Hospital Faribault-Northfield, MN

Northfield Hospital

Northfield Hospital in Northfield, MN publishes cash prices for 257 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Minnesota median for 145 of 256 procedures and above it for 110. By typical cash price it ranks #39 of 79 Minnesota hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

2000 North Avenue, Northfield, MN, 55057 Collected Sep 27, 2026 Source price file (507) 646-1004

Acute care hospital Emergency department CMS star rating 4 of 5 CCN 240014 · CMS hospital register

Scans and imaging

ProcedureCash price List priceInsurers payvs MinnesotaOff list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Upr/L Xtremity Art 2 Lvls Bil $217.00 $519.00 $341.09–$453.92 42% below 58%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ABI w/o Exercise $238.00 $567.00 $372.63–$453.92 36% below 58%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Upr/L Xtremity Art 2 Lvls Bil $217.00 $519.00 $341.09–$453.92 — 58%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ABI w/o Exercise $238.00 $567.00 $372.63–$453.92 — 58%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-Ray Esophagus $291.00 $696.00 $457.41–$626.87 at median 58%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X-Ray Esophagus $291.00 $696.00 $457.41–$626.87 — 58%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone Scan (Whole Body) $760.00 $1,816.00 $1,193.48–$1,415.01 38% below 58%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone Scan (Whole Body) $760.00 $1,816.00 $1,193.48–$1,415.01 — 58%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiogram Thoracic Aorta $1,313.00 $3,141.00 $543.47–$2,117.03 21% below 58%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Chest Pulm Emb w/IV Contras $1,313.00 $3,141.00 $543.47–$2,117.03 21% below 58%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Chest Pulm Emb w/IV Contras $1,313.00 $3,141.00 $543.47–$2,117.03 — 58%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angiogram Thoracic Aorta $1,313.00 $3,141.00 $543.47–$2,117.03 — 58%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd Pel w/o Contrast $2,087.00 $4,992.00 $737.94–$3,364.61 9% above 58%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd Pel w/o Contrast $2,087.00 $4,992.00 $737.94–$3,364.61 — 58%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pel w/ Contrast $2,300.00 $5,502.00 $1,090.28–$3,708.35 7% below 58%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd Pel w/ Contrast $2,300.00 $5,502.00 $1,090.28–$3,708.35 — 58%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd Pel w/wo Contrast $2,569.00 $6,144.00 $1,090.28–$4,141.06 at median 58%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd Pel w/wo Contrast $2,569.00 $6,144.00 $1,090.28–$4,141.06 — 58%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Dye $1,151.00 $2,753.00 $543.47–$1,855.52 21% below 58%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Dye $1,151.00 $2,753.00 $543.47–$1,855.52 — 58%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Dye $1,045.00 $2,500.00 $324.64–$1,685.00 11% below 58%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Dye $1,045.00 $2,500.00 $324.64–$1,685.00 — 58%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Facial Bones w/o IV Cont $1,045.00 $2,500.00 $324.64–$1,685.00 16% below 58%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Dye $1,045.00 $2,500.00 $324.64–$1,685.00 16% below 58%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Facial Bones w/o IV Cont $1,045.00 $2,500.00 $324.64–$1,685.00 — 58%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Dye $1,045.00 $2,500.00 $324.64–$1,685.00 — 58%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain w/o Dye $1,045.00 $2,500.00 $324.64–$1,685.00 17% below 58%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head/Brain w/o Dye $1,045.00 $2,500.00 $324.64–$1,685.00 — 58%
CT scan of the head with contrast CPT 70460 CT Head/Brain w/Dye $1,101.00 $2,633.00 $543.47–$1,774.64 15% below 58%
CT scan of the head with contrast inpatient CPT 70460 CT Head/Brain w/Dye $1,101.00 $2,633.00 $543.47–$1,774.64 — 58%
CT scan of the head without and with contrast CPT 70470 CT Head/Brain w/wo Dye $1,231.00 $2,944.00 $543.47–$1,984.26 23% below 58%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head/Brain w/wo Dye $1,231.00 $2,944.00 $543.47–$1,984.26 — 58%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine w/o Dye $1,101.00 $2,633.00 $324.64–$1,774.64 19% below 58%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumbar Spine w/o Dye $1,101.00 $2,633.00 $324.64–$1,774.64 — 58%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Neck Spine w/o Dye $1,101.00 $2,633.00 $324.64–$1,774.64 19% below 58%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Neck Spine w/o Dye $1,101.00 $2,633.00 $324.64–$1,774.64 — 58%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Dye $1,151.00 $2,753.00 $543.47–$1,855.52 22% below 58%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Dye $1,151.00 $2,753.00 $543.47–$1,855.52 — 58%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Carotid $561.00 $1,340.00 $737.94–$903.16 32% below 58%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Carotid $561.00 $1,340.00 $737.94–$903.16 — 58%
Chest X-ray, 2 views CPT 71046 X-Ray Chest 2V $210.00 $502.00 $268.80–$338.35 9% below 58%
Chest X-ray, 2 views inpatient CPT 71046 X-Ray Chest 2V $210.00 $502.00 $268.80–$338.35 — 58%
Chest X-ray, single view CPT 71045 X-Ray Chest 1V $156.00 $372.00 $244.48–$310.04 12% below 58%
Chest X-ray, single view CPT 71045 X-Ray Chest Port IV $191.00 $456.00 $268.80–$310.04 8% above 58%
Chest X-ray, single view inpatient CPT 71045 X-Ray Chest 1V $156.00 $372.00 $244.48–$310.04 — 58%
Chest X-ray, single view inpatient CPT 71045 X-Ray Chest Port IV $191.00 $456.00 $268.80–$310.04 — 58%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Renal/Bladder $443.00 $1,058.00 $324.64–$713.09 15% below 58%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Renal/Bladder $443.00 $1,058.00 $324.64–$713.09 — 58%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bone Density $280.00 $668.00 $324.64–$450.23 11% below 58%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Bone Density $280.00 $668.00 $324.64–$450.23 — 58%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA Appendicular (Wrist) $224.00 $534.00 $268.80–$359.92 16% above 58%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA Appendicular (Wrist) $224.00 $534.00 $268.80–$359.92 — 58%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB Level 2 $839.00 $2,007.00 $737.94–$1,352.72 85% above 58%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB Level 2 $839.00 $2,007.00 $737.94–$1,352.72 — 58%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Dye $1,076.00 $2,573.00 $324.64–$1,734.20 14% below 58%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Dye $1,076.00 $2,573.00 $324.64–$1,734.20 — 58%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Dye $1,313.00 $3,141.00 $543.47–$2,117.03 12% below 58%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Chest - Pe Protocol $1,313.00 $3,141.00 $543.47–$2,117.03 12% below 58%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Dye $1,313.00 $3,141.00 $543.47–$2,117.03 — 58%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Chest - Pe Protocol $1,313.00 $3,141.00 $543.47–$2,117.03 — 58%
Diagnostic mammogram, both breasts both sides CPT 77066 Diag Mammo Bilat Digital w/Cad $383.00 $915.00 $169.01–$823.50 — 58%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Diag Mammo Bilat Digital w/Cad $383.00 $915.00 $169.01–$823.50 — 58%
Duplex ultrasound of the leg arteries, both legs CPT 93925 Ext Lwr Art Dop B $598.00 $1,430.00 $737.94–$963.82 26% below 58%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Ext Lwr Art Dop B $598.00 $1,430.00 $737.94–$963.82 — 58%
Duplex ultrasound of the leg veins, both legs CPT 93970 Ext Lwr Ven Dop B $646.00 $1,544.00 $737.94–$1,040.66 27% below 58%
Duplex ultrasound of the leg veins, both legs CPT 93970 Ext Up Ven Dop B $646.00 $1,544.00 $737.94–$1,040.66 27% below 58%
Duplex ultrasound of the leg veins, both legs CPT 93970 Lower Ext Venous Insuf Bil $765.00 $1,828.00 $737.94–$1,232.07 14% below 58%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Ext Up Ven Dop B $646.00 $1,544.00 $737.94–$1,040.66 — 58%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Ext Lwr Ven Dop B $646.00 $1,544.00 $737.94–$1,040.66 — 58%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Lower Ext Venous Insuf Bil $765.00 $1,828.00 $737.94–$1,232.07 — 58%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo w/Cf and SD $1,030.00 $2,464.00 $1,619.34–$1,930.79 18% below 58%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo w/Cf and SD $1,030.00 $2,464.00 $1,619.34–$1,930.79 — 58%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary w/o Gbef $1,066.00 $2,549.00 $1,226.74–$1,718.03 21% below 58%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepatobiliary w/o Gbef $1,066.00 $2,549.00 $1,226.74–$1,718.03 — 58%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HST Home Sleep Study $872.00 $2,085.00 $477.66–$1,405.29 42% above 58%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Mailed HST Home Sleep Study $972.00 $2,325.00 $477.66–$1,567.05 59% above 58%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Disorder Testing w/CPAP $2,438.00 $5,832.00 $3,105.97–$3,930.77 30% below 58%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Titration of CPAP or BiPAP $2,438.00 $5,832.00 $3,105.97–$3,930.77 30% below 58%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 CPAP Titration, Fully Attended $2,957.00 $7,072.00 $3,105.97–$4,766.53 15% below 58%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ABD Ltd $443.00 $1,058.00 $324.64–$713.09 6% above 58%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Ltd Fac 76705 $443.00 $1,058.00 $324.64–$713.09 6% above 58%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Ltd Fac 76705 $443.00 $1,058.00 $324.64–$713.09 — 58%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ABD Ltd $443.00 $1,058.00 $324.64–$713.09 — 58%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Thorax Lung Screen w/o Cont $1,317.00 $3,149.00 $324.64–$2,122.43 128% above 58%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Thorax Lung Screen w/o Cont $1,317.00 $3,149.00 $324.64–$2,122.43 — 58%
MRI of both breasts, without and then with contrast dye CPT 77049 MRI Breast w/wo Con w/CAD Bil $3,087.00 $7,383.00 $370.40–$4,976.14 115% above 58%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI Breast w/wo Con w/CAD Bil $3,087.00 $7,383.00 $370.40–$4,976.14 — 58%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Dye $1,761.00 $4,211.00 $737.94–$2,838.21 19% below 58%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Dye $1,761.00 $4,211.00 $737.94–$2,838.21 — 58%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/wo Dye $2,669.00 $6,384.00 $1,090.28–$4,302.82 9% below 58%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/wo Dye $2,669.00 $6,384.00 $1,090.28–$4,302.82 — 58%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Dye $1,058.00 $2,529.00 $737.94–$2,325.74 48% below 58%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Dye $1,058.00 $2,529.00 $737.94–$2,325.74 — 58%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/wo Dye $1,779.00 $4,255.00 $1,090.28–$2,867.87 34% below 58%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/wo Dye $1,779.00 $4,255.00 $1,090.28–$2,867.87 — 58%
MRI of the lower back, no contrast dye CPT 72148 MRI L-Spine w/o Dye $1,002.00 $2,396.00 $737.94–$2,325.74 52% below 58%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-Spine w/o Dye $1,002.00 $2,396.00 $737.94–$2,325.74 — 58%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-Spine w/wo Dye $1,782.00 $4,261.00 $1,090.28–$2,871.91 31% below 58%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L-Spine w/wo Dye $1,782.00 $4,261.00 $1,090.28–$2,871.91 — 58%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-Spine w/o Dye $1,012.00 $2,420.00 $737.94–$2,325.74 52% below 58%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T-Spine w/o Dye $1,012.00 $2,420.00 $737.94–$2,325.74 — 58%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-Spine w/wo Dye $1,793.00 $4,289.00 $1,090.28–$2,890.79 28% below 58%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-Spine w/wo Dye $1,793.00 $4,289.00 $1,090.28–$2,890.79 — 58%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-Spine w/o Dye $1,012.00 $2,420.00 $737.94–$2,325.74 52% below 58%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-Spine w/o Dye $1,012.00 $2,420.00 $737.94–$2,325.74 — 58%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/wo Dye $2,661.00 $6,366.00 $1,090.28–$4,290.68 at median 58%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/wo Dye $2,661.00 $6,366.00 $1,090.28–$4,290.68 — 58%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Dye $2,050.00 $4,904.00 $737.94–$3,305.30 3% below 58%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Dye $2,050.00 $4,904.00 $737.94–$3,305.30 — 58%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myo Perf/Spect/Mult $1,426.00 $3,411.00 $2,241.71–$3,411.00 50% below 58%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Myo Perf/Spect/Mult $1,426.00 $3,411.00 $2,241.71–$3,411.00 — 58%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet/CT Standard Body Study $1,708.00 $4,085.00 $2,684.66–$4,085.00 33% below 58%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Pet/CT Standard Body Study $1,708.00 $4,085.00 $2,684.66–$4,085.00 — 58%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Emer Rm Bladder Volume US $67.00 $160.00 $105.15–$160.00 78% below 58%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic TA Ltd Fac 76857 $67.00 $160.00 $105.15–$160.00 78% below 58%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic TA Ltd Pro 76857 $74.00 $176.00 $118.62–$176.00 76% below 58%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Pelvic Limited TA $443.00 $1,058.00 $324.64–$713.09 45% above 58%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic TA Ltd Fac 76857 $67.00 $160.00 $105.15–$160.00 — 58%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Emer Rm Bladder Volume US $67.00 $160.00 $105.15–$160.00 — 58%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic TA Ltd Pro 76857 $74.00 $176.00 $118.62–$176.00 — 58%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Pelvic Limited TA $443.00 $1,058.00 $324.64–$713.09 — 58%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Pelvic TA $443.00 $1,058.00 $324.64–$713.09 5% below 58%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Pelvic TA $443.00 $1,058.00 $324.64–$713.09 — 58%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB Greater 14 Wks $513.00 $1,226.00 $324.64–$826.32 7% above 58%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB Greater 14 Wks $513.00 $1,226.00 $324.64–$826.32 — 58%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US <14 Wks TA $443.00 $1,058.00 $324.64–$713.09 6% above 58%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US <14 Wks TA $443.00 $1,058.00 $324.64–$713.09 — 58%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB TA Ltd Pro 76815 $97.00 $231.00 $155.69–$231.00 70% below 58%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Ultrasound In OB $137.00 $326.00 $214.25–$326.00 57% below 58%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB TA Ltd Fac 76815 $151.00 $360.00 $236.59–$360.00 53% below 58%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB Limited $354.00 $845.00 $324.64–$569.53 10% above 58%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB TA Ltd Pro 76815 $97.00 $231.00 $155.69–$231.00 — 58%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Ultrasound In OB $137.00 $326.00 $214.25–$326.00 — 58%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB TA Ltd Fac 76815 $151.00 $360.00 $236.59–$360.00 — 58%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB Limited $354.00 $845.00 $324.64–$569.53 — 58%
Screening mammogram, both breasts CPT 77067 Implant Mammo Views $123.00 $294.00 $136.99–$264.60 64% below 58%
Screening mammogram, both breasts CPT 77067 Screen Mammo Bil Digital w/Cad $353.00 $844.00 $136.99–$759.60 5% above 58%
Screening mammogram, both breasts inpatient CPT 77067 Implant Mammo Views $123.00 $294.00 $136.99–$264.60 — 58%
Screening mammogram, both breasts inpatient CPT 77067 Screen Mammo Bil Digital w/Cad $353.00 $844.00 $136.99–$759.60 — 58%
Sleep study in a lab (polysomnography) CPT 95810 Sleep Disorder Test w/o CPAP $2,438.00 $5,832.00 $3,105.97–$3,930.77 21% below 58%
Sleep study in a lab (polysomnography) CPT 95810 Sleep Study with Dental Device $2,438.00 $5,832.00 $3,105.97–$3,930.77 21% below 58%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Stress Test & Echo $908.00 $2,170.00 $1,426.12–$1,930.79 49% below 58%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Stress Test & Echo $908.00 $2,170.00 $1,426.12–$1,930.79 — 58%
Swallow study (modified barium swallow, video X-ray) CPT 74230 BA Swallow w/ Video $388.00 $927.00 $543.47–$626.87 31% above 58%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BA Swallow w/ Video $388.00 $927.00 $543.47–$626.87 — 58%
Transvaginal pelvic ultrasound CPT 76830 US Pelvic TV Pro 76830 $103.00 $246.00 $165.80–$246.00 73% below 58%
Transvaginal pelvic ultrasound CPT 76830 US Pelvic TV Fac 76830 $255.00 $608.00 $324.64–$409.79 34% below 58%
Transvaginal pelvic ultrasound CPT 76830 Pelvic TV $443.00 $1,058.00 $324.64–$713.09 14% above 58%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Pelvic TV Pro 76830 $103.00 $246.00 $165.80–$246.00 — 58%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Pelvic TV Fac 76830 $255.00 $608.00 $324.64–$409.79 — 58%
Transvaginal pelvic ultrasound inpatient CPT 76830 Pelvic TV $443.00 $1,058.00 $324.64–$713.09 — 58%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TV Pro 76817 $113.00 $270.00 $181.98–$270.00 66% below 58%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TV Fac 76817 $173.00 $412.00 $270.77–$374.48 48% below 58%
Transvaginal ultrasound during pregnancy CPT 76817 OB Transvag $443.00 $1,058.00 $324.64–$713.09 33% above 58%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TV Pro 76817 $113.00 $270.00 $181.98–$270.00 — 58%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TV Fac 76817 $173.00 $412.00 $270.77–$374.48 — 58%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 OB Transvag $443.00 $1,058.00 $324.64–$713.09 — 58%
Ultrasound of the abdomen, complete CPT 76700 ABD Comp $443.00 $1,058.00 $324.64–$713.09 25% below 58%
Ultrasound of the abdomen, complete inpatient CPT 76700 ABD Comp $443.00 $1,058.00 $324.64–$713.09 — 58%
Ultrasound of the scrotum and testicles CPT 76870 Scrotum $443.00 $1,058.00 $324.64–$713.09 3% below 58%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Scrotum $443.00 $1,058.00 $324.64–$713.09 — 58%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Thyroid / Soft Tissue Neck $443.00 $1,058.00 $324.64–$713.09 3% below 58%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head/Neck $443.00 $1,058.00 $324.64–$713.09 3% below 58%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Head/Neck $443.00 $1,058.00 $324.64–$713.09 — 58%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Thyroid / Soft Tissue Neck $443.00 $1,058.00 $324.64–$713.09 — 58%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-Ray Upper GI $285.00 $681.00 $447.55–$626.87 11% below 58%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-Ray Upper GI $285.00 $681.00 $447.55–$626.87 — 58%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Arm Vein Rt Fac 93971 $449.00 $1,074.00 $324.64–$723.88 18% below 58%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Arm Vein Rt Fac 93971 $449.00 $1,074.00 $324.64–$723.88 — 58%
X-ray of the abdomen, 1 view CPT 74018 X-Ray Abdomen 1V $145.00 $345.00 $226.73–$310.04 31% below 58%
X-ray of the abdomen, 1 view inpatient CPT 74018 X-Ray Abdomen 1V $145.00 $345.00 $226.73–$310.04 — 58%
X-ray of the finger(s), 2 or more views CPT 73140 X-Ray Fingers Bil $329.00 $787.00 $268.80–$530.44 70% above 58%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-Ray Fingers Bil $329.00 $787.00 $268.80–$530.44 — 58%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-Ray Lumbar Spine Rout $260.00 $622.00 $324.64–$419.23 1% below 58%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-Ray Lumbar Spine Rout $260.00 $622.00 $324.64–$419.23 — 58%
X-ray of the lower back, 4 or more views CPT 72110 X-Ray Lumbar Spine Obl $341.00 $814.00 $324.64–$548.64 at median 58%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-Ray Lumbar Spine Obl $341.00 $814.00 $324.64–$548.64 — 58%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-Ray Thoracic Spine 2V $232.00 $555.00 $324.64–$374.48 6% below 58%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-Ray Thoracic Spine 2V $232.00 $555.00 $324.64–$374.48 — 58%
X-ray of the nasal bones, 3 or more views CPT 70160 X-Ray Nose $190.00 $454.00 $268.80–$310.04 13% below 58%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-Ray Nose $190.00 $454.00 $268.80–$310.04 — 58%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-Ray Cervical Spine 2V $190.00 $454.00 $268.80–$310.04 23% below 58%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-Ray Cervical Spine 2V $190.00 $454.00 $268.80–$310.04 — 58%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-Ray Pelvis 1 or 2V $161.00 $383.00 $251.71–$374.48 19% below 58%
X-ray of the pelvis, 1 or 2 views CPT 72170 Operative Hip $220.00 $524.00 $324.64–$374.48 10% above 58%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-Ray Pelvis 1 or 2V $161.00 $383.00 $251.71–$374.48 — 58%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Operative Hip $220.00 $524.00 $324.64–$374.48 — 58%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-Ray Sacrum Coccyx $181.00 $432.00 $268.80–$310.04 20% below 58%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-Ray Sacrum Coccyx $181.00 $432.00 $268.80–$310.04 — 58%

Lab tests

ProcedureCash price List priceInsurers payvs MinnesotaOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT $44.00 $105.00 $5.40–$70.77 2% below 58%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT $44.00 $105.00 $5.40–$70.77 — 58%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT $43.00 $102.00 $5.27–$68.75 4% below 58%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT $43.00 $102.00 $5.27–$68.75 — 58%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel-Acute $379.00 $906.00 $48.49–$610.64 62% above 58%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel-Acute $379.00 $906.00 $48.49–$610.64 — 58%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Nos $44.00 $104.00 $5.31–$70.10 189% above 58%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Nos $44.00 $104.00 $5.31–$70.10 — 58%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrollinated Peptide $104.00 $248.00 $13.18–$167.15 149% above 58%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrollinated Peptide $104.00 $248.00 $13.18–$167.15 — 58%
Antinuclear antibody (ANA) blood test, screen CPT 86038 FANA $97.00 $232.00 $12.31–$156.37 115% above 58%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 FANA $97.00 $232.00 $12.31–$156.37 — 58%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Pro - BNP $271.00 $647.00 $39.97–$436.08 101% above 58%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Pro - BNP $271.00 $647.00 $39.97–$436.08 — 58%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel $103.00 $246.00 $8.61–$165.80 15% above 58%
Basic metabolic panel (blood test) CPT 80048 Chem 6 Panel $103.00 $246.00 $8.61–$165.80 15% above 58%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel $103.00 $246.00 $8.61–$165.80 — 58%
Basic metabolic panel (blood test) inpatient CPT 80048 Chem 6 Panel $103.00 $246.00 $8.61–$165.80 — 58%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV - Tissue $86.00 $205.00 $134.73–$188.15 18% below 58%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Endo Bx Tissue Lvl 4 $212.00 $506.00 $163.11–$341.04 103% above 58%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level IV - Tissue $86.00 $205.00 $134.73–$188.15 — 58%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Endo Bx Tissue Lvl 4 $212.00 $506.00 $163.11–$341.04 — 58%
Blood culture for bacteria CPT 87040 Culture, Blood $95.00 $225.00 $10.51–$151.65 14% below 58%
Blood culture for bacteria inpatient CPT 87040 Culture, Blood $95.00 $225.00 $10.51–$151.65 — 58%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Collection (Cap Or Ven) $16.00 $36.00 $9.25–$24.26 23% below 56%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture $20.00 $46.00 $9.25–$31.00 4% below 57%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Paternity Testing Collection $20.00 $46.00 $9.25–$31.00 4% below 57%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood Collection (Cap Or Ven) $16.00 $36.00 $9.25–$24.26 — 56%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Paternity Testing Collection $20.00 $46.00 $9.25–$31.00 — 57%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture $20.00 $46.00 $9.25–$31.00 — 57%
Blood glucose (sugar) test CPT 82947 Body Fluid Chemistry $36.00 $86.00 $4.00–$57.96 19% below 58%
Blood glucose (sugar) test CPT 82947 Glucose $36.00 $86.00 $4.00–$57.96 19% below 58%
Blood glucose (sugar) test inpatient CPT 82947 Body Fluid Chemistry $36.00 $86.00 $4.00–$57.96 — 58%
Blood glucose (sugar) test inpatient CPT 82947 Glucose $36.00 $86.00 $4.00–$57.96 — 58%
Blood lead test CPT 83655 Lead Level $98.00 $234.00 $12.33–$157.72 214% above 58%
Blood lead test inpatient CPT 83655 Lead Level $98.00 $234.00 $12.33–$157.72 — 58%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG-Serum Qual $62.00 $147.00 $7.66–$99.08 11% below 58%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG-Serum Qual $62.00 $147.00 $7.66–$99.08 — 58%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Group-Referred $136.00 $324.00 $91.28–$324.00 158% above 58%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Group $142.00 $338.00 $91.28–$338.00 169% above 58%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Group-Referred $136.00 $324.00 $91.28–$324.00 — 58%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Abo Group $142.00 $338.00 $91.28–$338.00 — 58%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP $62.00 $148.00 $5.27–$99.75 14% above 58%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP $62.00 $148.00 $5.27–$99.75 — 58%
C. difficile toxin gene test (stool PCR) CPT 87493 C Diff Amp Probe $147.00 $350.00 $37.94–$235.90 11% above 58%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C Diff Amp Probe $147.00 $350.00 $37.94–$235.90 — 58%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 $166.00 $397.00 $21.18–$267.58 63% above 58%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 $166.00 $397.00 $21.18–$267.58 — 58%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 $166.00 $397.00 $21.18–$267.58 63% above 58%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 $166.00 $397.00 $21.18–$267.58 — 58%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Covid19 - 87635 Sars-2-Cov-2 $132.00 $315.00 $52.23–$212.31 10% above 58%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Covid19 - 87635 Sars-2-Cov-2 $132.00 $315.00 $52.23–$212.31 — 58%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trach Amplified $147.00 $351.00 $35.72–$236.57 56% above 58%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trach Amplified $147.00 $351.00 $35.72–$236.57 — 58%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel $83.00 $198.00 $13.63–$133.45 10% below 58%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel $83.00 $198.00 $13.63–$133.45 — 58%
Complete blood count (CBC) with differential CPT 85025 Hemogram/Diff/Platelet $96.00 $229.00 $7.91–$154.35 15% above 58%
Complete blood count (CBC) with differential inpatient CPT 85025 Hemogram/Diff/Platelet $96.00 $229.00 $7.91–$154.35 — 58%
Complete blood count (CBC), no differential CPT 85027 Hemogram/Platelet/No Dif $53.00 $126.00 $6.59–$84.92 19% below 58%
Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram/Platelet/No Dif $53.00 $126.00 $6.59–$84.92 — 58%
Comprehensive metabolic panel (blood test) CPT 80053 Comp. Metabolic Panel $129.00 $308.00 $10.75–$207.59 36% above 58%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comp. Metabolic Panel $129.00 $308.00 $10.75–$207.59 — 58%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer Quant $82.00 $196.00 $10.36–$132.10 17% below 58%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer Quant $82.00 $196.00 $10.36–$132.10 — 58%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-Sulfate $178.00 $424.00 $22.63–$285.78 208% above 58%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-Sulfate $178.00 $424.00 $22.63–$285.78 — 58%
Estradiol blood test CPT 82670 Estradiol $224.00 $534.00 $28.44–$359.92 239% above 58%
Estradiol blood test inpatient CPT 82670 Estradiol $224.00 $534.00 $28.44–$359.92 — 58%
FSH (follicle-stimulating hormone) test CPT 83001 FSH $149.00 $356.00 $18.91–$239.94 111% above 58%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH $149.00 $356.00 $18.91–$239.94 — 58%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal $157.00 $374.00 $19.98–$252.08 87% above 58%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal $157.00 $374.00 $19.98–$252.08 — 58%
Ferritin blood test (iron stores) CPT 82728 Ferritin Level $110.00 $261.00 $13.88–$175.91 23% above 58%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin Level $110.00 $261.00 $13.88–$175.91 — 58%
Folate (folic acid) blood test CPT 82746 Folate Level $118.00 $281.00 $14.96–$189.39 48% above 58%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level $118.00 $281.00 $14.96–$189.39 — 58%
Free T3 thyroid hormone test CPT 84481 T3 Free $136.00 $325.00 $17.24–$219.05 33% above 58%
Free T3 thyroid hormone test inpatient CPT 84481 T3 Free $136.00 $325.00 $17.24–$219.05 — 58%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4-Free $74.00 $175.00 $9.18–$117.95 8% above 58%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4-Free $74.00 $175.00 $9.18–$117.95 — 58%
Free testosterone test CPT 84402 Testosterone, Free $204.00 $486.00 $25.93–$327.56 227% above 58%
Free testosterone test inpatient CPT 84402 Testosterone, Free $204.00 $486.00 $25.93–$327.56 — 58%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel $123.00 $294.00 $51.03–$198.16 50% below 58%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel $123.00 $294.00 $51.03–$198.16 — 58%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT-1 Hr $36.00 $84.00 $4.84–$56.62 15% below 57%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose, 2 Hour Post Challenge $36.00 $86.00 $4.84–$57.96 15% below 58%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose, 2 Hour Post Challenge $36.00 $86.00 $4.84–$57.96 — 58%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT-1 Hr $36.00 $84.00 $4.84–$56.62 — 57%
Glucose tolerance test, 3 samples CPT 82951 Gtt-2 Hr $107.00 $254.00 $13.10–$171.20 11% above 58%
Glucose tolerance test, 3 samples inpatient CPT 82951 Gtt-2 Hr $107.00 $254.00 $13.10–$171.20 — 58%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N Gonorrhoeae Amplified $147.00 $351.00 $35.72–$236.57 74% above 58%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N Gonorrhoeae Amplified $147.00 $351.00 $35.72–$236.57 — 58%
H. pylori antibody blood test CPT 86677 H. Pylori $117.00 $279.00 $17.15–$188.04 at median 58%
H. pylori antibody blood test inpatient CPT 86677 H. Pylori $117.00 $279.00 $17.15–$188.04 — 58%
H. pylori stool antigen test CPT 87338 H Pylori Stool $116.00 $276.00 $14.64–$186.02 7% above 58%
H. pylori stool antigen test inpatient CPT 87338 H Pylori Stool $116.00 $276.00 $14.64–$186.02 — 58%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 Quant&Revrse Trnscrpj $260.00 $622.00 $86.63–$419.23 126% above 58%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 RNA Quant By PCR $292.00 $697.00 $86.63–$469.78 154% above 58%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 Quant&Revrse Trnscrpj $260.00 $622.00 $86.63–$419.23 — 58%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 RNA Quant By PCR $292.00 $697.00 $86.63–$469.78 — 58%
HIV-1 and HIV-2 antibody test CPT 86703 HIV1/HIV2 Ea $110.00 $263.00 $13.96–$177.26 66% above 58%
HIV-1 and HIV-2 antibody test CPT 86703 HIV $110.00 $263.00 $13.96–$177.26 66% above 58%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV1/HIV2 Ea $110.00 $263.00 $13.96–$177.26 — 58%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV $110.00 $263.00 $13.96–$177.26 — 58%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 Ag W HIV-1 and HIV-2 Ab $192.00 $458.00 $24.51–$308.69 204% above 58%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 Ag W HIV-1 and HIV-2 Ab $192.00 $458.00 $24.51–$308.69 — 58%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV Thin Prep $92.00 $220.00 $35.72–$148.28 29% below 58%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV Thin Prep $92.00 $220.00 $35.72–$148.28 — 58%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 ANCA Screen Each Ab $26.00 $60.00 $9.88–$40.43 55% below 57%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C $60.00 $142.00 $9.88–$95.71 4% above 58%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 ANCA Screen Each Ab $26.00 $60.00 $9.88–$40.43 — 57%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C $60.00 $142.00 $9.88–$95.71 — 58%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab $87.00 $207.00 $10.93–$139.52 32% above 58%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab $87.00 $207.00 $10.93–$139.52 — 58%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surf AG $84.00 $199.00 $10.52–$134.13 58% above 58%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep B Surf AG $84.00 $199.00 $10.52–$134.13 — 58%
Hepatitis C antibody blood test (screening) CPT 86803 Hep C AB $115.00 $274.00 $14.53–$184.68 44% above 58%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hep C AB $115.00 $274.00 $14.53–$184.68 — 58%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Revrs Transcrpj $342.00 $817.00 $43.61–$550.66 176% above 58%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Revrs Transcrpj $342.00 $817.00 $43.61–$550.66 — 58%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Type 1 IGG Confirmation $107.00 $254.00 $13.43–$171.20 131% above 58%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Type 1 IGG Confirmation $107.00 $254.00 $13.43–$171.20 — 58%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Type 2 IGG Confirmation $156.00 $371.00 $19.70–$250.05 171% above 58%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Type 2 IGG Confirmation $156.00 $371.00 $19.70–$250.05 — 58%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP High Sensitivity $104.00 $248.00 $13.18–$167.15 47% above 58%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP High Sensitivity $104.00 $248.00 $13.18–$167.15 — 58%
Homocysteine blood test CPT 83090 Homocysteine $136.00 $324.00 $18.24–$218.38 52% above 58%
Homocysteine blood test inpatient CPT 83090 Homocysteine $136.00 $324.00 $18.24–$218.38 — 58%
Insulin blood test CPT 83525 Insulin Level Serum $92.00 $220.00 $11.64–$148.28 68% above 58%
Insulin blood test inpatient CPT 83525 Insulin Level Serum $92.00 $220.00 $11.64–$148.28 — 58%
Iron blood test (serum iron) CPT 83540 Serum Iron $53.00 $126.00 $6.59–$84.92 3% above 58%
Iron blood test (serum iron) inpatient CPT 83540 Serum Iron $53.00 $126.00 $6.59–$84.92 — 58%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity $72.00 $171.00 $8.90–$115.25 11% above 58%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity $72.00 $171.00 $8.90–$115.25 — 58%
Kidney function blood test panel CPT 80069 Kidney Function Panel $106.00 $253.00 $8.84–$170.52 at median 58%
Kidney function blood test panel inpatient CPT 80069 Kidney Function Panel $106.00 $253.00 $8.84–$170.52 — 58%
LH (luteinizing hormone) test CPT 83002 LH $148.00 $354.00 $18.85–$238.60 82% above 58%
LH (luteinizing hormone) test inpatient CPT 83002 LH $148.00 $354.00 $18.85–$238.60 — 58%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase $56.00 $133.00 $7.01–$89.65 5% below 58%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase $56.00 $133.00 $7.01–$89.65 — 58%
Liver function blood test panel CPT 80076 Liver Function Panel $67.00 $158.00 $8.32–$106.49 34% below 58%
Liver function blood test panel CPT 80076 Liver Transplant PR $67.00 $158.00 $8.32–$106.49 34% below 58%
Liver function blood test panel inpatient CPT 80076 Liver Transplant PR $67.00 $158.00 $8.32–$106.49 — 58%
Liver function blood test panel inpatient CPT 80076 Liver Function Panel $67.00 $158.00 $8.32–$106.49 — 58%
Lyme disease antibody test CPT 86618 Lyme Disease Antibody $137.00 $326.00 $17.34–$219.71 112% above 58%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Antibody $137.00 $326.00 $17.34–$219.71 — 58%
Magnesium blood test CPT 83735 RBC Mg $55.00 $130.00 $6.82–$87.62 76% above 58%
Magnesium blood test CPT 83735 Magnesium $55.00 $131.00 $6.82–$88.29 76% above 58%
Magnesium blood test inpatient CPT 83735 Magnesium $55.00 $131.00 $6.82–$88.29 — 58%
Magnesium blood test inpatient CPT 83735 RBC Mg $55.00 $130.00 $6.82–$87.62 — 58%
Measles (rubeola) antibody test CPT 86765 Rubeola $104.00 $247.00 $13.11–$166.48 185% above 58%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola $104.00 $247.00 $13.11–$166.48 — 58%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Test $43.00 $102.00 $5.27–$68.75 16% below 58%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Test $43.00 $102.00 $5.27–$68.75 — 58%
Obstetric blood test panel CPT 80055 Obstetric Panel $381.00 $910.00 $48.67–$613.34 44% above 58%
Obstetric blood test panel inpatient CPT 80055 Obstetric Panel $381.00 $910.00 $48.67–$613.34 — 58%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free - Diagnostic $148.00 $353.00 $18.72–$237.92 311% above 58%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free - Diagnostic $148.00 $353.00 $18.72–$237.92 — 58%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic $148.00 $353.00 $18.72–$237.92 83% above 58%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diagnostic $148.00 $353.00 $18.72–$237.92 — 58%
Pap test (liquid-based, automated screening with review) CPT 88175 Cytopath C/V Auto $64.00 $152.00 $27.09–$102.45 25% below 58%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopath C/V Auto $64.00 $152.00 $27.09–$102.45 — 58%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytopath C/V Thin Layer $50.00 $119.00 $20.62–$80.21 35% below 58%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cytopath C/V Thin Layer $50.00 $119.00 $20.62–$80.21 — 58%
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone $329.00 $787.00 $42.02–$530.44 181% above 58%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone $329.00 $787.00 $42.02–$530.44 — 58%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin T $34.00 $80.00 $6.12–$53.92 42% below 58%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin T $34.00 $80.00 $6.12–$53.92 — 58%
Progesterone blood test CPT 84144 Progesterone $167.00 $398.00 $21.24–$268.25 107% above 58%
Progesterone blood test inpatient CPT 84144 Progesterone $167.00 $398.00 $21.24–$268.25 — 58%
Prolactin blood test CPT 84146 Prolactin Dilution Study $106.00 $252.00 $19.73–$169.85 62% above 58%
Prolactin blood test CPT 84146 Prolactin $156.00 $371.00 $19.73–$250.05 139% above 58%
Prolactin blood test inpatient CPT 84146 Prolactin Dilution Study $106.00 $252.00 $19.73–$169.85 — 58%
Prolactin blood test inpatient CPT 84146 Prolactin $156.00 $371.00 $19.73–$250.05 — 58%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time $31.00 $74.00 $4.37–$49.88 2% above 58%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time $31.00 $74.00 $4.37–$49.88 — 58%
Rapid flu test (influenza antigen) CPT 87804 Influenza AG, Each $97.00 $231.00 $16.85–$155.69 73% above 58%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza AG, Each $97.00 $231.00 $16.85–$155.69 — 58%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor $47.00 $112.00 $5.77–$75.49 3% below 58%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor $47.00 $112.00 $5.77–$75.49 — 58%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody $67.00 $158.00 $14.65–$106.49 42% above 58%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody $67.00 $158.00 $14.65–$106.49 — 58%
Stool ova and parasites exam CPT 87177 Ova & Parasites $73.00 $173.00 $9.06–$116.60 107% above 58%
Stool ova and parasites exam inpatient CPT 87177 Ova & Parasites $73.00 $173.00 $9.06–$116.60 — 58%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Hemoccult $26.00 $61.00 $4.46–$41.11 26% below 57%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Hemoccult $26.00 $61.00 $4.46–$41.11 — 57%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Immunochemical Assay Occultbld $128.00 $306.00 $16.21–$206.24 122% above 58%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Immunochemical Assay Occultbld $128.00 $306.00 $16.21–$206.24 — 58%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR $36.00 $85.00 $4.35–$57.29 22% above 58%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, CSF $36.00 $85.00 $4.35–$57.29 22% above 58%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Treponema Pallidum Screen $36.00 $85.00 $4.35–$57.29 22% above 58%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR $36.00 $85.00 $4.35–$57.29 — 58%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, CSF $36.00 $85.00 $4.35–$57.29 — 58%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Treponema Pallidum Screen $36.00 $85.00 $4.35–$57.29 — 58%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB By Quantiferon $118.00 $280.00 $63.10–$188.72 4% below 58%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB By Quantiferon $118.00 $280.00 $63.10–$188.72 — 58%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone $141.00 $336.00 $26.27–$226.46 125% above 58%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone $141.00 $336.00 $26.27–$226.46 — 58%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibodies $117.00 $279.00 $14.81–$188.04 122% above 58%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Antibodies $117.00 $279.00 $14.81–$188.04 — 58%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH $136.00 $323.00 $17.10–$217.70 45% above 58%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH $136.00 $323.00 $17.10–$217.70 — 58%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Amp $98.00 $234.00 $35.72–$157.72 95% above 58%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis Amp $98.00 $234.00 $35.72–$157.72 — 58%
Uric acid blood test CPT 84550 Uric Acid,Serum $37.00 $88.00 $4.60–$59.31 15% below 58%
Uric acid blood test inpatient CPT 84550 Uric Acid,Serum $37.00 $88.00 $4.60–$59.31 — 58%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Complete $50.00 $118.00 $3.23–$79.53 1% above 58%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Complete $50.00 $118.00 $3.23–$79.53 — 58%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick $20.00 $46.00 $2.29–$31.00 22% below 57%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Dipstick $20.00 $46.00 $2.29–$31.00 — 57%
Urine culture for bacteria, with colony count CPT 87086 Culture-Urine $66.00 $157.00 $8.22–$105.82 20% above 58%
Urine culture for bacteria, with colony count inpatient CPT 87086 Culture-Urine $66.00 $157.00 $8.22–$105.82 — 58%
Urine pregnancy test, read by color change CPT 81025 HCG-Urine $52.00 $124.00 $8.76–$83.58 34% above 58%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG-Urine $52.00 $124.00 $8.76–$83.58 — 58%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level $122.00 $290.00 $15.35–$195.46 37% above 58%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level $122.00 $290.00 $15.35–$195.46 — 58%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-Hydroxy $147.00 $350.00 $30.13–$235.90 51% above 58%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 25-Hydroxy $147.00 $350.00 $30.13–$235.90 — 58%
Zinc blood test CPT 84630 Zinc $72.00 $172.00 $11.60–$115.93 139% above 58%
Zinc blood test CPT 84630 Zinc Level $92.00 $220.00 $11.60–$148.28 206% above 58%
Zinc blood test inpatient CPT 84630 Zinc $72.00 $172.00 $11.60–$115.93 — 58%
Zinc blood test inpatient CPT 84630 Zinc Level $92.00 $220.00 $11.60–$148.28 — 58%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadortopin, Chronic (HCG) $77.00 $182.00 $15.32–$122.67 17% below 58%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG-Serum Quant $90.00 $213.00 $15.32–$143.56 3% below 58%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin, Chorionic (Hcg) $90.00 $213.00 $15.32–$143.56 3% below 58%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Gonadortopin, Chronic (HCG) $77.00 $182.00 $15.32–$122.67 — 58%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Gonadotropin, Chorionic (Hcg) $90.00 $213.00 $15.32–$143.56 — 58%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG-Serum Quant $90.00 $213.00 $15.32–$143.56 — 58%

Surgery and procedures

ProcedureCash price List priceInsurers payvs MinnesotaOff list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Fracture Distal Fibula $670.00 $1,601.00 $732.33–$1,079.07 44% above 58%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Fracture Distal Fibula $670.00 $1,601.00 $732.33–$1,079.07 — 58%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Elective $587.00 $1,403.00 $945.62–$1,403.00 43% below 58%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Electric Ext $600.00 $1,434.00 $942.42–$1,434.00 42% below 58%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardiovers Elective Ext ER Fa $861.00 $2,058.00 $1,008.00–$2,058.00 16% below 58%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Elective $587.00 $1,403.00 $945.62–$1,403.00 — 58%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Electric Ext $600.00 $1,434.00 $942.42–$1,434.00 — 58%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardiovers Elective Ext ER Fa $861.00 $2,058.00 $1,008.00–$2,058.00 — 58%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision $161.00 $385.00 $253.02–$385.00 34% below 58%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision $161.00 $385.00 $253.02–$385.00 — 58%
Colonoscopy with polyp removal CPT 45385 Colonoscopy w/Lesion Remova $382.00 $913.00 $615.36–$913.00 69% below 58%
Colonoscopy with polyp removal CPT 45385 Colon Polyp w/Snare $1,448.00 $3,463.00 $2,334.06–$3,463.00 16% above 58%
Colonoscopy with polyp removal inpatient CPT 45385 Colonoscopy w/Lesion Remova $382.00 $913.00 $615.36–$913.00 — 58%
Colonoscopy with polyp removal inpatient CPT 45385 Colon Polyp w/Snare $1,448.00 $3,463.00 $2,334.06–$3,463.00 — 58%
Colonoscopy with tissue sample CPT 45380 Colon w/Bx Or Polyp Bx Forceps $1,361.00 $3,254.00 $2,193.20–$3,254.00 8% above 58%
Colonoscopy with tissue sample inpatient CPT 45380 Colon w/Bx Or Polyp Bx Forceps $1,361.00 $3,254.00 $2,193.20–$3,254.00 — 58%
Colonoscopy, diagnostic CPT 45378 Colonoscopy w/o Biopsy $1,290.00 $3,084.00 $2,078.62–$3,084.00 7% above 58%
Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy w/o Biopsy $1,290.00 $3,084.00 $2,078.62–$3,084.00 — 58%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Lesion Destruction $149.00 $356.00 $239.94–$356.00 18% below 58%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Lesion Destruction $149.00 $356.00 $239.94–$356.00 — 58%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal Cerumen $39.00 $91.00 $61.33–$91.00 50% below 57%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Remve Impacted Ear Wax Uni Fac $82.00 $196.00 $132.10–$196.00 6% above 58%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal Impacted Cerumen $109.00 $260.00 $170.87–$209.16 41% above 58%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Removal Cerumen $39.00 $91.00 $61.33–$91.00 — 57%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remve Impacted Ear Wax Uni Fac $82.00 $196.00 $132.10–$196.00 — 58%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Removal Impacted Cerumen $109.00 $260.00 $170.87–$209.16 — 58%
Earwax removal with instruments, one ear CPT 69210 Remove Impact Cerumen w/ Instr $109.00 $260.00 $170.87–$209.16 12% below 58%
Earwax removal with instruments, one ear inpatient CPT 69210 Remove Impact Cerumen w/ Instr $109.00 $260.00 $170.87–$209.16 — 58%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial Bx w/o Cervical Di $258.00 $616.00 $404.84–$616.00 4% above 58%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Endometrial Bx w/o Cervical Di $258.00 $616.00 $404.84–$616.00 — 58%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Nrv Inj Interlaminar Epi C-T w $1,132.00 $2,707.00 $1,824.52–$2,707.00 13% above 58%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Nrv Inj Interlaminar Epi C-T w $1,132.00 $2,707.00 $1,824.52–$2,707.00 — 58%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Nrv Inj Facet L/S Single w/Gui $1,003.00 $2,399.00 $1,616.93–$2,399.00 28% below 58%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Nrv Inj Facet L/S Single w/Gui $1,003.00 $2,399.00 $1,616.93–$2,399.00 — 58%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Flex Sig $951.00 $2,274.00 $1,532.68–$2,274.00 11% above 58%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Flex Sig $951.00 $2,274.00 $1,532.68–$2,274.00 — 58%
Hemorrhoid banding (rubber band ligation) CPT 46221 Hemorrhoidectomy,Int,Band $890.00 $2,127.00 $1,433.60–$2,127.00 10% above 58%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 Hemorrhoidectomy,Int,Band $890.00 $2,127.00 $1,433.60–$2,127.00 — 58%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Intro Saline Hysterosono $190.00 $454.00 $0.01–$306.00 37% below 58%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Inject for Hysterosal Pi $190.00 $454.00 $0.01–$454.00 37% below 58%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Inject for Hysterosal Pi $190.00 $454.00 $0.01–$454.00 — 58%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Intro Saline Hysterosono $190.00 $454.00 $0.01–$306.00 — 58%
IUD insertion (the device itself billed separately) CPT 58300 IUD Placement $204.00 $488.00 $115.64–$328.91 20% below 58%
IUD insertion (the device itself billed separately) inpatient CPT 58300 IUD Placement $204.00 $488.00 $115.64–$328.91 — 58%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Skin Abscess $198.00 $473.00 $318.80–$473.00 31% below 58%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Abscess Smple/Sngle ER Fac $266.00 $635.00 $427.99–$635.00 8% below 58%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Absc; Smpl Or Sgl $348.00 $831.00 $546.13–$699.72 21% above 58%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Abcess Simple $716.00 $1,711.00 $606.61–$1,153.21 148% above 58%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Skin Abscess $198.00 $473.00 $318.80–$473.00 — 58%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Abscess Smple/Sngle ER Fac $266.00 $635.00 $427.99–$635.00 — 58%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Absc; Smpl Or Sgl $348.00 $831.00 $546.13–$699.72 — 58%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Abcess Simple $716.00 $1,711.00 $606.61–$1,153.21 — 58%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Sgl Tendon Shth or Ligamnt $424.00 $1,013.00 $665.74–$1,013.00 15% above 58%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj Sgl Tendon Shth or Ligamnt $424.00 $1,013.00 $665.74–$1,013.00 — 58%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Artrocentesis Major Hip $137.00 $326.00 $219.71–$326.00 62% below 58%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/Inj Joint Large $292.00 $698.00 $470.45–$698.00 20% below 58%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Inj/Asp Large Joint $292.00 $698.00 $458.73–$698.00 20% below 58%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drn/inj Joint/Bursa w/o US Fac $393.00 $939.00 $632.89–$939.00 8% above 58%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Artrocentesis Major Hip $137.00 $326.00 $219.71–$326.00 — 58%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/Inj Joint Large $292.00 $698.00 $470.45–$698.00 — 58%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Inj/Asp Large Joint $292.00 $698.00 $458.73–$698.00 — 58%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Drn/inj Joint/Bursa w/o US Fac $393.00 $939.00 $632.89–$939.00 — 58%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis-Intermed $137.00 $326.00 $219.71–$326.00 55% below 58%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Asp/Inj Joint Medium $202.00 $481.00 $324.19–$481.00 34% below 58%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Inj/Asp Medium Joint $292.00 $698.00 $458.73–$698.00 4% below 58%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drn/Inj Jnt/Bursa w/o US ER Fa $392.00 $937.00 $631.54–$937.00 28% above 58%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis-Intermed $137.00 $326.00 $219.71–$326.00 — 58%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Asp/Inj Joint Medium $202.00 $481.00 $324.19–$481.00 — 58%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Inj/Asp Medium Joint $292.00 $698.00 $458.73–$698.00 — 58%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drn/Inj Jnt/Bursa w/o US ER Fa $392.00 $937.00 $631.54–$937.00 — 58%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/Inj Joint Small $144.00 $343.00 $225.42–$343.00 56% below 58%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Inj/Asp Small Joint $292.00 $698.00 $458.73–$698.00 10% below 58%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/Inj Joint Small $144.00 $343.00 $225.42–$343.00 — 58%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Inj/Asp Small Joint $292.00 $698.00 $458.73–$698.00 — 58%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 YAG Laser Capsulotomy $2,019.00 $4,829.00 $1,674.81–$3,254.75 33% above 58%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 2.5 cm Layer Closure Exc $308.00 $736.00 $496.06–$736.00 32% below 58%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 2.5 cm Layer Closure Exc $308.00 $736.00 $496.06–$736.00 — 58%
Lower-back epidural injection, with imaging guidance CPT 62323 Nrv Inj Interlaminar L/S w/Gui $1,205.00 $2,881.00 $1,941.79–$2,881.00 24% above 58%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Nrv Inj Interlaminar L/S w/Gui $1,205.00 $2,881.00 $1,941.79–$2,881.00 — 58%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Nrv Inj Transforam L/S Singl w $1,173.00 $2,805.00 $1,890.57–$2,805.00 9% below 58%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Nrv Inj Transforam L/S Singl w $1,173.00 $2,805.00 $1,890.57–$2,805.00 — 58%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Benign Lesion $370.00 $885.00 $596.49–$885.00 9% below 58%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc Benign Lesion $370.00 $885.00 $596.49–$885.00 — 58%
Nail removal (partial or complete), one nail CPT 11730 Avul Nail Plate Simple $210.00 $502.00 $338.35–$502.00 25% below 58%
Nail removal (partial or complete), one nail CPT 11730 Removal of Nail Plate ER Fac $266.00 $635.00 $427.99–$635.00 5% below 58%
Nail removal (partial or complete), one nail CPT 11730 Avulse Nail Plate Simple Sngl $348.00 $831.00 $546.13–$699.72 25% above 58%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avul Nail Plate Simple $210.00 $502.00 $338.35–$502.00 — 58%
Nail removal (partial or complete), one nail inpatient CPT 11730 Removal of Nail Plate ER Fac $266.00 $635.00 $427.99–$635.00 — 58%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulse Nail Plate Simple Sngl $348.00 $831.00 $546.13–$699.72 — 58%
Occipital nerve block (injection for headaches) CPT 64405 Injection Occipital Nerve Pro $243.00 $581.00 $391.59–$581.00 60% below 58%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/Strd Gr Ocpl Nrv ER Fa $354.00 $846.00 $570.20–$846.00 41% below 58%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Injection Occipital Nerve Pro $243.00 $581.00 $391.59–$581.00 — 58%
Occipital nerve block (injection for headaches) inpatient CPT 64405 NJX AA&/Strd Gr Ocpl Nrv ER Fa $354.00 $846.00 $570.20–$846.00 — 58%
Paracentesis with imaging guidance CPT 49083 Paracentesis w/Imaging $151.00 $361.00 $243.31–$361.00 83% below 58%
Paracentesis with imaging guidance CPT 49083 Abd Paracent w/Img ER Fac $949.00 $2,269.00 $1,008.00–$2,269.00 9% above 58%
Paracentesis with imaging guidance inpatient CPT 49083 Paracentesis w/Imaging $151.00 $361.00 $243.31–$361.00 — 58%
Paracentesis with imaging guidance inpatient CPT 49083 Abd Paracent w/Img ER Fac $949.00 $2,269.00 $1,008.00–$2,269.00 — 58%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Exc Nail & Matrix $267.00 $638.00 $430.01–$638.00 47% below 58%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal Of Nail Bed $669.00 $1,599.00 $1,050.86–$1,406.91 33% above 58%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Exc Nail & Matrix $267.00 $638.00 $430.01–$638.00 — 58%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal Of Nail Bed $669.00 $1,599.00 $1,050.86–$1,406.91 — 58%
Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 FL RFA Spine MBB L-S w/I Bilat $4,978.00 $11,909.00 $4,979.01–$8,026.67 — 58%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 FL RFA L5 Dorsal Prim Ram w/Im $3,319.00 $7,939.00 $4,979.01–$6,876.51 58% above 58%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 FL RFA Spine MBB L-S w/Imaging $3,319.00 $7,939.00 $4,979.01–$6,876.51 58% above 58%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient both sides CPT 64635 FL RFA Spine MBB L-S w/I Bilat $4,978.00 $11,909.00 $4,979.01–$8,026.67 — 58%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 FL RFA Spine MBB L-S w/Imaging $3,319.00 $7,939.00 $4,979.01–$6,876.51 — 58%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 FL RFA L5 Dorsal Prim Ram w/Im $3,319.00 $7,939.00 $4,979.01–$6,876.51 — 58%
Removal of a foreign object under the skin, simple CPT 10120 FB Removal Simple $204.00 $486.00 $327.56–$486.00 49% below 58%
Removal of a foreign object under the skin, simple CPT 10120 Inc&Rmvl FB Subq Tiss Smpl Fac $539.00 $1,289.00 $868.79–$1,289.00 35% above 58%
Removal of a foreign object under the skin, simple CPT 10120 Inc & Rem Fb Sq; Smpl $669.00 $1,599.00 $1,050.86–$1,406.91 67% above 58%
Removal of a foreign object under the skin, simple inpatient CPT 10120 FB Removal Simple $204.00 $486.00 $327.56–$486.00 — 58%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Inc&Rmvl FB Subq Tiss Smpl Fac $539.00 $1,289.00 $868.79–$1,289.00 — 58%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Inc & Rem Fb Sq; Smpl $669.00 $1,599.00 $1,050.86–$1,406.91 — 58%
Short arm cast (elbow to hand) CPT 29075 Apply Forearm Cast ER Facility $356.00 $851.00 $573.57–$851.00 51% above 58%
Short arm cast (elbow to hand) inpatient CPT 29075 Apply Forearm Cast ER Facility $356.00 $851.00 $573.57–$851.00 — 58%
Short arm splint (forearm and hand) CPT 29125 Apply Forearm Splint ER Facili $171.00 $408.00 $274.99–$408.00 14% below 58%
Short arm splint (forearm and hand) CPT 29125 Splint Appl Short Arm $244.00 $582.00 $392.27–$453.92 23% above 58%
Short arm splint (forearm and hand) inpatient CPT 29125 Apply Forearm Splint ER Facili $171.00 $408.00 $274.99–$408.00 — 58%
Short arm splint (forearm and hand) inpatient CPT 29125 Splint Appl Short Arm $244.00 $582.00 $392.27–$453.92 — 58%
Short leg cast (below the knee) CPT 29405 Apply Short Leg Cast ER Facili $356.00 $851.00 $573.57–$851.00 31% above 58%
Short leg cast (below the knee) inpatient CPT 29405 Apply Short Leg Cast ER Facili $356.00 $851.00 $573.57–$851.00 — 58%
Short leg splint (calf to foot) CPT 29515 Apply Lower Leg Splint ER Faci $210.00 $501.00 $337.67–$501.00 6% below 58%
Short leg splint (calf to foot) CPT 29515 Splint Appl Short Leg $244.00 $582.00 $392.27–$555.65 9% above 58%
Short leg splint (calf to foot) inpatient CPT 29515 Apply Lower Leg Splint ER Faci $210.00 $501.00 $337.67–$501.00 — 58%
Short leg splint (calf to foot) inpatient CPT 29515 Splint Appl Short Leg $244.00 $582.00 $392.27–$555.65 — 58%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr S/N/Ax/Gen/Trnk <2.5cm Fac $266.00 $635.00 $427.99–$635.00 2% below 58%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 2.5 cm Laceration-T,E,S, $276.00 $659.00 $444.17–$659.00 2% above 58%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 2.5 cm Laceration - N,H, $276.00 $659.00 $444.17–$659.00 2% above 58%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Rpr S/N/Ax/Gen/Trnk <2.5cm Fac $266.00 $635.00 $427.99–$635.00 — 58%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 2.5 cm Laceration-T,E,S, $276.00 $659.00 $444.17–$659.00 — 58%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 2.5 cm Laceration - N,H, $276.00 $659.00 $444.17–$659.00 — 58%
Skin biopsy, punch, one lesion CPT 11104 Punch Bx Single Lesion $74.00 $177.00 $119.30–$177.00 74% below 58%
Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin Single Lesion $669.00 $1,599.00 $1,050.86–$1,406.91 132% above 58%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx Single Lesion $74.00 $177.00 $119.30–$177.00 — 58%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx Skin Single Lesion $669.00 $1,599.00 $1,050.86–$1,406.91 — 58%
Skin tag removal, up to 15 tags CPT 11200 Removal Skin Tag $137.00 $326.00 $219.71–$326.00 30% below 58%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal Skin Tag $137.00 $326.00 $219.71–$326.00 — 58%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Neonate $186.00 $443.00 $291.14–$443.00 74% below 58%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumar Puncture Dx $255.00 $608.00 $409.79–$608.00 65% below 58%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture DX MDA $255.00 $608.00 $409.79–$608.00 65% below 58%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Dx Lmbr Spi Pnxr ER Fac $949.00 $2,269.00 $1,008.00–$2,269.00 31% above 58%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture Neonate $186.00 $443.00 $291.14–$443.00 — 58%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture DX MDA $255.00 $608.00 $409.79–$608.00 — 58%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumar Puncture Dx $255.00 $608.00 $409.79–$608.00 — 58%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Dx Lmbr Spi Pnxr ER Fac $949.00 $2,269.00 $1,008.00–$2,269.00 — 58%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Rpr S/N/A/Gen/Tr 2.6-7.5cm Fac $266.00 $635.00 $427.99–$635.00 13% below 58%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 2.6-7.5 cm Laceration N, $350.00 $836.00 $563.46–$699.72 14% above 58%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 2.6-7.5 cm Laceration $350.00 $836.00 $563.46–$699.72 14% above 58%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Rpr S/N/A/Gen/Tr 2.6-7.5cm Fac $266.00 $635.00 $427.99–$635.00 — 58%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 2.6-7.5 cm Laceration N, $350.00 $836.00 $563.46–$699.72 — 58%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 2.6-7.5 cm Laceration $350.00 $836.00 $563.46–$699.72 — 58%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Rpr F/E/E/N/L/M <2.5cm Facilit $266.00 $635.00 $427.99–$635.00 3% below 58%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 2.5 cm Lac Simp/Closure $276.00 $659.00 $444.17–$659.00 1% above 58%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Rpr F/E/E/N/L/M <2.5cm Facilit $266.00 $635.00 $427.99–$635.00 — 58%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 2.5 cm Lac Simp/Closure $276.00 $659.00 $444.17–$659.00 — 58%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl Bx Skin Single Les $348.00 $831.00 $546.13–$699.72 38% above 58%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangntl Bx Skin Single Les $348.00 $831.00 $546.13–$699.72 — 58%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis w/ Imagi-MedSurg $1,027.00 $2,455.00 $1,613.43–$2,177.15 15% above 58%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis w/ Imaging $1,027.00 $2,455.00 $1,613.43–$2,177.15 15% above 58%
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis w/ Imagi-MedSurg $1,027.00 $2,455.00 $1,613.43–$2,177.15 — 58%
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis w/ Imaging $1,027.00 $2,455.00 $1,613.43–$2,177.15 — 58%
Trigger point injections, 1 or 2 muscles CPT 20552 Sing/Mult Trigger Point $141.00 $337.00 $227.14–$337.00 54% below 58%
Trigger point injections, 1 or 2 muscles CPT 20552 Trigger Injection Single/Multi $199.00 $476.00 $320.82–$476.00 36% below 58%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Sing/Mult Trigger Point $141.00 $337.00 $227.14–$337.00 — 58%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Trigger Injection Single/Multi $199.00 $476.00 $320.82–$476.00 — 58%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD Esoph Balloon Dil $1,647.00 $3,939.00 $2,654.89–$3,939.00 9% below 58%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD Esoph Balloon Dil $1,647.00 $3,939.00 $2,654.89–$3,939.00 — 58%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD Biopsy Single/Multiple $207.00 $495.00 $333.63–$495.00 80% below 58%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD w/Bx or Polyp Bx Forceps $1,246.00 $2,980.00 $2,008.52–$2,980.00 18% above 58%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD Biopsy Single/Multiple $207.00 $495.00 $333.63–$495.00 — 58%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD w/Bx or Polyp Bx Forceps $1,246.00 $2,980.00 $2,008.52–$2,980.00 — 58%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD Submuc Inj $1,482.00 $3,544.00 $2,388.66–$3,544.00 16% above 58%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD Submuc Inj $1,482.00 $3,544.00 $2,388.66–$3,544.00 — 58%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD Remove Polyp Snare $1,359.00 $3,249.00 $2,189.83–$3,249.00 23% below 58%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD Remove Polyp Snare $1,359.00 $3,249.00 $2,189.83–$3,249.00 — 58%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD Savary Dil $1,359.00 $3,249.00 $2,189.83–$3,249.00 3% below 58%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD Savary Dil $1,359.00 $3,249.00 $2,189.83–$3,249.00 — 58%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD Diagnostic Brush Wash $1,246.00 $2,980.00 $2,008.52–$2,980.00 30% above 58%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD Diagnostic Brush Wash $1,246.00 $2,980.00 $2,008.52–$2,980.00 — 58%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Deb Subq Tiss 20 Sq cm or Less $669.00 $1,599.00 $1,050.86–$1,406.91 50% above 58%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Deb Subq Tiss 20 Sq cm or Less $669.00 $1,599.00 $1,050.86–$1,406.91 — 58%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs MinnesotaOff list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion-Daily Charge Anes $520.00 $1,243.00 $816.90–$1,243.00 27% below 58%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion-Daily Charge ER $520.00 $1,243.00 $816.90–$1,243.00 27% below 58%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion-Daily Charge Recov $520.00 $1,243.00 $816.90–$1,243.00 27% below 58%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion-Daily Charge-Birth $520.00 $1,243.00 $816.90–$1,243.00 27% below 58%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion-Daily Charge-M/S $520.00 $1,243.00 $816.90–$1,243.00 27% below 58%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion-Daily Charge-CCIC $520.00 $1,243.00 $816.90–$1,243.00 27% below 58%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion-Daily Charge-OP Cl $520.00 $1,243.00 $816.90–$1,243.00 27% below 58%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion-Daily Charge-OP Cl $520.00 $1,243.00 $816.90–$1,243.00 — 58%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion-Daily Charge-M/S $520.00 $1,243.00 $816.90–$1,243.00 — 58%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion-Daily Charge-Birth $520.00 $1,243.00 $816.90–$1,243.00 — 58%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion-Daily Charge Recov $520.00 $1,243.00 $816.90–$1,243.00 — 58%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion-Daily Charge ER $520.00 $1,243.00 $816.90–$1,243.00 — 58%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion-Daily Charge Anes $520.00 $1,243.00 $816.90–$1,243.00 — 58%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion-Daily Charge-CCIC $520.00 $1,243.00 $816.90–$1,243.00 — 58%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Neb Treatment - Medsurg $40.00 $95.00 $62.43–$95.00 66% below 58%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Neb Treatment $40.00 $95.00 $62.43–$95.00 66% below 58%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Sputum Induction $88.00 $210.00 $138.01–$210.00 25% below 58%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Neb Treatment - Medsurg $40.00 $95.00 $62.43–$95.00 — 58%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Neb Treatment $40.00 $95.00 $62.43–$95.00 — 58%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Sputum Induction $88.00 $210.00 $138.01–$210.00 — 58%
Chemotherapy IV infusion, first hour CPT 96413 Chemo Infusion First Hour $283.00 $675.00 $443.61–$675.00 45% below 58%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Infusion First Hour $283.00 $675.00 $443.61–$675.00 — 58%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care-First Hour $442.00 $1,057.00 $712.42–$1,057.00 71% below 58%
Critical care, first 30 to 74 minutes CPT 99291 Level 6 ER Critical Care $885.00 $2,116.00 $1,008.00–$2,116.00 43% below 58%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care 1st Hour $326.00 $779.00 $525.05–$779.00 — 58%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care-First Hour $442.00 $1,057.00 $712.42–$1,057.00 — 58%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Level 6 ER Critical Care $885.00 $2,116.00 $1,008.00–$2,116.00 — 58%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 Lead EKG; Trace-Only-CCIC $216.00 $515.00 $181.34–$347.11 25% above 58%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 Lead EKG;Trace-Only-Recover $222.00 $530.00 $181.34–$357.22 29% above 58%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 Lead EKG; Trace-Only-OB $222.00 $530.00 $181.34–$357.22 29% above 58%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 Lead EKG;Trace-Only-Medsurg $222.00 $530.00 $181.34–$357.22 29% above 58%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 Lead EKG; Trace-Only-ED $222.00 $530.00 $181.34–$357.22 29% above 58%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 Lead EKG; Trace-Only-SDS $222.00 $530.00 $181.34–$357.22 29% above 58%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 Lead EKG; Trace-Only-CCIC $216.00 $515.00 $181.34–$347.11 — 58%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 Lead EKG; Trace-Only-ED $222.00 $530.00 $181.34–$357.22 — 58%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 Lead EKG;Trace-Only-Medsurg $222.00 $530.00 $181.34–$357.22 — 58%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 Lead EKG;Trace-Only-Recover $222.00 $530.00 $181.34–$357.22 — 58%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 Lead EKG; Trace-Only-SDS $222.00 $530.00 $181.34–$357.22 — 58%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 Lead EKG; Trace-Only-OB $222.00 $530.00 $181.34–$357.22 — 58%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Level 1 Emergency Room $113.00 $270.00 $181.98–$270.00 41% below 58%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Level 1 Emergency Room $113.00 $270.00 $181.98–$270.00 — 58%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Level 2 Emergency Room $225.00 $537.00 $361.94–$537.00 9% below 58%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Level 2 Emergency Room $225.00 $537.00 $361.94–$537.00 — 58%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Level 3 Emergency Room $426.00 $1,019.00 $686.81–$1,008.00 2% above 58%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Level 3 Emergency Room $426.00 $1,019.00 $686.81–$1,008.00 — 58%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Level 4 Emergency Room $586.00 $1,401.00 $944.27–$1,401.00 8% below 58%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Level 4 Emergency Room $586.00 $1,401.00 $944.27–$1,401.00 — 58%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Level 5 Emergency Room $820.00 $1,961.00 $1,008.00–$1,961.00 13% below 58%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Level 5 Emergency Room $820.00 $1,961.00 $1,008.00–$1,961.00 — 58%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test-Tech Comp $354.00 $845.00 $555.33–$845.00 51% below 58%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test-Tech Comp $354.00 $845.00 $555.33–$845.00 — 58%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 1st Hydration Up to 1 Hr Endo $222.00 $529.00 $347.66–$529.00 19% below 58%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 1st Hydration Up to 1 Hr Obser $222.00 $529.00 $347.66–$529.00 19% below 58%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 1st Hydration Up to 1 Hr - ED $222.00 $529.00 $347.66–$529.00 19% below 58%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 1st Hydration Up to 1 Hr Birth $222.00 $529.00 $347.66–$529.00 19% below 58%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 1st Hydration Up to 1 Hr- CCIC $222.00 $529.00 $347.66–$529.00 19% below 58%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 1st Hydration Up to 1 Hr Endo $222.00 $529.00 $347.66–$529.00 — 58%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 1st Hydration Up to 1 Hr Birth $222.00 $529.00 $347.66–$529.00 — 58%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 1st Hydration Up to 1 Hr Obser $222.00 $529.00 $347.66–$529.00 — 58%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 1st Hydration Up to 1 Hr- CCIC $222.00 $529.00 $347.66–$529.00 — 58%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 1st Hydration Up to 1 Hr - ED $222.00 $529.00 $347.66–$529.00 — 58%
IV infusion of a medicine, first hour CPT 96365 1st Infus Ther to 1 Hr Birth $267.00 $638.00 $419.29–$638.00 19% below 58%
IV infusion of a medicine, first hour CPT 96365 1st Infus Ther to 1 Hr - ED $267.00 $638.00 $419.29–$638.00 19% below 58%
IV infusion of a medicine, first hour CPT 96365 1st Infus Ther to 1 Hr Stress $267.00 $638.00 $419.29–$638.00 19% below 58%
IV infusion of a medicine, first hour CPT 96365 1st Infus Ther to 1 Hr MedSurg $267.00 $638.00 $419.29–$638.00 19% below 58%
IV infusion of a medicine, first hour CPT 96365 1st Infus Ther to 1 Hr CCIC $267.00 $638.00 $419.29–$638.00 19% below 58%
IV infusion of a medicine, first hour inpatient CPT 96365 1st Infus Ther to 1 Hr CCIC $267.00 $638.00 $419.29–$638.00 — 58%
IV infusion of a medicine, first hour inpatient CPT 96365 1st Infus Ther to 1 Hr - ED $267.00 $638.00 $419.29–$638.00 — 58%
IV infusion of a medicine, first hour inpatient CPT 96365 1st Infus Ther to 1 Hr Birth $267.00 $638.00 $419.29–$638.00 — 58%
IV infusion of a medicine, first hour inpatient CPT 96365 1st Infus Ther to 1 Hr MedSurg $267.00 $638.00 $419.29–$638.00 — 58%
IV infusion of a medicine, first hour inpatient CPT 96365 1st Infus Ther to 1 Hr Stress $267.00 $638.00 $419.29–$638.00 — 58%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection Observ $76.00 $180.00 $118.30–$180.00 2% below 58%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OP - IM/SQ Injection - ED $76.00 $180.00 $118.30–$180.00 2% below 58%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection Birth $76.00 $180.00 $118.30–$180.00 2% below 58%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection CCIC $76.00 $180.00 $118.30–$180.00 2% below 58%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - Wound $122.00 $290.00 $190.59–$250.63 58% above 58%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection Observ $76.00 $180.00 $118.30–$180.00 — 58%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection Birth $76.00 $180.00 $118.30–$180.00 — 58%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OP - IM/SQ Injection - ED $76.00 $180.00 $118.30–$180.00 — 58%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection CCIC $76.00 $180.00 $118.30–$180.00 — 58%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - Wound $122.00 $290.00 $190.59–$250.63 — 58%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Re-Educ - 15 Min $73.00 $173.00 $35.23–$139.09 1% above 58%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Re-Educ - 15 Min $73.00 $173.00 $35.23–$139.09 — 58%
New patient office visit, about 30 minutes CPT 99203 Level 3 New Patient Oncology $96.00 $229.00 $119.91–$206.10 18% below 58%
New patient office visit, about 30 minutes CPT 99203 Telehealth Lvl 3 New Pro $157.00 $374.00 $119.91–$336.60 34% above 58%
New patient office visit, about 30 minutes inpatient CPT 99203 Level 3 New Patient Oncology $96.00 $229.00 $119.91–$206.10 — 58%
New patient office visit, about 30 minutes inpatient CPT 99203 Telehealth Lvl 3 New Pro $157.00 $374.00 $119.91–$336.60 — 58%
New patient office visit, about 45 minutes CPT 99204 Level 4 New Pt Oncology $104.00 $248.00 $162.99–$223.20 39% below 58%
New patient office visit, about 45 minutes CPT 99204 Telehealth Lvl 4 New Pro $238.00 $569.00 $179.68–$512.10 39% above 58%
New patient office visit, about 45 minutes inpatient CPT 99204 Level 4 New Pt Oncology $104.00 $248.00 $162.99–$223.20 — 58%
New patient office visit, about 45 minutes inpatient CPT 99204 Telehealth Lvl 4 New Pro $238.00 $569.00 $179.68–$512.10 — 58%
New patient office visit, about 60 minutes CPT 99205 Level 5 New Pt Oncology $113.00 $270.00 $177.44–$243.00 52% below 58%
New patient office visit, about 60 minutes CPT 99205 Telehealth Lvl 5 New Pro $298.00 $711.00 $237.33–$639.90 27% above 58%
New patient office visit, about 60 minutes inpatient CPT 99205 Level 5 New Pt Oncology $113.00 $270.00 $177.44–$243.00 — 58%
New patient office visit, about 60 minutes inpatient CPT 99205 Telehealth Lvl 5 New Pro $298.00 $711.00 $237.33–$639.90 — 58%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Level 2 New Patient Oncology $73.00 $173.00 $76.86–$155.70 4% below 58%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Telehealth Lvl 2 New Pro $108.00 $258.00 $76.86–$232.20 42% above 58%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Level 2 New Patient Oncology $73.00 $173.00 $76.86–$155.70 — 58%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Telehealth Lvl 2 New Pro $108.00 $258.00 $76.86–$232.20 — 58%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Initial Assessment Ea 15 Min $43.00 $101.00 $39.14–$90.90 31% below 57%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Initial Assessment Ea 15 Min $43.00 $101.00 $39.14–$90.90 — 57%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Ea 15 Mins $73.00 $173.00 $29.89–$118.03 12% below 58%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Ea 15 Mins $73.00 $173.00 $29.89–$118.03 — 58%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Ea 15 Min $81.00 $193.00 $31.67–$130.08 10% below 58%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise Ea 15 Min $81.00 $193.00 $31.67–$130.08 — 58%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Telehealth Lvl 5 Est Pt Pro $212.00 $505.00 $193.21–$454.50 25% above 58%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Telehealth Lvl 5 Est Pt Pro $212.00 $505.00 $193.21–$454.50 — 58%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Telehealth Lvl 3 Est Pt Pro $105.00 $250.00 $97.85–$225.00 12% above 58%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Telehealth Lvl 3 Est Pt Pro $105.00 $250.00 $97.85–$225.00 — 58%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Telehealth Lvl 4 Est Pt Pro $156.00 $372.00 $137.70–$334.80 30% above 58%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Telehealth Lvl 4 Est Pt Pro $156.00 $372.00 $137.70–$334.80 — 58%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Telehealth Lvl 2 Est Pt Pro $66.00 $157.00 $60.49–$141.30 21% below 58%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Telehealth Lvl 2 Est Pt Pro $66.00 $157.00 $60.49–$141.30 — 58%
Spirometry (breathing test) CPT 94010 Spirometry Ltd Bedside $86.00 $205.00 $134.73–$205.00 46% below 58%
Spirometry (breathing test) CPT 94010 Spirometry $107.00 $254.00 $166.93–$254.00 33% below 58%
Spirometry (breathing test) inpatient CPT 94010 Spirometry Ltd Bedside $86.00 $205.00 $134.73–$205.00 — 58%
Spirometry (breathing test) inpatient CPT 94010 Spirometry $107.00 $254.00 $166.93–$254.00 — 58%
Spirometry before and after a bronchodilator CPT 94060 Spiro/Bronchodilator $192.00 $459.00 $301.65–$459.00 34% below 58%
Spirometry before and after a bronchodilator inpatient CPT 94060 Spiro/Bronchodilator $192.00 $459.00 $301.65–$459.00 — 58%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activity Ea 15 Min $73.00 $173.00 $38.07–$150.33 6% below 58%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activity Ea 15 Min $73.00 $173.00 $38.07–$150.33 — 58%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy-Therapeutic $387.00 $925.00 $393.52–$623.45 83% above 58%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy-Therapeutic $387.00 $925.00 $393.52–$623.45 — 58%

Vaccines

ProcedureCash price List priceInsurers payvs MinnesotaOff list
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone HD Vaccine $115.00 $275.05 $79.09–$185.38 53% above 58%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone HD Vaccine $115.00 $275.05 $79.09–$185.38 — 58%
Rabies vaccine, one dose CPT 90675 Imovax $512.00 $1,222.50 $356.44–$823.96 7% below 58%
Rabies vaccine, one dose CPT 90675 Rabavert 2.5 Unit Inj $609.00 $1,455.00 $356.44–$980.67 11% above 58%
Rabies vaccine, one dose inpatient CPT 90675 Imovax $512.00 $1,222.50 $356.44–$823.96 — 58%
Rabies vaccine, one dose inpatient CPT 90675 Rabavert 2.5 Unit Inj $609.00 $1,455.00 $356.44–$980.67 — 58%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus/Diphtheria Toxoid $92.00 $218.70 $34.57–$147.40 47% above 58%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus/Diphtheria Toxoid $92.00 $218.70 $34.57–$147.40 — 58%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Adacel $103.00 $244.85 $39.77–$165.03 31% above 58%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Adacel $103.00 $244.85 $39.77–$165.03 — 58%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin of Single Vaccine ED $44.00 $104.00 $68.35–$104.00 8% above 58%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin of Single Vaccine ED $44.00 $104.00 $68.35–$104.00 — 58%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin Each Additional $25.00 $58.00 $0.01–$39.09 1% below 57%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin Each Additional $25.00 $58.00 $0.01–$39.09 — 57%

Source file: https://www.northfieldhospital.org/sites/default/files/2026-03/416007241_northfield-hospital_standardcharges.csv