm and hand) inpatient CPT 29125 HC ED Apply Forearm Splint	$131.50	$263.00	$131.50–$263.00	—	50%
Short leg splint (calf to foot) CPT 29515 HC ED Application Lower Leg Splint	$157.00	$314.00	$157.00–$314.00	40% below	50%
Short leg splint (calf to foot) CPT 29515 HC Uc Application Lower Leg Splint	$157.00	$314.00	$157.00–$314.00	40% below	50%
Short leg splint (calf to foot) inpatient CPT 29515 HC Uc Application Lower Leg Splint	$157.00	$314.00	$157.00–$314.00	—	50%
Short leg splint (calf to foot) inpatient CPT 29515 HC ED Application Lower Leg Splint	$157.00	$314.00	$157.00–$314.00	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC ED Rpr S/N/Ax/Gen/Trnk 2.5cm/<	$208.00	$416.00	$208.00–$416.00	43% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Uc Repair Simple S/N/Ax/Gen/Trnk 2.5cm/<	$208.00	$416.00	$208.00–$416.00	43% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC Uc Repair Simple S/N/Ax/Gen/Trnk 2.5cm/<	$208.00	$416.00	$208.00–$416.00	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC ED Rpr S/N/Ax/Gen/Trnk 2.5cm/<	$208.00	$416.00	$208.00–$416.00	—	50%
Skin biopsy, punch, one lesion CPT 11104 HC Bx Skin Punch Single Lesion	$309.50	$619.00	$309.50–$619.00	32% below	50%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC Bx Skin Punch Single Lesion	$309.50	$619.00	$309.50–$619.00	—	50%
Skin tag removal, up to 15 tags CPT 11200 HC Removal of Skin Tags	$195.00	$390.00	$195.00–$390.00	39% below	50%
Skin tag removal, up to 15 tags CPT 11200 HC ED Rmvl Skin Tags Up to&Inc 15	$195.00	$390.00	$195.00–$390.00	39% below	50%
Skin tag removal, up to 15 tags CPT 11200 HC Uc Rmvl Skin Tags Up to&Inc 15	$195.00	$390.00	$195.00–$390.00	39% below	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC Removal of Skin Tags	$195.00	$390.00	$195.00–$390.00	—	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC ED Rmvl Skin Tags Up to&Inc 15	$195.00	$390.00	$195.00–$390.00	—	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC Uc Rmvl Skin Tags Up to&Inc 15	$195.00	$390.00	$195.00–$390.00	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Lumbar Puncture Diagnostic	$513.50	$1,027.00	$513.50–$1,027.00	51% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC ED Dx Lmbr Spi Pnxr	$513.50	$1,027.00	$513.50–$1,027.00	51% below	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC Lumbar Puncture Diagnostic	$513.50	$1,027.00	$513.50–$1,027.00	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC ED Dx Lmbr Spi Pnxr	$513.50	$1,027.00	$513.50–$1,027.00	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Uc Rpr S/N/Ax/Gen/Trnk2.6-7.5cm	$208.00	$416.00	$208.00–$416.00	54% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC ED Rpr S/N/Ax/Gen/Trnk2.6-7.5cm	$208.00	$416.00	$208.00–$416.00	54% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC ED Rpr S/N/Ax/Gen/Trnk2.6-7.5cm	$208.00	$416.00	$208.00–$416.00	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC Uc Rpr S/N/Ax/Gen/Trnk2.6-7.5cm	$208.00	$416.00	$208.00–$416.00	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC ED Rpr F/E/E/N/L/M 2.5 Cm/<	$208.00	$416.00	$208.00–$416.00	47% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Uc Rpr F/E/E/N/L/M 2.5 Cm/<	$208.00	$416.00	$208.00–$416.00	47% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC ED Rpr F/E/E/N/L/M 2.5 Cm/<	$208.00	$416.00	$208.00–$416.00	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC Uc Rpr F/E/E/N/L/M 2.5 Cm/<	$208.00	$416.00	$208.00–$416.00	—	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC Biopsy Skin Tangential Single Lesion	$309.50	$619.00	$309.50–$619.00	14% below	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC Biopsy Skin Tangential Single Lesion	$309.50	$619.00	$309.50–$619.00	—	50%
Thoracentesis with imaging guidance CPT 32555 HC Thoracentesis CT Guided Uni	$1,926.50	$3,853.00	$1,926.50–$3,853.00	35% above	50%
Thoracentesis with imaging guidance CPT 32555 HC Thoracentesis US Guided Uni	$1,926.50	$3,853.00	$1,926.50–$3,853.00	35% above	50%
Thoracentesis with imaging guidance CPT 32555 HC Thoracentesis US Guided Bil	$3,082.00	$6,164.00	$3,082.00–$6,164.00	116% above	50%
Thoracentesis with imaging guidance CPT 32555 HC Thoracentesis CT Guided Bil	$3,082.00	$6,164.00	$3,082.00–$6,164.00	116% above	50%
Thoracentesis with imaging guidance inpatient CPT 32555 HC Thoracentesis CT Guided Uni	$1,926.50	$3,853.00	$1,926.50–$3,853.00	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 HC Thoracentesis US Guided Uni	$1,926.50	$3,853.00	$1,926.50–$3,853.00	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 HC Thoracentesis CT Guided Bil	$3,082.00	$6,164.00	$3,082.00–$6,164.00	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 HC Thoracentesis US Guided Bil	$3,082.00	$6,164.00	$3,082.00–$6,164.00	—	50%
Trigger finger release surgery CPT 26055 HC Incise Finger Tendon Sheath	$2,414.50	$4,829.00	$2,414.50–$4,829.00	29% below	50%
Trigger finger release surgery inpatient CPT 26055 HC Incise Finger Tendon Sheath	$2,414.50	$4,829.00	$2,414.50–$4,829.00	—	50%
Trigger point injections, 1 or 2 muscles CPT 20552 HC Inj Trigger Point 1-2 Muscle	$702.50	$1,405.00	$702.50–$1,405.00	22% above	50%
Trigger point injections, 1 or 2 muscles CPT 20552 HC ED Njx 1/Mlt Trigger Point 1/2	$702.50	$1,405.00	$702.50–$1,405.00	22% above	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC ED Njx 1/Mlt Trigger Point 1/2	$702.50	$1,405.00	$702.50–$1,405.00	—	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC Inj Trigger Point 1-2 Muscle	$702.50	$1,405.00	$702.50–$1,405.00	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC Breast Bx W US Guide Core Init	$4,472.50	$8,945.00	$4,472.50–$8,945.00	62% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC Breast Bx W US Guide Core Init	$4,472.50	$8,945.00	$4,472.50–$8,945.00	—	50%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HC Egd Transoral Transmural Drainage Pseudocyst	$5,551.50	$11,103.00	$5,551.50–$11,103.00	317% above	50%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 HC Egd Transoral Transmural Drainage Pseudocyst	$5,551.50	$11,103.00	$5,551.50–$11,103.00	—	50%
Wart removal, up to 14 warts CPT 17110 HC ED Destruction B9 Les Up to 14	$188.50	$377.00	$188.50–$377.00	6% below	50%
Wart removal, up to 14 warts inpatient CPT 17110 HC ED Destruction B9 Les Up to 14	$188.50	$377.00	$188.50–$377.00	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debridement Sk Tiss 1st 20scm	$685.50	$1,371.00	$685.50–$1,371.00	32% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC ED Dbrdmt Subq Tis 1st 20sqcm/<	$685.50	$1,371.00	$685.50–$1,371.00	32% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC ED Dbrdmt Subq Tis 1st 20sqcm/<	$685.50	$1,371.00	$685.50–$1,371.00	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC Debridement Sk Tiss 1st 20scm	$685.50	$1,371.00	$685.50–$1,371.00	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Administration Fee	$1,275.00	$2,550.00	$1,275.00–$2,550.00	45% above	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Administration Fee	$1,275.00	$2,550.00	$1,275.00–$2,550.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Inhalation Treatment	$69.50	$139.00	$69.50–$139.00	66% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Intrapulmonic Perc Vent	$108.50	$217.00	$108.50–$217.00	47% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Mdi Tx	$151.00	$302.00	$151.00–$302.00	26% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Ippb Tx	$151.00	$302.00	$151.00–$302.00	26% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Sputum Ind/Aerostar Cart	$151.00	$302.00	$151.00–$302.00	26% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Uabd Tx	$151.00	$302.00	$151.00–$302.00	26% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Hm/Cm Tx	$151.00	$302.00	$151.00–$302.00	26% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Inhalation Treatment	$69.50	$139.00	$69.50–$139.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Intrapulmonic Perc Vent	$108.50	$217.00	$108.50–$217.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Mdi Tx	$151.00	$302.00	$151.00–$302.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Hm/Cm Tx	$151.00	$302.00	$151.00–$302.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Sputum Ind/Aerostar Cart	$151.00	$302.00	$151.00–$302.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Uabd Tx	$151.00	$302.00	$151.00–$302.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Ippb Tx	$151.00	$302.00	$151.00–$302.00	—	50%
Chemotherapy IV infusion, first hour CPT 96413 HC Chemo IV Drip Initial 0-60 Min	$611.00	$1,222.00	$611.00–$1,222.00	13% above	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC Chemo IV Drip Initial 0-60 Min	$611.00	$1,222.00	$611.00–$1,222.00	—	50%
Critical care, first 30 to 74 minutes CPT 99291 HC ER Critical Care 99291	$2,327.00	$4,654.00	$2,327.00–$4,654.00	10% below	50%
Critical care, first 30 to 74 minutes CPT 99291 HC ER OB Critical Care 99291	$2,327.00	$4,654.00	$2,327.00–$4,654.00	10% below	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ER OB Critical Care 99291	$2,327.00	$4,654.00	$2,327.00–$4,654.00	—	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ER Critical Care 99291	$2,327.00	$4,654.00	$2,327.00–$4,654.00	—	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake/Drowsy	$660.00	$1,320.00	$660.00–$1,320.00	33% below	50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC Eeg Awake/Drowsy	$660.00	$1,320.00	$660.00–$1,320.00	—	50%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC Ecg Routine Ecg W/Least 12 Lds W/I&R	$334.50	$669.00	$334.50–$669.00	134% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Routine Ekg	$315.50	$631.00	$315.50–$631.00	11% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC Routine Ekg	$315.50	$631.00	$315.50–$631.00	—	50%
Electroconvulsive therapy (ECT), one session CPT 90870 HC Ect	$1,427.00	$2,854.00	$1,427.00–$2,854.00	at median	50%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HC Ect	$1,427.00	$2,854.00	$1,427.00–$2,854.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER Level I 99281	$262.00	$524.00	$262.00–$524.00	at median	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER OB Level I 99281	$262.00	$524.00	$262.00–$524.00	at median	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ER OB Level I 99281	$262.00	$524.00	$262.00–$524.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ER Level I 99281	$262.00	$524.00	$262.00–$524.00	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER OB Level II 99282	$463.00	$926.00	$463.00–$926.00	1% below	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER Level II 99282	$463.00	$926.00	$463.00–$926.00	1% below	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ER Level II 99282	$463.00	$926.00	$463.00–$926.00	—	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ER OB Level II 99282	$463.00	$926.00	$463.00–$926.00	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER Level III 99283	$978.00	$1,956.00	$978.00–$1,956.00	19% above	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER OB Level III 99283	$978.00	$1,956.00	$978.00–$1,956.00	19% above	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ER Level III 99283	$978.00	$1,956.00	$978.00–$1,956.00	—	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ER OB Level III 99283	$978.00	$1,956.00	$978.00–$1,956.00	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER OB Level IV 99284	$1,291.00	$2,582.00	$1,291.00–$2,582.00	1% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER Level IV 99284	$1,291.00	$2,582.00	$1,291.00–$2,582.00	1% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ER Level IV 99284	$1,291.00	$2,582.00	$1,291.00–$2,582.00	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ER OB Level IV 99284	$1,291.00	$2,582.00	$1,291.00–$2,582.00	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER OB Level V 99285	$1,774.50	$3,549.00	$1,774.50–$3,549.00	12% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER Level V 99285	$1,774.50	$3,549.00	$1,774.50–$3,549.00	12% below	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ER Level V 99285	$1,774.50	$3,549.00	$1,774.50–$3,549.00	—	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ER OB Level V 99285	$1,774.50	$3,549.00	$1,774.50–$3,549.00	—	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC Cardiovascular Stress Test	$1,439.00	$2,878.00	$1,439.00–$2,878.00	12% above	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC Myocardial Perf Study	$1,439.00	$2,878.00	$1,439.00–$2,878.00	12% above	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Cardiovascular Stress Test	$1,439.00	$2,878.00	$1,439.00–$2,878.00	—	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Myocardial Perf Study	$1,439.00	$2,878.00	$1,439.00–$2,878.00	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC Obed IV Hydrate Initial 31-60 Min	$434.50	$869.00	$434.50–$869.00	3% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC ED IV Hydrate Initial 31-60 Min	$434.50	$869.00	$434.50–$869.00	3% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Hydrate Initial W/Min 31min-60 Min	$434.50	$869.00	$434.50–$869.00	3% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC ED IV Hydrate Initial 31-60 Min	$434.50	$869.00	$434.50–$869.00	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC Obed IV Hydrate Initial 31-60 Min	$434.50	$869.00	$434.50–$869.00	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV Hydrate Initial W/Min 31min-60 Min	$434.50	$869.00	$434.50–$869.00	—	50%
IV infusion of a medicine, first hour CPT 96365 HC ED Ivpb/Infusion Initial 16-60 Min	$434.50	$869.00	$434.50–$869.00	7% below	50%
IV infusion of a medicine, first hour CPT 96365 HC Obed Ivpb/Infusion Initial 16-60 Min	$434.50	$869.00	$434.50–$869.00	7% below	50%
IV infusion of a medicine, first hour CPT 96365 HC IV Infusion Initial W/Min 16 Min-60 Min	$434.50	$869.00	$434.50–$869.00	7% below	50%
IV infusion of a medicine, first hour inpatient CPT 96365 HC ED Ivpb/Infusion Initial 16-60 Min	$434.50	$869.00	$434.50–$869.00	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV Infusion Initial W/Min 16 Min-60 Min	$434.50	$869.00	$434.50–$869.00	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 HC Obed Ivpb/Infusion Initial 16-60 Min	$434.50	$869.00	$434.50–$869.00	—	50%
IV push of a medicine, first drug CPT 96374 HC Obed Non Chemo Ivp Single/Initial Drug	$230.50	$461.00	$230.50–$461.00	at median	50%
IV push of a medicine, first drug CPT 96374 HC Non Chemo Ivp Single/Ini Drug	$230.50	$461.00	$230.50–$461.00	at median	50%
IV push of a medicine, first drug CPT 96374 HC Gastrin Stimulation W Secretin	$230.50	$461.00	$230.50–$461.00	at median	50%
IV push of a medicine, first drug CPT 96374 HC ED Non Chemo Ivp Single/Initial Drug	$230.50	$461.00	$230.50–$461.00	at median	50%
IV push of a medicine, first drug inpatient CPT 96374 HC Non Chemo Ivp Single/Ini Drug	$230.50	$461.00	$230.50–$461.00	—	50%
IV push of a medicine, first drug inpatient CPT 96374 HC Gastrin Stimulation W Secretin	$230.50	$461.00	$230.50–$461.00	—	50%
IV push of a medicine, first drug inpatient CPT 96374 HC Obed Non Chemo Ivp Single/Initial Drug	$230.50	$461.00	$230.50–$461.00	—	50%
IV push of a medicine, first drug inpatient CPT 96374 HC ED Non Chemo Ivp Single/Initial Drug	$230.50	$461.00	$230.50–$461.00	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Non Chemo Sq Im Injection	$168.50	$337.00	$168.50–$337.00	11% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Obed Non Chemo Sq Im Injection	$168.50	$337.00	$168.50–$337.00	11% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Uc Non Chemo Sq Im Injection	$168.50	$337.00	$168.50–$337.00	11% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC ED Non Chemo Sq Im Injection	$168.50	$337.00	$168.50–$337.00	11% above	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Obed Non Chemo Sq Im Injection	$168.50	$337.00	$168.50–$337.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC ED Non Chemo Sq Im Injection	$168.50	$337.00	$168.50–$337.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Non Chemo Sq Im Injection	$168.50	$337.00	$168.50–$337.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Uc Non Chemo Sq Im Injection	$168.50	$337.00	$168.50–$337.00	—	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC Eval Psych OP	$197.00	$394.00	$197.00–$394.00	49% below	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC Eval Psych OP	$197.00	$394.00	$197.00–$394.00	—	50%
Neuromuscular re-education, 15 minutes CPT 97112 HC Neuromuscular	$112.00	$224.00	$112.00–$224.00	1% below	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Neuromuscular	$112.00	$224.00	$112.00–$224.00	—	50%
New patient office visit, about 30 minutes CPT 99203 HC Urgent Care New Level III	$211.00	$422.00	$211.00–$422.00	at median	50%
New patient office visit, about 30 minutes CPT 99203 HC Pt Visit New Level III	$211.00	$422.00	$211.00–$422.00	at median	50%
New patient office visit, about 30 minutes inpatient CPT 99203 HC Urgent Care New Level III	$211.00	$422.00	$211.00–$422.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 HC Pt Visit New Level III	$211.00	$422.00	$211.00–$422.00	—	50%
New patient office visit, about 45 minutes CPT 99204 HC Urgent Care New Level IV	$321.00	$642.00	$321.00–$642.00	at median	50%
New patient office visit, about 45 minutes CPT 99204 HC Pt Visit New Level IV	$321.00	$642.00	$321.00–$642.00	at median	50%
New patient office visit, about 45 minutes inpatient CPT 99204 HC Pt Visit New Level IV	$321.00	$642.00	$321.00–$642.00	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 HC Urgent Care New Level IV	$321.00	$642.00	$321.00–$642.00	—	50%
New patient office visit, about 60 minutes CPT 99205 HC Urgent Care New Level V	$367.50	$735.00	$367.50–$735.00	9% above	50%
New patient office visit, about 60 minutes CPT 99205 HC Pt Visit New Level V	$367.50	$735.00	$367.50–$735.00	9% above	50%
New patient office visit, about 60 minutes inpatient CPT 99205 HC Pt Visit New Level V	$367.50	$735.00	$367.50–$735.00	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 HC Urgent Care New Level V	$367.50	$735.00	$367.50–$735.00	—	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Pt Visit New Level II	$195.00	$390.00	$195.00–$390.00	14% above	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Urgent Care New Level II	$195.00	$390.00	$195.00–$390.00	14% above	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Pt Visit New Level II	$195.00	$390.00	$195.00–$390.00	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Urgent Care New Level II	$195.00	$390.00	$195.00–$390.00	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC Tele Med Nutrit Indiv Initial 15 Min	$58.50	$117.00	$58.50–$117.00	1% above	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC Med Nutrit Indiv Initial 15 Min	$58.50	$117.00	$58.50–$117.00	1% above	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC Tele Med Nutrit Indiv Initial 15 Min	$58.50	$117.00	$58.50–$117.00	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC Med Nutrit Indiv Initial 15 Min	$58.50	$117.00	$58.50–$117.00	—	50%
Occupational therapy evaluation, low complexity CPT 97165 HC Ot Eval Complexity	$445.50	$891.00	$445.50–$891.00	83% above	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Eval Complexity	$445.50	$891.00	$445.50–$891.00	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Eval Complexity High	$481.50	$963.00	$481.50–$963.00	58% above	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Eval Complexity High	$481.50	$963.00	$481.50–$963.00	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Eval Complexity Low	$445.50	$891.00	$445.50–$891.00	122% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Eval Complexity Low	$445.50	$891.00	$445.50–$891.00	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Eval Complexity Mod	$463.50	$927.00	$463.50–$927.00	84% above	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Eval Complexity Mod	$463.50	$927.00	$463.50–$927.00	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Manual Therapy	$112.00	$224.00	$112.00–$224.00	at median	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Manual Therapy	$112.00	$224.00	$112.00–$224.00	—	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Therapeutic Exercise Ea 15 Min	$112.00	$224.00	$112.00–$224.00	at median	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Therapeutic Rx Each 15 Min	$112.00	$224.00	$112.00–$224.00	at median	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Therapeutic Treatment	$112.00	$224.00	$112.00–$224.00	at median	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Therapeutic Exercise Ea 15 Min	$112.00	$224.00	$112.00–$224.00	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Therapeutic Treatment	$112.00	$224.00	$112.00–$224.00	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Therapeutic Rx Each 15 Min	$112.00	$224.00	$112.00–$224.00	—	50%
Psychiatric evaluation with medical services CPT 90792 HC Psych Diag Eval W/Med Srvcs	$253.50	$507.00	$253.50–$507.00	23% below	50%
Psychiatric evaluation with medical services inpatient CPT 90792 HC Psych Diag Eval W/Med Srvcs	$253.50	$507.00	$253.50–$507.00	—	50%
Psychotherapy session, 30 minutes CPT 90832 HC Psytx W Pt 30 Min	$156.00	$312.00	$156.00–$312.00	18% below	50%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC Psytx W Pt 30 Min	$156.00	$312.00	$156.00–$312.00	—	50%
Psychotherapy session, 60 minutes CPT 90837 HC Psytx W Pt 60 Minutes	$172.50	$345.00	$172.50–$345.00	37% below	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC Psytx W Pt 60 Minutes	$172.50	$345.00	$172.50–$345.00	—	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC Smoke Cessation 3-10 Min	$25.50	$51.00	$25.50–$51.00	42% below	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC Smoke Cessation 3-10 Min	$25.50	$51.00	$25.50–$51.00	—	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Urgent Care Est Level V	$367.50	$735.00	$367.50–$735.00	19% above	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Pt Visit Est Level V	$367.50	$735.00	$367.50–$735.00	19% above	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Pt Visit Est Level V	$367.50	$735.00	$367.50–$735.00	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Urgent Care Est Level V	$367.50	$735.00	$367.50–$735.00	—	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Urgent Care Est Level III	$211.00	$422.00	$211.00–$422.00	3% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Pt Visit Est Level III	$211.00	$422.00	$211.00–$422.00	3% above	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Pt Visit Est Level III	$211.00	$422.00	$211.00–$422.00	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Urgent Care Est Level III	$211.00	$422.00	$211.00–$422.00	—	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Pt Visit Est Level IV	$321.00	$642.00	$321.00–$642.00	50% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Urgent Care Est Level IV	$321.00	$642.00	$321.00–$642.00	50% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OP Newborn Exam	$321.00	$642.00	$321.00–$642.00	50% above	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OP Newborn Exam	$321.00	$642.00	$321.00–$642.00	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Urgent Care Est Level IV	$321.00	$642.00	$321.00–$642.00	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Pt Visit Est Level IV	$321.00	$642.00	$321.00–$642.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Urgent Care Est Level II	$195.00	$390.00	$195.00–$390.00	19% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Pt Visit Est Level II	$195.00	$390.00	$195.00–$390.00	19% above	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Urgent Care Est Level II	$195.00	$390.00	$195.00–$390.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Pt Visit Est Level II	$195.00	$390.00	$195.00–$390.00	—	50%
Speech and language evaluation CPT 92523 HC Speech Eval Sound Comp Express	$433.00	$866.00	$433.00–$866.00	2% above	50%
Speech and language evaluation inpatient CPT 92523 HC Speech Eval Sound Comp Express	$433.00	$866.00	$433.00–$866.00	—	50%
Speech therapy session, individual CPT 92507 HC Speech Treatment	$216.50	$433.00	$216.50–$433.00	at median	50%
Speech therapy session, individual inpatient CPT 92507 HC Speech Treatment	$216.50	$433.00	$216.50–$433.00	—	50%
Spirometry (breathing test) CPT 94010 HC Spirometry First Exam	$170.50	$341.00	$170.50–$341.00	52% below	50%
Spirometry (breathing test) CPT 94010 HC Spirometry Single	$176.00	$352.00	$176.00–$352.00	51% below	50%
Spirometry (breathing test) CPT 94010 HC Spirometry	$189.50	$379.00	$189.50–$379.00	47% below	50%
Spirometry (breathing test) inpatient CPT 94010 HC Spirometry First Exam	$170.50	$341.00	$170.50–$341.00	—	50%
Spirometry (breathing test) inpatient CPT 94010 HC Spirometry Single	$176.00	$352.00	$176.00–$352.00	—	50%
Spirometry (breathing test) inpatient CPT 94010 HC Spirometry	$189.50	$379.00	$189.50–$379.00	—	50%
Spirometry before and after a bronchodilator CPT 94060 HC Spirometry Pre/Post	$193.00	$386.00	$193.00–$386.00	68% below	50%
Spirometry before and after a bronchodilator CPT 94060 HC Spirometry Pre/Post Broncho	$525.50	$1,051.00	$525.50–$1,051.00	12% below	50%
Spirometry before and after a bronchodilator CPT 94060 HC Spirometry Pre/Post W/Mvv	$629.50	$1,259.00	$629.50–$1,259.00	6% above	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC Spirometry Pre/Post	$193.00	$386.00	$193.00–$386.00	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC Spirometry Pre/Post Broncho	$525.50	$1,051.00	$525.50–$1,051.00	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC Spirometry Pre/Post W/Mvv	$629.50	$1,259.00	$629.50–$1,259.00	—	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC Functional Training	$112.00	$224.00	$112.00–$224.00	at median	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Functional Training	$112.00	$224.00	$112.00–$224.00	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Therapeutic Phlebotomy	$134.00	$268.00	$134.00–$268.00	44% below	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC Therapeutic Phlebotomy	$134.00	$268.00	$134.00–$268.00	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 HC Iiv Adjuvant Vaccine Im	$159.00	$318.00	$159.00–$318.00	96% above	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLU VACC 2025-26(65YR UP)-MF59C(PF) 45 MCG(15 MCGX3)/0.5 ML IM SYRINGE	$159.00	$318.00	$159.00–$318.00	96% above	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLU VACC 2025-26(65YR UP)-MF59C(PF) 45 MCG(15 MCGX3)/0.5 ML IM SYRINGE	$159.00	$318.00	$159.00–$318.00	—	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 HC Iiv Adjuvant Vaccine Im	$159.00	$318.00	$159.00–$318.00	—	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC Vaccine Varicella	$339.00	$678.00	$339.00–$678.00	32% below	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$356.00	$712.00	$356.00–$712.00	28% below	50%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC Vaccine Varicella	$339.00	$678.00	$339.00–$678.00	—	50%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$356.00	$712.00	$356.00–$712.00	—	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC Vaccine Dtap < 7yrs	$55.75	$111.50	$55.75–$111.50	38% below	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC Vaccine Dtap < 7yrs	$55.75	$111.50	$55.75–$111.50	—	50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC Vaccine Pediarix	$175.25	$350.50	$175.25–$350.50	28% below	50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HC Vaccine Pediarix	$175.25	$350.50	$175.25–$350.50	—	50%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC Vaccine Pentacel	$206.12	$412.25	$206.13–$412.25	26% below	50%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 HC Vaccine Pentacel	$206.12	$412.25	$206.13–$412.25	—	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$41.50	$83.00	$41.50–$83.00	13% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACC TS2025-26 (36 MOS UP)(PF)45 MCG (15 MCG X3)/0.5 ML IM SYRINGE	$45.62	$91.25	$45.63–$91.25	4% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC Iiv3 Vacc No Prsv 0.5 Ml Im	$45.62	$91.25	$45.63–$91.25	4% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$41.50	$83.00	$41.50–$83.00	—	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC Iiv3 Vacc No Prsv 0.5 Ml Im	$45.62	$91.25	$45.63–$91.25	—	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACC TS2025-26 (36 MOS UP)(PF)45 MCG (15 MCG X3)/0.5 ML IM SYRINGE	$45.62	$91.25	$45.63–$91.25	—	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC Vaccine 9vhpv 2/3 Dose Sched Im Use	$570.87	$1,141.75	$570.88–$1,141.75	18% below	50%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC Vaccine 9vhpv 2/3 Dose Sched Im Use	$570.87	$1,141.75	$570.88–$1,141.75	—	50%
Hepatitis A vaccine, adult dose CPT 90632 HC Vaccine Hep a Adult	$148.12	$296.25	$148.13–$296.25	34% below	50%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE INJECTION WRAPPER	$165.25	$330.50	$165.25–$330.50	27% below	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC Vaccine Hep a Adult	$148.12	$296.25	$148.13–$296.25	—	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE INJECTION WRAPPER	$165.25	$330.50	$165.25–$330.50	—	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC Vaccine Hep a Child	$78.25	$156.50	$78.25–$156.50	17% below	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC Vaccine Hep a Child	$78.25	$156.50	$78.25–$156.50	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC Vaccine Hep B >20 Yrs Sgl Dose	$127.87	$255.75	$127.88–$255.75	29% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE	$138.37	$276.75	$138.38–$276.75	23% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC Vaccine Hep B >20 Yrs Sgl Dose	$127.87	$255.75	$127.88–$255.75	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE	$138.37	$276.75	$138.38–$276.75	—	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC Vaccine Hep B <20yrs 3 Dse Sch	$58.12	$116.25	$58.13–$116.25	39% below	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML INJECTION WRAPPER	$61.75	$123.50	$61.75–$123.50	35% below	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC Vaccine Hep B <20yrs 3 Dse Sch	$58.12	$116.25	$58.13–$116.25	—	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML INJECTION WRAPPER	$61.75	$123.50	$61.75–$123.50	—	50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HC Hib Prp-Omp Vacc 3 Dose Im	$62.75	$125.50	$62.75–$125.50	14% below	50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HC Hib Prp-Omp Vacc 3 Dose Im	$62.75	$125.50	$62.75–$125.50	—	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN	$27.75	$55.50	$27.75–$55.50	41% below	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN	$27.75	$55.50	$27.75–$55.50	—	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC Vaccine Mumps/Measles/Rubella	$173.00	$346.00	$173.00–$346.00	30% below	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$178.12	$356.25	$178.13–$356.25	28% below	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACC LIVE(PF)10EXP3.4-4.2-3.3CCID50/0.5ML SUBCUT	$178.12	$356.25	$178.13–$356.25	28% below	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC Vaccine Mumps/Measles/Rubella	$173.00	$346.00	$173.00–$346.00	—	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACC LIVE(PF)10EXP3.4-4.2-3.3CCID50/0.5ML SUBCUT	$178.12	$356.25	$178.13–$356.25	—	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$178.12	$356.25	$178.13–$356.25	—	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC Vaccine Meningococcal	$291.37	$582.75	$291.38–$582.75	18% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS)	$327.37	$654.75	$327.38–$654.75	8% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION	$327.37	$654.75	$327.38–$654.75	8% below	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC Vaccine Meningococcal	$291.37	$582.75	$291.38–$582.75	—	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION	$327.37	$654.75	$327.38–$654.75	—	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS)	$327.37	$654.75	$327.38–$654.75	—	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$466.12	$932.25	$466.13–$932.25	23% below	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$466.12	$932.25	$466.13–$932.25	—	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC Vaccine Pcv20 Im	$485.12	$970.25	$485.13–$970.25	14% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$572.75	$1,145.50	$572.75–$1,145.50	2% above	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HC Vaccine Pcv20 Im	$485.12	$970.25	$485.13–$970.25	—	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$572.75	$1,145.50	$572.75–$1,145.50	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC Vaccine Pneumovax23	$217.87	$435.75	$217.88–$435.75	14% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC Vaccine Pneumovax23	$217.87	$435.75	$217.88–$435.75	—	50%
Polio vaccine, inactivated (IPV) CPT 90713 HC Vaccine Polio	$87.50	$175.00	$87.50–$175.00	74% below	50%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC Vaccine Polio	$87.50	$175.00	$87.50–$175.00	—	50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 HC Rsv Vaccine Pref Subunit Bivalent for Im Use	$184.08	$368.16	$184.08–$368.16	71% below	50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 HC Rsv Vaccine Pref Subunit Bivalent for Im Use	$184.08	$368.16	$184.08–$368.16	—	50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$775.00	$1,550.00	$775.00–$1,550.00	25% below	50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$775.00	$1,550.00	$775.00–$1,550.00	—	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC Vaccine Rotarix	$182.50	$365.00	$182.50–$365.00	77% above	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC Vaccine Rotarix	$182.50	$365.00	$182.50–$365.00	—	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC Shingrix Zoster Vacc Recomb Im Njx	$341.25	$682.50	$341.25–$682.50	at median	50%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HC Shingrix Zoster Vacc Recomb Im Njx	$341.25	$682.50	$341.25–$682.50	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC Vaccine Tetanus/Dip Toxoid	$58.87	$117.75	$58.88–$117.75	52% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC Vaccine Tetanus/Dip Toxoid	$58.87	$117.75	$58.88–$117.75	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC Vaccine Tdap 7yrs and Up	$87.50	$175.00	$87.50–$175.00	43% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHERIA PERTUSSIS TETANUS VACCINE INJECTION WRAPPER	$89.12	$178.25	$89.13–$178.25	41% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC Vaccine Tdap 7yrs and Up	$87.50	$175.00	$87.50–$175.00	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTHERIA PERTUSSIS TETANUS VACCINE INJECTION WRAPPER	$89.12	$178.25	$89.13–$178.25	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Inj Admin Hep B	$55.00	$110.00	$55.00–$110.00	26% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Inj Admin Vaccine Pneumococcal	$55.00	$110.00	$55.00–$110.00	26% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Inj Admin Vaccine Flu	$55.00	$110.00	$55.00–$110.00	26% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Inj Admin Vaccine 1st Vaccine	$55.00	$110.00	$55.00–$110.00	26% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Immunization Admin Charge Others	$55.00	$110.00	$55.00–$110.00	26% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Inj Admin Vaccine Pneumococcal	$55.00	$110.00	$55.00–$110.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Inj Admin Hep B	$55.00	$110.00	$55.00–$110.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Inj Admin Vaccine Flu	$55.00	$110.00	$55.00–$110.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Inj Admin Vaccine 1st Vaccine	$55.00	$110.00	$55.00–$110.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Immunization Admin Charge Others	$55.00	$110.00	$55.00–$110.00	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Inj Admin Vaccine Ea Add Vacc	$55.00	$110.00	$55.00–$110.00	3% above	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Inj Admin Vaccine Ea Add Vacc	$55.00	$110.00	$55.00–$110.00	—	50%

Source file: http://www.methodisthealthsystem.org/sites/default/files/Price%20Transparency/750800661_MethodistLegacyERandUrgentCare_standardcharges.zip