Hospital Jackson, MS

Crossgates River Oaks Hospital

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

Crossgates River Oaks Hospital in Brandon, MS publishes cash prices for 244 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Mississippi median for 187 of 241 procedures and below it for 48. By typical cash price it ranks #32 of 36 Mississippi hospitals and #8 of 9 hospitals in the Jackson, MS area, cheapest first. Click a procedure to compare it with other hospitals nearby.

350 Crossgates Blvd, Brandon, MS 39042 Collected Sep 27, 2026 Source price file (601) 825-2811

Acute care hospital Emergency department CMS star rating 2 of 5 CCN 250096 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete Min 3 V Bilateral DR	$508.35	$3,389.00	$52.76–$3,389.00	—	85%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete Min 3 V Bilateral CR	$508.35	$3,389.00	$52.76–$3,389.00	—	85%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Right CR	$298.50	$1,990.00	$52.76–$1,990.00	147% above	85%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Left DR	$298.50	$1,990.00	$52.76–$1,990.00	147% above	85%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Right DR	$298.50	$1,990.00	$52.76–$1,990.00	147% above	85%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Left CR	$298.50	$1,990.00	$52.76–$1,990.00	147% above	85%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle Complete Min 3 V Bilateral DR	$1,186.15	$3,389.00	$376.18–$3,050.10	—	65%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle Complete Min 3 V Bilateral CR	$1,186.15	$3,389.00	$376.18–$3,050.10	—	65%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Right DR	$696.50	$1,990.00	$220.89–$1,791.00	—	65%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Right CR	$696.50	$1,990.00	$220.89–$1,791.00	—	65%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Left DR	$696.50	$1,990.00	$220.89–$1,791.00	—	65%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Left CR	$696.50	$1,990.00	$220.89–$1,791.00	—	65%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US LE Arterial Doppler Single Lvl Bilat	$1,262.70	$8,418.00	$98.23–$7,576.20	—	85%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US LE Arterial Doppler Single Lvl Bilat	$2,946.30	$8,418.00	$934.40–$7,576.20	—	65%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RF Esophagus Gastrografin	$382.65	$2,551.00	$130.18–$2,551.00	89% above	85%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RF Esophagus Barium	$382.65	$2,551.00	$130.18–$2,551.00	89% above	85%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RF Esophagus Gastrografin	$892.85	$2,551.00	$283.16–$2,295.90	—	65%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RF Esophagus Barium	$892.85	$2,551.00	$283.16–$2,295.90	—	65%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone and or Joint Whole Body Scan 1 - NM Bone	$756.90	$5,046.00	$306.21–$5,046.00	18% above	85%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone and or Joint Whole Body Scan 1 - NM Bone	$1,766.10	$5,046.00	$560.11–$4,541.40	—	65%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest for PE	$308.70	$2,058.00	$135.66–$2,058.00	73% below	85%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest	$308.70	$2,058.00	$135.66–$2,058.00	73% below	85%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest for PE	$720.30	$2,058.00	$228.44–$1,852.20	—	65%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest	$720.30	$2,058.00	$228.44–$1,852.20	—	65%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis WO	$373.05	$2,487.00	$184.20–$2,487.00	73% below	85%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis WO	$870.45	$2,487.00	$276.06–$2,238.30	—	65%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis W	$534.45	$3,563.00	$272.15–$3,563.00	69% below	85%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis W	$1,247.05	$3,563.00	$395.49–$3,206.70	—	65%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen Pelvis WWO	$534.45	$3,563.00	$272.15–$3,563.00	71% below	85%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen Pelvis WWO	$1,247.05	$3,563.00	$395.49–$3,206.70	—	65%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W	$1,547.25	$10,315.00	$135.66–$9,283.50	61% above	85%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W	$3,610.25	$10,315.00	$1,144.96–$9,283.50	—	65%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen WO	$1,387.05	$9,247.00	$81.04–$8,322.30	63% above	85%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen WO	$3,236.45	$9,247.00	$1,026.42–$8,322.30	—	65%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial WO	$850.80	$5,672.00	$81.04–$5,166.45	21% above	85%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus WO	$850.80	$5,672.00	$81.04–$5,166.45	21% above	85%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial WO	$1,985.20	$5,672.00	$629.59–$5,104.80	—	65%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus WO	$1,985.20	$5,672.00	$629.59–$5,104.80	—	65%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head Stroke Alert	$982.65	$6,551.00	$81.04–$5,895.90	31% above	85%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain WO	$982.65	$6,551.00	$81.04–$5,895.90	31% above	85%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain WO	$2,292.85	$6,551.00	$727.16–$5,895.90	—	65%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Stroke Alert	$2,292.85	$6,551.00	$727.16–$5,895.90	—	65%
CT scan of the head with contrast CPT 70460 CT Head or Brain W	$1,260.60	$8,404.00	$135.66–$7,563.60	39% above	85%
CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain W	$2,941.40	$8,404.00	$932.84–$7,563.60	—	65%
CT scan of the head without and with contrast CPT 70470 CT Head or Brain WWO	$1,321.50	$8,810.00	$135.66–$7,929.00	27% above	85%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain WWO	$3,083.50	$8,810.00	$977.91–$7,929.00	—	65%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar WO	$2,229.90	$14,866.00	$81.04–$13,379.40	151% above	85%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar WO	$5,203.10	$14,866.00	$1,650.13–$13,379.40	—	65%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical WO	$2,280.60	$15,204.00	$81.04–$13,683.60	157% above	85%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical WO	$5,321.40	$15,204.00	$1,687.64–$13,683.60	—	65%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W	$1,450.20	$9,668.00	$135.66–$8,701.20	49% above	85%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W	$3,383.80	$9,668.00	$1,073.15–$8,701.20	—	65%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral	$901.20	$6,008.00	$184.20–$5,407.20	—	85%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral	$2,102.80	$6,008.00	$666.89–$5,407.20	—	65%
Chest X-ray, 2 views CPT 71046 XR Chest 2 V DR	$266.55	$1,777.00	$43.81–$1,777.00	100% above	85%
Chest X-ray, 2 views CPT 71046 XR Chest 2 V CR	$266.55	$1,777.00	$43.81–$1,777.00	100% above	85%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 V DR	$621.95	$1,777.00	$197.25–$1,599.30	—	65%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 V CR	$621.95	$1,777.00	$197.25–$1,599.30	—	65%
Chest X-ray, single view CPT 71045 XR Chest 1 V Portable DR	$156.75	$1,045.00	$32.39–$1,045.00	48% above	85%
Chest X-ray, single view CPT 71045 XR Chest 1 V Frontal DR	$156.75	$1,045.00	$32.39–$1,045.00	48% above	85%
Chest X-ray, single view CPT 71045 XR Chest 1 V Frontal CR	$156.75	$1,045.00	$32.39–$1,045.00	48% above	85%
Chest X-ray, single view CPT 71045 XR Chest 1 V Portable CR	$156.75	$1,045.00	$32.39–$1,045.00	48% above	85%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Portable DR	$365.75	$1,045.00	$116.00–$940.50	—	65%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Portable CR	$365.75	$1,045.00	$116.00–$940.50	—	65%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Frontal DR	$365.75	$1,045.00	$116.00–$940.50	—	65%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Frontal CR	$365.75	$1,045.00	$116.00–$940.50	—	65%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete	$647.40	$4,316.00	$81.04–$4,316.00	90% above	85%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete	$1,510.60	$4,316.00	$479.08–$3,884.40	—	65%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Pregnancy Complete w Detail	$813.90	$5,426.00	$115.00–$5,166.45	74% above	85%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Pregnancy Complete w Detail	$1,899.10	$5,426.00	$602.29–$4,883.40	—	65%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest Diagnostic WO	$1,116.60	$7,444.00	$81.04–$6,699.60	33% above	85%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest Diagnostic WO	$2,605.40	$7,444.00	$826.28–$6,699.60	—	65%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest Diagnostic W	$1,234.20	$8,228.00	$135.66–$7,405.20	24% above	85%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest Diagnostic W	$2,879.80	$8,228.00	$913.31–$7,405.20	—	65%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Bypass Grafts Comp Bilat	$182.40	$1,216.00	$134.98–$1,216.00	—	85%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE Arterial Bypass Grafts Comp Bilat	$425.60	$1,216.00	$134.98–$1,094.40	—	65%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Duplex Bilateral	$710.55	$4,737.00	$184.20–$4,737.00	—	85%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Mapping Duplex Bilateral	$710.55	$4,737.00	$184.20–$4,737.00	—	85%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Mapping Duplex Bilateral	$710.55	$4,737.00	$184.20–$4,737.00	—	85%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Duplex Bilateral	$710.55	$4,737.00	$184.20–$4,737.00	—	85%
Duplex ultrasound of the leg veins, both legs CPT 93970 US Upper Extremity Veins Limited Bilater - US Uppe	$710.55	$4,737.00	$184.20–$4,737.00	39% above	85%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LE Venous Mapping Duplex Bilateral	$1,657.95	$4,737.00	$525.81–$4,263.30	—	65%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US UE Venous Duplex Bilateral	$1,657.95	$4,737.00	$525.81–$4,263.30	—	65%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US UE Venous Mapping Duplex Bilateral	$1,657.95	$4,737.00	$525.81–$4,263.30	—	65%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LE Venous Duplex Bilateral	$1,657.95	$4,737.00	$525.81–$4,263.30	—	65%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Upper Extremity Veins Limited Bilater - US Uppe	$1,657.95	$4,737.00	$525.81–$4,263.30	—	65%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Transthoracic Echo 2D Doppler Comp	$2,408.10	$16,054.00	$226.56–$14,448.60	154% above	85%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Transthoracic Echo 2D Doppler Comp	$5,618.90	$16,054.00	$1,781.99–$14,448.60	—	65%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary System Scan 1	$267.30	$1,782.00	$197.80–$1,782.00	59% below	85%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary System Scan 1	$623.70	$1,782.00	$197.80–$1,603.80	—	65%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 CHRG - SLEEP TITRATE UNATT	$151.35	$1,009.00	$43.76–$1,009.00	at median	85%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 CHRG - SLEEP TITRATE UNATT	$353.15	$1,009.00	$112.00–$908.10	—	65%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 CHRG - POLYS-CPAP GT4 GE6YO	$4,804.05	$32,027.00	$284.00–$28,824.30	225% above	85%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 CHRG - POLYS-CPAP GT4 GE6YO	$11,209.45	$32,027.00	$3,555.00–$28,824.30	—	65%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Left DR	$223.05	$1,487.00	$59.53–$1,487.00	86% above	85%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Right DR	$223.05	$1,487.00	$59.53–$1,487.00	86% above	85%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Left CR	$223.05	$1,487.00	$59.53–$1,487.00	86% above	85%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Right CR	$223.05	$1,487.00	$59.53–$1,487.00	86% above	85%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Right DR	$520.45	$1,487.00	$165.06–$1,338.30	—	65%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Left CR	$520.45	$1,487.00	$165.06–$1,338.30	—	65%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Left DR	$520.45	$1,487.00	$165.06–$1,338.30	—	65%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Right CR	$520.45	$1,487.00	$165.06–$1,338.30	—	65%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen	$440.10	$2,934.00	$81.04–$2,934.00	64% above	85%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver	$440.10	$2,934.00	$81.04–$2,934.00	64% above	85%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$440.10	$2,934.00	$81.04–$2,934.00	64% above	85%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas	$440.10	$2,934.00	$81.04–$2,934.00	64% above	85%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder	$440.10	$2,934.00	$81.04–$2,934.00	64% above	85%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder	$1,026.90	$2,934.00	$325.67–$2,640.60	—	65%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas	$1,026.90	$2,934.00	$325.67–$2,640.60	—	65%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver	$1,026.90	$2,934.00	$325.67–$2,640.60	—	65%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen	$1,026.90	$2,934.00	$325.67–$2,640.60	—	65%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$1,026.90	$2,934.00	$325.67–$2,640.60	—	65%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Low Dose Cancer Screening WO	$69.45	$463.00	$51.39–$463.00	7% below	85%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Low Dose Cancer Screening WO	$162.05	$463.00	$51.39–$416.70	—	65%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Hip Bilateral WO	$3,202.20	$21,348.00	$184.20–$19,213.20	—	85%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Ankle Bilateral WO	$3,202.20	$21,348.00	$184.20–$19,213.20	—	85%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Knee Bilateral WO	$3,202.20	$21,348.00	$184.20–$19,213.20	—	85%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Left WO	$404.25	$2,695.00	$184.20–$2,695.00	67% below	85%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Left WO	$404.25	$2,695.00	$184.20–$2,695.00	67% below	85%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Right WO	$404.25	$2,695.00	$184.20–$2,695.00	67% below	85%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Right WO	$404.25	$2,695.00	$184.20–$2,695.00	67% below	85%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Right WO	$404.25	$2,695.00	$184.20–$2,695.00	67% below	85%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Left WO	$404.25	$2,695.00	$184.20–$2,695.00	67% below	85%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Ankle Bilateral WO	$7,471.80	$21,348.00	$2,369.63–$19,213.20	—	65%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Hip Bilateral WO	$7,471.80	$21,348.00	$2,369.63–$19,213.20	—	65%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Knee Bilateral WO	$7,471.80	$21,348.00	$2,369.63–$19,213.20	—	65%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Right WO	$943.25	$2,695.00	$299.14–$2,425.50	—	65%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Right WO	$943.25	$2,695.00	$299.14–$2,425.50	—	65%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Left WO	$943.25	$2,695.00	$299.14–$2,425.50	—	65%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Right WO	$943.25	$2,695.00	$299.14–$2,425.50	—	65%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Left WO	$943.25	$2,695.00	$299.14–$2,425.50	—	65%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Left WO	$943.25	$2,695.00	$299.14–$2,425.50	—	65%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Right WWO	$839.40	$5,596.00	$272.15–$5,166.45	48% below	85%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Right WWO	$839.40	$5,596.00	$272.15–$5,166.45	48% below	85%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Left WWO	$839.40	$5,596.00	$272.15–$5,166.45	48% below	85%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Left WWO	$839.40	$5,596.00	$272.15–$5,166.45	48% below	85%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Right WWO	$839.40	$5,596.00	$272.15–$5,166.45	48% below	85%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Left WWO	$839.40	$5,596.00	$272.15–$5,166.45	48% below	85%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Left WWO	$1,958.60	$5,596.00	$621.16–$5,036.40	—	65%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Right WWO	$1,958.60	$5,596.00	$621.16–$5,036.40	—	65%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Right WWO	$1,958.60	$5,596.00	$621.16–$5,036.40	—	65%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Right WWO	$1,958.60	$5,596.00	$621.16–$5,036.40	—	65%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Left WWO	$1,958.60	$5,596.00	$621.16–$5,036.40	—	65%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Left WWO	$1,958.60	$5,596.00	$621.16–$5,036.40	—	65%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen WO	$1,365.15	$9,101.00	$184.20–$8,190.90	21% above	85%
MRI of the abdomen without contrast CPT 74181 MRI MRCP WO	$1,365.15	$9,101.00	$184.20–$8,190.90	21% above	85%
MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP WO	$3,185.35	$9,101.00	$1,010.21–$8,190.90	—	65%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen WO	$3,185.35	$9,101.00	$1,010.21–$8,190.90	—	65%
MRI of the abdomen, without and then with contrast dye CPT 74183 74183- MR Abdomen WWO	$1,428.75	$9,525.00	$272.15–$8,572.50	19% below	85%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen WWO	$1,428.75	$9,525.00	$272.15–$8,572.50	19% below	85%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 74183- MR Abdomen WWO	$3,333.75	$9,525.00	$1,057.28–$8,572.50	—	65%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen WWO	$3,333.75	$9,525.00	$1,057.28–$8,572.50	—	65%
MRI of the brain, no contrast dye CPT 70551 MRI Brain WO Stroke Alert	$1,891.50	$12,610.00	$184.20–$11,349.00	90% above	85%
MRI of the brain, no contrast dye CPT 70551 MRV Brain WO	$1,891.50	$12,610.00	$184.20–$11,349.00	90% above	85%
MRI of the brain, no contrast dye CPT 70551 MRI Brain WO	$1,891.50	$12,610.00	$184.20–$11,349.00	90% above	85%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO Stroke Alert	$4,413.50	$12,610.00	$1,399.71–$11,349.00	—	65%
MRI of the brain, no contrast dye inpatient CPT 70551 MRV Brain WO	$4,413.50	$12,610.00	$1,399.71–$11,349.00	—	65%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO	$4,413.50	$12,610.00	$1,399.71–$11,349.00	—	65%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain WWO	$3,871.35	$25,809.00	$272.15–$23,228.10	99% above	85%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain WWO	$9,033.15	$25,809.00	$2,864.80–$23,228.10	—	65%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar WO	$1,734.30	$11,562.00	$184.20–$10,405.80	46% above	85%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar WO	$4,046.70	$11,562.00	$1,283.38–$10,405.80	—	65%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar WWO	$2,414.40	$16,096.00	$272.15–$14,486.40	18% above	85%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar WWO	$5,633.60	$16,096.00	$1,786.66–$14,486.40	—	65%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic WO	$2,016.60	$13,444.00	$184.20–$12,099.60	64% above	85%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic WO	$4,705.40	$13,444.00	$1,492.28–$12,099.60	—	65%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical WWO	$3,295.05	$21,967.00	$272.15–$19,770.30	70% above	85%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical WWO	$7,688.45	$21,967.00	$2,438.34–$19,770.30	—	65%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical WO	$1,523.85	$10,159.00	$184.20–$9,143.10	36% above	85%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical WO	$3,555.65	$10,159.00	$1,127.65–$9,143.10	—	65%
MRI of the pelvis without and with contrast CPT 72197 72197- MR Pelvis WWO	$1,722.75	$11,485.00	$272.15–$10,336.50	at median	85%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis WWO	$1,722.75	$11,485.00	$272.15–$10,336.50	at median	85%
MRI of the pelvis without and with contrast inpatient CPT 72197 72197- MR Pelvis WWO	$4,019.75	$11,485.00	$1,274.84–$10,336.50	—	65%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis WWO	$4,019.75	$11,485.00	$1,274.84–$10,336.50	—	65%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis WO	$1,303.35	$8,689.00	$184.20–$7,820.10	20% above	85%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis WO	$3,041.15	$8,689.00	$964.48–$7,820.10	—	65%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Wrist Bilateral WO	$2,496.45	$16,643.00	$184.20–$14,978.70	—	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Shoulder Bilateral WO	$2,496.45	$16,643.00	$184.20–$14,978.70	—	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Elbow Bilateral WO	$2,496.45	$16,643.00	$184.20–$14,978.70	—	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist Right WO	$468.15	$3,121.00	$184.20–$3,121.00	58% below	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder Right WO	$468.15	$3,121.00	$184.20–$3,121.00	58% below	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder Left WO	$468.15	$3,121.00	$184.20–$3,121.00	58% below	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow Right WO	$468.15	$3,121.00	$184.20–$3,121.00	58% below	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow Left WO	$468.15	$3,121.00	$184.20–$3,121.00	58% below	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist Left WO	$468.15	$3,121.00	$184.20–$3,121.00	58% below	85%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Shoulder Bilateral WO	$5,825.05	$16,643.00	$1,847.37–$14,978.70	—	65%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Wrist Bilateral WO	$5,825.05	$16,643.00	$1,847.37–$14,978.70	—	65%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Elbow Bilateral WO	$5,825.05	$16,643.00	$1,847.37–$14,978.70	—	65%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow Right WO	$1,092.35	$3,121.00	$346.43–$2,808.90	—	65%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow Left WO	$1,092.35	$3,121.00	$346.43–$2,808.90	—	65%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder Left WO	$1,092.35	$3,121.00	$346.43–$2,808.90	—	65%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder Right WO	$1,092.35	$3,121.00	$346.43–$2,808.90	—	65%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist Left WO	$1,092.35	$3,121.00	$346.43–$2,808.90	—	65%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist Right WO	$1,092.35	$3,121.00	$346.43–$2,808.90	—	65%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Stress Multi 1	$2,155.65	$14,371.00	$720.72–$12,933.90	11% above	85%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion RestStr Mult Sc1 - NM Myoc	$2,155.65	$14,371.00	$720.72–$12,933.90	11% above	85%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Rest Multi 1	$2,155.65	$14,371.00	$720.72–$12,933.90	11% above	85%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Stress Multi 1	$5,029.85	$14,371.00	$1,595.18–$12,933.90	—	65%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Rest Multi 1	$5,029.85	$14,371.00	$1,595.18–$12,933.90	—	65%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion RestStr Mult Sc1 - NM Myoc	$5,029.85	$14,371.00	$1,595.18–$12,933.90	—	65%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non OB FU	$450.30	$3,002.00	$45.08–$3,002.00	116% above	85%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non OB FU	$1,050.70	$3,002.00	$333.22–$2,701.80	—	65%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non OB Complete	$557.10	$3,714.00	$81.04–$3,714.00	108% above	85%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 76856 US-PELVIS NON OB	$557.10	$3,714.00	$81.04–$3,714.00	108% above	85%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non OB Complete	$1,299.90	$3,714.00	$412.25–$3,342.60	—	65%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 76856 US-PELVIS NON OB	$1,299.90	$3,714.00	$412.25–$3,342.60	—	65%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnancy After 1st Trimester Transabdominal	$396.15	$2,641.00	$81.04–$2,641.00	15% above	85%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Pregnancy After 1st Trimester Transabdominal	$924.35	$2,641.00	$293.15–$2,376.90	—	65%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnancy 1st Trimester Transabdominal	$589.20	$3,928.00	$81.04–$3,928.00	97% above	85%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pregnancy 1st Trimester Transabdominal	$1,374.80	$3,928.00	$436.01–$3,535.20	—	65%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited	$231.00	$1,540.00	$81.04–$1,540.00	15% above	85%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited	$539.00	$1,540.00	$170.94–$1,386.00	—	65%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Comp Min 2 V Bilateral CR	$563.70	$3,758.00	$44.93–$3,758.00	—	85%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Comp Min 2 V Bilateral DR	$563.70	$3,758.00	$44.93–$3,758.00	—	85%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Left CR	$269.70	$1,798.00	$44.93–$1,798.00	114% above	85%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Right CR	$269.70	$1,798.00	$44.93–$1,798.00	114% above	85%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Right DR	$269.70	$1,798.00	$44.93–$1,798.00	114% above	85%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Left DR	$269.70	$1,798.00	$44.93–$1,798.00	114% above	85%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Comp Min 2 V Bilateral DR	$1,315.30	$3,758.00	$417.14–$3,382.20	—	65%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Comp Min 2 V Bilateral CR	$1,315.30	$3,758.00	$417.14–$3,382.20	—	65%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Left DR	$629.30	$1,798.00	$199.58–$1,618.20	—	65%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Right DR	$629.30	$1,798.00	$199.58–$1,618.20	—	65%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Right CR	$629.30	$1,798.00	$199.58–$1,618.20	—	65%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Left CR	$629.30	$1,798.00	$199.58–$1,618.20	—	65%
Sleep study in a lab (polysomnography) CPT 95810 CHRG - POLYSOMNO GT4 GE6YO	$4,035.75	$26,905.00	$284.00–$24,214.50	215% above	85%
Sleep study in a lab (polysomnography) inpatient CPT 95810 CHRG - POLYSOMNO GT4 GE6YO	$9,416.75	$26,905.00	$2,986.46–$24,214.50	—	65%
Swallow study (modified barium swallow, video X-ray) CPT 74230 RF Modified Barium Swallow	$294.15	$1,961.00	$135.66–$1,961.00	26% above	85%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RF Modified Barium Swallow	$686.35	$1,961.00	$217.67–$1,764.90	—	65%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB	$450.60	$3,004.00	$81.04–$3,004.00	50% above	85%
Transvaginal pelvic ultrasound CPT 76830 76830 US-TRANSVAGINAL	$450.60	$3,004.00	$81.04–$3,004.00	50% above	85%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB	$1,051.40	$3,004.00	$333.44–$2,703.60	—	65%
Transvaginal pelvic ultrasound inpatient CPT 76830 76830 US-TRANSVAGINAL	$1,051.40	$3,004.00	$333.44–$2,703.60	—	65%
Transvaginal ultrasound during pregnancy CPT 76817 US Pregnancy Transvaginal	$496.05	$3,307.00	$81.04–$3,307.00	70% above	85%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pregnancy Transvaginal	$1,157.45	$3,307.00	$367.08–$2,976.30	—	65%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$711.90	$4,746.00	$81.04–$4,746.00	98% above	85%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$1,661.10	$4,746.00	$526.81–$4,271.40	—	65%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum Contents	$434.10	$2,894.00	$81.04–$2,894.00	62% above	85%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum Contents	$1,012.90	$2,894.00	$321.23–$2,604.60	—	65%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head Neck Soft Tissue	$544.05	$3,627.00	$81.04–$3,627.00	103% above	85%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$544.05	$3,627.00	$81.04–$3,627.00	103% above	85%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$1,269.45	$3,627.00	$402.60–$3,264.30	—	65%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head Neck Soft Tissue	$1,269.45	$3,627.00	$402.60–$3,264.30	—	65%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI w or wo KUB Gastrografin	$655.20	$4,368.00	$135.66–$4,368.00	129% above	85%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI w or wo KUB Barium	$655.20	$4,368.00	$135.66–$4,368.00	129% above	85%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 74240 FL-UPPER GI SINGLE	$655.20	$4,368.00	$135.66–$4,368.00	129% above	85%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI w or wo KUB Gastrografin	$1,528.80	$4,368.00	$484.85–$3,931.20	—	65%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI w or wo KUB Barium	$1,528.80	$4,368.00	$484.85–$3,931.20	—	65%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 74240 FL-UPPER GI SINGLE	$1,528.80	$4,368.00	$484.85–$3,931.20	—	65%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$149.36	$995.76	$81.04–$995.76	49% below	85%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Right	$442.95	$2,953.00	$81.04–$2,953.00	52% above	85%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Left	$442.95	$2,953.00	$81.04–$2,953.00	52% above	85%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Left	$442.95	$2,953.00	$81.04–$2,953.00	52% above	85%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Right	$442.95	$2,953.00	$81.04–$2,953.00	52% above	85%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Left	$1,033.55	$2,953.00	$327.78–$2,657.70	—	65%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Left	$1,033.55	$2,953.00	$327.78–$2,657.70	—	65%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Right	$1,033.55	$2,953.00	$327.78–$2,657.70	—	65%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Right	$1,033.55	$2,953.00	$327.78–$2,657.70	—	65%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete Min 3 V Bilateral CR	$277.05	$1,847.00	$59.34–$1,847.00	—	85%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete Min 3 V Bilateral DR	$470.55	$3,137.00	$59.34–$3,137.00	—	85%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Right DR	$277.05	$1,847.00	$59.34–$1,847.00	129% above	85%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Right CR	$277.05	$1,847.00	$59.34–$1,847.00	129% above	85%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Left DR	$277.05	$1,847.00	$59.34–$1,847.00	129% above	85%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Left CR	$277.05	$1,847.00	$59.34–$1,847.00	129% above	85%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete Min 3 V Bilateral CR	$646.45	$1,847.00	$205.02–$1,662.30	—	65%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete Min 3 V Bilateral DR	$1,097.95	$3,137.00	$348.21–$2,823.30	—	65%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Left CR	$646.45	$1,847.00	$205.02–$1,662.30	—	65%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Right CR	$646.45	$1,847.00	$205.02–$1,662.30	—	65%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Left DR	$646.45	$1,847.00	$205.02–$1,662.30	—	65%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Right DR	$646.45	$1,847.00	$205.02–$1,662.30	—	65%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left w Pelvis 2 or 3 Views DR	$149.85	$999.00	$67.09–$999.00	21% above	85%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left w Pelvis 2 or 3 Views CR	$149.85	$999.00	$67.09–$999.00	21% above	85%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right w Pelvis 2 or 3 Views DR	$149.85	$999.00	$67.09–$999.00	21% above	85%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left 2 or 3 Views DR	$149.85	$999.00	$67.09–$999.00	21% above	85%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left 2 or 3 Views CR	$149.85	$999.00	$67.09–$999.00	21% above	85%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right w Pelvis 2 or 3 Views CR	$149.85	$999.00	$67.09–$999.00	21% above	85%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right 2 or 3 Views DR	$149.85	$999.00	$67.09–$999.00	21% above	85%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right 2 or 3 Views CR	$149.85	$999.00	$67.09–$999.00	21% above	85%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right 2 or 3 Views CR	$349.65	$999.00	$110.89–$899.10	—	65%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left w Pelvis 2 or 3 Views CR	$349.65	$999.00	$110.89–$899.10	—	65%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right w Pelvis 2 or 3 Views CR	$349.65	$999.00	$110.89–$899.10	—	65%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right w Pelvis 2 or 3 Views DR	$349.65	$999.00	$110.89–$899.10	—	65%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left 2 or 3 Views CR	$349.65	$999.00	$110.89–$899.10	—	65%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left 2 or 3 Views DR	$349.65	$999.00	$110.89–$899.10	—	65%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left w Pelvis 2 or 3 Views DR	$349.65	$999.00	$110.89–$899.10	—	65%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right 2 or 3 Views DR	$349.65	$999.00	$110.89–$899.10	—	65%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP KUB CR	$170.55	$1,137.00	$40.64–$1,137.00	44% above	85%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP KUB DR	$170.55	$1,137.00	$40.64–$1,137.00	44% above	85%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen AP KUB CR	$397.95	$1,137.00	$126.21–$1,023.30	—	65%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen AP KUB DR	$397.95	$1,137.00	$126.21–$1,023.30	—	65%
X-ray of the ankle, 2 views both sides CPT 73600 XR Ankle 2 V Bilateral DR	$467.25	$3,115.00	$45.72–$3,115.00	—	85%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Left CR	$274.20	$1,828.00	$45.72–$1,828.00	195% above	85%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Left DR	$274.20	$1,828.00	$45.72–$1,828.00	195% above	85%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Right CR	$274.20	$1,828.00	$45.72–$1,828.00	195% above	85%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Right DR	$274.20	$1,828.00	$45.72–$1,828.00	195% above	85%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR Ankle 2 V Bilateral DR	$1,090.25	$3,115.00	$345.76–$2,803.50	—	65%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Left CR	$639.80	$1,828.00	$202.91–$1,645.20	—	65%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Left DR	$639.80	$1,828.00	$202.91–$1,645.20	—	65%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Right CR	$639.80	$1,828.00	$202.91–$1,645.20	—	65%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Right DR	$639.80	$1,828.00	$202.91–$1,645.20	—	65%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Left DR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Left CR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Left CR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Right DR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Right CR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Right DR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Left DR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Right CR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Right CR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Left CR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Right DR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Left DR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Left DR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Left CR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Right CR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Right DR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Right CR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Left CR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Left DR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Right DR	$140.70	$938.00	$56.68–$938.00	33% above	85%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Left DR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Right CR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Left DR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Left CR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Right DR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Right CR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Left DR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Left CR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Left CR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Right DR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Left DR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Right CR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Right CR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Right DR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Left CR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Left DR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Right DR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Right CR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Right DR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Left CR	$328.30	$938.00	$104.12–$844.20	—	65%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Right DR	$198.30	$1,322.00	$39.37–$1,322.00	89% above	85%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Right CR	$198.30	$1,322.00	$39.37–$1,322.00	89% above	85%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Left CR	$198.30	$1,322.00	$39.37–$1,322.00	89% above	85%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Left DR	$198.30	$1,322.00	$39.37–$1,322.00	89% above	85%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Left CR	$462.70	$1,322.00	$146.74–$1,189.80	—	65%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Right CR	$462.70	$1,322.00	$146.74–$1,189.80	—	65%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Right DR	$462.70	$1,322.00	$146.74–$1,189.80	—	65%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Left DR	$462.70	$1,322.00	$146.74–$1,189.80	—	65%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot Complete Min 3 V Bilateral CR	$475.35	$3,169.00	$49.02–$3,169.00	—	85%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot Complete Min 3 V Bilateral DR	$475.35	$3,169.00	$49.02–$3,169.00	—	85%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Left DR	$279.00	$1,860.00	$49.02–$1,860.00	138% above	85%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Right DR	$279.00	$1,860.00	$49.02–$1,860.00	138% above	85%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Right CR	$279.00	$1,860.00	$49.02–$1,860.00	138% above	85%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Left CR	$279.00	$1,860.00	$49.02–$1,860.00	138% above	85%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR Foot Complete Min 3 V Bilateral DR	$1,109.15	$3,169.00	$351.76–$2,852.10	—	65%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR Foot Complete Min 3 V Bilateral CR	$1,109.15	$3,169.00	$351.76–$2,852.10	—	65%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Left DR	$651.00	$1,860.00	$206.46–$1,674.00	—	65%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Left CR	$651.00	$1,860.00	$206.46–$1,674.00	—	65%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Right CR	$651.00	$1,860.00	$206.46–$1,674.00	—	65%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Right DR	$651.00	$1,860.00	$206.46–$1,674.00	—	65%
X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete Min 3 V Bilateral CR	$431.70	$2,878.00	$52.76–$2,878.00	—	85%
X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete Min 3 V Bilateral DR	$431.70	$2,878.00	$52.76–$2,878.00	—	85%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Left CR	$253.50	$1,690.00	$52.76–$1,690.00	107% above	85%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Right CR	$253.50	$1,690.00	$52.76–$1,690.00	107% above	85%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Right DR	$253.50	$1,690.00	$52.76–$1,690.00	107% above	85%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Left DR	$253.50	$1,690.00	$52.76–$1,690.00	107% above	85%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete Min 3 V Bilateral CR	$1,007.30	$2,878.00	$319.46–$2,590.20	—	65%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete Min 3 V Bilateral DR	$1,007.30	$2,878.00	$319.46–$2,590.20	—	65%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Right DR	$591.50	$1,690.00	$187.59–$1,521.00	—	65%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Right CR	$591.50	$1,690.00	$187.59–$1,521.00	—	65%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Left DR	$591.50	$1,690.00	$187.59–$1,521.00	—	65%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Left CR	$591.50	$1,690.00	$187.59–$1,521.00	—	65%
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 V Bilateral CR	$379.65	$2,531.00	$49.53–$2,531.00	—	85%
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 V Bilateral DR	$379.65	$2,531.00	$49.53–$2,531.00	—	85%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Left DR	$222.90	$1,486.00	$49.53–$1,486.00	84% above	85%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Right DR	$222.90	$1,486.00	$49.53–$1,486.00	84% above	85%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Left CR	$222.90	$1,486.00	$49.53–$1,486.00	84% above	85%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Right CR	$222.90	$1,486.00	$49.53–$1,486.00	84% above	85%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 V Bilateral CR	$885.85	$2,531.00	$280.94–$2,277.90	—	65%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 V Bilateral DR	$885.85	$2,531.00	$280.94–$2,277.90	—	65%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Left CR	$520.10	$1,486.00	$164.95–$1,337.40	—	65%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Right DR	$520.10	$1,486.00	$164.95–$1,337.40	—	65%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Right CR	$520.10	$1,486.00	$164.95–$1,337.40	—	65%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Left DR	$520.10	$1,486.00	$164.95–$1,337.40	—	65%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 V DR	$288.75	$1,925.00	$54.90–$1,925.00	119% above	85%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 V CR	$288.75	$1,925.00	$54.90–$1,925.00	119% above	85%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 V CR	$673.75	$1,925.00	$213.68–$1,732.50	—	65%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 V DR	$673.75	$1,925.00	$213.68–$1,732.50	—	65%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 V DR	$508.35	$3,389.00	$68.58–$3,389.00	176% above	85%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 V DR	$1,186.15	$3,389.00	$376.18–$3,050.10	—	65%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 V CR	$230.85	$1,539.00	$41.91–$1,539.00	86% above	85%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 V DR	$230.85	$1,539.00	$41.91–$1,539.00	86% above	85%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 V DR	$538.65	$1,539.00	$170.83–$1,385.10	—	65%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 V CR	$538.65	$1,539.00	$170.83–$1,385.10	—	65%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Comp Minimum 3 V DR	$264.75	$1,765.00	$54.96–$1,765.00	100% above	85%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Comp Minimum 3 V DR	$617.75	$1,765.00	$195.92–$1,588.50	—	65%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 V DR	$330.90	$2,206.00	$54.61–$2,206.00	151% above	85%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 V CR	$330.90	$2,206.00	$54.61–$2,206.00	151% above	85%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 V CR	$772.10	$2,206.00	$244.87–$1,985.40	—	65%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 V DR	$772.10	$2,206.00	$244.87–$1,985.40	—	65%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 V DR	$193.35	$1,289.00	$43.18–$1,289.00	56% above	85%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 V CR	$193.35	$1,289.00	$43.18–$1,289.00	56% above	85%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 V DR	$451.15	$1,289.00	$143.08–$1,160.10	—	65%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 V CR	$451.15	$1,289.00	$143.08–$1,160.10	—	65%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum Coccyx Minimum 2 V DR	$256.05	$1,707.00	$45.72–$1,707.00	108% above	85%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum Coccyx Minimum 2 V CR	$256.05	$1,707.00	$45.72–$1,707.00	108% above	85%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum Coccyx Minimum 2 V CR	$597.45	$1,707.00	$189.48–$1,536.30	—	65%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum Coccyx Minimum 2 V DR	$597.45	$1,707.00	$189.48–$1,536.30	—	65%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase Body Fluid	$81.15	$541.00	$4.77–$541.00	115% above	85%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase	$81.15	$541.00	$4.77–$541.00	115% above	85%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase	$189.35	$541.00	$60.05–$486.90	—	65%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase Body Fluid	$189.35	$541.00	$60.05–$486.90	—	65%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase	$81.15	$541.00	$4.66–$541.00	121% above	85%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase	$189.35	$541.00	$60.05–$486.90	—	65%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute	$354.75	$2,365.00	$42.87–$2,365.00	127% above	85%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel Acute	$827.75	$2,365.00	$262.52–$2,128.50	—	65%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab IgG IgA (LC)	$34.65	$231.00	$11.66–$231.00	25% below	85%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab IgG IgA (LC)	$80.85	$231.00	$25.64–$207.90	—	65%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex if Positive (LC)	$115.65	$771.00	$10.88–$771.00	60% above	85%
Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 L52373 ANA	$115.65	$771.00	$10.88–$771.00	60% above	85%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Anti Nuclear Antibody IFA (LC)	$115.65	$771.00	$10.88–$771.00	60% above	85%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex if Positive (LC)	$269.85	$771.00	$85.58–$693.90	—	65%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86038 L52373 ANA	$269.85	$771.00	$85.58–$693.90	—	65%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Anti Nuclear Antibody IFA (LC)	$269.85	$771.00	$85.58–$693.90	—	65%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide	$161.40	$1,076.00	$35.33–$1,076.00	16% above	85%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide Prohormone	$161.40	$1,076.00	$35.33–$1,076.00	16% above	85%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptide	$376.60	$1,076.00	$119.44–$968.40	—	65%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptide Prohormone	$376.60	$1,076.00	$119.44–$968.40	—	65%
Basic metabolic panel (blood test) CPT 80048 BMPWTCA	$87.90	$586.00	$7.61–$586.00	19% above	85%
Basic metabolic panel (blood test) inpatient CPT 80048 BMPWTCA	$205.10	$586.00	$65.05–$527.40	—	65%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 $APRL 88305 Bill Surg Path Gross Lvl4	$385.80	$2,572.00	$29.46–$2,572.00	487% above	85%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 $APRL 88305 Bill Surg Path Gross Lvl4	$900.20	$2,572.00	$285.49–$2,314.80	—	65%
Blood culture for bacteria CPT 87040 Blood Culture	$94.35	$629.00	$9.29–$629.00	7% above	85%
Blood culture for bacteria inpatient CPT 87040 Blood Culture	$220.15	$629.00	$69.82–$566.10	—	65%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Chg	$24.30	$162.00	$2.70–$162.00	156% above	85%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Chg BCE	$24.30	$162.00	$2.70–$162.00	156% above	85%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 $ Contract Collection Charge Blood	$3.50	$10.00	$1.11–$9.00	—	65%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Chg BCE	$56.70	$162.00	$17.98–$145.80	—	65%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Chg	$56.70	$162.00	$17.98–$145.80	—	65%
Blood glucose (sugar) test CPT 82947 .Glucose POC	$57.90	$386.00	$3.54–$386.00	80% above	85%
Blood glucose (sugar) test CPT 82947 .Glucose Fasting	$57.90	$386.00	$3.54–$386.00	80% above	85%
Blood glucose (sugar) test CPT 82947 Glucose Level	$57.90	$386.00	$3.54–$386.00	80% above	85%
Blood glucose (sugar) test inpatient CPT 82947 .Glucose Fasting	$135.10	$386.00	$42.85–$347.40	—	65%
Blood glucose (sugar) test inpatient CPT 82947 .Glucose POC	$135.10	$386.00	$42.85–$347.40	—	65%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$135.10	$386.00	$42.85–$347.40	—	65%
Blood lead test CPT 83655 Lead Blood Adult (LC)	$5.30	$35.31	$3.92–$35.31	89% below	85%
Blood lead test CPT 83655 Lead Blood Pediatric (LC)	$5.30	$35.31	$3.92–$35.31	89% below	85%
Blood lead test CPT 83655 83655 L7046 LEAD	$35.10	$234.00	$10.90–$234.00	30% below	85%
Blood lead test inpatient CPT 83655 Lead Blood Adult (LC)	$12.36	$35.31	$3.92–$31.78	—	65%
Blood lead test inpatient CPT 83655 Lead Blood Pediatric (LC)	$12.36	$35.31	$3.92–$31.78	—	65%
Blood lead test inpatient CPT 83655 83655 L7046 LEAD	$81.90	$234.00	$25.97–$210.60	—	65%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 hCG Qual, Urine CQ	$165.15	$1,101.00	$6.77–$1,101.00	244% above	85%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCGQLS	$165.15	$1,101.00	$6.77–$1,101.00	244% above	85%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 hCG Qual, Urine CQ	$385.35	$1,101.00	$122.21–$990.90	—	65%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCGQLS	$385.35	$1,101.00	$122.21–$990.90	—	65%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO	$58.65	$391.00	$2.69–$391.00	25% above	85%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 86900 BLOOD TYPING ABO	$58.65	$391.00	$2.69–$391.00	25% above	85%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill MBS 86900/86901 ABO/Rh	$58.65	$391.00	$2.69–$391.00	25% above	85%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO Forward	$58.65	$391.00	$2.69–$391.00	25% above	85%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO Reverse	$58.65	$391.00	$2.69–$391.00	25% above	85%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill MBS 86900/86901 ABO/Rh	$136.85	$391.00	$43.40–$351.90	—	65%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO	$136.85	$391.00	$43.40–$351.90	—	65%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO Reverse	$136.85	$391.00	$43.40–$351.90	—	65%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 86900 BLOOD TYPING ABO	$136.85	$391.00	$43.40–$351.90	—	65%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO Forward	$136.85	$391.00	$43.40–$351.90	—	65%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein	$71.70	$478.00	$4.66–$478.00	115% above	85%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein Quant (LC)	$71.70	$478.00	$4.66–$478.00	115% above	85%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein Quant (LC)	$167.30	$478.00	$53.06–$430.20	—	65%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein	$167.30	$478.00	$53.06–$430.20	—	65%
C. difficile toxin gene test (stool PCR) CPT 87493 C difficile NAA w/reflex Toxin Confirmation	$43.50	$290.00	$32.19–$290.00	42% below	85%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLI PROBE - BCE	$43.50	$290.00	$32.19–$290.00	42% below	85%
C. difficile toxin gene test (stool PCR) CPT 87493 C diff AB PCR	$43.50	$290.00	$32.19–$290.00	42% below	85%
C. difficile toxin gene test (stool PCR) CPT 87493 C difficile PCR w/reflex Toxin Confirmation	$43.50	$290.00	$32.19–$290.00	42% below	85%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C diff AB PCR	$101.50	$290.00	$32.19–$261.00	—	65%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLI PROBE - BCE	$101.50	$290.00	$32.19–$261.00	—	65%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile PCR w/reflex Toxin Confirmation	$101.50	$290.00	$32.19–$261.00	—	65%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile NAA w/reflex Toxin Confirmation	$101.50	$290.00	$32.19–$261.00	—	65%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 LC	$161.25	$1,075.00	$18.73–$1,075.00	90% above	85%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 LC	$376.25	$1,075.00	$119.32–$967.50	—	65%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 LC	$221.70	$1,478.00	$18.73–$1,478.00	101% above	85%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125 LC	$517.30	$1,478.00	$164.06–$1,330.20	—	65%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 PCR	$25.65	$171.00	$18.98–$171.00	59% below	85%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 NAA (LC)	$33.75	$225.00	$24.98–$225.00	46% below	85%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 PCR	$59.85	$171.00	$18.98–$153.90	—	65%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 NAA (LC)	$78.75	$225.00	$24.98–$202.50	—	65%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 L183160 C TRACH AMP	$54.00	$360.00	$31.58–$360.00	30% below	85%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 L183194CHLMYD TRACH	$54.00	$360.00	$31.58–$360.00	30% below	85%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 L183160 C TRACH AMP	$126.00	$360.00	$39.96–$324.00	—	65%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 L183194CHLMYD TRACH	$126.00	$360.00	$39.96–$324.00	—	65%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID	$258.90	$1,726.00	$12.05–$1,726.00	250% above	85%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID	$604.10	$1,726.00	$191.59–$1,553.40	—	65%
Complete blood count (CBC) with differential CPT 85025 CBCADIFF	$86.40	$576.00	$6.99–$576.00	108% above	85%
Complete blood count (CBC) with differential inpatient CPT 85025 CBCADIFF	$201.60	$576.00	$63.94–$518.40	—	65%
Complete blood count (CBC), no differential CPT 85027 CBC	$82.20	$548.00	$5.82–$548.00	133% above	85%
Complete blood count (CBC), no differential CPT 85027 85027 CBC W-PLT	$82.20	$548.00	$5.82–$548.00	133% above	85%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC	$191.80	$548.00	$60.83–$493.20	—	65%
Complete blood count (CBC), no differential inpatient CPT 85027 85027 CBC W-PLT	$191.80	$548.00	$60.83–$493.20	—	65%
Comprehensive metabolic panel (blood test) CPT 80053 CMP	$190.05	$1,267.00	$9.50–$1,267.00	81% above	85%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP	$443.45	$1,267.00	$140.64–$1,140.30	—	65%
D-dimer blood test (blood clot marker) CPT 85379 D Dimer Quant	$87.60	$584.00	$9.16–$584.00	13% above	85%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer Quant	$204.40	$584.00	$64.82–$525.60	—	65%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate (LC)	$100.05	$667.00	$20.01–$667.00	3% above	85%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate (LC)	$233.45	$667.00	$74.04–$600.30	—	65%
Estradiol blood test CPT 82670 Estradiol Level	$78.90	$526.00	$25.15–$526.00	22% below	85%
Estradiol blood test inpatient CPT 82670 Estradiol Level	$184.10	$526.00	$58.39–$473.40	—	65%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Serum	$274.20	$1,828.00	$16.72–$1,828.00	164% above	85%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone Serum	$639.80	$1,828.00	$202.91–$1,645.20	—	65%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Feces (LC)	$265.35	$1,769.00	$17.67–$1,769.00	67% above	85%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Feces (LC)	$619.15	$1,769.00	$196.36–$1,592.10	—	65%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$157.65	$1,051.00	$12.27–$1,051.00	104% above	85%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$367.85	$1,051.00	$116.66–$945.90	—	65%
Folate (folic acid) blood test CPT 82746 Folate Level	$142.05	$947.00	$13.23–$947.00	98% above	85%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$331.45	$947.00	$105.12–$852.30	—	65%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine 3 Free Serum (LC)	$135.15	$901.00	$12.02–$901.00	47% above	85%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine 3 Free	$135.15	$901.00	$12.02–$901.00	47% above	85%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine 3 Free	$315.35	$901.00	$100.01–$810.90	—	65%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine 3 Free Serum (LC)	$315.35	$901.00	$100.01–$810.90	—	65%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine 4 Free	$116.40	$776.00	$8.12–$776.00	132% above	85%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine 4 Free	$271.60	$776.00	$86.14–$698.40	—	65%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hour Postprandial	$118.80	$792.00	$4.28–$792.00	208% above	85%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hour Postprandial	$277.20	$792.00	$87.91–$712.80	—	65%
Glucose tolerance test, 3 samples CPT 82951 .GTT Fasting	$147.60	$984.00	$11.58–$984.00	100% above	85%
Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT Fasting	$344.40	$984.00	$109.22–$885.60	—	65%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 L183194N.GONORRHO,DN	$55.05	$367.00	$31.58–$367.00	1% below	85%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 L183160 N GONO AMP	$55.05	$367.00	$31.58–$367.00	1% below	85%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 L183194N.GONORRHO,DN	$128.45	$367.00	$40.74–$330.30	—	65%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 L183160 N GONO AMP	$128.45	$367.00	$40.74–$330.30	—	65%
H. pylori antibody blood test CPT 86677 Heliobacter pylori Ab IgG (LC)	$133.05	$887.00	$14.15–$887.00	135% above	85%
H. pylori antibody blood test inpatient CPT 86677 Heliobacter pylori Ab IgG (LC)	$310.45	$887.00	$98.46–$798.30	—	65%
H. pylori stool antigen test CPT 87338 Heliobacter pylori Stool Ag EIA (LC)	$76.65	$511.00	$6.46–$511.00	32% below	85%
H. pylori stool antigen test inpatient CPT 87338 Heliobacter pylori Stool Ag EIA (LC)	$178.85	$511.00	$56.72–$459.90	—	65%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA Real Time PCR (Non-Graph) Sendout to LabCorp	$252.45	$1,683.00	$76.59–$1,683.00	20% above	85%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA Real Time PCR (Graph) LC	$252.45	$1,683.00	$76.59–$1,683.00	20% above	85%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA Real Time PCR (Graph) LC	$589.05	$1,683.00	$186.81–$1,514.70	—	65%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA Real Time PCR (Non-Graph) Sendout to LabCorp	$589.05	$1,683.00	$186.81–$1,514.70	—	65%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV Aptima LC	$55.50	$370.00	$31.58–$370.00	10% above	85%
HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 L199330 HPV HR	$55.50	$370.00	$31.58–$370.00	10% above	85%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV Aptima LC	$129.50	$370.00	$41.07–$333.00	—	65%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 L199330 HPV HR	$129.50	$370.00	$41.07–$333.00	—	65%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$116.40	$776.00	$8.74–$776.00	117% above	85%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$271.60	$776.00	$86.14–$698.40	—	65%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab (LC)	$41.70	$278.00	$9.67–$278.00	26% below	85%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB - BCE	$178.80	$1,192.00	$9.67–$1,192.00	217% above	85%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab (LC)	$97.30	$278.00	$30.86–$250.20	—	65%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF AB - BCE	$417.20	$1,192.00	$132.31–$1,072.80	—	65%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$146.40	$976.00	$9.30–$976.00	191% above	85%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG- BCE	$146.40	$976.00	$9.30–$976.00	191% above	85%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAG- BCE	$341.60	$976.00	$108.34–$878.40	—	65%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$341.60	$976.00	$108.34–$878.40	—	65%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Antibody (LC)	$53.85	$359.00	$12.84–$359.00	22% below	85%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Antibody (LC)	$125.65	$359.00	$39.85–$323.10	—	65%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno. (LC)	$344.40	$2,296.00	$38.56–$2,296.00	100% above	85%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 Hepatitis C Virus RT PCR Quant Non-Graph (LC)	$344.40	$2,296.00	$38.56–$2,296.00	100% above	85%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno. (LC)	$803.60	$2,296.00	$254.86–$2,066.40	—	65%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 Hepatitis C Virus RT PCR Quant Non-Graph (LC)	$803.60	$2,296.00	$254.86–$2,066.40	—	65%
High-sensitivity CRP (hs-CRP) test CPT 86141 C Reactive Protein Cardiac (LC)	$33.15	$221.00	$11.66–$221.00	16% below	85%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C Reactive Protein Cardiac (LC)	$77.35	$221.00	$24.53–$198.90	—	65%
Homocysteine blood test CPT 83090 Homocyst(e)ine Plasma LC	$238.20	$1,588.00	$16.13–$1,588.00	194% above	85%
Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine Plasma LC	$555.80	$1,588.00	$176.27–$1,429.20	—	65%
Insulin blood test CPT 83525 Insulin LC	$177.00	$1,180.00	$10.29–$1,180.00	226% above	85%
Insulin blood test inpatient CPT 83525 Insulin LC	$413.00	$1,180.00	$130.98–$1,062.00	—	65%
Iron blood test (serum iron) CPT 83540 83540 IRON	$99.90	$666.00	$5.82–$666.00	165% above	85%
Iron blood test (serum iron) CPT 83540 IRON	$99.90	$666.00	$5.82–$666.00	165% above	85%
Iron blood test (serum iron) inpatient CPT 83540 83540 IRON	$233.10	$666.00	$73.93–$599.40	—	65%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$233.10	$666.00	$73.93–$599.40	—	65%
Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity DM	$11.55	$77.00	$7.87–$77.00	74% below	85%
Iron-binding capacity (TIBC) test CPT 83550 83550 IRON BINDING CAPACIT	$11.55	$77.00	$7.87–$77.00	74% below	85%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity DM	$26.95	$77.00	$8.55–$69.30	—	65%
Iron-binding capacity (TIBC) test inpatient CPT 83550 83550 IRON BINDING CAPACIT	$26.95	$77.00	$8.55–$69.30	—	65%
Kidney function blood test panel CPT 80069 RFP	$127.05	$847.00	$7.81–$847.00	62% above	85%
Kidney function blood test panel inpatient CPT 80069 RFP	$296.45	$847.00	$94.02–$762.30	—	65%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$230.55	$1,537.00	$16.67–$1,537.00	147% above	85%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$537.95	$1,537.00	$170.61–$1,383.30	—	65%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase, Body Fluid Sendout to LabCorp	$116.25	$775.00	$6.20–$775.00	189% above	85%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$116.25	$775.00	$6.20–$775.00	189% above	85%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$271.25	$775.00	$86.02–$697.50	—	65%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase, Body Fluid Sendout to LabCorp	$271.25	$775.00	$86.02–$697.50	—	65%
Liver function blood test panel CPT 80076 HFP	$175.20	$1,168.00	$7.35–$1,168.00	113% above	85%
Liver function blood test panel inpatient CPT 80076 HFP	$408.80	$1,168.00	$129.65–$1,051.20	—	65%
Lyme disease antibody test CPT 86618 Lyme Disease Total Ab Rfx Immunoassay LC	$135.15	$901.00	$15.33–$901.00	70% above	85%
Lyme disease antibody test CPT 86618 86618 L139825 LYME DIS AB	$135.15	$901.00	$15.33–$901.00	70% above	85%
Lyme disease antibody test inpatient CPT 86618 86618 L139825 LYME DIS AB	$315.35	$901.00	$100.01–$810.90	—	65%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Total Ab Rfx Immunoassay LC	$315.35	$901.00	$100.01–$810.90	—	65%
Magnesium blood test CPT 83735 Magnesium Serum	$93.60	$624.00	$6.03–$624.00	175% above	85%
Magnesium blood test inpatient CPT 83735 Magnesium Serum	$218.40	$624.00	$69.26–$561.60	—	65%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen	$120.45	$803.00	$4.66–$803.00	221% above	85%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen	$281.05	$803.00	$89.13–$722.70	—	65%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total (Reflex To Free) (LC)	$49.50	$330.00	$16.55–$330.00	43% below	85%
PSA (prostate-specific antigen) blood test, total CPT 84153 84153 L480947 PSA, TOTAL	$49.50	$330.00	$16.55–$330.00	43% below	85%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Ag Total	$253.05	$1,687.00	$16.55–$1,687.00	194% above	85%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 L480947 PSA, TOTAL	$115.50	$330.00	$36.63–$297.00	—	65%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total (Reflex To Free) (LC)	$115.50	$330.00	$36.63–$297.00	—	65%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Ag Total	$590.45	$1,687.00	$187.26–$1,518.30	—	65%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 L199330 PAP AU MN RS	$29.40	$196.00	$21.76–$196.00	2% below	85%
Pap test (liquid-based, automated screening with review) CPT 88175 Pap IG (Image Guided) (LC)	$29.40	$196.00	$21.76–$196.00	2% below	85%
Pap test (liquid-based, automated screening with review) CPT 88175 PapIG rfx Aptima HPV ASCU (LC)	$29.40	$196.00	$21.76–$196.00	2% below	85%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PapIG rfx Aptima HPV ASCU (LC)	$68.60	$196.00	$21.76–$176.40	—	65%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Pap IG (Image Guided) (LC)	$68.60	$196.00	$21.76–$176.40	—	65%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 L199330 PAP AU MN RS	$68.60	$196.00	$21.76–$176.40	—	65%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact (LC)	$372.00	$2,480.00	$37.15–$2,480.00	132% above	85%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact (LC)	$868.00	$2,480.00	$275.28–$2,232.00	—	65%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$89.10	$594.00	$5.41–$594.00	126% above	85%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$207.90	$594.00	$65.93–$534.60	—	65%
Progesterone blood test CPT 84144 Progesterone Level	$274.65	$1,831.00	$18.77–$1,831.00	199% above	85%
Progesterone blood test inpatient CPT 84144 Progesterone Level	$640.85	$1,831.00	$203.24–$1,647.90	—	65%
Prolactin blood test CPT 84146 Prolactin Level	$272.40	$1,816.00	$17.44–$1,816.00	147% above	85%
Prolactin blood test inpatient CPT 84146 Prolactin Level	$635.60	$1,816.00	$201.58–$1,634.40	—	65%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time w/INR	$71.25	$475.00	$3.86–$475.00	101% above	85%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time w/INR	$166.25	$475.00	$52.72–$427.50	—	65%
Rapid flu test (influenza antigen) CPT 87804 87804 INFLUENZA ASSAY W-OP	$39.15	$261.00	$14.90–$261.00	9% below	85%
Rapid flu test (influenza antigen) inpatient CPT 87804 87804 INFLUENZA ASSAY W-OP	$91.35	$261.00	$28.97–$234.90	—	65%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor (LC)	$85.35	$569.00	$5.10–$569.00	118% above	85%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Arthritis Factor (LC)	$199.15	$569.00	$63.16–$512.10	—	65%
Rubella antibody test (immunity check) CPT 86762 Rubella Ab IgG Auto w/Interp	$114.90	$766.00	$12.95–$766.00	128% above	85%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab IgG Auto w/Interp	$268.10	$766.00	$85.03–$689.40	—	65%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESRA	$51.15	$341.00	$2.43–$341.00	31% above	85%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESRA	$119.35	$341.00	$37.85–$306.90	—	65%
Stool ova and parasites exam CPT 87177 87177 L8623 OVA-PARASITES SMEARS	$133.65	$891.00	$8.01–$891.00	160% above	85%
Stool ova and parasites exam inpatient CPT 87177 87177 L8623 OVA-PARASITES SMEARS	$311.85	$891.00	$98.90–$801.90	—	65%
Stool test for hidden blood (guaiac FOBT) CPT 82270 FOBT	$31.50	$210.00	$3.23–$210.00	75% above	85%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 FOBT	$73.50	$210.00	$23.31–$189.00	—	65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 .Rapid Plasma Reagin Qual w/Reflex Quant	$52.05	$347.00	$3.84–$347.00	102% above	85%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF LC	$52.05	$347.00	$3.84–$347.00	102% above	85%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Qual w/Reflex Quant	$52.05	$347.00	$3.84–$347.00	102% above	85%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 .Rapid Plasma Reagin Qual w/Reflex Quant	$121.45	$347.00	$38.52–$312.30	—	65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF LC	$121.45	$347.00	$38.52–$312.30	—	65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Qual w/Reflex Quant	$121.45	$347.00	$38.52–$312.30	—	65%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus (Client Incubated) LC	$38.25	$255.00	$28.30–$255.00	72% below	85%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus (Client Incubated) LC	$89.25	$255.00	$28.30–$229.50	—	65%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$344.85	$2,299.00	$23.23–$2,299.00	190% above	85%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total	$804.65	$2,299.00	$255.19–$2,069.10	—	65%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsomal Ab LC	$48.45	$323.00	$13.10–$323.00	38% above	85%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Antibody (LC)	$48.45	$323.00	$13.10–$323.00	38% above	85%
Thyroid peroxidase (TPO) antibody test CPT 86376 86376 L6684 MICROSOMAL AB	$48.45	$323.00	$13.10–$323.00	38% above	85%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsomal Ab LC	$113.05	$323.00	$35.85–$290.70	—	65%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 86376 L6684 MICROSOMAL AB	$113.05	$323.00	$35.85–$290.70	—	65%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Antibody (LC)	$113.05	$323.00	$35.85–$290.70	—	65%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$232.05	$1,547.00	$15.12–$1,547.00	224% above	85%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/Reflex to T4 Total	$232.05	$1,547.00	$15.12–$1,547.00	224% above	85%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4	$232.05	$1,547.00	$15.12–$1,547.00	224% above	85%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH LC	$9.26	$26.46	$2.94–$23.81	—	65%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH reflex to T4F (LC)	$9.26	$26.46	$2.94–$23.81	—	65%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4	$541.45	$1,547.00	$171.72–$1,392.30	—	65%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/Reflex to T4 Total	$541.45	$1,547.00	$171.72–$1,392.30	—	65%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$541.45	$1,547.00	$171.72–$1,392.30	—	65%
Trichomonas test (NAAT) CPT 87661 87661 L183160 T VAG AMP	$43.50	$290.00	$31.58–$290.00	10% below	85%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis, NAA (LC)	$43.50	$290.00	$31.58–$290.00	10% below	85%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis, NAA (LC)	$101.50	$290.00	$32.19–$261.00	—	65%
Trichomonas test (NAAT) inpatient CPT 87661 87661 L183160 T VAG AMP	$101.50	$290.00	$32.19–$261.00	—	65%
Uric acid blood test CPT 84550 Uric Acid Level	$80.55	$537.00	$4.07–$537.00	131% above	85%
Uric acid blood test inpatient CPT 84550 Uric Acid Level	$187.95	$537.00	$59.61–$483.30	—	65%
Urinalysis with microscope exam, automated CPT 81001 Perform Microscopic - Yes	$39.00	$260.00	$2.85–$260.00	16% above	85%
Urinalysis with microscope exam, automated CPT 81001 .Bill Only DS Auto/MSc Reqd	$39.00	$260.00	$2.85–$260.00	16% above	85%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis w/Microscopic Automated	$39.00	$260.00	$2.85–$260.00	16% above	85%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis w/Microscopic Automated	$91.00	$260.00	$28.86–$234.00	—	65%
Urinalysis with microscope exam, automated inpatient CPT 81001 Perform Microscopic - Yes	$91.00	$260.00	$28.86–$234.00	—	65%
Urinalysis with microscope exam, automated inpatient CPT 81001 .Bill Only DS Auto/MSc Reqd	$91.00	$260.00	$28.86–$234.00	—	65%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis w/Microscopic Manual	$45.75	$305.00	$3.62–$305.00	26% above	85%
Urinalysis with microscope exam, manual CPT 81000 .Bill Only DS Man/MSc Reqd	$45.75	$305.00	$3.62–$305.00	26% above	85%
Urinalysis with microscope exam, manual inpatient CPT 81000 .Bill Only DS Man/MSc Reqd	$106.75	$305.00	$33.86–$274.50	—	65%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis w/Microscopic Manual	$106.75	$305.00	$33.86–$274.50	—	65%
Urinalysis without microscope exam, automated CPT 81003 Reflex Microscopic Type? - Not Required	$29.55	$197.00	$2.03–$197.00	95% above	85%
Urinalysis without microscope exam, automated CPT 81003 Urine Color Urine Dipstick	$29.55	$197.00	$2.03–$197.00	95% above	85%
Urinalysis without microscope exam, automated CPT 81003 .Bill Only DS Auto/No MSc	$29.55	$197.00	$2.03–$197.00	95% above	85%
Urinalysis without microscope exam, automated CPT 81003 Dipstick Type? - Auto	$29.55	$197.00	$2.03–$197.00	95% above	85%
Urinalysis without microscope exam, automated CPT 81003 Perform Microscopic - No	$29.55	$197.00	$2.03–$197.00	95% above	85%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis w/o Microscopic Automated	$29.55	$197.00	$2.03–$197.00	95% above	85%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis w/o Microscopic Automated	$68.95	$197.00	$21.87–$177.30	—	65%
Urinalysis without microscope exam, automated inpatient CPT 81003 Reflex Microscopic Type? - Not Required	$68.95	$197.00	$21.87–$177.30	—	65%
Urinalysis without microscope exam, automated inpatient CPT 81003 .Bill Only DS Auto/No MSc	$68.95	$197.00	$21.87–$177.30	—	65%
Urinalysis without microscope exam, automated inpatient CPT 81003 Dipstick Type? - Auto	$68.95	$197.00	$21.87–$177.30	—	65%
Urinalysis without microscope exam, automated inpatient CPT 81003 Perform Microscopic - No	$68.95	$197.00	$21.87–$177.30	—	65%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Color Urine Dipstick	$68.95	$197.00	$21.87–$177.30	—	65%
Urinalysis without microscope exam, manual CPT 81002 Specific Gravity Urine Manual	$11.10	$74.00	$3.13–$74.00	21% below	85%
Urinalysis without microscope exam, manual CPT 81002 .Bill Only DS Man/No MSc	$11.10	$74.00	$3.13–$74.00	21% below	85%
Urinalysis without microscope exam, manual CPT 81002 Dipstick Type? - Manual	$11.10	$74.00	$3.13–$74.00	21% below	85%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis w/o Microscopic Manual	$11.10	$74.00	$3.13–$74.00	21% below	85%
Urinalysis without microscope exam, manual inpatient CPT 81002 Dipstick Type? - Manual	$25.90	$74.00	$8.21–$66.60	—	65%
Urinalysis without microscope exam, manual inpatient CPT 81002 .Bill Only DS Man/No MSc	$25.90	$74.00	$8.21–$66.60	—	65%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis w/o Microscopic Manual	$25.90	$74.00	$8.21–$66.60	—	65%
Urinalysis without microscope exam, manual inpatient CPT 81002 Specific Gravity Urine Manual	$25.90	$74.00	$8.21–$66.60	—	65%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture Qn	$101.85	$679.00	$7.26–$679.00	121% above	85%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture Qn	$237.65	$679.00	$75.37–$611.10	—	65%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result - Negative	$148.95	$993.00	$7.75–$993.00	276% above	85%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result	$148.95	$993.00	$7.75–$993.00	276% above	85%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result - Positive	$148.95	$993.00	$7.75–$993.00	276% above	85%
Urine pregnancy test, read by color change CPT 81025 Human Chorionic Gonadotropin Urine Qual Manual	$148.95	$993.00	$7.75–$993.00	276% above	85%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result - Positive	$347.55	$993.00	$110.22–$893.70	—	65%
Urine pregnancy test, read by color change inpatient CPT 81025 Human Chorionic Gonadotropin Urine Qual Manual	$347.55	$993.00	$110.22–$893.70	—	65%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result	$347.55	$993.00	$110.22–$893.70	—	65%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result - Negative	$347.55	$993.00	$110.22–$893.70	—	65%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12	$130.80	$872.00	$13.57–$872.00	57% above	85%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12	$305.20	$872.00	$96.79–$784.80	—	65%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 hydroxy	$210.00	$1,400.00	$26.64–$1,400.00	126% above	85%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy D2 + D3 LC	$210.00	$1,400.00	$26.64–$1,400.00	126% above	85%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy D2 + D3 LC	$490.00	$1,400.00	$155.40–$1,260.00	—	65%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 hydroxy	$490.00	$1,400.00	$155.40–$1,260.00	—	65%
Zinc blood test CPT 84630 Zinc Plasma or Serum (LC)	$124.95	$833.00	$10.25–$833.00	84% above	85%
Zinc blood test CPT 84630 Zinc, Whole Blood (LC)	$124.95	$833.00	$10.25–$833.00	84% above	85%
Zinc blood test inpatient CPT 84630 Zinc, Whole Blood (LC)	$291.55	$833.00	$92.46–$749.70	—	65%
Zinc blood test inpatient CPT 84630 Zinc Plasma or Serum (LC)	$291.55	$833.00	$92.46–$749.70	—	65%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Tumor Marker (LC)	$233.40	$1,556.00	$13.55–$1,556.00	186% above	85%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Human Chorionic Gonadotropin Quant	$233.40	$1,556.00	$13.55–$1,556.00	186% above	85%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG Tumor Marker (LC)	$544.60	$1,556.00	$172.72–$1,400.40	—	65%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Human Chorionic Gonadotropin Quant	$544.60	$1,556.00	$172.72–$1,400.40	—	65%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 ARTHRD ANT NTRBDY CERVICAL	$28,352.64	$189,017.62	$1,523.34–$170,115.86	82% above	85%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECTION OF BUNION	$15,729.03	$104,860.23	$762.43–$94,374.21	37% above	85%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRECTION OF BUNION	$14,208.00	$94,720.02	$611.00–$85,248.02	41% above	85%
Cardioversion, elective (restoring heart rhythm) CPT 92960 $ED Cardioversion	$587.55	$3,917.00	$135.36–$3,917.00	54% above	85%
Cardioversion, elective (restoring heart rhythm) CPT 92960 $ED Cardioversion/Defibrillation	$587.55	$3,917.00	$135.36–$3,917.00	54% above	85%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ED Cardioversion Set up for procedure - Cardiovers	$587.55	$3,917.00	$135.36–$3,917.00	54% above	85%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC, EXT	$18,274.65	$121,831.01	$135.36–$109,647.91	4684% above	85%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 $ED Cardioversion	$1,370.95	$3,917.00	$434.79–$3,525.30	—	65%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED Cardioversion Set up for procedure - Cardiovers	$1,370.95	$3,917.00	$434.79–$3,525.30	—	65%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 $ED Cardioversion/Defibrillation	$1,370.95	$3,917.00	$434.79–$3,525.30	—	65%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$7,880.24	$52,534.96	$399.22–$47,281.46	31% above	85%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION	$7,960.01	$53,066.73	$179.34–$47,760.06	109% above	85%
Colonoscopy with polyp removal CPT 45385 LESION REMOVAL COLONOSCOPY	$4,543.97	$30,293.12	$391.30–$27,263.81	172% above	85%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$4,015.55	$26,770.34	$369.07–$24,093.31	186% above	85%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$2,693.90	$17,959.30	$293.61–$16,163.37	128% above	85%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT	$10,504.31	$70,028.74	$321.49–$63,025.87	at median	85%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$7,550.29	$50,335.26	$188.45–$45,301.73	1217% above	85%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$253.67	$1,691.10	$12.93–$1,691.10	475% above	85%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$2,857.69	$19,051.28	$157.17–$17,146.15	263% above	85%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$17,264.09	$115,093.90	$595.84–$103,584.51	108% above	85%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE	$10,325.46	$68,836.38	$472.84–$61,952.74	70% above	85%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS	$730.59	$4,870.57	$111.31–$4,870.57	450% above	85%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INGUINAL HERNIA	$14,605.86	$97,372.41	$471.99–$87,635.17	440% above	85%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY, APPENDECTOMY	$14,539.11	$96,927.40	$543.02–$87,234.66	at median	85%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$2,701.38	$18,009.20	$218.43–$16,208.28	495% above	85%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ FORAMEN EPIDURAL L/S	$2,701.04	$18,006.93	$209.84–$16,206.24	401% above	85%
Lumbar laminectomy (spinal decompression), one level CPT 63047 REMOVAL OF SPINAL LAMINA	$26,335.64	$175,570.93	$993.23–$158,013.84	83% above	85%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$2,341.78	$15,611.89	$99.06–$14,050.70	1676% above	85%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION FOR NERVE BLOCK	$2,327.88	$15,519.20	$66.46–$13,967.28	1030% above	85%
Paracentesis with imaging guidance CPT 49083 CT Abdominal Paracentesis w Imaging	$413.25	$2,755.00	$245.21–$2,755.00	25% below	85%
Paracentesis with imaging guidance CPT 49083 IR Abdominal Paracentesis w Imaging	$413.25	$2,755.00	$245.21–$2,755.00	25% below	85%
Paracentesis with imaging guidance inpatient CPT 49083 IR Abdominal Paracentesis w Imaging	$964.25	$2,755.00	$305.80–$2,479.50	—	65%
Paracentesis with imaging guidance inpatient CPT 49083 CT Abdominal Paracentesis w Imaging	$964.25	$2,755.00	$305.80–$2,479.50	—	65%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE	$5,253.40	$35,022.64	$209.88–$31,520.38	450% above	85%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY	$392.12	$2,614.14	$130.83–$2,614.14	112% above	85%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$2,561.30	$17,075.32	$293.86–$15,367.79	134% above	85%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND	$2,252.53	$15,016.88	$293.61–$13,515.19	194% above	85%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy ESWL	$8,714.55	$58,097.00	$654.31–$52,287.30	9% below	85%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Lithotripsy ESWL	$20,333.95	$58,097.00	$6,448.77–$52,287.30	—	65%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$939.59	$6,263.96	$59.50–$5,637.56	1079% above	85%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$1,125.96	$7,506.39	$65.45–$6,755.75	1004% above	85%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SUPERFICIAL WOUND(S)	$640.26	$4,268.38	$81.30–$4,268.38	295% above	85%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SUPERFICIAL WOUND(S)	$1,034.94	$6,899.62	$99.39–$6,209.66	536% above	85%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR SUPERFICIAL WOUND(S)	$1,167.73	$7,784.85	$97.43–$7,006.37	621% above	85%
TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP)	$10,063.01	$67,086.71	$661.12–$60,378.04	11% above	85%
Thoracentesis with imaging guidance CPT 32555 IR Thoracentesis w Imging Guidance	$321.15	$2,141.00	$237.65–$2,141.00	50% below	85%
Thoracentesis with imaging guidance CPT 32555 CT Thoracentesis w Imaging Guidance	$321.15	$2,141.00	$237.65–$2,141.00	50% below	85%
Thoracentesis with imaging guidance inpatient CPT 32555 CT Thoracentesis w Imaging Guidance	$749.35	$2,141.00	$237.65–$1,926.90	—	65%
Thoracentesis with imaging guidance inpatient CPT 32555 IR Thoracentesis w Imging Guidance	$749.35	$2,141.00	$237.65–$1,926.90	—	65%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY, BIOPSY	$4,538.58	$30,257.23	$314.91–$27,231.51	279% above	85%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 OPERATIVE UPPER GI ENDOSCOPY	$7,471.39	$49,809.26	$414.23–$44,828.33	459% above	85%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UPPR GI ENDOSCOPY/GUIDE WIRE	$4,688.93	$31,259.56	$347.80–$28,133.60	299% above	85%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPR GI ENDOSCOPY, DIAGNOSIS	$3,562.47	$23,749.81	$244.63–$21,374.83	266% above	85%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETERO W/LITHOTRIPSY	$9,662.11	$64,414.04	$353.17–$57,972.64	19% below	85%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$10,620.07	$70,800.48	$375.19–$63,720.43	at median	85%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$8,778.20	$58,521.31	$290.91–$52,669.18	761% above	85%
Wart removal, up to 14 warts CPT 17110 DESTRUCT LESION, 1-14	$6,278.90	$41,859.36	$96.89–$37,673.42	5226% above	85%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN/TISSUE	$7,932.71	$52,884.74	$111.14–$47,596.27	3599% above	85%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Fee	$217.80	$1,452.00	$35.47–$1,452.00	51% below	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood transfusions	$217.80	$1,452.00	$35.47–$1,452.00	51% below	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Platelets (random donor)	$217.80	$1,452.00	$35.47–$1,452.00	51% below	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Platelets (single donor)	$217.80	$1,452.00	$35.47–$1,452.00	51% below	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Red blood cells (postoperati	$217.80	$1,452.00	$35.47–$1,452.00	51% below	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Red blood cells (preoperativ	$217.80	$1,452.00	$35.47–$1,452.00	51% below	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Whole blood	$217.80	$1,452.00	$35.47–$1,452.00	51% below	85%
Blood transfusion (giving blood or blood components) CPT 36430 $ED Transfusion >2 yrs	$217.80	$1,452.00	$35.47–$1,452.00	51% below	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Verified with Pt Information: - Transfu	$217.80	$1,452.00	$35.47–$1,452.00	51% below	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Fresh frozen plasma	$217.80	$1,452.00	$35.47–$1,452.00	51% below	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Cryoprecipitate	$217.80	$1,452.00	$35.47–$1,452.00	51% below	85%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Packed red blood cells	$217.80	$1,452.00	$35.47–$1,452.00	51% below	85%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Fresh frozen plasma	$508.20	$1,452.00	$161.17–$1,306.80	—	65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood transfusions	$508.20	$1,452.00	$161.17–$1,306.80	—	65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Fee	$508.20	$1,452.00	$161.17–$1,306.80	—	65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Cryoprecipitate	$508.20	$1,452.00	$161.17–$1,306.80	—	65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Packed red blood cells	$508.20	$1,452.00	$161.17–$1,306.80	—	65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Platelets (random donor)	$508.20	$1,452.00	$161.17–$1,306.80	—	65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Platelets (single donor)	$508.20	$1,452.00	$161.17–$1,306.80	—	65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Red blood cells (postoperati	$508.20	$1,452.00	$161.17–$1,306.80	—	65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Red blood cells (preoperativ	$508.20	$1,452.00	$161.17–$1,306.80	—	65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Whole blood	$508.20	$1,452.00	$161.17–$1,306.80	—	65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 $ED Transfusion >2 yrs	$508.20	$1,452.00	$161.17–$1,306.80	—	65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Verified with Pt Information: - Transfu	$508.20	$1,452.00	$161.17–$1,306.80	—	65%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Charge - Initial	$81.75	$545.00	$6.59–$545.00	33% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPV Subsequent	$81.75	$545.00	$6.59–$545.00	33% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Charge - Subsequent	$81.75	$545.00	$6.59–$545.00	33% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPPB Subsequent	$81.75	$545.00	$6.59–$545.00	33% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPV Initial	$81.75	$545.00	$6.59–$545.00	33% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPPB Initial	$81.75	$545.00	$6.59–$545.00	33% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - Initial	$81.75	$545.00	$6.59–$545.00	33% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - Subsequent	$81.75	$545.00	$6.59–$545.00	33% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$1,232.88	$8,219.20	$6.59–$7,397.28	1905% above	85%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPV Subsequent	$190.75	$545.00	$60.50–$490.50	—	65%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler Charge - Initial	$190.75	$545.00	$60.50–$490.50	—	65%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - Initial	$190.75	$545.00	$60.50–$490.50	—	65%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPPB Initial	$190.75	$545.00	$60.50–$490.50	—	65%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler Charge - Subsequent	$190.75	$545.00	$60.50–$490.50	—	65%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPV Initial	$190.75	$545.00	$60.50–$490.50	—	65%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPPB Subsequent	$190.75	$545.00	$60.50–$490.50	—	65%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - Subsequent	$190.75	$545.00	$60.50–$490.50	—	65%
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care	$713.55	$4,757.00	$246.61–$4,757.00	19% above	85%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care	$1,664.95	$4,757.00	$528.03–$4,281.30	—	65%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Including Recording Awake and Drowsy	$325.80	$2,172.00	$185.20–$2,172.00	16% above	85%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Including Recording Awake and Drowsy	$760.20	$2,172.00	$241.09–$1,954.80	—	65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG BCE	$205.80	$1,372.00	$45.26–$1,372.00	163% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Series 1 Hour	$205.80	$1,372.00	$45.26–$1,372.00	163% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 1 Hour	$205.80	$1,372.00	$45.26–$1,372.00	163% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Is the patient scheduled for a Cath Lab procedure	$205.80	$1,372.00	$45.26–$1,372.00	163% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Start Time	$205.80	$1,372.00	$45.26–$1,372.00	163% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 3 Hours	$205.80	$1,372.00	$45.26–$1,372.00	163% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 6 Hours	$205.80	$1,372.00	$45.26–$1,372.00	163% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Series 3 Hours	$205.80	$1,372.00	$45.26–$1,372.00	163% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead Series Now	$205.80	$1,372.00	$45.26–$1,372.00	163% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG 12 Lead Series Now	$205.80	$1,372.00	$45.26–$1,372.00	163% above	85%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Series 3 Hours	$480.20	$1,372.00	$152.29–$1,234.80	—	65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 3 Hours	$480.20	$1,372.00	$152.29–$1,234.80	—	65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 6 Hours	$480.20	$1,372.00	$152.29–$1,234.80	—	65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead Series Now	$480.20	$1,372.00	$152.29–$1,234.80	—	65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG 12 Lead Series Now	$480.20	$1,372.00	$152.29–$1,234.80	—	65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Series 1 Hour	$480.20	$1,372.00	$152.29–$1,234.80	—	65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 1 Hour	$480.20	$1,372.00	$152.29–$1,234.80	—	65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Is the patient scheduled for a Cath Lab procedure	$480.20	$1,372.00	$152.29–$1,234.80	—	65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Start Time	$480.20	$1,372.00	$152.29–$1,234.80	—	65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG BCE	$480.20	$1,372.00	$152.29–$1,234.80	—	65%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1	$187.35	$1,249.00	$10.49–$1,249.00	103% above	85%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1	$437.15	$1,249.00	$138.64–$1,124.10	—	65%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$223.35	$1,489.00	$38.63–$1,489.00	70% above	85%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$521.15	$1,489.00	$165.28–$1,340.10	—	65%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$359.40	$2,396.00	$65.37–$2,396.00	74% above	85%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$838.60	$2,396.00	$265.96–$2,156.40	—	65%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$604.05	$4,027.00	$111.54–$4,027.00	107% above	85%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$1,409.45	$4,027.00	$447.00–$3,624.30	—	65%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Trauma Notification Level - No Prior Notification	$646.50	$4,310.00	$161.84–$4,310.00	25% above	85%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$646.50	$4,310.00	$161.84–$4,310.00	25% above	85%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Trauma Notification Level - No Prior Notification	$1,508.50	$4,310.00	$478.41–$3,879.00	—	65%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$1,508.50	$4,310.00	$478.41–$3,879.00	—	65%
Exercise stress test, tracing only, the hospital charge CPT 93017 NM Cardiovascular Stress Test Trace Only	$443.25	$2,955.00	$31.64–$2,955.00	19% above	85%
Exercise stress test, tracing only, the hospital charge CPT 93017 NI Stress Test	$443.25	$2,955.00	$31.64–$2,955.00	19% above	85%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiac Stress Test	$443.25	$2,955.00	$31.64–$2,955.00	19% above	85%
Exercise stress test, tracing only, the hospital charge CPT 93017 NM Stress Test	$443.25	$2,955.00	$31.64–$2,955.00	19% above	85%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NI Stress Test	$1,034.25	$2,955.00	$328.00–$2,659.50	—	65%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NM Stress Test	$1,034.25	$2,955.00	$328.00–$2,659.50	—	65%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NM Cardiovascular Stress Test Trace Only	$1,034.25	$2,955.00	$328.00–$2,659.50	—	65%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiac Stress Test	$1,034.25	$2,955.00	$328.00–$2,659.50	—	65%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CHRG - Inf/Inj/Hydration - IV HYDRATION 1 HR	$166.35	$1,109.00	$26.42–$1,109.00	14% below	85%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour	$166.35	$1,109.00	$26.42–$1,109.00	14% below	85%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration therapy 1st hour	$166.35	$1,109.00	$26.42–$1,109.00	14% below	85%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration therapy 1st hour	$388.15	$1,109.00	$123.10–$998.10	—	65%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour	$388.15	$1,109.00	$123.10–$998.10	—	65%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 CHRG - Inf/Inj/Hydration - IV HYDRATION 1 HR	$388.15	$1,109.00	$123.10–$998.10	—	65%
IV infusion of a medicine, first hour CPT 96365 Infusion 1st hour	$160.35	$1,069.00	$50.23–$1,069.00	29% below	85%
IV infusion of a medicine, first hour CPT 96365 CHRG - Inf/Inj/Hydration - IV THERAPY DX 1 HR	$160.35	$1,069.00	$50.23–$1,069.00	29% below	85%
IV infusion of a medicine, first hour CPT 96365 96365 - IV tx, first hour	$160.35	$1,069.00	$50.23–$1,069.00	29% below	85%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 - IV tx, first hour	$374.15	$1,069.00	$118.66–$962.10	—	65%
IV infusion of a medicine, first hour inpatient CPT 96365 CHRG - Inf/Inj/Hydration - IV THERAPY DX 1 HR	$374.15	$1,069.00	$118.66–$962.10	—	65%
IV infusion of a medicine, first hour inpatient CPT 96365 Infusion 1st hour	$374.15	$1,069.00	$118.66–$962.10	—	65%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM Injection	$47.10	$314.00	$12.64–$545.00	20% below	85%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 - Subq/IM Injection	$47.10	$314.00	$12.64–$1,000.00	20% below	85%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CHRG - THERAPEUTIC DX SQ IM	$47.10	$314.00	$12.64–$545.00	20% below	85%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 - Subq/IM Injection	$109.90	$314.00	$34.85–$282.60	—	65%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM Injection	$109.90	$314.00	$34.85–$282.60	—	65%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CHRG - THERAPEUTIC DX SQ IM	$109.90	$314.00	$34.85–$282.60	—	65%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$1,206.57	$8,043.78	$122.44–$7,239.40	550% above	85%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 181	$45.00	$300.00	$26.69–$300.00	14% below	85%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Charges	$45.00	$300.00	$26.69–$300.00	14% below	85%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA - Redoc 1	$45.00	$300.00	$26.69–$300.00	14% below	85%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Charges	$45.00	$300.00	$26.69–$300.00	14% below	85%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 185	$45.00	$300.00	$26.69–$300.00	14% below	85%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Units	$45.00	$300.00	$26.69–$300.00	14% below	85%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducatn Assist Charge	$45.00	$300.00	$26.69–$300.00	14% below	85%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULR RE-EDUCATION EA 15 MIN COTA - Redoc 1	$45.00	$300.00	$26.69–$300.00	14% below	85%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units	$45.00	$300.00	$26.69–$300.00	14% below	85%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromusclr Reeducation Assist Charge	$45.00	$300.00	$26.69–$300.00	14% below	85%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromusclr Reeducation Assist Charge	$105.00	$300.00	$33.30–$270.00	—	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducatn Assist Charge	$105.00	$300.00	$33.30–$270.00	—	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 185	$105.00	$300.00	$33.30–$270.00	—	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 181	$105.00	$300.00	$33.30–$270.00	—	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Charges	$105.00	$300.00	$33.30–$270.00	—	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Charges	$105.00	$300.00	$33.30–$270.00	—	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units	$105.00	$300.00	$33.30–$270.00	—	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Units	$105.00	$300.00	$33.30–$270.00	—	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULR RE-EDUCATION EA 15 MIN COTA - Redoc 1	$105.00	$300.00	$33.30–$270.00	—	65%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA - Redoc 1	$105.00	$300.00	$33.30–$270.00	—	65%
New patient office visit, about 60 minutes CPT 99205 CHRG - WOUND CARE LEVEL 5 NEW PT	$312.45	$2,083.00	$56.77–$2,083.00	76% above	85%
New patient office visit, about 60 minutes inpatient CPT 99205 CHRG - WOUND CARE LEVEL 5 NEW PT	$729.05	$2,083.00	$231.21–$1,874.70	—	65%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW Unit - Yes	$163.50	$1,090.00	$72.35–$1,090.00	19% above	85%
Occupational therapy evaluation, low complexity CPT 97165 IRF OT EVAL LOW	$163.50	$1,090.00	$72.35–$1,090.00	19% above	85%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL- LOW COMP - REDOC 185	$163.50	$1,090.00	$72.35–$1,090.00	19% above	85%
Occupational therapy evaluation, low complexity CPT 97165 OT Eval Low Assistant Unit - Yes	$163.50	$1,090.00	$72.35–$1,090.00	19% above	85%
Occupational therapy evaluation, low complexity CPT 97165 OCCUPAT THERAPY EVAL LOW COMPLEXITY COTA - Redoc 1	$163.50	$1,090.00	$72.35–$1,090.00	19% above	85%
Occupational therapy evaluation, low complexity CPT 97165 TH OTEVL- LOW CMP OT - REDOC 185	$163.50	$1,090.00	$72.35–$1,090.00	19% above	85%
Occupational therapy evaluation, low complexity inpatient CPT 97165 IRF OT EVAL LOW	$381.50	$1,090.00	$120.99–$981.00	—	65%
Occupational therapy evaluation, low complexity inpatient CPT 97165 TH OTEVL- LOW CMP OT - REDOC 185	$381.50	$1,090.00	$120.99–$981.00	—	65%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OCCUPAT THERAPY EVAL LOW COMPLEXITY COTA - Redoc 1	$381.50	$1,090.00	$120.99–$981.00	—	65%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Eval Low Assistant Unit - Yes	$381.50	$1,090.00	$120.99–$981.00	—	65%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL- LOW COMP - REDOC 185	$381.50	$1,090.00	$120.99–$981.00	—	65%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW Unit - Yes	$381.50	$1,090.00	$120.99–$981.00	—	65%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PHYSICAL THERAPY EVAL HGH COMPLEXITY PTA - Redoc 1	$84.30	$562.00	$45.00–$562.00	43% below	85%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH Unit - Yes	$84.30	$562.00	$45.00–$562.00	43% below	85%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH COMP - REDOC 181	$84.30	$562.00	$45.00–$562.00	43% below	85%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval High Assistant Unit - Yes	$84.30	$562.00	$45.00–$562.00	43% below	85%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 IRF PT EVAL HIGH	$84.30	$562.00	$45.00–$562.00	43% below	85%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Eval High Assistant Unit - Yes	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH Unit - Yes	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH COMP - REDOC 181	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PHYSICAL THERAPY EVAL HGH COMPLEXITY PTA - Redoc 1	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 IRF PT EVAL HIGH	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW Unit - Yes	$84.30	$562.00	$45.00–$562.00	34% below	85%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW COMP - REDOC 181	$84.30	$562.00	$45.00–$562.00	34% below	85%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PHYSICAL THERAPY EVAL LOW COMPLEXITY PTA - Redoc 1	$84.30	$562.00	$45.00–$562.00	34% below	85%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 IRF PT EVAL LOW	$84.30	$562.00	$45.00–$562.00	34% below	85%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Eval Low Assistant Unit - Yes	$84.30	$562.00	$45.00–$562.00	34% below	85%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 TH PTEVL- LOW CMP PT - REDOC 181	$84.30	$562.00	$62.38–$562.00	34% below	85%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW COMP - REDOC 181	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 IRF PT EVAL LOW	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW Unit - Yes	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TH PTEVL- LOW CMP PT - REDOC 181	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PHYSICAL THERAPY EVAL LOW COMPLEXITY PTA - Redoc 1	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval Low Assistant Unit - Yes	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD COMP - REDOC 181	$84.30	$562.00	$45.00–$562.00	39% below	85%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 TH PTEVL- MOD CMP PT - REDOC 181	$84.30	$562.00	$62.38–$562.00	39% below	85%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 IRF PT EVAL MOD	$84.30	$562.00	$45.00–$562.00	39% below	85%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PHYSICAL THERAPY EVAL MOD COMPLEXITY PTA - Redoc 1	$84.30	$562.00	$45.00–$562.00	39% below	85%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD Unit - Yes	$84.30	$562.00	$45.00–$562.00	39% below	85%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Eval Mod Assistant Unit - Yes	$84.30	$562.00	$45.00–$562.00	39% below	85%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TH PTEVL- MOD CMP PT - REDOC 181	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PHYSICAL THERAPY EVAL MOD COMPLEXITY PTA - Redoc 1	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Eval Mod Assistant Unit - Yes	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD COMP - REDOC 181	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD Unit - Yes	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 IRF PT EVAL MOD	$196.70	$562.00	$62.38–$505.80	—	65%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 181	$51.60	$344.00	$22.66–$344.00	9% below	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 185	$51.60	$344.00	$22.66–$344.00	9% below	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 181	$51.60	$344.00	$22.66–$344.00	9% below	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Charges	$51.60	$344.00	$22.66–$344.00	9% below	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units	$51.60	$344.00	$22.66–$344.00	9% below	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Assistant Charges	$51.60	$344.00	$22.66–$344.00	9% below	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units	$51.60	$344.00	$22.66–$344.00	9% below	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 185	$51.60	$344.00	$22.66–$344.00	9% below	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Charges	$51.60	$344.00	$22.66–$344.00	9% below	85%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Assistant Charges	$51.60	$344.00	$22.66–$344.00	9% below	85%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 185	$120.40	$344.00	$38.18–$309.60	—	65%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units	$120.40	$344.00	$38.18–$309.60	—	65%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units	$120.40	$344.00	$38.18–$309.60	—	65%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Charges	$120.40	$344.00	$38.18–$309.60	—	65%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Charges	$120.40	$344.00	$38.18–$309.60	—	65%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 181	$120.40	$344.00	$38.18–$309.60	—	65%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 185	$120.40	$344.00	$38.18–$309.60	—	65%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 181	$120.40	$344.00	$38.18–$309.60	—	65%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Assistant Charges	$120.40	$344.00	$38.18–$309.60	—	65%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Assistant Charges	$120.40	$344.00	$38.18–$309.60	—	65%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units	$57.15	$381.00	$10.96–$381.00	4% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181	$57.15	$381.00	$10.96–$381.00	4% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Charge	$57.15	$381.00	$10.96–$381.00	4% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$57.15	$381.00	$10.96–$381.00	4% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges	$57.15	$381.00	$10.96–$381.00	4% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 TH THEREXRS-15MIN PT - REDOC 181	$57.15	$381.00	$10.96–$381.00	4% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 185	$57.15	$381.00	$10.96–$381.00	4% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 181	$57.15	$381.00	$10.96–$381.00	4% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Charges	$57.15	$381.00	$10.96–$381.00	4% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185	$57.15	$381.00	$10.96–$381.00	4% above	85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Charge	$57.15	$381.00	$10.96–$381.00	4% above	85%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 185	$133.35	$381.00	$42.29–$342.90	—	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 181	$133.35	$381.00	$42.29–$342.90	—	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Charges	$133.35	$381.00	$42.29–$342.90	—	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units	$133.35	$381.00	$42.29–$342.90	—	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Charge	$133.35	$381.00	$42.29–$342.90	—	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Charges	$133.35	$381.00	$42.29–$342.90	—	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TH THEREXRS-15MIN PT - REDOC 181	$133.35	$381.00	$42.29–$342.90	—	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Charge	$133.35	$381.00	$42.29–$342.90	—	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181	$133.35	$381.00	$42.29–$342.90	—	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185	$133.35	$381.00	$42.29–$342.90	—	65%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units	$133.35	$381.00	$42.29–$342.90	—	65%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco counseling Charge - 3-10 minutes	$19.50	$130.00	$12.95–$257.00	41% below	85%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Behavior change Smoke Charge - 1-10 minutes	$19.50	$130.00	$12.95–$257.00	41% below	85%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco counseling Charge - 3-10 minutes	$45.50	$130.00	$14.43–$117.00	—	65%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Behavior change Smoke Charge - 1-10 minutes	$45.50	$130.00	$14.43–$117.00	—	65%
Speech and language evaluation CPT 92523 Speech Evaluation with Language Charge	$247.05	$1,647.00	$169.45–$1,647.00	39% above	85%
Speech and language evaluation CPT 92523 SLP Eval Lang Comprehension,Express Unit	$247.05	$1,647.00	$169.45–$1,647.00	39% above	85%
Speech and language evaluation CPT 92523 SP SOUND LANG COMP - REDOC 187	$247.05	$1,647.00	$169.45–$1,647.00	39% above	85%
Speech and language evaluation CPT 92523 Speech Evaluation with Language Units	$247.05	$1,647.00	$169.45–$1,647.00	39% above	85%
Speech and language evaluation inpatient CPT 92523 SP SOUND LANG COMP - REDOC 187	$576.45	$1,647.00	$182.82–$1,482.30	—	65%
Speech and language evaluation inpatient CPT 92523 Speech Evaluation with Language Charge	$576.45	$1,647.00	$182.82–$1,482.30	—	65%
Speech and language evaluation inpatient CPT 92523 SLP Eval Lang Comprehension,Express Unit	$576.45	$1,647.00	$182.82–$1,482.30	—	65%
Speech and language evaluation inpatient CPT 92523 Speech Evaluation with Language Units	$576.45	$1,647.00	$182.82–$1,482.30	—	65%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 187	$539.85	$3,599.00	$32.79–$3,599.00	243% above	85%
Speech therapy session, individual CPT 92507 Speech Treatment Charge - Yes	$539.85	$3,599.00	$32.79–$3,599.00	243% above	85%
Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units	$539.85	$3,599.00	$32.79–$3,599.00	243% above	85%
Speech therapy session, individual CPT 92507 Speech Treatment Charge	$539.85	$3,599.00	$32.79–$3,599.00	243% above	85%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Charge - Yes	$1,259.65	$3,599.00	$399.49–$3,239.10	—	65%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Charge	$1,259.65	$3,599.00	$399.49–$3,239.10	—	65%
Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units	$1,259.65	$3,599.00	$399.49–$3,239.10	—	65%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 187	$1,259.65	$3,599.00	$399.49–$3,239.10	—	65%
Spirometry (breathing test) CPT 94010 Pulmonary Function Test Charge - spirometry	$56.55	$377.00	$41.85–$558.00	55% below	85%
Spirometry (breathing test) inpatient CPT 94010 Pulmonary Function Test Charge - spirometry	$131.95	$377.00	$41.85–$339.30	—	65%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities Charge	$36.15	$241.00	$8.76–$241.00	28% below	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Charges	$36.15	$241.00	$8.76–$241.00	28% below	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA - Redoc 1	$36.15	$241.00	$8.76–$241.00	28% below	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units	$36.15	$241.00	$8.76–$241.00	28% below	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 TH THER ACT-15MIN PT - REDOC 181	$36.15	$241.00	$8.76–$241.00	28% below	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Assist Charges	$36.15	$241.00	$8.76–$241.00	28% below	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA - Redoc 1	$36.15	$241.00	$8.76–$241.00	28% below	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities Assist Charge	$36.15	$241.00	$8.76–$241.00	28% below	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Units	$36.15	$241.00	$8.76–$241.00	28% below	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 185	$36.15	$241.00	$8.76–$241.00	28% below	85%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 181	$36.15	$241.00	$8.76–$241.00	28% below	85%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Units	$84.35	$241.00	$26.75–$216.90	—	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units	$84.35	$241.00	$26.75–$216.90	—	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Charges	$84.35	$241.00	$26.75–$216.90	—	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities Charge	$84.35	$241.00	$26.75–$216.90	—	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 181	$84.35	$241.00	$26.75–$216.90	—	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 185	$84.35	$241.00	$26.75–$216.90	—	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities Assist Charge	$84.35	$241.00	$26.75–$216.90	—	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Assist Charges	$84.35	$241.00	$26.75–$216.90	—	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA - Redoc 1	$84.35	$241.00	$26.75–$216.90	—	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA - Redoc 1	$84.35	$241.00	$26.75–$216.90	—	65%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TH THER ACT-15MIN PT - REDOC 181	$84.35	$241.00	$26.75–$216.90	—	65%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 08213-1000-33 - Collagen Matrix 10.5 cm2 Misc	$35.79	$238.62	$26.49–$238.62	81% below	85%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 08213-1000-33 - Collagen Matrix 10.5 cm2 Misc	$83.52	$238.62	$26.49–$214.76	—	65%
Rabies vaccine, one dose CPT 90675 18474-0000-19 - Collagen-Antimicrobial Sheet 2 cm2	$120.00	$800.00	$88.80–$800.00	79% below	85%
Rabies vaccine, one dose CPT 90675 61958-2901-01 - remdesivir 100 mg Powder-Inj	$121.64	$810.96	$90.02–$810.96	79% below	85%
Rabies vaccine, one dose CPT 90675 61958-2901-02 - remdesivir 100 mg Powder-Inj	$121.64	$810.96	$90.02–$810.96	79% below	85%
Rabies vaccine, one dose inpatient CPT 90675 18474-0000-19 - Collagen-Antimicrobial Sheet 2 cm2	$280.00	$800.00	$88.80–$720.00	—	65%
Rabies vaccine, one dose inpatient CPT 90675 61958-2901-01 - remdesivir 100 mg Powder-Inj	$283.84	$810.96	$90.02–$729.86	—	65%
Rabies vaccine, one dose inpatient CPT 90675 61958-2901-02 - remdesivir 100 mg Powder-Inj	$283.84	$810.96	$90.02–$729.86	—	65%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM 1ST VACCINE - BCE	$41.10	$274.00	$17.87–$274.00	14% below	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Emergency Departme	$41.10	$274.00	$17.87–$274.00	14% below	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - In House/Observati	$41.10	$274.00	$17.87–$274.00	14% below	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Infusion Center	$41.10	$274.00	$17.87–$274.00	14% below	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 $ED Admin Vaccine	$41.10	$274.00	$17.87–$274.00	14% below	85%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM 1ST VACCINE - BCE 191	$41.10	$274.00	$17.87–$274.00	14% below	85%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM 1ST VACCINE - BCE 191	$95.90	$274.00	$30.41–$246.60	—	65%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Infusion Center	$95.90	$274.00	$30.41–$246.60	—	65%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - In House/Observati	$95.90	$274.00	$30.41–$246.60	—	65%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM 1ST VACCINE - BCE	$95.90	$274.00	$30.41–$246.60	—	65%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Emergency Departme	$95.90	$274.00	$30.41–$246.60	—	65%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 $ED Admin Vaccine	$95.90	$274.00	$30.41–$246.60	—	65%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pt. Location - Vaccine Charge - ED Additional	$66.45	$443.00	$12.82–$443.00	120% above	85%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Pt. Location - Vaccine Charge - ED Additional	$155.05	$443.00	$49.17–$398.70	—	65%

Dental

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACTION ERUPTED TOOTH/EXR	$4,835.37	$32,235.79	$1,266.98–$32,235.79	at median	85%

Source file: https://www.merithealthrankin.com/Uploads/Public/Documents/charge-masters/charge-masters-2024/640885458_merit-health-rankin_standardcharges.csv