Hospital

Northwest Health - Starke

Listed in its price file as “Knox Hospital Company LLC”.

Northwest Health - Starke in Knox, IN publishes cash prices for 272 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Indiana median for 167 of 268 procedures and above it for 99. By typical cash price it ranks #26 of 84 Indiana hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

102 E Culver Rd, Knox, IN 46534 Collected Sep 27, 2026 Source price file (574) 772-6231

Acute care hospital Emergency department CMS star rating 1 of 5 CCN 150102 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Right CR	$127.06	$470.60	$34.49–$442.36	35% below	73%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Right DR	$127.06	$470.60	$34.49–$442.36	35% below	73%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Left DR	$127.06	$470.60	$34.49–$442.36	35% below	73%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Left CR	$127.06	$470.60	$34.49–$442.36	35% below	73%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Left DR	$258.83	$470.60	$157.65–$442.36	—	45%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Right DR	$258.83	$470.60	$157.65–$442.36	—	45%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Right CR	$258.83	$470.60	$157.65–$442.36	—	45%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Left CR	$258.83	$470.60	$157.65–$442.36	—	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US UE Arterial Doppler Single Lvl Bilat	$349.61	$1,294.85	$76.95–$1,217.16	—	73%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US LE Arterial Doppler Single Lvl Bilat	$349.61	$1,294.85	$76.95–$1,217.16	—	73%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US- EXT ARTERIAL LTD - Net Health - 208	$349.61	$1,294.85	$76.95–$1,217.16	2% above	73%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US UE Arterial Doppler Single Lvl Bilat	$712.17	$1,294.85	$433.77–$1,217.16	—	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US LE Arterial Doppler Single Lvl Bilat	$712.17	$1,294.85	$433.77–$1,217.16	—	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US- EXT ARTERIAL LTD - Net Health - 208	$712.17	$1,294.85	$433.77–$1,217.16	—	45%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RF Esophagus Gastrografin	$198.88	$736.61	$176.01–$747.81	57% below	73%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RF Esophagus Barium	$198.88	$736.61	$176.01–$747.81	57% below	73%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RF Esophagus Gastrografin	$405.14	$736.61	$246.76–$692.41	—	45%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RF Esophagus Barium	$405.14	$736.61	$246.76–$692.41	—	45%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone and or Joint Whole Body Scan 1 - NM Bone	$1,070.15	$3,963.51	$241.14–$3,725.70	30% below	73%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone and or Joint Whole Body Scan 1 - NM Bone	$2,179.93	$3,963.51	$1,327.78–$3,725.70	—	45%
Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Complete Bilateral	$499.05	$1,848.32	$93.88–$1,737.42	—	73%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left	$288.85	$1,069.83	$93.88–$1,005.64	33% below	73%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right	$288.85	$1,069.83	$93.88–$1,005.64	33% below	73%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Complete Bilateral	$1,016.58	$1,848.32	$619.19–$1,737.42	—	45%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left	$588.41	$1,069.83	$358.39–$1,005.64	—	45%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right	$588.41	$1,069.83	$358.39–$1,005.64	—	45%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US Breast Limited Bilateral	$221.55	$820.56	$78.28–$771.33	—	73%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right	$128.24	$474.95	$78.28–$446.45	57% below	73%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left	$128.24	$474.95	$78.28–$446.45	57% below	73%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US Breast Limited Bilateral	$451.31	$820.56	$274.89–$771.33	—	45%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left	$261.22	$474.95	$159.11–$446.45	—	45%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right	$261.22	$474.95	$159.11–$446.45	—	45%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest	$1,041.35	$3,856.86	$176.30–$3,625.45	8% below	73%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest for PE	$1,041.35	$3,856.86	$176.30–$3,625.45	8% below	73%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest for PE	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Heart Function W	$1,041.35	$3,856.86	$350.00–$3,625.45	25% above	73%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Heart Function W	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart WO	$78.12	$289.35	$87.33–$369.86	40% below	73%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Cardiac Score WO	$78.12	$289.35	$87.33–$369.86	40% below	73%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Cardiac Score WO	$159.14	$289.35	$96.93–$271.99	—	45%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart WO	$159.14	$289.35	$96.93–$271.99	—	45%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis WO	$832.99	$3,085.14	$239.82–$2,900.03	18% below	73%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis Stone Protocol	$832.99	$3,085.14	$239.82–$2,900.03	18% below	73%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis Stone Protocol	$1,696.83	$3,085.14	$1,033.52–$2,900.03	—	45%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis WO	$1,696.83	$3,085.14	$1,033.52–$2,900.03	—	45%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis W	$937.17	$3,471.01	$350.00–$3,262.75	36% below	73%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography Abdomen Pelvis	$937.17	$3,471.01	$350.00–$3,262.75	36% below	73%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography Abdomen Pelvis	$1,909.06	$3,471.01	$1,162.79–$3,262.75	—	45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis W	$1,909.06	$3,471.01	$1,162.79–$3,262.75	—	45%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen Pelvis WWO	$1,041.35	$3,856.86	$350.65–$3,625.45	38% below	73%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen Pelvis WWO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W	$937.17	$3,471.01	$176.30–$3,262.75	4% above	73%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W	$1,909.06	$3,471.01	$1,162.79–$3,262.75	—	45%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen WO	$832.99	$3,085.14	$105.08–$2,900.03	6% above	73%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen WO	$1,696.83	$3,085.14	$1,033.52–$2,900.03	—	45%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus WO	$832.99	$3,085.14	$105.08–$2,900.03	6% above	73%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial WO	$832.99	$3,085.14	$105.08–$2,900.03	6% above	73%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial WO	$1,696.83	$3,085.14	$1,033.52–$2,900.03	—	45%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus WO	$1,696.83	$3,085.14	$1,033.52–$2,900.03	—	45%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain WO	$832.99	$3,085.14	$105.08–$2,900.03	14% above	73%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head Stroke Alert	$832.99	$3,085.14	$105.08–$2,900.03	14% above	73%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Stroke Alert	$1,696.83	$3,085.14	$1,033.52–$2,900.03	—	45%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain WO	$1,696.83	$3,085.14	$1,033.52–$2,900.03	—	45%
CT scan of the head with contrast CPT 70460 CT Head or Brain W	$993.59	$3,679.96	$176.30–$3,459.16	21% above	73%
CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain W	$2,023.98	$3,679.96	$1,232.79–$3,459.16	—	45%
CT scan of the head without and with contrast CPT 70470 CT Head or Brain WWO	$1,041.35	$3,856.86	$176.30–$3,625.45	2% above	73%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain WWO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar WO	$832.99	$3,085.14	$105.08–$2,900.03	at median	73%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar WO	$1,696.83	$3,085.14	$1,033.52–$2,900.03	—	45%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical WO	$832.99	$3,085.14	$105.08–$2,900.03	6% above	73%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical WO	$1,696.83	$3,085.14	$1,033.52–$2,900.03	—	45%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W	$937.17	$3,471.01	$176.30–$3,262.75	5% above	73%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W	$1,909.06	$3,471.01	$1,162.79–$3,262.75	—	45%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral	$482.99	$1,788.86	$175.68–$1,681.53	—	73%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral	$983.87	$1,788.86	$599.27–$1,681.53	—	45%
Chest X-ray, 2 views CPT 71046 XR Chest 2 V DR	$149.15	$552.41	$30.87–$519.27	27% below	73%
Chest X-ray, 2 views CPT 71046 XR Chest 2 V CR	$149.15	$552.41	$30.87–$519.27	27% below	73%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 V DR	$303.83	$552.41	$185.06–$519.27	—	45%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 V CR	$303.83	$552.41	$185.06–$519.27	—	45%
Chest X-ray, single view CPT 71045 XR Chest 1 V Frontal - zzXR Chest 1 V Frontal	$72.20	$267.42	$87.33–$369.86	55% below	73%
Chest X-ray, single view CPT 71045 XR Chest 1 V Portable DR	$93.91	$347.80	$87.33–$369.86	42% below	73%
Chest X-ray, single view CPT 71045 XR Chest 1 V Frontal CR	$93.91	$347.80	$87.33–$369.86	42% below	73%
Chest X-ray, single view CPT 71045 XR Chest 1 V Frontal DR	$93.91	$347.80	$87.33–$369.86	42% below	73%
Chest X-ray, single view CPT 71045 XR Chest 1 V Portable CR	$93.91	$347.80	$87.33–$369.86	42% below	73%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Frontal - zzXR Chest 1 V Frontal	$147.08	$267.42	$89.59–$251.37	—	45%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Portable DR	$191.29	$347.80	$116.51–$326.93	—	45%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Portable CR	$191.29	$347.80	$116.51–$326.93	—	45%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Frontal DR	$191.29	$347.80	$116.51–$326.93	—	45%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Frontal CR	$191.29	$347.80	$116.51–$326.93	—	45%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete	$460.10	$1,704.06	$99.48–$1,601.82	7% below	73%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete	$937.23	$1,704.06	$570.86–$1,601.82	—	45%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton	$213.87	$792.12	$36.73–$744.59	24% below	73%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton	$435.67	$792.12	$265.36–$744.59	—	45%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Bone Density DEXA App Skeleton	$98.09	$363.29	$86.98–$369.86	32% below	73%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD Bone Density DEXA App Skeleton	$199.81	$363.29	$121.70–$341.49	—	45%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 76811 US-PLV PRG 2T DETAIL	$477.46	$1,768.38	$171.64–$1,662.28	12% below	73%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Pregnancy Complete w Detail	$477.46	$1,768.38	$171.64–$1,662.28	12% below	73%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Pregnancy Complete w Detail	$972.61	$1,768.38	$592.41–$1,662.28	—	45%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 76811 US-PLV PRG 2T DETAIL	$972.61	$1,768.38	$592.41–$1,662.28	—	45%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest Diagnostic WO	$832.99	$3,085.14	$105.08–$2,900.03	6% above	73%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT High Resolution Chest	$832.99	$3,085.14	$105.08–$2,900.03	6% above	73%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest Diagnostic WO	$1,696.83	$3,085.14	$1,033.52–$2,900.03	—	45%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT High Resolution Chest	$1,696.83	$3,085.14	$1,033.52–$2,900.03	—	45%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest Diagnostic W	$937.17	$3,471.01	$176.30–$3,262.75	8% above	73%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest Diagnostic W	$1,909.06	$3,471.01	$1,162.79–$3,262.75	—	45%
Diagnostic mammogram, both breasts both sides CPT 77066 77066 BR-DIG MAMMO BILAT	$179.93	$666.41	$90.50–$626.43	—	73%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD	$179.93	$666.41	$90.50–$626.43	—	73%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 77066 BR-DIG MAMMO BILAT	$366.53	$666.41	$223.25–$626.43	—	45%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD	$366.53	$666.41	$223.25–$626.43	—	45%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left WWO CAD	$141.65	$524.63	$70.61–$493.15	27% below	73%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right WWO CAD	$141.65	$524.63	$70.61–$493.15	27% below	73%
Diagnostic mammogram, one breast one side CPT 77065 77065 BR-DIG MAMMO UNILAT	$141.65	$524.63	$70.61–$493.15	27% below	73%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left WWO CAD	$288.55	$524.63	$175.75–$493.15	—	45%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right WWO CAD	$288.55	$524.63	$175.75–$493.15	—	45%
Diagnostic mammogram, one breast inpatient one side CPT 77065 77065 BR-DIG MAMMO UNILAT	$288.55	$524.63	$175.75–$493.15	—	45%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Duplex Bilateral	$609.65	$2,257.97	$220.43–$2,122.49	—	73%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE Arterial Duplex Bilateral	$1,241.88	$2,257.97	$756.42–$2,122.49	—	45%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Duplex Bilateral	$632.55	$2,342.77	$170.94–$2,202.20	—	73%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Duplex Bilateral	$632.55	$2,342.77	$170.94–$2,202.20	—	73%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US UE Venous Duplex Bilateral	$1,288.52	$2,342.77	$784.83–$2,202.20	—	45%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LE Venous Duplex Bilateral	$1,288.52	$2,342.77	$784.83–$2,202.20	—	45%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 NI Echo TTE 2D Complete w Color Doppler	$866.15	$3,207.95	$184.65–$3,015.47	47% below	73%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 NI Echo TTE 2D Complete w Color Doppler	$1,764.37	$3,207.95	$1,074.66–$3,015.47	—	45%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary System Scan 1	$1,030.29	$3,815.89	$264.54–$3,586.94	21% below	73%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary System Scan 1	$2,098.74	$3,815.89	$1,278.32–$3,586.94	—	45%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 CHRG - SLEEP TITRATE UNATT	$286.87	$1,062.48	$216.68–$1,308.11	11% above	73%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 CHRG - SLEEP TITRATE UNATT	$584.36	$1,062.48	$355.93–$998.73	—	45%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Left DR	$127.06	$470.60	$39.47–$442.36	45% below	73%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Right CR	$127.06	$470.60	$39.47–$442.36	45% below	73%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Right DR	$127.06	$470.60	$39.47–$442.36	45% below	73%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Left CR	$34.27	$62.30	$20.87–$58.56	—	45%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Right CR	$258.83	$470.60	$157.65–$442.36	—	45%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Right DR	$258.83	$470.60	$157.65–$442.36	—	45%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Left DR	$258.83	$470.60	$157.65–$442.36	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen	$428.93	$1,588.63	$80.71–$1,493.31	3% above	73%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder	$428.93	$1,588.63	$80.71–$1,493.31	3% above	73%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$428.93	$1,588.63	$80.71–$1,493.31	3% above	73%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas	$428.93	$1,588.63	$80.71–$1,493.31	3% above	73%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver	$428.93	$1,588.63	$80.71–$1,493.31	3% above	73%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder	$873.75	$1,588.63	$532.19–$1,493.31	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver	$873.75	$1,588.63	$532.19–$1,493.31	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas	$873.75	$1,588.63	$532.19–$1,493.31	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$873.75	$1,588.63	$532.19–$1,493.31	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen	$873.75	$1,588.63	$532.19–$1,493.31	—	45%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Low Dose Cancer Screening WO	$125.48	$464.74	$104.48–$446.72	31% below	73%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Low Dose Cancer Screening WO	$255.61	$464.74	$155.69–$436.86	—	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Left WO	$1,041.35	$3,856.86	$239.82–$3,625.45	6% above	73%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Right WO	$1,041.35	$3,856.86	$239.82–$3,625.45	6% above	73%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Right WO	$1,041.35	$3,856.86	$239.82–$3,625.45	6% above	73%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Right WO	$1,041.35	$3,856.86	$239.82–$3,625.45	6% above	73%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Left WO	$1,041.35	$3,856.86	$239.82–$3,625.45	6% above	73%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Left WO	$1,041.35	$3,856.86	$239.82–$3,625.45	6% above	73%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Left WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Right WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Left WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Right WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Left WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Right WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Right WWO	$1,249.70	$4,628.51	$350.65–$4,350.80	14% below	73%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Left WWO	$1,249.70	$4,628.51	$350.65–$4,350.80	14% below	73%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Left WWO	$1,249.70	$4,628.51	$350.65–$4,350.80	14% below	73%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Right WWO	$1,249.70	$4,628.51	$350.65–$4,350.80	14% below	73%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Left WWO	$1,249.70	$4,628.51	$350.65–$4,350.80	14% below	73%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Right WWO	$1,249.70	$4,628.51	$350.65–$4,350.80	14% below	73%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Left WWO	$2,545.68	$4,628.51	$1,550.55–$4,350.80	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Left WWO	$2,545.68	$4,628.51	$1,550.55–$4,350.80	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Right WWO	$2,545.68	$4,628.51	$1,550.55–$4,350.80	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Left WWO	$2,545.68	$4,628.51	$1,550.55–$4,350.80	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Right WWO	$2,545.68	$4,628.51	$1,550.55–$4,350.80	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Right WWO	$2,545.68	$4,628.51	$1,550.55–$4,350.80	—	45%
MRI of the abdomen without contrast CPT 74181 MRI MRCP WO	$1,041.35	$3,856.86	$239.82–$3,625.45	4% above	73%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen WO	$1,041.35	$3,856.86	$239.82–$3,625.45	4% above	73%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen WWO	$1,249.70	$4,628.51	$350.65–$4,350.80	6% below	73%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen WWO	$2,545.68	$4,628.51	$1,550.55–$4,350.80	—	45%
MRI of the brain, no contrast dye CPT 70551 MRI Brain WO	$1,041.35	$3,856.86	$239.82–$3,625.45	5% above	73%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain WWO	$1,249.70	$4,628.51	$350.65–$4,350.80	3% below	73%
MRI of the brain, with and without contrast dye CPT 70553 MRI IAC WWO	$1,249.70	$4,628.51	$350.65–$4,350.80	3% below	73%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain WWO	$2,545.68	$4,628.51	$1,550.55–$4,350.80	—	45%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC WWO	$2,545.68	$4,628.51	$1,550.55–$4,350.80	—	45%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar WO	$1,041.35	$3,856.86	$239.82–$3,625.45	6% above	73%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar WWO	$1,249.70	$4,628.51	$350.65–$4,350.80	6% below	73%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar WWO	$2,545.68	$4,628.51	$1,550.55–$4,350.80	—	45%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic WO	$1,041.35	$3,856.86	$239.82–$3,625.45	8% above	73%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical WWO	$1,249.70	$4,628.51	$350.65–$4,350.80	3% below	73%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical WWO	$2,545.68	$4,628.51	$1,550.55–$4,350.80	—	45%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical WO	$1,041.35	$3,856.86	$239.82–$3,625.45	2% above	73%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis WWO	$1,249.70	$4,628.51	$350.65–$4,350.80	4% below	73%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis WWO	$2,545.68	$4,628.51	$1,550.55–$4,350.80	—	45%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis WO	$1,041.35	$3,856.86	$239.82–$3,625.45	1% above	73%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder Right WO	$1,041.35	$3,856.86	$239.82–$3,625.45	11% below	73%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow Right WO	$1,041.35	$3,856.86	$239.82–$3,625.45	11% below	73%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder Left WO	$1,041.35	$3,856.86	$239.82–$3,625.45	11% below	73%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist Right WO	$1,041.35	$3,856.86	$239.82–$3,625.45	11% below	73%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow Left WO	$1,041.35	$3,856.86	$239.82–$3,625.45	11% below	73%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist Left WO	$1,041.35	$3,856.86	$239.82–$3,625.45	11% below	73%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist Right WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow Left WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder Right WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist Left WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow Right WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder Left WO	$2,121.27	$3,856.86	$1,292.05–$3,625.45	—	45%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion RestStr Mult Sc1 - NM Myoc	$1,316.39	$4,875.51	$1,299.18–$5,484.04	64% below	73%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Stress Multi 1	$1,316.39	$4,875.51	$1,299.18–$5,484.04	64% below	73%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Rest Multi 1	$1,316.39	$4,875.51	$1,299.18–$5,484.04	64% below	73%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Stress Multi 1	$2,681.53	$4,875.51	$1,633.30–$4,582.98	—	45%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion RestStr Mult Sc1 - NM Myoc	$2,681.53	$4,875.51	$1,633.30–$4,582.98	—	45%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Rest Multi 1	$2,681.53	$4,875.51	$1,633.30–$4,582.98	—	45%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET Tumor Imaging Skull Base to Midthigh Scan	$1,533.81	$5,680.77	$1,434.95–$6,127.23	61% below	73%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET w CT Scan Skull Base to Midthigh Scan	$1,577.60	$5,842.98	$1,434.95–$6,127.23	60% below	73%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET Tumor Imaging Skull Base to Midthigh Scan	$3,124.42	$5,680.77	$1,903.06–$5,339.92	—	45%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET w CT Scan Skull Base to Midthigh Scan	$3,213.64	$5,842.98	$1,957.40–$5,492.40	—	45%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non OB Limited	$306.20	$1,134.07	$47.98–$1,066.03	4% above	73%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non OB FU	$306.20	$1,134.07	$47.98–$1,066.03	4% above	73%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non OB Limited	$623.74	$1,134.07	$379.91–$1,066.03	—	45%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non OB FU	$623.74	$1,134.07	$379.91–$1,066.03	—	45%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non OB Complete	$475.09	$1,759.60	$98.43–$1,654.02	9% above	73%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 76856 US-PELVIS NON OB	$475.09	$1,759.60	$98.43–$1,654.02	9% above	73%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non OB Complete	$967.78	$1,759.60	$589.47–$1,654.02	—	45%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 76856 US-PELVIS NON OB	$967.78	$1,759.60	$589.47–$1,654.02	—	45%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 76805 US-PELVIS PREG	$473.51	$1,753.75	$105.08–$1,648.52	11% below	73%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnancy After 1st Trimester Transabdominal	$473.51	$1,753.75	$105.08–$1,648.52	11% below	73%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 76805 US-PELVIS PREG	$964.56	$1,753.75	$587.51–$1,648.52	—	45%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Pregnancy After 1st Trimester Transabdominal	$964.56	$1,753.75	$587.51–$1,648.52	—	45%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnancy 1st Trimester Transabdominal	$473.51	$1,753.75	$105.08–$1,648.52	1% below	73%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 76801 US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GES	$473.51	$1,753.75	$105.08–$1,648.52	1% below	73%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 76801 US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GES	$964.56	$1,753.75	$587.51–$1,648.52	—	45%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pregnancy 1st Trimester Transabdominal	$964.56	$1,753.75	$587.51–$1,648.52	—	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited	$333.44	$1,234.97	$76.35–$1,160.87	2% above	73%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited Placenta Location	$333.44	$1,234.97	$76.35–$1,160.87	2% above	73%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited Fetal Position	$333.44	$1,234.97	$76.35–$1,160.87	2% above	73%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited Placenta Location	$679.23	$1,234.97	$413.71–$1,160.87	—	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited	$679.23	$1,234.97	$413.71–$1,160.87	—	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited Fetal Position	$679.23	$1,234.97	$413.71–$1,160.87	—	45%
Screening mammogram, both breasts both sides CPT 77067 77067 BR-DIG MAMMO SCRN BI	$138.11	$511.51	$74.42–$480.82	—	73%
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD	$138.11	$511.51	$74.42–$480.82	—	73%
Screening mammogram, both breasts CPT 77067 77067 BR-DIG MAMMO SCRN UN	$138.11	$511.51	$74.42–$480.82	45% below	73%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Right WWO CAD	$138.11	$511.51	$74.42–$480.82	45% below	73%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Left WWO CAD	$138.11	$511.51	$74.42–$480.82	45% below	73%
Screening mammogram, both breasts inpatient both sides CPT 77067 77067 BR-DIG MAMMO SCRN BI	$281.33	$511.51	$171.36–$480.82	—	45%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD	$281.33	$511.51	$171.36–$480.82	—	45%
Screening mammogram, both breasts inpatient CPT 77067 77067 BR-DIG MAMMO SCRN UN	$281.33	$511.51	$171.36–$480.82	—	45%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Left WWO CAD	$281.33	$511.51	$171.36–$480.82	—	45%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Right WWO CAD	$281.33	$511.51	$171.36–$480.82	—	45%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Left DR	$143.64	$531.99	$33.27–$500.07	28% below	73%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Right DR	$143.64	$531.99	$33.27–$500.07	28% below	73%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Right DR	$292.59	$531.99	$178.22–$500.07	—	45%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Left DR	$292.59	$531.99	$178.22–$500.07	—	45%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 NI Echo TTE 2D Rest Stress w Cont Monito	$741.46	$2,746.13	$219.13–$2,581.36	58% below	73%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 NI Echo TTE 2D Rest Stress w Cont Monito	$1,510.37	$2,746.13	$919.95–$2,581.36	—	45%
Swallow study (modified barium swallow, video X-ray) CPT 74230 RF Modified Barium Swallow	$232.03	$859.37	$112.14–$807.81	22% below	73%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RF Modified Barium Swallow	$472.65	$859.37	$287.89–$807.81	—	45%
Transvaginal pelvic ultrasound CPT 76830 76830 US-TRANSVAGINAL	$419.06	$1,552.08	$105.08–$1,458.96	20% above	73%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB	$419.06	$1,552.08	$105.08–$1,458.96	20% above	73%
Transvaginal pelvic ultrasound inpatient CPT 76830 76830 US-TRANSVAGINAL	$853.64	$1,552.08	$519.95–$1,458.96	—	45%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB	$853.64	$1,552.08	$519.95–$1,458.96	—	45%
Transvaginal ultrasound during pregnancy CPT 76817 US Pregnancy Transvaginal	$419.06	$1,552.08	$87.12–$1,458.96	23% above	73%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pregnancy Transvaginal	$853.64	$1,552.08	$519.95–$1,458.96	—	45%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$535.86	$1,984.68	$105.08–$1,865.60	3% above	73%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$1,091.57	$1,984.68	$664.87–$1,865.60	—	45%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum Contents	$418.27	$1,549.15	$87.45–$1,456.20	1% below	73%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum Contents	$852.03	$1,549.15	$518.97–$1,456.20	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Parotid	$394.99	$1,462.91	$101.38–$1,375.14	11% above	73%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head Neck Soft Tissue	$394.99	$1,462.91	$101.38–$1,375.14	11% above	73%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Parathyroid	$394.99	$1,462.91	$101.38–$1,375.14	11% above	73%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$394.99	$1,462.91	$101.38–$1,375.14	11% above	73%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$804.60	$1,462.91	$490.07–$1,375.14	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Parotid	$804.60	$1,462.91	$490.07–$1,375.14	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head Neck Soft Tissue	$804.60	$1,462.91	$490.07–$1,375.14	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Parathyroid	$804.60	$1,462.91	$490.07–$1,375.14	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI wo KUB Barium - zzRF Upper GI wo KUB B	$72.20	$267.42	$176.01–$747.81	86% below	73%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 74240 FL-UPPER GI SINGLE	$363.03	$1,344.55	$114.18–$1,263.88	30% below	73%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI w or wo KUB Gastrografin	$363.03	$1,344.55	$114.18–$1,263.88	30% below	73%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI w or wo KUB Barium	$363.03	$1,344.55	$114.18–$1,263.88	30% below	73%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI wo KUB Barium - zzRF Upper GI wo KUB B	$147.08	$267.42	$89.59–$251.37	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI w or wo KUB Gastrografin	$739.50	$1,344.55	$450.42–$1,263.88	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI w or wo KUB Barium	$739.50	$1,344.55	$450.42–$1,263.88	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 74240 FL-UPPER GI SINGLE	$739.50	$1,344.55	$450.42–$1,263.88	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Left	$563.87	$2,088.42	$105.08–$1,963.11	11% below	73%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Right	$563.87	$2,088.42	$105.08–$1,963.11	11% below	73%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Right	$563.87	$2,088.42	$105.08–$1,963.11	11% below	73%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Left	$563.87	$2,088.42	$105.08–$1,963.11	11% below	73%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Left	$1,148.63	$2,088.42	$699.62–$1,963.11	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Left	$1,148.63	$2,088.42	$699.62–$1,963.11	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Right	$1,148.63	$2,088.42	$699.62–$1,963.11	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Right	$1,148.63	$2,088.42	$699.62–$1,963.11	—	45%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Left DR	$116.40	$431.12	$39.75–$405.25	55% below	73%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Right DR	$116.40	$431.12	$39.75–$405.25	55% below	73%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete w Navicular Lt CR	$116.40	$431.12	$39.75–$405.25	55% below	73%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete w Navicular Rt DR	$116.40	$431.12	$39.75–$405.25	55% below	73%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete w Navicular Lt DR	$116.40	$431.12	$39.75–$405.25	55% below	73%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete w Navicular Rt CR	$116.40	$431.12	$39.75–$405.25	55% below	73%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete w Navicular Lt CR	$237.12	$431.12	$144.43–$405.25	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete w Navicular Rt CR	$237.12	$431.12	$144.43–$405.25	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete w Navicular Rt DR	$237.12	$431.12	$144.43–$405.25	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Left DR	$237.12	$431.12	$144.43–$405.25	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete w Navicular Lt DR	$237.12	$431.12	$144.43–$405.25	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Right DR	$237.12	$431.12	$144.43–$405.25	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right w Pelvis 2 or 3 Views DR	$116.02	$429.69	$45.42–$403.91	57% below	73%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right 2 or 3 Views DR	$116.02	$429.69	$45.42–$403.91	57% below	73%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left 2 or 3 Views DR	$116.02	$429.69	$45.42–$403.91	57% below	73%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left w Pelvis 2 or 3 Views DR	$116.02	$429.69	$45.42–$403.91	57% below	73%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left w Pelvis 2 or 3 Views DR	$236.33	$429.69	$143.95–$403.91	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right 2 or 3 Views DR	$236.33	$429.69	$143.95–$403.91	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left 2 or 3 Views DR	$236.33	$429.69	$143.95–$403.91	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right w Pelvis 2 or 3 Views DR	$236.33	$429.69	$143.95–$403.91	—	45%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP KUB DR	$121.53	$450.10	$27.70–$423.09	42% below	73%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen AP KUB DR	$247.56	$450.10	$150.78–$423.09	—	45%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Left DR	$99.44	$368.30	$87.33–$369.86	33% below	73%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Right DR	$99.44	$368.30	$87.33–$369.86	33% below	73%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Right DR	$202.57	$368.30	$123.38–$346.20	—	45%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Left DR	$202.57	$368.30	$123.38–$346.20	—	45%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Left DR	$104.97	$388.77	$87.33–$369.86	32% below	73%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Right DR	$104.97	$388.77	$87.33–$369.86	32% below	73%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Left DR	$104.97	$388.77	$87.33–$369.86	32% below	73%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Right DR	$104.97	$388.77	$87.33–$369.86	32% below	73%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Left DR	$104.97	$388.77	$87.33–$369.86	32% below	73%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Right DR	$104.97	$388.77	$87.33–$369.86	32% below	73%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Left DR	$104.97	$388.77	$87.33–$369.86	32% below	73%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Right DR	$104.97	$388.77	$87.33–$369.86	32% below	73%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Left DR	$104.97	$388.77	$87.33–$369.86	32% below	73%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Right DR	$104.97	$388.77	$87.33–$369.86	32% below	73%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Left DR	$213.82	$388.77	$130.24–$365.44	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Right DR	$213.82	$388.77	$130.24–$365.44	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Left DR	$213.82	$388.77	$130.24–$365.44	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Right DR	$213.82	$388.77	$130.24–$365.44	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Left DR	$213.82	$388.77	$130.24–$365.44	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Right DR	$213.82	$388.77	$130.24–$365.44	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Left DR	$213.82	$388.77	$130.24–$365.44	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Right DR	$213.82	$388.77	$130.24–$365.44	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Left DR	$213.82	$388.77	$130.24–$365.44	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Right DR	$213.82	$388.77	$130.24–$365.44	—	45%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Left DR	$116.02	$429.69	$26.72–$403.91	20% below	73%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Right DR	$116.02	$429.69	$26.72–$403.91	20% below	73%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Left DR	$236.33	$429.69	$143.95–$403.91	—	45%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Right DR	$236.33	$429.69	$143.95–$403.91	—	45%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Right DR	$127.06	$470.60	$31.70–$442.36	35% below	73%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Left DR	$127.06	$470.60	$31.70–$442.36	35% below	73%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Left CR	$34.27	$62.30	$20.87–$58.56	—	45%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Right CR	$34.27	$62.30	$20.87–$58.56	—	45%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Right DR	$258.83	$470.60	$157.65–$442.36	—	45%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Left DR	$258.83	$470.60	$157.65–$442.36	—	45%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Left DR	$116.02	$429.69	$35.42–$403.91	42% below	73%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Right DR	$116.02	$429.69	$35.42–$403.91	42% below	73%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Right CR	$116.02	$429.69	$35.42–$403.91	42% below	73%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Right CR	$236.33	$429.69	$143.95–$403.91	—	45%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Right DR	$236.33	$429.69	$143.95–$403.91	—	45%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Left DR	$236.33	$429.69	$143.95–$403.91	—	45%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Right DR	$116.02	$429.69	$31.99–$403.91	44% below	73%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Left DR	$116.02	$429.69	$31.99–$403.91	44% below	73%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Right DR	$236.33	$429.69	$143.95–$403.91	—	45%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Left DR	$236.33	$429.69	$143.95–$403.91	—	45%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 V DR	$160.21	$593.38	$37.68–$557.78	34% below	73%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 V DR	$326.36	$593.38	$198.78–$557.78	—	45%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 V DR	$237.16	$878.38	$49.71–$825.68	30% below	73%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 V DR	$483.11	$878.38	$294.26–$825.68	—	45%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 V DR	$154.68	$572.89	$30.85–$538.52	31% below	73%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 V CR	$45.95	$83.55	$27.99–$78.54	—	45%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 V DR	$315.09	$572.89	$191.92–$538.52	—	45%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Comp Minimum 3 V DR	$127.06	$470.60	$34.80–$442.36	37% below	73%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Comp Minimum 3 V DR	$258.83	$470.60	$157.65–$442.36	—	45%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 V DR	$143.64	$531.99	$37.06–$500.07	42% below	73%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 V DR	$292.59	$531.99	$178.22–$500.07	—	45%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 V CR	$28.20	$104.44	$104.44–$446.72	85% below	73%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 V DR	$104.97	$388.77	$104.90–$446.72	46% below	73%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 V CR	$57.44	$104.44	$34.99–$98.17	—	45%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 V DR	$213.82	$388.77	$130.24–$365.44	—	45%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum Coccyx Minimum 2 V DR	$138.11	$511.51	$29.84–$480.82	37% below	73%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum Coccyx Minimum 2 V DR	$281.33	$511.51	$171.36–$480.82	—	45%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase	$59.99	$222.17	$4.67–$208.84	124% above	73%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 84460 TRANSFERASE ALT	$59.99	$222.17	$4.67–$208.84	124% above	73%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase	$122.19	$222.17	$74.43–$208.84	—	45%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 84460 TRANSFERASE ALT	$122.19	$222.17	$74.43–$208.84	—	45%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase	$71.10	$263.33	$4.57–$247.53	154% above	73%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase	$144.83	$263.33	$88.22–$247.53	—	45%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel (4) LC	$169.68	$628.44	$42.01–$590.73	39% below	73%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute	$169.68	$628.44	$42.01–$590.73	39% below	73%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel Acute	$345.64	$628.44	$210.53–$590.73	—	45%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel (4) LC	$345.64	$628.44	$210.53–$590.73	—	45%
Allergy blood test, specific IgE, per allergen CPT 86003 F044-IgE Strawberry LC	$10.29	$38.10	$4.61–$35.81	40% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 F210-IgE Pineapple LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 W016-IgE Marsh Elder Rough LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 M004-IgE Mucor racemosus LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 M003-IgE Aspergillus fumigatu LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 E001-IgE Cat Hair/Dander LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 W003-IgE Ragweed Giant LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 E005-IgE Dog Hair/Dander LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 F075-IgE Egg (Yolk) LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003-L602998 ALG IGE QT	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L601823 ALG IGE QT	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L600973 ALLERGEN IGE	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 ALG VEG PNL L601831	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PNL FOOD MEAT L602284	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 ALG PROFILE FOOD GRAIN L601633	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 ALG PROFILE LATEX PLUS L670654	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 ALG PROFILE FOOD CITRS L600981	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 - L601872 ALG FRUIT PN	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 W020-IgE Nettle LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L674010 ALG IGE QT	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L671935 ALG IGE QT	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L671926 ALG IGE QT	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L62695 ALG IGE QT	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 I006-IgE Cockroach,German LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgE Soybean LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L648014 ALG IGE QT	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L601013 ALG IGE QT	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L602632 ALLERGEN IGE QUANT	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 F013-IgE Peanut LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 F203-IgE Pistachio Nut LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 G010-IgE Johnson Grass LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk (Cow) LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 F001-IgE Egg White LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 K087-IgE Alpha-Amylase (LC)	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 Mouse Urine LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 F245-IgE Egg Whole LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 F256-IgE Walnut, Food LC	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L602989 ALG IGE QT	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L139825 ALG IGE QT	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 I100-IgE Cockroach American Sendout to LabCorp	$10.80	$40.01	$4.61–$37.61	37% below	73%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F044-IgE Strawberry LC	$20.96	$38.10	$12.76–$35.81	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F210-IgE Pineapple LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mouse Urine LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F256-IgE Walnut, Food LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I006-IgE Cockroach,German LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L601013 ALG IGE QT	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L648014 ALG IGE QT	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L139825 ALG IGE QT	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L602989 ALG IGE QT	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L62695 ALG IGE QT	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L671926 ALG IGE QT	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L671935 ALG IGE QT	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L674010 ALG IGE QT	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W020-IgE Nettle LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 - L601872 ALG FRUIT PN	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALG PROFILE FOOD CITRS L600981	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALG PROFILE LATEX PLUS L670654	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALG PROFILE FOOD GRAIN L601633	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PNL FOOD MEAT L602284	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALG VEG PNL L601831	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L600973 ALLERGEN IGE	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L601823 ALG IGE QT	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003-L602998 ALG IGE QT	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F075-IgE Egg (Yolk) LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E005-IgE Dog Hair/Dander LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W003-IgE Ragweed Giant LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E001-IgE Cat Hair/Dander LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M003-IgE Aspergillus fumigatu LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M004-IgE Mucor racemosus LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W016-IgE Marsh Elder Rough LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I100-IgE Cockroach American Sendout to LabCorp	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F001-IgE Egg White LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F002-IgE Milk (Cow) LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G010-IgE Johnson Grass LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F203-IgE Pistachio Nut LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F014-IgE Soybean LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F013-IgE Peanut LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F004-IgE Wheat LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L602632 ALLERGEN IGE QUANT	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F245-IgE Egg Whole LC	$22.01	$40.01	$13.40–$37.61	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 K087-IgE Alpha-Amylase (LC)	$22.01	$40.01	$13.40–$37.61	—	45%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab IgG IgA (LC)	$46.53	$172.35	$11.42–$162.01	8% below	73%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab IgG IgA (LC)	$94.79	$172.35	$57.74–$162.01	—	45%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Anti Nuclear Antibody IFA (LC)	$46.90	$173.70	$10.66–$163.28	22% below	73%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Anti Nuclear Antibody IFA (LC)	$95.54	$173.70	$58.19–$163.28	—	45%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide Prohormone	$66.29	$245.50	$34.62–$230.77	61% below	73%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide	$66.29	$245.50	$34.62–$230.77	61% below	73%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptide Prohormone	$135.03	$245.50	$82.24–$230.77	—	45%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptide	$135.03	$245.50	$82.24–$230.77	—	45%
Basic metabolic panel (blood test) CPT 80048 BMPWTCA	$63.66	$235.76	$7.46–$221.61	18% below	73%
Basic metabolic panel (blood test) inpatient CPT 80048 BMPWTCA	$129.67	$235.76	$78.98–$221.61	—	45%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Bone Marrow Biopsy	$97.86	$362.44	$52.37–$340.69	62% below	73%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Non-Gyn Cytology Cell Block	$97.86	$362.44	$52.37–$340.69	62% below	73%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SO 88305 Bill Surg Compre Review of Data	$97.86	$362.44	$52.37–$340.69	62% below	73%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexi	$97.86	$362.44	$52.37–$340.69	62% below	73%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Non-Gyn Cytology Cell Block	$199.34	$362.44	$121.42–$340.69	—	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Bone Marrow Biopsy	$199.34	$362.44	$121.42–$340.69	—	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SO 88305 Bill Surg Compre Review of Data	$199.34	$362.44	$121.42–$340.69	—	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexi	$199.34	$362.44	$121.42–$340.69	—	45%
Blood culture for bacteria CPT 87040 Blood Culture	$110.49	$409.21	$9.10–$384.66	14% below	73%
Blood culture for bacteria inpatient CPT 87040 Blood Culture	$225.07	$409.21	$137.09–$384.66	—	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Chg BCE	$13.42	$49.69	$8.24–$46.71	2% above	73%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Chg	$13.42	$49.69	$8.24–$46.71	2% above	73%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Chg	$27.33	$49.69	$16.65–$46.71	—	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Chg BCE	$27.33	$49.69	$16.65–$46.71	—	45%
Blood glucose (sugar) test CPT 82947 Glucose Level	$18.95	$70.17	$3.47–$65.96	27% below	73%
Blood glucose (sugar) test CPT 82947 .GTT 2nd Hr OB	$18.95	$70.17	$3.47–$65.96	27% below	73%
Blood glucose (sugar) test CPT 82947 .GTT 3rd Hr OB	$18.95	$70.17	$3.47–$65.96	27% below	73%
Blood glucose (sugar) test inpatient CPT 82947 .GTT 2nd Hr OB	$38.59	$70.17	$23.51–$65.96	—	45%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$38.59	$70.17	$23.51–$65.96	—	45%
Blood glucose (sugar) test inpatient CPT 82947 .GTT 3rd Hr OB	$38.59	$70.17	$23.51–$65.96	—	45%
Blood lead test CPT 83655 83655 L038170 LEAD	$47.36	$175.41	$10.68–$164.89	22% below	73%
Blood lead test CPT 83655 83655 LEAD	$47.36	$175.41	$10.68–$164.89	22% below	73%
Blood lead test CPT 83655 Lead Blood Adult (LC)	$47.36	$175.41	$10.68–$164.89	22% below	73%
Blood lead test CPT 83655 Lead Blood Pediatric (LC)	$47.36	$175.41	$10.68–$164.89	22% below	73%
Blood lead test CPT 83655 83655 L7046 LEAD	$47.36	$175.41	$10.68–$164.89	22% below	73%
Blood lead test CPT 83655 83655 L706200 LEAD	$47.36	$175.41	$10.68–$164.89	22% below	73%
Blood lead test CPT 83655 83655 L250281 LEAD	$47.36	$175.41	$10.68–$164.89	22% below	73%
Blood lead test inpatient CPT 83655 83655 LEAD	$96.48	$175.41	$58.76–$164.89	—	45%
Blood lead test inpatient CPT 83655 83655 L038170 LEAD	$96.48	$175.41	$58.76–$164.89	—	45%
Blood lead test inpatient CPT 83655 Lead Blood Pediatric (LC)	$96.48	$175.41	$58.76–$164.89	—	45%
Blood lead test inpatient CPT 83655 Lead Blood Adult (LC)	$96.48	$175.41	$58.76–$164.89	—	45%
Blood lead test inpatient CPT 83655 83655 L250281 LEAD	$96.48	$175.41	$58.76–$164.89	—	45%
Blood lead test inpatient CPT 83655 83655 L706200 LEAD	$96.48	$175.41	$58.76–$164.89	—	45%
Blood lead test inpatient CPT 83655 83655 L7046 LEAD	$96.48	$175.41	$58.76–$164.89	—	45%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Human Chorionic Gonadotropin Qual	$55.84	$206.81	$6.63–$194.40	26% below	73%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Human Chorionic Gonadotropin Qual	$113.75	$206.81	$69.28–$194.40	—	45%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Ref Lab ABO/Rh	$37.09	$137.36	$133.51–$541.49	24% below	73%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO Reverse	$37.09	$137.36	$133.51–$541.49	24% below	73%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO	$37.09	$137.36	$133.51–$541.49	24% below	73%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO Forward	$37.09	$137.36	$133.51–$541.49	24% below	73%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO	$75.55	$137.36	$46.02–$129.12	—	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO Forward	$75.55	$137.36	$46.02–$129.12	—	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Ref Lab ABO/Rh	$75.55	$137.36	$46.02–$129.12	—	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO Reverse	$75.55	$137.36	$46.02–$129.12	—	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein	$37.49	$138.86	$4.57–$130.53	44% below	73%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein Quant (LC)	$37.49	$138.86	$4.57–$130.53	44% below	73%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein Quant (LC)	$76.37	$138.86	$46.52–$130.53	—	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein	$76.37	$138.86	$46.52–$130.53	—	45%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile Toxin A B Amp Probe	$60.37	$223.59	$32.87–$210.17	54% below	73%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile Toxin PCR	$60.37	$223.59	$32.87–$210.17	54% below	73%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile by DNA Amp	$60.37	$223.59	$32.87–$210.17	54% below	73%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile by DNA Amp	$122.97	$223.59	$74.90–$210.17	—	45%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile Toxin PCR	$122.97	$223.59	$74.90–$210.17	—	45%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile Toxin A B Amp Probe	$122.97	$223.59	$74.90–$210.17	—	45%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 LC	$40.65	$150.56	$18.35–$141.53	72% below	73%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 LC	$82.81	$150.56	$50.44–$141.53	—	45%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer 125 - Send Out to CQ	$24.57	$91.01	$18.35–$85.55	85% below	73%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125	$31.96	$118.37	$18.35–$111.27	80% below	73%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer 125 - Send Out to CQ	$50.06	$91.01	$30.49–$85.55	—	45%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen 125	$65.10	$118.37	$39.65–$111.27	—	45%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 PCR	$40.74	$150.89	$40.74–$153.93	61% below	73%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 NAA (LC)	$53.74	$199.02	$45.25–$187.08	49% below	73%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 PCR	$82.99	$150.89	$50.55–$141.84	—	45%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 NAA (LC)	$109.46	$199.02	$66.67–$187.08	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia DNA Amplified Probe	$58.00	$214.81	$30.95–$201.92	40% below	73%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia DNA Amplified Probe 2	$58.00	$214.81	$30.95–$201.92	40% below	73%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 L183194CHLMYD TRACH	$58.00	$214.81	$30.95–$201.92	40% below	73%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 CHLMYD TRACH DNA AMP	$58.00	$214.81	$30.95–$201.92	40% below	73%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 L183194CHLMYD TRACH	$118.15	$214.81	$71.96–$201.92	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia DNA Amplified Probe 2	$118.15	$214.81	$71.96–$201.92	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 CHLMYD TRACH DNA AMP	$118.15	$214.81	$71.96–$201.92	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia DNA Amplified Probe	$118.15	$214.81	$71.96–$201.92	—	45%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$113.24	$419.42	$11.81–$394.25	26% above	73%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$230.68	$419.42	$140.51–$394.25	—	45%
Complete blood count (CBC) with differential CPT 85025 CBCADIFF	$72.21	$267.44	$6.85–$251.39	90% above	73%
Complete blood count (CBC) with differential inpatient CPT 85025 CBCADIFF	$147.09	$267.44	$89.59–$251.39	—	45%
Complete blood count (CBC), no differential CPT 85027 CBC	$39.07	$144.71	$5.71–$136.03	37% above	73%
Complete blood count (CBC), no differential CPT 85027 85027 CBC W-PLT	$39.07	$144.71	$5.71–$136.03	37% above	73%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC	$79.59	$144.71	$48.48–$136.03	—	45%
Complete blood count (CBC), no differential inpatient CPT 85027 85027 CBC W-PLT	$79.59	$144.71	$48.48–$136.03	—	45%
Comprehensive metabolic panel (blood test) CPT 80053 CMP	$107.33	$397.51	$9.31–$373.66	46% above	73%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP	$218.63	$397.51	$133.17–$373.66	—	45%
D-dimer blood test (blood clot marker) CPT 85379 D Dimer Quant	$52.87	$195.81	$8.98–$184.06	57% below	73%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer Quant	$107.70	$195.81	$65.60–$184.06	—	45%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate (LC)	$119.95	$444.26	$19.61–$417.60	18% below	73%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate (LC)	$244.34	$444.26	$148.83–$417.60	—	45%
Estradiol blood test CPT 82670 Estradiol Level	$85.15	$315.36	$24.64–$296.44	26% below	73%
Estradiol blood test CPT 82670 82670-L4606 Estradiol	$85.15	$315.36	$24.64–$296.44	26% below	73%
Estradiol blood test CPT 82670 82670 L4606 ESTRADIOL	$85.15	$315.36	$24.64–$296.44	26% below	73%
Estradiol blood test inpatient CPT 82670 Estradiol Level	$173.45	$315.36	$105.65–$296.44	—	45%
Estradiol blood test inpatient CPT 82670 82670-L4606 Estradiol	$173.45	$315.36	$105.65–$296.44	—	45%
Estradiol blood test inpatient CPT 82670 82670 L4606 ESTRADIOL	$173.45	$315.36	$105.65–$296.44	—	45%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Serum	$70.24	$260.15	$16.39–$244.54	41% below	73%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone Serum	$143.08	$260.15	$87.15–$244.54	—	45%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Feces (LC)	$33.94	$125.72	$17.32–$118.18	81% below	73%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Feces (LC)	$69.15	$125.72	$42.12–$118.18	—	45%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$40.65	$150.56	$12.02–$141.53	30% below	73%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$82.81	$150.56	$50.44–$141.53	—	45%
Folate (folic acid) blood test CPT 82746 Folate Level	$57.21	$211.88	$12.97–$199.17	20% below	73%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$116.53	$211.88	$70.98–$199.17	—	45%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine 3 Free	$57.70	$213.71	$14.94–$200.89	49% below	73%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine 3 Free	$117.54	$213.71	$71.59–$200.89	—	45%
Free T4 (free thyroxine) thyroid blood test CPT 84439 .Thyroxine (T4) Free LC	$47.65	$176.49	$7.96–$165.90	36% below	73%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (T4) Free, Direct, S (LC)	$47.65	$176.49	$7.96–$165.90	36% below	73%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine 4 Free	$47.65	$176.49	$7.96–$165.90	36% below	73%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 .Thyroxine (T4) Free LC	$97.07	$176.49	$59.12–$165.90	—	45%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine (T4) Free, Direct, S (LC)	$97.07	$176.49	$59.12–$165.90	—	45%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine 4 Free	$97.07	$176.49	$59.12–$165.90	—	45%
Free testosterone test CPT 84402 84402 TESTOSTERONE, FREE	$88.22	$326.74	$22.46–$307.14	9% above	73%
Free testosterone test CPT 84402 84402 L329562 TESTOSTERONE, FREE (TTFSHBLC)	$88.22	$326.74	$22.46–$307.14	9% above	73%
Free testosterone test CPT 84402 Testosterone Free Direct LC	$88.22	$326.74	$22.46–$307.14	9% above	73%
Free testosterone test inpatient CPT 84402 Testosterone Free Direct LC	$179.71	$326.74	$109.46–$307.14	—	45%
Free testosterone test inpatient CPT 84402 84402 TESTOSTERONE, FREE	$179.71	$326.74	$109.46–$307.14	—	45%
Free testosterone test inpatient CPT 84402 84402 L329562 TESTOSTERONE, FREE (TTFSHBLC)	$179.71	$326.74	$109.46–$307.14	—	45%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 $ General Health Panel	$210.33	$779.00	$58.90–$779.00	25% below	73%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 $ General Health Panel	$428.45	$779.00	$260.97–$732.26	—	45%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .GTT 1st Hr OB	$29.59	$109.59	$4.19–$103.01	28% below	73%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 .GTT 1st Hr OB	$60.27	$109.59	$36.71–$103.01	—	45%
Glucose tolerance test, 3 samples CPT 82951 .GTT Fasting	$72.61	$268.94	$11.35–$252.80	2% above	73%
Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT Fasting	$147.92	$268.94	$90.09–$252.80	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhea DNA Amplified Probe 2	$58.00	$214.81	$30.95–$201.92	40% below	73%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 L183194N.GONORRHO,DN	$58.00	$214.81	$30.95–$201.92	40% below	73%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhea DNA Amplified Probe	$58.00	$214.81	$30.95–$201.92	40% below	73%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 N.GONORRHO,DNA,AMPPR	$58.00	$214.81	$30.95–$201.92	40% below	73%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 L183194N.GONORRHO,DN	$118.15	$214.81	$71.96–$201.92	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonorrhea DNA Amplified Probe 2	$118.15	$214.81	$71.96–$201.92	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 N.GONORRHO,DNA,AMPPR	$118.15	$214.81	$71.96–$201.92	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonorrhea DNA Amplified Probe	$118.15	$214.81	$71.96–$201.92	—	45%
H. pylori antibody blood test CPT 86677 Heliobacter pylori Ab IgM (LC)	$29.99	$111.08	$14.86–$104.42	70% below	73%
H. pylori antibody blood test CPT 86677 Heliobacter pylori Ab IgG	$29.99	$111.08	$14.86–$104.42	70% below	73%
H. pylori antibody blood test inpatient CPT 86677 Heliobacter pylori Ab IgG	$61.09	$111.08	$37.21–$104.42	—	45%
H. pylori antibody blood test inpatient CPT 86677 Heliobacter pylori Ab IgM (LC)	$61.09	$111.08	$37.21–$104.42	—	45%
H. pylori stool antigen test CPT 87338 Heliobacter pylori Stool Ag EIA (LC)	$81.69	$302.55	$12.68–$284.40	34% below	73%
H. pylori stool antigen test inpatient CPT 87338 Heliobacter pylori Stool Ag EIA (LC)	$166.40	$302.55	$101.35–$284.40	—	45%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA, PCR (NonGraph) Rfx Geno LC	$126.67	$469.16	$75.06–$441.01	65% below	73%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV1 QT PCR w/ Reflex No Graph (LC)	$126.67	$469.16	$75.06–$441.01	65% below	73%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 .GenoSure(R) MG Quant RNA PCR (LC)	$126.67	$469.16	$75.06–$441.01	65% below	73%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 .GenoSure PRIme(R) Quant RNA PCR (LC)	$126.67	$469.16	$75.06–$441.01	65% below	73%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV1 QT PCR w/ Reflex No Graph (LC)	$258.04	$469.16	$157.17–$441.01	—	45%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA, PCR (NonGraph) Rfx Geno LC	$258.04	$469.16	$157.17–$441.01	—	45%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 .GenoSure(R) MG Quant RNA PCR (LC)	$258.04	$469.16	$157.17–$441.01	—	45%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 .GenoSure PRIme(R) Quant RNA PCR (LC)	$258.04	$469.16	$157.17–$441.01	—	45%
HPV test for high-risk types, one combined (pooled) result CPT 87624 SO 87624 AP Bill HPV High Risk Types	$82.87	$306.92	$30.95–$288.50	19% below	73%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 SO 87624 AP Bill HPV High Risk Types	$168.81	$306.92	$102.82–$288.50	—	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$38.72	$143.40	$8.57–$134.80	39% below	73%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c (LC)	$38.72	$143.40	$8.57–$134.80	39% below	73%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$78.87	$143.40	$48.04–$134.80	—	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c (LC)	$78.87	$143.40	$48.04–$134.80	—	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab w/Interp	$90.77	$336.18	$9.48–$316.01	56% above	73%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab w/Interp	$184.90	$336.18	$112.62–$316.01	—	45%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$81.69	$302.55	$9.11–$284.40	67% above	73%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag Screen (LC)	$81.69	$302.55	$9.11–$284.40	67% above	73%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag Screen (LC)	$166.40	$302.55	$101.35–$284.40	—	45%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$166.40	$302.55	$101.35–$284.40	—	45%
Hepatitis C antibody blood test (screening) CPT 86803 HCAB2	$110.89	$410.71	$12.58–$386.07	33% above	73%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody RFX to Quant PCR (LC)	$110.89	$410.71	$12.58–$386.07	33% above	73%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C IgG Antibody	$110.89	$410.71	$12.58–$386.07	33% above	73%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Antibody (LC)	$110.89	$410.71	$12.58–$386.07	33% above	73%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Antibody (LC)	$225.89	$410.71	$137.59–$386.07	—	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C IgG Antibody	$225.89	$410.71	$137.59–$386.07	—	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCAB2	$225.89	$410.71	$137.59–$386.07	—	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody RFX to Quant PCR (LC)	$225.89	$410.71	$137.59–$386.07	—	45%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno (LC)	$274.24	$1,015.72	$37.78–$954.78	46% above	73%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 .HCV RT-PCR, Quant (Non-Graph) LC	$274.24	$1,015.72	$37.78–$954.78	46% above	73%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 Hepatitis C Virus RT PCR Quant Non-Graph (LC)	$274.24	$1,015.72	$37.78–$954.78	46% above	73%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno (LC)	$558.65	$1,015.72	$340.27–$954.78	—	45%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 .HCV RT-PCR, Quant (Non-Graph) LC	$558.65	$1,015.72	$340.27–$954.78	—	45%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 Hepatitis C Virus RT PCR Quant Non-Graph (LC)	$558.65	$1,015.72	$340.27–$954.78	—	45%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IgG, Type Spec LC	$36.70	$135.92	$11.64–$127.76	26% below	73%
Herpes blood test, HSV-1 antibody CPT 86695 86695 HERPES SIMP TYPE 1	$36.70	$135.92	$11.64–$127.76	26% below	73%
Herpes blood test, HSV-1 antibody CPT 86695 86695 L164922 HSV1	$36.70	$135.92	$11.64–$127.76	26% below	73%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Virus 1 Specific Antibody IgG (LC)	$36.70	$135.92	$11.64–$127.76	26% below	73%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 HERPES SIMP TYPE 1	$74.76	$135.92	$45.53–$127.76	—	45%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 L164922 HSV1	$74.76	$135.92	$45.53–$127.76	—	45%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Virus 1 Specific Antibody IgG (LC)	$74.76	$135.92	$45.53–$127.76	—	45%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IgG, Type Spec LC	$74.76	$135.92	$45.53–$127.76	—	45%
Herpes blood test, HSV-2 antibody CPT 86696 86696 L164922 HSV2	$36.70	$135.92	$17.06–$127.76	48% below	73%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Virus 2 Specific Antibody IgG (LC)	$36.70	$135.92	$17.06–$127.76	48% below	73%
Herpes blood test, HSV-2 antibody CPT 86696 86696 HERPES SIMP TYPE 2	$36.70	$135.92	$17.06–$127.76	48% below	73%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 HERPES SIMP TYPE 2	$74.76	$135.92	$45.53–$127.76	—	45%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Virus 2 Specific Antibody IgG (LC)	$74.76	$135.92	$45.53–$127.76	—	45%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 L164922 HSV2	$74.76	$135.92	$45.53–$127.76	—	45%
High-sensitivity CRP (hs-CRP) test CPT 86141 C Reactive Protein High Sensitivity	$51.29	$189.98	$11.42–$178.58	27% below	73%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C Reactive Protein High Sensitivity	$104.49	$189.98	$63.64–$178.58	—	45%
Homocysteine blood test CPT 83090 Homocyst(e)ine Plasma LC	$79.70	$295.20	$15.80–$277.49	36% below	73%
Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine Plasma LC	$162.36	$295.20	$98.89–$277.49	—	45%
Insulin blood test CPT 83525 Insulin LC	$93.12	$344.88	$10.08–$324.19	47% above	73%
Insulin blood test CPT 83525 83525 INSULIN, TOTAL	$93.12	$344.88	$10.08–$324.19	47% above	73%
Insulin blood test CPT 83525 83525 L501561 INSULIN TOT	$93.12	$344.88	$10.08–$324.19	47% above	73%
Insulin blood test inpatient CPT 83525 83525 L501561 INSULIN TOT	$189.68	$344.88	$115.53–$324.19	—	45%
Insulin blood test inpatient CPT 83525 83525 INSULIN, TOTAL	$189.68	$344.88	$115.53–$324.19	—	45%
Insulin blood test inpatient CPT 83525 Insulin LC	$189.68	$344.88	$115.53–$324.19	—	45%
Iron blood test (serum iron) CPT 83540 IRON	$24.46	$90.59	$5.71–$85.15	40% below	73%
Iron blood test (serum iron) CPT 83540 83540 IRON	$24.46	$90.59	$5.71–$85.15	40% below	73%
Iron blood test (serum iron) inpatient CPT 83540 83540 IRON	$49.82	$90.59	$30.35–$85.15	—	45%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$49.82	$90.59	$30.35–$85.15	—	45%
Iron-binding capacity (TIBC) test CPT 83550 Iron and TIBC (LC)	$32.57	$120.63	$7.71–$113.39	22% below	73%
Iron-binding capacity (TIBC) test CPT 83550 83550 IRON BINDING CAPACIT	$35.91	$132.99	$7.71–$125.01	14% below	73%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron and TIBC (LC)	$66.35	$120.63	$40.41–$113.39	—	45%
Iron-binding capacity (TIBC) test inpatient CPT 83550 83550 IRON BINDING CAPACIT	$73.14	$132.99	$44.55–$125.01	—	45%
Kidney function blood test panel CPT 80069 RFP	$82.87	$306.92	$7.66–$288.50	14% below	73%
Kidney function blood test panel inpatient CPT 80069 RFP	$168.81	$306.92	$102.82–$288.50	—	45%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone, Pediatric (LC)	$69.06	$255.79	$16.34–$240.44	51% below	73%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$69.06	$255.79	$16.34–$240.44	51% below	73%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone, Pediatric (LC)	$140.68	$255.79	$85.69–$240.44	—	45%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$140.68	$255.79	$85.69–$240.44	—	45%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$38.28	$141.77	$6.08–$133.26	57% below	73%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$77.97	$141.77	$47.49–$133.26	—	45%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$144.43	$534.92	$7.21–$502.82	58% above	73%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$294.21	$534.92	$179.20–$502.82	—	45%
Lyme disease antibody test CPT 86618 Borrelia burgdorferi Total Antibody Test w/Reflex	$83.04	$307.57	$15.02–$289.12	12% below	73%
Lyme disease antibody test CPT 86618 Lyme Disease Total Ab Rfx Immunoassay LC	$91.56	$339.10	$15.02–$318.75	3% below	73%
Lyme disease antibody test CPT 86618 86618 L139825 LYME DIS AB	$91.56	$339.10	$15.02–$318.75	3% below	73%
Lyme disease antibody test CPT 86618 C6 B burgdorferi w/Reflex WB (LC)	$91.56	$339.10	$15.02–$318.75	3% below	73%
Lyme disease antibody test CPT 86618 86618 LYME DISEASE AB	$91.56	$339.10	$15.02–$318.75	3% below	73%
Lyme disease antibody test inpatient CPT 86618 Borrelia burgdorferi Total Antibody Test w/Reflex	$169.16	$307.57	$103.04–$289.12	—	45%
Lyme disease antibody test inpatient CPT 86618 C6 B burgdorferi w/Reflex WB (LC)	$186.51	$339.10	$113.60–$318.75	—	45%
Lyme disease antibody test inpatient CPT 86618 86618 LYME DISEASE AB	$186.51	$339.10	$113.60–$318.75	—	45%
Lyme disease antibody test inpatient CPT 86618 86618 L139825 LYME DIS AB	$186.51	$339.10	$113.60–$318.75	—	45%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Total Ab Rfx Immunoassay LC	$186.51	$339.10	$113.60–$318.75	—	45%
Magnesium blood test CPT 83735 Magnesium Serum	$46.16	$170.98	$5.91–$160.72	5% above	73%
Magnesium blood test CPT 83735 Magnesium, Urine (LC)	$46.16	$170.98	$5.91–$160.72	5% above	73%
Magnesium blood test CPT 83735 83735 L306266 MAGNESIUM	$46.16	$170.98	$5.91–$160.72	5% above	73%
Magnesium blood test inpatient CPT 83735 83735 L306266 MAGNESIUM	$94.04	$170.98	$57.28–$160.72	—	45%
Magnesium blood test inpatient CPT 83735 Magnesium Serum	$94.04	$170.98	$57.28–$160.72	—	45%
Magnesium blood test inpatient CPT 83735 Magnesium, Urine (LC)	$94.04	$170.98	$57.28–$160.72	—	45%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Antibodies, IgG (LC)	$52.49	$194.41	$11.36–$182.75	28% below	73%
Measles (rubeola) antibody test CPT 86765 86765 L58495 RUBEOLA AB	$52.49	$194.41	$11.36–$182.75	28% below	73%
Measles (rubeola) antibody test inpatient CPT 86765 86765 L58495 RUBEOLA AB	$106.93	$194.41	$65.13–$182.75	—	45%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Antibodies, IgG (LC)	$106.93	$194.41	$65.13–$182.75	—	45%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Test, Qual (LC)	$81.69	$302.55	$4.57–$284.40	13% above	73%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen	$81.69	$302.55	$4.57–$284.40	13% above	73%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen	$166.40	$302.55	$101.35–$284.40	—	45%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Test, Qual (LC)	$166.40	$302.55	$101.35–$284.40	—	45%
Obstetric blood test panel CPT 80055 Obstetric Panel CS	$348.82	$1,291.93	$42.16–$1,214.41	17% above	73%
Obstetric blood test panel inpatient CPT 80055 Obstetric Panel CS	$710.56	$1,291.93	$432.80–$1,214.41	—	45%
PSA (prostate-specific antigen) blood test, free CPT 84154 84154 L480947 PSA, FREE	$54.72	$202.65	$16.22–$190.49	21% below	73%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 L480947 PSA, FREE	$111.46	$202.65	$67.89–$190.49	—	45%
PSA (prostate-specific antigen) blood test, total CPT 84153 84153 L480947 PSA, TOTAL	$49.13	$181.97	$16.22–$171.05	33% below	73%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Ag Total	$49.13	$181.97	$16.22–$171.05	33% below	73%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Ag Total	$100.08	$181.97	$60.96–$171.05	—	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 L480947 PSA, TOTAL	$100.08	$181.97	$60.96–$171.05	—	45%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 88142 AP Bill Gyn Cytology Liquid Prep	$44.58	$165.12	$17.87–$155.21	36% below	73%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 88142 AP Bill Gyn Cytology Liquid Prep	$90.82	$165.12	$55.32–$155.21	—	45%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact Intraop	$106.53	$394.56	$36.41–$370.89	43% below	73%
Parathyroid hormone (PTH) blood test CPT 83970 83970 L54601 PARATHORMONE PTH	$106.53	$394.56	$36.41–$370.89	43% below	73%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact	$106.53	$394.56	$36.41–$370.89	43% below	73%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact	$217.01	$394.56	$132.18–$370.89	—	45%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 83970 L54601 PARATHORMONE PTH	$217.01	$394.56	$132.18–$370.89	—	45%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact Intraop	$217.01	$394.56	$132.18–$370.89	—	45%
Partial thromboplastin time (PTT) clotting test CPT 85730 85730 L117199 THROMBO TIME	$34.95	$129.45	$5.30–$121.68	29% below	73%
Partial thromboplastin time (PTT) clotting test CPT 85730 85730 - L117079 APTT	$36.70	$135.92	$5.30–$127.76	25% below	73%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT, Activated (LC)	$36.70	$135.92	$5.30–$127.76	25% below	73%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$36.70	$135.92	$5.30–$127.76	25% below	73%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 L117199 THROMBO TIME	$71.20	$129.45	$43.37–$121.68	—	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT, Activated (LC)	$74.76	$135.92	$45.53–$127.76	—	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 - L117079 APTT	$74.76	$135.92	$45.53–$127.76	—	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$74.76	$135.92	$45.53–$127.76	—	45%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MaterniT21 PLUS Core+SCA (LC)	$677.85	$2,510.56	$669.48–$2,359.93	19% below	73%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MaterniT21 PLUS Core+SCA (LC)	$1,380.81	$2,510.56	$841.04–$2,359.93	—	45%
Progesterone blood test CPT 84144 Progesterone Sendout to LabCorp	$76.32	$282.65	$18.40–$265.69	44% below	73%
Progesterone blood test inpatient CPT 84144 Progesterone Sendout to LabCorp	$155.46	$282.65	$94.69–$265.69	—	45%
Prolactin blood test CPT 84146 Prolactin Level	$67.01	$248.19	$17.09–$233.30	31% below	73%
Prolactin blood test inpatient CPT 84146 Prolactin Level	$136.50	$248.19	$83.14–$233.30	—	45%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time w/INR	$29.20	$108.16	$3.78–$101.67	13% above	73%
Prothrombin time (PT/INR) clotting test CPT 85610 .Protime w/INR POC	$29.20	$108.16	$3.78–$101.67	13% above	73%
Prothrombin time (PT/INR) clotting test CPT 85610 85610 - L117079 PT	$29.20	$108.16	$3.78–$101.67	13% above	73%
Prothrombin time (PT/INR) clotting test CPT 85610 85610 L117028 PROTHROMBIN	$29.20	$108.16	$3.78–$101.67	13% above	73%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time w/INR	$59.49	$108.16	$36.23–$101.67	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 L117028 PROTHROMBIN	$59.49	$108.16	$36.23–$101.67	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 - L117079 PT	$59.49	$108.16	$36.23–$101.67	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .Protime w/INR POC	$59.49	$108.16	$36.23–$101.67	—	45%
Rapid flu test (influenza antigen) CPT 87804 87804 INFLUENZA ASSAY W-OP	$48.53	$179.75	$14.60–$168.96	at median	73%
Rapid flu test (influenza antigen) CPT 87804 Influenza B Antigen Result	$48.53	$179.75	$14.60–$168.96	at median	73%
Rapid flu test (influenza antigen) CPT 87804 Influenza A Antigen Result	$48.53	$179.75	$14.60–$168.96	at median	73%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A Antigen Result	$98.86	$179.75	$60.22–$168.96	—	45%
Rapid flu test (influenza antigen) inpatient CPT 87804 87804 INFLUENZA ASSAY W-OP	$98.86	$179.75	$60.22–$168.96	—	45%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza B Antigen Result	$98.86	$179.75	$60.22–$168.96	—	45%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Titer	$56.42	$208.97	$5.00–$196.43	19% above	73%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor (LC)	$56.42	$208.97	$5.00–$196.43	19% above	73%
Rheumatoid factor (RF) test CPT 86431 86431 L56499 RA FACT QT	$56.42	$208.97	$5.00–$196.43	19% above	73%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Titer	$114.93	$208.97	$70.00–$196.43	—	45%
Rheumatoid factor (RF) test inpatient CPT 86431 86431 L56499 RA FACT QT	$114.93	$208.97	$70.00–$196.43	—	45%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Arthritis Factor (LC)	$114.93	$208.97	$70.00–$196.43	—	45%
Rubella antibody test (immunity check) CPT 86762 86762 L58495 RUBELLA AB	$87.20	$322.97	$12.69–$303.59	31% above	73%
Rubella antibody test (immunity check) CPT 86762 Rubella Ab IgG Auto w/Interp	$87.20	$322.97	$12.69–$303.59	31% above	73%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab IgG Auto w/Interp	$177.63	$322.97	$108.19–$303.59	—	45%
Rubella antibody test (immunity check) inpatient CPT 86762 86762 L58495 RUBELLA AB	$177.63	$322.97	$108.19–$303.59	—	45%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESRA	$56.03	$207.52	$2.39–$195.07	44% above	73%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESRA	$114.14	$207.52	$69.52–$195.07	—	45%
Stool ova and parasites exam CPT 87177 87177 L8623 OVA-PARASITES SMEARS	$25.25	$93.51	$7.85–$87.90	47% below	73%
Stool ova and parasites exam inpatient CPT 87177 87177 L8623 OVA-PARASITES SMEARS	$51.43	$93.51	$31.33–$87.90	—	45%
Stool test for hidden blood (guaiac FOBT) CPT 82270 FOBT	$32.36	$119.87	$3.86–$112.68	9% below	73%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 FOBT	$65.93	$119.87	$40.16–$112.68	—	45%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Immunochemical Fecal Occult Blood Diagnostic	$45.37	$168.05	$14.04–$157.97	10% below	73%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Immunochemical Fecal Occult Blood Diagnostic	$92.43	$168.05	$56.30–$157.97	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF LC	$56.42	$208.97	$3.76–$196.43	43% above	73%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Titer w/Reflex Titer	$56.42	$208.97	$3.76–$196.43	43% above	73%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Reflex Titer + TP-PA (LC)	$56.42	$208.97	$3.76–$196.43	43% above	73%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Reflex Titer + TP-PA (LC)	$114.93	$208.97	$70.00–$196.43	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Titer w/Reflex Titer	$114.93	$208.97	$70.00–$196.43	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF LC	$114.93	$208.97	$70.00–$196.43	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 .QuantiFERON In Tube LC	$39.01	$144.47	$39.01–$185.94	74% below	73%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON TB Gold (In Tube) LC	$39.01	$144.47	$39.01–$185.94	74% below	73%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus (Client Incubated) LC	$43.00	$159.27	$43.00–$185.94	72% below	73%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 .QuantiFERON In Tube LC	$79.46	$144.47	$48.40–$135.80	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON TB Gold (In Tube) LC	$79.46	$144.47	$48.40–$135.80	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus (Client Incubated) LC	$87.60	$159.27	$53.36–$149.71	—	45%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$86.75	$321.28	$22.76–$302.00	16% below	73%
Testosterone blood test, total (not free testosterone) CPT 84403 84403 TESTOSTERONE, TOTAL	$86.75	$321.28	$22.76–$302.00	16% below	73%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total	$176.70	$321.28	$107.63–$302.00	—	45%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 84403 TESTOSTERONE, TOTAL	$176.70	$321.28	$107.63–$302.00	—	45%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Antibody (LC)	$48.15	$178.33	$12.83–$167.63	42% below	73%
Thyroid peroxidase (TPO) antibody test CPT 86376 86376 L6684 MICROSOMAL AB	$48.15	$178.33	$12.83–$167.63	42% below	73%
Thyroid peroxidase (TPO) antibody test CPT 86376 86376 MICROSOMAL AB	$48.15	$178.33	$12.83–$167.63	42% below	73%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 86376 MICROSOMAL AB	$98.08	$178.33	$59.74–$167.63	—	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Antibody (LC)	$98.08	$178.33	$59.74–$167.63	—	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 86376 L6684 MICROSOMAL AB	$98.08	$178.33	$59.74–$167.63	—	45%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH LC	$27.23	$100.86	$14.81–$94.81	67% below	73%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/Reflex to T4 Total	$27.23	$100.86	$14.81–$94.81	67% below	73%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 84443 NBS THYROID STIM TSH	$27.23	$100.86	$14.81–$94.81	67% below	73%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$27.23	$100.86	$14.81–$94.81	67% below	73%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH reflex to T4F (LC)	$27.23	$100.86	$14.81–$94.81	67% below	73%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH LC	$55.47	$100.86	$33.79–$94.81	—	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$55.47	$100.86	$33.79–$94.81	—	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH reflex to T4F (LC)	$55.47	$100.86	$33.79–$94.81	—	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 84443 NBS THYROID STIM TSH	$55.47	$100.86	$33.79–$94.81	—	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/Reflex to T4 Total	$55.47	$100.86	$33.79–$94.81	—	45%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis, NAA (LC)	$60.37	$223.59	$30.95–$210.17	36% below	73%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis, NAA (LC)	$122.97	$223.59	$74.90–$210.17	—	45%
Uric acid blood test CPT 84550 Uric Acid Level	$46.16	$170.98	$3.99–$160.72	1% above	73%
Uric acid blood test inpatient CPT 84550 Uric Acid Level	$94.04	$170.98	$57.28–$160.72	—	45%
Urinalysis with microscope exam, automated CPT 81001 .Bill Only DS Auto/MSc Reqd	$45.78	$169.54	$2.80–$159.37	10% above	73%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis w/Microscopic Automated	$45.78	$169.54	$2.80–$159.37	10% above	73%
Urinalysis with microscope exam, automated CPT 81001 Perform Microscopic - Yes	$45.78	$169.54	$2.80–$159.37	10% above	73%
Urinalysis with microscope exam, automated inpatient CPT 81001 Perform Microscopic - Yes	$93.25	$169.54	$56.80–$159.37	—	45%
Urinalysis with microscope exam, automated inpatient CPT 81001 .Bill Only DS Auto/MSc Reqd	$93.25	$169.54	$56.80–$159.37	—	45%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis w/Microscopic Automated	$93.25	$169.54	$56.80–$159.37	—	45%
Urinalysis with microscope exam, manual CPT 81000 .Bill Only DS Man/MSc Reqd	$17.49	$64.79	$3.55–$60.90	17% below	73%
Urinalysis with microscope exam, manual inpatient CPT 81000 .Bill Only DS Man/MSc Reqd	$35.63	$64.79	$21.70–$60.90	—	45%
Urinalysis without microscope exam, automated CPT 81003 Perform Microscopic - No	$38.67	$143.22	$1.98–$134.63	99% above	73%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis w/o Microscopic Automated	$38.67	$143.22	$1.98–$134.63	99% above	73%
Urinalysis without microscope exam, automated CPT 81003 Dipstick Type? - Auto	$38.67	$143.22	$1.98–$134.63	99% above	73%
Urinalysis without microscope exam, automated CPT 81003 .Bill Only DS Auto/No MSc	$38.67	$143.22	$1.98–$134.63	99% above	73%
Urinalysis without microscope exam, automated CPT 81003 Urine Color Urine Dipstick	$38.67	$143.22	$1.98–$134.63	99% above	73%
Urinalysis without microscope exam, automated CPT 81003 81003 L306266 UA, AUTO, W-O SCOPE	$38.67	$143.22	$1.98–$134.63	99% above	73%
Urinalysis without microscope exam, automated inpatient CPT 81003 81003 L306266 UA, AUTO, W-O SCOPE	$78.77	$143.22	$47.98–$134.63	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Color Urine Dipstick	$78.77	$143.22	$47.98–$134.63	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 .Bill Only DS Auto/No MSc	$78.77	$143.22	$47.98–$134.63	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 Dipstick Type? - Auto	$78.77	$143.22	$47.98–$134.63	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 Perform Microscopic - No	$78.77	$143.22	$47.98–$134.63	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis w/o Microscopic Automated	$78.77	$143.22	$47.98–$134.63	—	45%
Urinalysis without microscope exam, manual CPT 81002 Dipstick Type? - Manual	$17.49	$64.79	$3.07–$60.90	61% above	73%
Urinalysis without microscope exam, manual CPT 81002 Ketones Ur Ql	$17.49	$64.79	$3.07–$60.90	61% above	73%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis w/o Microscopic Manual	$17.49	$64.79	$3.07–$60.90	61% above	73%
Urinalysis without microscope exam, manual CPT 81002 .Urinalysis Manual w/o MicroSc POC	$17.49	$64.79	$3.07–$60.90	61% above	73%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis w/o Microscopic Manual	$35.63	$64.79	$21.70–$60.90	—	45%
Urinalysis without microscope exam, manual inpatient CPT 81002 Ketones Ur Ql	$35.63	$64.79	$21.70–$60.90	—	45%
Urinalysis without microscope exam, manual inpatient CPT 81002 Dipstick Type? - Manual	$35.63	$64.79	$21.70–$60.90	—	45%
Urinalysis without microscope exam, manual inpatient CPT 81002 .Urinalysis Manual w/o MicroSc POC	$35.63	$64.79	$21.70–$60.90	—	45%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture Qn	$44.19	$163.68	$7.12–$153.86	6% above	73%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture Qn	$90.02	$163.68	$54.83–$153.86	—	45%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result - Positive	$13.42	$49.69	$7.60–$46.71	75% below	73%
Urine pregnancy test, read by color change CPT 81025 Human Chorionic Gonadotropin Urine Qual Manual	$13.42	$49.69	$7.60–$46.71	75% below	73%
Urine pregnancy test, read by color change CPT 81025 .HCG Urine Ql POC	$13.42	$49.69	$7.60–$46.71	75% below	73%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result	$13.42	$49.69	$7.60–$46.71	75% below	73%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result - Negative	$13.42	$49.69	$7.60–$46.71	75% below	73%
Urine pregnancy test, read by color change inpatient CPT 81025 Human Chorionic Gonadotropin Urine Qual Manual	$27.33	$49.69	$16.65–$46.71	—	45%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result - Positive	$27.33	$49.69	$16.65–$46.71	—	45%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result - Negative	$27.33	$49.69	$16.65–$46.71	—	45%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result	$27.33	$49.69	$16.65–$46.71	—	45%
Urine pregnancy test, read by color change inpatient CPT 81025 .HCG Urine Ql POC	$27.33	$49.69	$16.65–$46.71	—	45%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12	$52.08	$192.90	$13.30–$181.33	19% below	73%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12	$106.10	$192.90	$64.62–$181.33	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 hydroxy	$57.21	$211.88	$26.11–$199.17	51% below	73%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy D2 + D3 LC	$57.21	$211.88	$26.11–$199.17	51% below	73%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy LC	$57.21	$211.88	$26.11–$199.17	51% below	73%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 hydroxy	$116.53	$211.88	$70.98–$199.17	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy D2 + D3 LC	$116.53	$211.88	$70.98–$199.17	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy LC	$116.53	$211.88	$70.98–$199.17	—	45%
Zinc blood test CPT 84630 Zinc Plasma or Serum (LC)	$55.84	$206.81	$10.04–$194.40	17% below	73%
Zinc blood test inpatient CPT 84630 Zinc Plasma or Serum (LC)	$113.75	$206.81	$69.28–$194.40	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Human Chorionic Gonadotropin Beta Sub unit Quant (	$99.83	$369.74	$13.28–$347.56	30% above	73%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 84702 L17319 HCG QUANT	$99.83	$369.74	$13.28–$347.56	30% above	73%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Human Chorionic Gonadotropin Quant	$99.83	$369.74	$13.28–$347.56	30% above	73%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 84702 HCG QUANT	$99.83	$369.74	$13.28–$347.56	30% above	73%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 84702 HCG QUANT	$203.36	$369.74	$123.86–$347.56	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 84702 L17319 HCG QUANT	$203.36	$369.74	$123.86–$347.56	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Human Chorionic Gonadotropin Quant	$203.36	$369.74	$123.86–$347.56	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Human Chorionic Gonadotropin Beta Sub unit Quant (	$203.36	$369.74	$123.86–$347.56	—	45%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w Loc w Stereo 1 Lsn Rt	$1,006.62	$3,728.22	$1,657.38–$6,806.27	55% below	73%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w Loc w Stereo 1 Lsn Lt	$1,006.62	$3,728.22	$1,657.38–$6,806.27	55% below	73%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w Loc w Stereo 1 Lsn Rt	$2,050.52	$3,728.22	$1,248.95–$3,504.53	—	45%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w Loc w Stereo 1 Lsn Lt	$2,050.52	$3,728.22	$1,248.95–$3,504.53	—	45%
Cardioversion, elective (restoring heart rhythm) CPT 92960 $ED Cardioversion	$1,148.29	$4,252.92	$90.48–$3,997.74	17% below	73%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ED Cardioversion Set up for procedure - Cardiovers	$1,148.29	$4,252.92	$90.48–$3,997.74	17% below	73%
Cardioversion, elective (restoring heart rhythm) CPT 92960 $ED Cardioversion/Defibrillation	$1,148.29	$4,252.92	$90.48–$3,997.74	17% below	73%
Cardioversion, elective (restoring heart rhythm) CPT 92960 NI Cardioversion	$1,148.29	$4,252.92	$90.48–$3,997.74	17% below	73%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 NI Cardioversion	$2,339.11	$4,252.92	$1,424.73–$3,997.74	—	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 $ED Cardioversion	$2,339.11	$4,252.92	$1,424.73–$3,997.74	—	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED Cardioversion Set up for procedure - Cardiovers	$2,339.11	$4,252.92	$1,424.73–$3,997.74	—	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 $ED Cardioversion/Defibrillation	$2,339.11	$4,252.92	$1,424.73–$3,997.74	—	45%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$9,707.26	$35,952.82	$389.54–$33,795.65	420% above	73%
Cataract surgery with lens implant CPT 66984 REMOVE CATARACT/INSERT LENS	$6,765.94	$25,059.02	$438.36–$23,555.48	88% above	73%
Colonoscopy with polyp removal CPT 45385 LESION REMOVAL COLONOSCOPY	$4,898.23	$18,141.59	$210.50–$17,053.09	163% above	73%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$4,867.62	$18,028.21	$167.00–$16,946.52	249% above	73%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$3,995.04	$14,796.43	$154.36–$13,908.64	244% above	73%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$252.48	$935.11	$15.64–$879.00	99% above	73%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 S-INJ-CATH HYSTERSO	$98.85	$366.12	$48.34–$344.15	65% below	73%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 S-INJ CATH HYSTERSO	$98.85	$366.12	$48.34–$344.15	65% below	73%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 58340 S-INJ CATH HYSTERSO	$108.99	$403.65	$48.34–$379.43	62% below	73%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 58340 DR S-INJ CATH HYSTERSO	$108.99	$403.65	$48.34–$379.43	62% below	73%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 S-INJ-CATH HYSTERSO	$201.37	$366.12	$122.65–$344.15	—	45%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 S-INJ CATH HYSTERSO	$201.37	$366.12	$122.65–$344.15	—	45%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 58340 DR S-INJ CATH HYSTERSO	$222.01	$403.65	$135.22–$379.43	—	45%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 58340 S-INJ CATH HYSTERSO	$222.01	$403.65	$135.22–$379.43	—	45%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS	$706.77	$2,617.67	$94.18–$2,460.61	74% above	73%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 S-JNT ASP INJ MAJ UN	$169.42	$627.48	$308.03–$1,240.05	56% below	73%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJECT, JOINT/BURSA	$876.36	$3,245.77	$36.81–$3,051.02	129% above	73%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 S-JNT ASP INJ MAJ UN	$345.11	$627.48	$210.21–$589.83	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 S-JOINT ASP-INJ IM	$133.42	$494.14	$308.03–$1,240.05	62% below	73%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 S-JOINT ASP-INJ IM	$271.78	$494.14	$165.54–$464.49	—	45%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 S-JOINT ASP-INJ SM	$102.27	$378.77	$308.03–$1,240.05	63% below	73%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 S-JOINT ASP-INJ SM	$208.32	$378.77	$126.89–$356.04	—	45%
Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY	$12,385.72	$45,873.04	$474.14–$43,120.66	243% above	73%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY	$12,942.82	$47,936.37	$490.09–$45,060.19	243% above	73%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE OF WOUND(S)	$12,537.32	$46,434.53	$124.91–$43,648.46	2626% above	73%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$625.96	$2,318.37	$46.51–$2,179.27	92% above	73%
Paracentesis with imaging guidance CPT 49083 CT Abdominal Paracentesis w Imaging	$992.24	$3,674.95	$910.16–$3,938.48	26% below	73%
Paracentesis with imaging guidance CPT 49083 US Paracentesis Abd w Image	$992.24	$3,674.95	$910.16–$3,938.48	26% below	73%
Paracentesis with imaging guidance inpatient CPT 49083 CT Abdominal Paracentesis w Imaging	$2,021.22	$3,674.95	$1,231.11–$3,454.45	—	45%
Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis Abd w Image	$2,021.22	$3,674.95	$1,231.11–$3,454.45	—	45%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY	$650.20	$2,408.16	$95.59–$2,263.67	51% above	73%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$3,945.05	$14,611.29	$154.52–$13,734.61	140% above	73%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND	$3,764.38	$13,942.13	$154.36–$13,105.60	191% above	73%
Short arm splint (forearm and hand) CPT 29125 SPLINT APPLICATION SHORT ARM STATIC PTA - Redoc 17	$60.96	$225.78	$133.51–$541.49	66% below	73%
Short arm splint (forearm and hand) CPT 29125 SPLINT APPLICATION SHORT ARM STATIC COTA - Redoc 2	$60.96	$225.78	$133.51–$541.49	66% below	73%
Short arm splint (forearm and hand) CPT 29125 SPLINT APPLICATION SHORT ARM STATIC COTA - Redoc 1	$84.06	$311.33	$133.51–$541.49	54% below	73%
Short arm splint (forearm and hand) CPT 29125 OT Static Short Arm Splint Assist Units	$84.06	$311.33	$133.51–$541.49	54% below	73%
Short arm splint (forearm and hand) CPT 29125 SPLNT SHRT ARM STATC - REDOC 185	$84.06	$311.33	$133.51–$541.49	54% below	73%
Short arm splint (forearm and hand) CPT 29125 SPLNT SHRT ARM STATC - REDOC 181	$84.06	$311.33	$133.51–$541.49	54% below	73%
Short arm splint (forearm and hand) CPT 29125 OT Static Short Arm Splint Charge	$84.06	$311.33	$133.51–$541.49	54% below	73%
Short arm splint (forearm and hand) CPT 29125 OT Static Short Arm Splint Units	$84.06	$311.33	$133.51–$541.49	54% below	73%
Short arm splint (forearm and hand) CPT 29125 SPLINT APPLICATION SHORT ARM STATIC PTA - Redoc 18	$84.06	$311.33	$133.51–$541.49	54% below	73%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$895.62	$3,317.12	$37.95–$3,118.09	393% above	73%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT APPLICATION SHORT ARM STATIC PTA - Redoc 17	$124.18	$225.78	$75.64–$212.23	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT APPLICATION SHORT ARM STATIC COTA - Redoc 2	$124.18	$225.78	$75.64–$212.23	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT APPLICATION SHORT ARM STATIC COTA - Redoc 1	$171.23	$311.33	$104.30–$292.65	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 OT Static Short Arm Splint Assist Units	$171.23	$311.33	$104.30–$292.65	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 OT Static Short Arm Splint Units	$171.23	$311.33	$104.30–$292.65	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLNT SHRT ARM STATC - REDOC 185	$171.23	$311.33	$104.30–$292.65	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLNT SHRT ARM STATC - REDOC 181	$171.23	$311.33	$104.30–$292.65	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 OT Static Short Arm Splint Charge	$171.23	$311.33	$104.30–$292.65	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT APPLICATION SHORT ARM STATIC PTA - Redoc 18	$171.23	$311.33	$104.30–$292.65	—	45%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST COTA - Redoc 186	$60.96	$225.78	$225.78–$1,115.65	81% below	73%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST COTA - Redoc 189	$60.96	$225.78	$225.78–$1,115.65	81% below	73%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST PTA - Redoc 175	$60.96	$225.78	$225.78–$1,115.65	81% below	73%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST PTA - Redoc 182	$60.96	$225.78	$225.78–$1,115.65	81% below	73%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST COTA - Redoc 258	$60.96	$225.78	$225.78–$1,115.65	81% below	73%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST PTA - Redoc 183	$60.96	$225.78	$225.78–$1,115.65	81% below	73%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST PTA - Redoc 184	$60.96	$225.78	$225.78–$1,115.65	81% below	73%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST PTA - Redoc 181	$84.06	$311.33	$280.67–$1,115.65	73% below	73%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST COTA - Redoc 179	$84.06	$311.33	$280.67–$1,115.65	73% below	73%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST COTA - Redoc 189	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST COTA - Redoc 258	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST PTA - Redoc 175	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST PTA - Redoc 182	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST PTA - Redoc 183	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST PTA - Redoc 184	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST COTA - Redoc 186	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST PTA - Redoc 181	$171.23	$311.33	$104.30–$292.65	—	45%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST COTA - Redoc 179	$171.23	$311.33	$104.30–$292.65	—	45%
Short leg splint (calf to foot) CPT 29515 SPLINT APPLICATION SHORT LEG COTA - Redoc 258	$60.96	$225.78	$163.06–$662.86	67% below	73%
Short leg splint (calf to foot) CPT 29515 SPLINT APPLICATION SHORT LEG COTA - Redoc 189	$60.96	$225.78	$163.06–$662.86	67% below	73%
Short leg splint (calf to foot) CPT 29515 SPLINT APPLICATION SHORT LEG COTA - Redoc 186	$60.96	$225.78	$163.06–$662.86	67% below	73%
Short leg splint (calf to foot) CPT 29515 SPLINT APPLICATION SHORT LEG PTA - Redoc 183	$60.96	$225.78	$163.06–$662.86	67% below	73%
Short leg splint (calf to foot) CPT 29515 SPLINT APPLICATION SHORT LEG PTA - Redoc 182	$60.96	$225.78	$163.06–$662.86	67% below	73%
Short leg splint (calf to foot) CPT 29515 SPLINT APPLICATION SHORT LEG PTA - Redoc 175	$60.96	$225.78	$163.06–$662.86	67% below	73%
Short leg splint (calf to foot) CPT 29515 SPLINT APPLICATION SHORT LEG PTA - Redoc 184	$68.50	$253.71	$163.06–$662.86	62% below	73%
Short leg splint (calf to foot) CPT 29515 APP SHORT LEG SPLINT - REDOC 181	$84.06	$311.33	$163.06–$662.86	54% below	73%
Short leg splint (calf to foot) CPT 29515 PT Application Short Leg Splint Charge	$84.06	$311.33	$163.06–$662.86	54% below	73%
Short leg splint (calf to foot) CPT 29515 SPLINT APPLICATION SHORT LEG COTA - Redoc 185	$84.06	$311.33	$163.06–$662.86	54% below	73%
Short leg splint (calf to foot) CPT 29515 PT Application Short Leg Splint Units	$84.06	$311.33	$163.06–$662.86	54% below	73%
Short leg splint (calf to foot) CPT 29515 APP SHORT LEG SPLINT - REDOC 185	$84.06	$311.33	$163.06–$662.86	54% below	73%
Short leg splint (calf to foot) CPT 29515 PT Applicat Short Leg Splint Assist Unit	$84.06	$311.33	$163.06–$662.86	54% below	73%
Short leg splint (calf to foot) CPT 29515 SPLINT APPLICATION SHORT LEG PTA - Redoc 181	$84.06	$311.33	$163.06–$662.86	54% below	73%
Short leg splint (calf to foot) CPT 29515 SPLINT APPLICATION SHORT LEG COTA - Redoc 179	$84.06	$311.33	$163.06–$662.86	54% below	73%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$909.01	$3,366.69	$46.10–$3,164.69	399% above	73%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPLICATION SHORT LEG COTA - Redoc 189	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPLICATION SHORT LEG COTA - Redoc 258	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPLICATION SHORT LEG PTA - Redoc 175	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPLICATION SHORT LEG PTA - Redoc 182	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPLICATION SHORT LEG PTA - Redoc 183	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPLICATION SHORT LEG COTA - Redoc 186	$124.18	$225.78	$75.64–$212.23	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPLICATION SHORT LEG PTA - Redoc 184	$139.54	$253.71	$84.99–$238.49	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 APP SHORT LEG SPLINT - REDOC 181	$171.23	$311.33	$104.30–$292.65	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPLICATION SHORT LEG COTA - Redoc 185	$171.23	$311.33	$104.30–$292.65	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPLICATION SHORT LEG PTA - Redoc 181	$171.23	$311.33	$104.30–$292.65	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPLICATION SHORT LEG COTA - Redoc 179	$171.23	$311.33	$104.30–$292.65	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 PT Applicat Short Leg Splint Assist Unit	$171.23	$311.33	$104.30–$292.65	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 PT Application Short Leg Splint Units	$171.23	$311.33	$104.30–$292.65	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 PT Application Short Leg Splint Charge	$171.23	$311.33	$104.30–$292.65	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 APP SHORT LEG SPLINT - REDOC 185	$171.23	$311.33	$104.30–$292.65	—	45%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHOULDER ARTHROSCOPY/SURGERY	$19,349.52	$71,664.88	$135.46–$67,364.99	168% above	73%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SUPERFICIAL WOUND(S)	$649.40	$2,405.19	$40.22–$2,260.88	151% above	73%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS	$12,537.32	$46,434.53	$64.86–$43,648.46	5262% above	73%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Punctures w/o imaging	$418.65	$1,550.57	$708.35–$2,909.14	56% below	73%
Spinal tap (lumbar puncture), diagnostic CPT 62270 S-SPINAL TAP DIAGNST	$418.65	$1,550.57	$708.35–$2,909.14	56% below	73%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 S-SPINAL TAP DIAGNST	$852.81	$1,550.57	$519.44–$1,457.54	—	45%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Punctures w/o imaging	$852.81	$1,550.57	$519.44–$1,457.54	—	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SUPERFICIAL WOUND(S)	$832.84	$3,084.60	$52.43–$2,899.52	169% above	73%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR SUPERFICIAL WOUND(S)	$1,128.28	$4,178.83	$49.62–$3,928.10	420% above	73%
Thoracentesis with imaging guidance CPT 32555 US Thoracentesis w Imaging Guidance	$883.51	$3,272.26	$89.15–$3,075.92	19% below	73%
Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis w Imaging Guidance	$1,799.74	$3,272.26	$1,096.21–$3,075.92	—	45%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$10,283.59	$38,087.36	$265.43–$35,802.12	413% above	73%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Lt	$1,006.24	$3,726.80	$1,657.38–$6,806.27	47% below	73%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Rt	$1,006.24	$3,726.80	$1,657.38–$6,806.27	47% below	73%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Rt	$2,049.74	$3,726.80	$1,248.48–$3,503.19	—	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Lt	$2,049.74	$3,726.80	$1,248.48–$3,503.19	—	45%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY, BIOPSY	$5,508.55	$20,402.02	$116.27–$19,177.90	180% above	73%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 OPERATIVE UPPER GI ENDOSCOPY	$5,446.77	$20,173.23	$162.88–$18,962.84	172% above	73%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPR GI ENDOSCOPY, DIAGNOSIS	$4,341.04	$16,077.93	$103.93–$15,113.25	225% above	73%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Packed red blood cells	$294.77	$1,091.74	$442.72–$1,836.49	67% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 Blood transfusions	$294.77	$1,091.74	$442.72–$1,836.49	67% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Fresh frozen plasma	$294.77	$1,091.74	$442.72–$1,836.49	67% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Red blood cells (preoperativ	$294.77	$1,091.74	$442.72–$1,836.49	67% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Red blood cells (postoperati	$294.77	$1,091.74	$442.72–$1,836.49	67% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Cryoprecipitate	$294.77	$1,091.74	$442.72–$1,836.49	67% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Fee	$294.77	$1,091.74	$442.72–$1,836.49	67% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Verified with Pt Information: - Transfu	$294.77	$1,091.74	$442.72–$1,836.49	67% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Platelets (single donor)	$294.77	$1,091.74	$442.72–$1,836.49	67% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 $ED Transfusion >2 yrs	$294.77	$1,091.74	$442.72–$1,836.49	67% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Whole blood	$294.77	$1,091.74	$442.72–$1,836.49	67% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Platelets (random donor)	$294.77	$1,091.74	$442.72–$1,836.49	67% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE	$3,808.61	$14,105.95	$43.53–$13,259.59	323% above	73%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Verified with Pt Information: - Transfu	$600.46	$1,091.74	$365.73–$1,026.24	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood transfusions	$600.46	$1,091.74	$365.73–$1,026.24	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Cryoprecipitate	$600.46	$1,091.74	$365.73–$1,026.24	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Platelets (random donor)	$600.46	$1,091.74	$365.73–$1,026.24	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Fee	$600.46	$1,091.74	$365.73–$1,026.24	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Platelets (single donor)	$600.46	$1,091.74	$365.73–$1,026.24	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Fresh frozen plasma	$600.46	$1,091.74	$365.73–$1,026.24	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 $ED Transfusion >2 yrs	$600.46	$1,091.74	$365.73–$1,026.24	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Whole blood	$600.46	$1,091.74	$365.73–$1,026.24	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Red blood cells (preoperativ	$600.46	$1,091.74	$365.73–$1,026.24	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Red blood cells (postoperati	$600.46	$1,091.74	$365.73–$1,026.24	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Packed red blood cells	$600.46	$1,091.74	$365.73–$1,026.24	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Charge - Subsequent	$41.44	$153.48	$153.48–$854.42	63% below	73%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Charge - Initial	$41.44	$153.48	$153.48–$854.42	63% below	73%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPV Subsequent	$41.44	$153.48	$153.48–$854.42	63% below	73%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPV Initial	$41.44	$153.48	$153.48–$854.42	63% below	73%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPPB Initial	$41.44	$153.48	$153.48–$854.42	63% below	73%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPPB Subsequent	$41.44	$153.48	$153.48–$854.42	63% below	73%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - Subsequent	$41.44	$153.48	$153.48–$854.42	63% below	73%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - Initial	$41.44	$153.48	$153.48–$854.42	63% below	73%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$1,343.98	$4,977.69	$7.90–$4,679.03	1091% above	73%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler Charge - Initial	$84.41	$153.48	$51.42–$144.27	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPV Subsequent	$84.41	$153.48	$51.42–$144.27	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPV Initial	$84.41	$153.48	$51.42–$144.27	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler Charge - Subsequent	$84.41	$153.48	$51.42–$144.27	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - Initial	$84.41	$153.48	$51.42–$144.27	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPPB Initial	$84.41	$153.48	$51.42–$144.27	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPPB Subsequent	$84.41	$153.48	$51.42–$144.27	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - Subsequent	$84.41	$153.48	$51.42–$144.27	—	45%
Chemotherapy IV infusion, first hour CPT 96413 CHRG - CHEMO IV INFU 1ST HR	$185.47	$686.91	$331.46–$1,393.36	69% below	73%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHRG - CHEMO IV INFU 1ST HR	$377.80	$686.91	$230.11–$645.70	—	45%
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care	$1,100.53	$4,076.02	$188.73–$3,831.46	42% below	73%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care	$2,241.81	$4,076.02	$1,365.47–$3,831.46	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead Series Now	$165.34	$612.37	$6.35–$575.63	18% below	73%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Series 3 Hours	$165.34	$612.37	$6.35–$575.63	18% below	73%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 1 Hour	$165.34	$612.37	$6.35–$575.63	18% below	73%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG 12 Lead Series Now	$165.34	$612.37	$6.35–$575.63	18% below	73%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Series 1 Hour	$165.34	$612.37	$6.35–$575.63	18% below	73%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG BCE	$165.34	$612.37	$6.35–$575.63	18% below	73%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 6 Hours	$165.34	$612.37	$6.35–$575.63	18% below	73%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 3 Hours	$165.34	$612.37	$6.35–$575.63	18% below	73%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Start Time	$165.34	$612.37	$6.35–$575.63	18% below	73%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead	$165.34	$612.37	$6.35–$575.63	18% below	73%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Series 1 Hour	$336.80	$612.37	$205.14–$575.63	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 1 Hour	$336.80	$612.37	$205.14–$575.63	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG 12 Lead Series Now	$336.80	$612.37	$205.14–$575.63	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Series 3 Hours	$336.80	$612.37	$205.14–$575.63	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG BCE	$336.80	$612.37	$205.14–$575.63	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram 12 Lead	$336.80	$612.37	$205.14–$575.63	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Start Time	$336.80	$612.37	$205.14–$575.63	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead Series Now	$336.80	$612.37	$205.14–$575.63	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 6 Hours	$336.80	$612.37	$205.14–$575.63	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 3 Hours	$336.80	$612.37	$205.14–$575.63	—	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1	$98.27	$363.95	$84.62–$369.90	34% below	73%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1	$200.17	$363.95	$121.92–$342.11	—	45%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$149.55	$553.90	$154.09–$665.22	52% below	73%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$304.65	$553.90	$185.56–$520.67	—	45%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$314.49	$1,164.78	$273.93–$1,163.15	50% below	73%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 $ED Cricothyrotomy	$532.70	$1,972.98	$65.36–$1,854.60	15% below	73%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$640.63	$1,164.78	$390.20–$1,094.89	—	45%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 $ED Cricothyrotomy	$1,085.14	$1,972.98	$660.95–$1,854.60	—	45%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$618.73	$2,291.59	$111.13–$2,154.09	40% below	73%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$1,260.37	$2,291.59	$767.68–$2,154.09	—	45%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$827.07	$3,063.23	$161.52–$2,879.44	46% below	73%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$1,684.78	$3,063.23	$1,026.18–$2,879.44	—	45%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiac Stress Test	$444.31	$1,645.59	$35.93–$1,546.85	36% below	73%
Exercise stress test, tracing only, the hospital charge CPT 93017 NI Stress Test	$444.31	$1,645.59	$35.93–$1,546.85	36% below	73%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NI Stress Test	$905.07	$1,645.59	$551.27–$1,546.85	—	45%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiac Stress Test	$905.07	$1,645.59	$551.27–$1,546.85	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CHRG - Inf/Inj/Hydration - IV HYDRATION 1 HR	$120.74	$447.20	$213.44–$885.06	67% below	73%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour	$120.74	$447.20	$213.44–$885.06	67% below	73%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration therapy 1st hour	$120.74	$447.20	$213.44–$885.06	67% below	73%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 CHRG - Inf/Inj/Hydration - IV HYDRATION 1 HR	$245.96	$447.20	$149.81–$420.37	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration therapy 1st hour	$245.96	$447.20	$149.81–$420.37	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour	$245.96	$447.20	$149.81–$420.37	—	45%
IV infusion of a medicine, first hour CPT 96365 Infusion 1st hour	$120.74	$447.20	$213.44–$885.06	70% below	73%
IV infusion of a medicine, first hour CPT 96365 CHRG - Inf/Inj/Hydration - IV THERAPY DX 1 HR	$120.74	$447.20	$213.44–$885.06	70% below	73%
IV infusion of a medicine, first hour CPT 96365 96365 - IV tx, first hour	$120.74	$447.20	$213.44–$885.06	70% below	73%
IV infusion of a medicine, first hour inpatient CPT 96365 Infusion 1st hour	$245.96	$447.20	$149.81–$420.37	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 - IV tx, first hour	$245.96	$447.20	$149.81–$420.37	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 CHRG - Inf/Inj/Hydration - IV THERAPY DX 1 HR	$245.96	$447.20	$149.81–$420.37	—	45%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM Injection	$37.09	$137.36	$72.25–$298.99	63% below	73%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 - Subq/IM Injection	$37.09	$137.36	$72.25–$298.99	63% below	73%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CHRG - THERAPEUTIC DX SQ IM	$37.09	$137.36	$72.25–$298.99	63% below	73%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CHRG - THERAPEUTIC DX SQ IM	$75.55	$137.36	$46.02–$129.12	—	45%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 - Subq/IM Injection	$75.55	$137.36	$46.02–$129.12	—	45%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM Injection	$75.55	$137.36	$46.02–$129.12	—	45%
Neuromuscular re-education, 15 minutes CPT 97112 TH NEU REED-15MIN PT - REDOC 185	$41.93	$155.28	$27.83–$145.96	39% below	73%
Neuromuscular re-education, 15 minutes CPT 97112 TH NEU REED-15MIN PT - REDOC 181	$41.93	$155.28	$27.83–$145.96	39% below	73%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULR RE-EDUCATION EA 15 MIN COTA - Redoc 2	$48.37	$179.14	$27.83–$186.46	30% below	73%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Charges	$66.69	$247.00	$27.83–$232.18	3% below	73%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Charges	$66.69	$247.00	$27.83–$232.18	3% below	73%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 181	$66.69	$247.00	$27.83–$232.18	3% below	73%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 185	$66.69	$247.00	$27.83–$232.18	3% below	73%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Units	$66.69	$247.00	$27.83–$232.18	3% below	73%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducatn Assist Charge	$66.69	$247.00	$27.83–$232.18	3% below	73%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromusclr Reeducation Assist Charge	$66.69	$247.00	$27.83–$232.18	3% below	73%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULR RE-EDUCATION EA 15 MIN COTA - Redoc 1	$66.69	$247.00	$27.83–$232.18	3% below	73%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA - Redoc 1	$66.69	$247.00	$27.83–$232.18	3% below	73%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units	$66.69	$247.00	$27.83–$232.18	3% below	73%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 TH NEU REED-15MIN PT - REDOC 181	$85.40	$155.28	$52.02–$145.96	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 TH NEU REED-15MIN PT - REDOC 185	$85.40	$155.28	$52.02–$145.96	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULR RE-EDUCATION EA 15 MIN COTA - Redoc 2	$98.53	$179.14	$60.01–$168.39	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULR RE-EDUCATION EA 15 MIN COTA - Redoc 1	$135.85	$247.00	$82.75–$232.18	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA - Redoc 1	$135.85	$247.00	$82.75–$232.18	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromusclr Reeducation Assist Charge	$135.85	$247.00	$82.75–$232.18	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducatn Assist Charge	$135.85	$247.00	$82.75–$232.18	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 185	$135.85	$247.00	$82.75–$232.18	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 181	$135.85	$247.00	$82.75–$232.18	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Charges	$135.85	$247.00	$82.75–$232.18	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Charges	$135.85	$247.00	$82.75–$232.18	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units	$135.85	$247.00	$82.75–$232.18	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Units	$135.85	$247.00	$82.75–$232.18	—	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 CHRG - MNT INITIAL EA 15 MIN	$29.20	$108.16	$25.61–$101.67	13% below	73%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TH MNT INITIAL EA 15 MN	$40.44	$149.77	$25.61–$140.78	20% above	73%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 CHRG - MNT INITIAL EA 15 MIN	$59.49	$108.16	$36.23–$101.67	—	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TH MNT INITIAL EA 15 MN	$82.37	$149.77	$50.17–$140.78	—	45%
Occupational therapy evaluation, low complexity CPT 97165 TH OTEVL- LOW CMP OT - REDOC 185	$107.86	$399.48	$85.73–$375.51	32% below	73%
Occupational therapy evaluation, low complexity CPT 97165 OCCUPAT THERAPY EVAL LOW COMPLEXITY COTA - Redoc 2	$126.79	$469.58	$85.73–$441.41	20% below	73%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW Unit - Yes	$174.81	$647.43	$85.73–$608.58	10% above	73%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL- LOW COMP - REDOC 185	$174.81	$647.43	$85.73–$608.58	10% above	73%
Occupational therapy evaluation, low complexity CPT 97165 OT Eval Low Assistant Unit - Yes	$174.81	$647.43	$85.73–$608.58	10% above	73%
Occupational therapy evaluation, low complexity CPT 97165 OCCUPAT THERAPY EVAL LOW COMPLEXITY COTA - Redoc 1	$174.81	$647.43	$85.73–$608.58	10% above	73%
Occupational therapy evaluation, low complexity inpatient CPT 97165 TH OTEVL- LOW CMP OT - REDOC 185	$219.71	$399.48	$133.83–$375.51	—	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OCCUPAT THERAPY EVAL LOW COMPLEXITY COTA - Redoc 2	$258.27	$469.58	$157.31–$441.41	—	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OCCUPAT THERAPY EVAL LOW COMPLEXITY COTA - Redoc 1	$356.09	$647.43	$216.89–$608.58	—	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW Unit - Yes	$356.09	$647.43	$216.89–$608.58	—	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL- LOW COMP - REDOC 185	$356.09	$647.43	$216.89–$608.58	—	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Eval Low Assistant Unit - Yes	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 TH PTEVL- HGH CMP PT - REDOC 181	$101.84	$377.17	$83.82–$354.54	56% below	73%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH Unit - Yes	$174.81	$647.43	$83.82–$608.58	24% below	73%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH COMP - REDOC 181	$174.81	$647.43	$83.82–$608.58	24% below	73%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PHYSICAL THERAPY EVAL HGH COMPLEXITY PTA - Redoc 1	$174.81	$647.43	$83.82–$608.58	24% below	73%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval High Assistant Unit - Yes	$174.81	$647.43	$83.82–$608.58	24% below	73%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TH PTEVL- HGH CMP PT - REDOC 181	$207.44	$377.17	$126.35–$354.54	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PHYSICAL THERAPY EVAL HGH COMPLEXITY PTA - Redoc 1	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH COMP - REDOC 181	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH Unit - Yes	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Eval High Assistant Unit - Yes	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 TH PTEVL- LOW CMP PT - REDOC 181	$101.84	$377.17	$83.82–$354.54	28% below	73%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PHYSICAL THERAPY EVAL LOW COMPLEXITY PTA - Redoc 1	$174.81	$647.43	$83.82–$608.58	24% above	73%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Eval Low Assistant Unit - Yes	$174.81	$647.43	$83.82–$608.58	24% above	73%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW COMP - REDOC 181	$174.81	$647.43	$83.82–$608.58	24% above	73%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW Unit - Yes	$174.81	$647.43	$83.82–$608.58	24% above	73%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TH PTEVL- LOW CMP PT - REDOC 181	$207.44	$377.17	$126.35–$354.54	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW COMP - REDOC 181	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval Low Assistant Unit - Yes	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW Unit - Yes	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PHYSICAL THERAPY EVAL LOW COMPLEXITY PTA - Redoc 1	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 TH PTEVL- MOD CMP PT - REDOC 181	$101.84	$377.17	$83.82–$354.54	43% below	73%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD Unit - Yes	$174.81	$647.43	$83.82–$608.58	3% below	73%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PHYSICAL THERAPY EVAL MOD COMPLEXITY PTA - Redoc 1	$174.81	$647.43	$83.82–$608.58	3% below	73%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Eval Mod Assistant Unit - Yes	$174.81	$647.43	$83.82–$608.58	3% below	73%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD COMP - REDOC 181	$174.81	$647.43	$83.82–$608.58	3% below	73%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TH PTEVL- MOD CMP PT - REDOC 181	$207.44	$377.17	$126.35–$354.54	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD COMP - REDOC 181	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PHYSICAL THERAPY EVAL MOD COMPLEXITY PTA - Redoc 1	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD Unit - Yes	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Eval Mod Assistant Unit - Yes	$356.09	$647.43	$216.89–$608.58	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 258	$48.37	$179.14	$23.55–$186.46	10% below	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 175	$48.37	$179.14	$23.55–$186.46	10% below	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 182	$48.37	$179.14	$23.55–$186.46	10% below	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 183	$48.37	$179.14	$23.55–$186.46	10% below	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 184	$48.37	$179.14	$23.55–$186.46	10% below	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 186	$48.37	$179.14	$23.55–$186.46	10% below	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 189	$48.37	$179.14	$23.55–$186.46	10% below	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 181	$66.69	$247.00	$23.55–$232.18	24% above	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Assistant Charges	$66.69	$247.00	$23.55–$232.18	24% above	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 179	$66.69	$247.00	$23.55–$232.18	24% above	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Charges	$66.69	$247.00	$23.55–$232.18	24% above	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units	$66.69	$247.00	$23.55–$232.18	24% above	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 181	$66.69	$247.00	$23.55–$232.18	24% above	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Charges	$66.69	$247.00	$23.55–$232.18	24% above	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 185	$66.69	$247.00	$23.55–$232.18	24% above	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units	$66.69	$247.00	$23.55–$232.18	24% above	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 185	$66.69	$247.00	$23.55–$232.18	24% above	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Assistant Charges	$66.69	$247.00	$23.55–$232.18	24% above	73%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 183	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 184	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 186	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 189	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 258	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 175	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 182	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Assistant Charges	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Assistant Charges	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 181	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 185	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 185	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 181	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Charges	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Charges	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 179	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 TH THEREXRS-15MIN PT - REDOC 181	$41.93	$155.28	$24.70–$145.96	23% below	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 TH THEREXRS-15MIN PT - REDOC 185	$41.93	$155.28	$24.70–$145.96	23% below	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 182	$48.37	$179.14	$24.70–$186.46	11% below	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 258	$48.37	$179.14	$24.70–$186.46	11% below	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 189	$48.37	$179.14	$24.70–$186.46	11% below	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 186	$48.37	$179.14	$24.70–$186.46	11% below	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 183	$48.37	$179.14	$24.70–$186.46	11% below	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 175	$48.37	$179.14	$24.70–$186.46	11% below	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 184	$54.35	$201.29	$24.70–$189.21	at median	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Charge	$66.69	$247.00	$24.70–$232.18	23% above	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 179	$66.69	$247.00	$24.70–$232.18	23% above	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Charge	$66.69	$247.00	$24.70–$232.18	23% above	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 185	$66.69	$247.00	$24.70–$232.18	23% above	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181	$66.69	$247.00	$24.70–$232.18	23% above	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185	$66.69	$247.00	$24.70–$232.18	23% above	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$66.69	$247.00	$24.70–$232.18	23% above	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units	$66.69	$247.00	$24.70–$232.18	23% above	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 181	$66.69	$247.00	$24.70–$232.18	23% above	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Charges	$66.69	$247.00	$24.70–$232.18	23% above	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges	$66.69	$247.00	$24.70–$232.18	23% above	73%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TH THEREXRS-15MIN PT - REDOC 185	$85.40	$155.28	$52.02–$145.96	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TH THEREXRS-15MIN PT - REDOC 181	$85.40	$155.28	$52.02–$145.96	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 258	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 186	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 189	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 183	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 175	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 182	$98.53	$179.14	$60.01–$168.39	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 184	$110.71	$201.29	$67.43–$189.21	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 179	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Charges	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Charges	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 181	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Charge	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Charge	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185	$135.85	$247.00	$82.75–$232.18	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 185	$135.85	$247.00	$82.75–$232.18	—	45%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco counseling Charge - 3-10 minutes	$10.66	$39.48	$37.45–$127.38	63% below	73%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Behavior change Smoke Charge - 1-10 minutes	$10.66	$39.48	$37.45–$127.38	63% below	73%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Behavior change Smoke Charge - 1-10 minutes	$21.71	$39.48	$13.23–$37.11	—	45%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco counseling Charge - 3-10 minutes	$21.71	$39.48	$13.23–$37.11	—	45%
Speech and language evaluation CPT 92523 TH EVL SP SND PR CMP - REDOC 187	$110.03	$407.51	$110.03–$657.42	46% below	73%
Speech and language evaluation CPT 92523 TH EVL SP SND PR CMP - REDOC 188	$110.03	$407.51	$110.03–$657.42	46% below	73%
Speech and language evaluation CPT 92523 Speech Evaluation with Language Units	$185.47	$686.91	$143.43–$657.42	9% below	73%
Speech and language evaluation CPT 92523 SP SOUND LANG COMP - REDOC 187	$185.47	$686.91	$143.43–$657.42	9% below	73%
Speech and language evaluation CPT 92523 Speech Evaluation with Language Charge - Yes	$185.47	$686.91	$143.43–$657.42	9% below	73%
Speech and language evaluation inpatient CPT 92523 TH EVL SP SND PR CMP - REDOC 188	$224.13	$407.51	$136.52–$383.06	—	45%
Speech and language evaluation inpatient CPT 92523 TH EVL SP SND PR CMP - REDOC 187	$224.13	$407.51	$136.52–$383.06	—	45%
Speech and language evaluation inpatient CPT 92523 SP SOUND LANG COMP - REDOC 187	$377.80	$686.91	$230.11–$645.70	—	45%
Speech and language evaluation inpatient CPT 92523 Speech Evaluation with Language Units	$377.80	$686.91	$230.11–$645.70	—	45%
Speech and language evaluation inpatient CPT 92523 Speech Evaluation with Language Charge - Yes	$377.80	$686.91	$230.11–$645.70	—	45%
Speech therapy session, individual CPT 92507 TH SP-HEAR-TX-IN VST - REDOC 188	$94.94	$351.63	$65.20–$330.53	4% below	73%
Speech therapy session, individual CPT 92507 TH SP-HEAR-TX-IN VST - REDOC 187	$94.94	$351.63	$65.20–$330.53	4% below	73%
Speech therapy session, individual CPT 92507 Speech Treatment Charge	$133.77	$495.44	$65.20–$465.71	35% above	73%
Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units	$133.77	$495.44	$65.20–$465.71	35% above	73%
Speech therapy session, individual CPT 92507 Speech Treatment Charge - Yes	$133.77	$495.44	$65.20–$465.71	35% above	73%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 187	$133.77	$495.44	$65.20–$465.71	35% above	73%
Speech therapy session, individual inpatient CPT 92507 TH SP-HEAR-TX-IN VST - REDOC 188	$193.40	$351.63	$117.80–$330.53	—	45%
Speech therapy session, individual inpatient CPT 92507 TH SP-HEAR-TX-IN VST - REDOC 187	$193.40	$351.63	$117.80–$330.53	—	45%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Charge - Yes	$272.49	$495.44	$165.97–$465.71	—	45%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 187	$272.49	$495.44	$165.97–$465.71	—	45%
Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units	$272.49	$495.44	$165.97–$465.71	—	45%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Charge	$272.49	$495.44	$165.97–$465.71	—	45%
Spirometry (breathing test) CPT 94010 Pulmonary Function Test Charge - spirometry	$107.22	$397.11	$216.68–$1,308.11	56% below	73%
Spirometry (breathing test) inpatient CPT 94010 Pulmonary Function Test Charge - spirometry	$218.41	$397.11	$133.03–$373.28	—	45%
Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Test Charge - Pre and post bron	$216.63	$802.34	$374.46–$2,228.94	60% below	73%
Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Test Charge - Pre and post bron	$441.29	$802.34	$268.78–$754.20	—	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 TH THER ACT-15MIN PT - REDOC 185	$46.54	$172.36	$29.62–$162.02	19% below	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 TH THER ACT-15MIN PT - REDOC 181	$46.54	$172.36	$29.62–$162.02	19% below	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA - Redoc 2	$48.37	$179.14	$29.62–$186.46	16% below	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities Assist Charge	$66.69	$247.00	$29.62–$232.18	16% above	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Charges	$66.69	$247.00	$29.62–$232.18	16% above	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Units	$66.69	$247.00	$29.62–$232.18	16% above	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units	$66.69	$247.00	$29.62–$232.18	16% above	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA - Redoc 1	$66.69	$247.00	$29.62–$232.18	16% above	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA - Redoc 1	$66.69	$247.00	$29.62–$232.18	16% above	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities Charge	$66.69	$247.00	$29.62–$232.18	16% above	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 181	$66.69	$247.00	$29.62–$232.18	16% above	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Assist Charges	$66.69	$247.00	$29.62–$232.18	16% above	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 185	$66.69	$247.00	$29.62–$232.18	16% above	73%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TH THER ACT-15MIN PT - REDOC 185	$94.80	$172.36	$57.74–$162.02	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TH THER ACT-15MIN PT - REDOC 181	$94.80	$172.36	$57.74–$162.02	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA - Redoc 2	$98.53	$179.14	$60.01–$168.39	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 185	$135.85	$247.00	$82.75–$232.18	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 181	$135.85	$247.00	$82.75–$232.18	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Assist Charges	$135.85	$247.00	$82.75–$232.18	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA - Redoc 1	$135.85	$247.00	$82.75–$232.18	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities Charge	$135.85	$247.00	$82.75–$232.18	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA - Redoc 1	$135.85	$247.00	$82.75–$232.18	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units	$135.85	$247.00	$82.75–$232.18	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Charges	$135.85	$247.00	$82.75–$232.18	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Units	$135.85	$247.00	$82.75–$232.18	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities Assist Charge	$135.85	$247.00	$82.75–$232.18	—	45%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy	$71.82	$266.00	$133.51–$541.49	65% below	73%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy	$146.30	$266.00	$89.11–$250.04	—	45%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 00069-2377-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$463.47	$1,716.57	$155.07–$1,613.58	38% above	73%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 00069-2432-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$463.47	$1,716.57	$155.07–$1,613.58	38% above	73%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 00069-2377-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$944.11	$1,716.57	$575.05–$1,613.58	—	45%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 00069-2432-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$944.11	$1,716.57	$575.05–$1,613.58	—	45%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 00006-4827-00 - varicella virus vaccine REC Inject	$601.98	$2,229.57	$193.46–$2,229.57	60% above	73%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 54569-4055-00 - varicella virus vaccine - Powder	$601.98	$2,229.57	$193.46–$2,229.57	60% above	73%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 54569-4056-00 - varicella virus vaccine - Powder	$601.98	$2,229.57	$193.46–$2,229.57	60% above	73%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 00006-4826-00 - varicella virus vaccine REC Inject	$601.98	$2,229.57	$193.46–$2,229.57	60% above	73%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 54569-4055-00 - varicella virus vaccine - Powder	$1,226.26	$2,229.57	$746.91–$2,095.80	—	45%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 54569-4056-00 - varicella virus vaccine - Powder	$1,226.26	$2,229.57	$746.91–$2,095.80	—	45%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 00006-4827-00 - varicella virus vaccine REC Inject	$1,226.26	$2,229.57	$746.91–$2,095.80	—	45%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 00006-4826-00 - varicella virus vaccine REC Inject	$1,226.26	$2,229.57	$746.91–$2,095.80	—	45%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 19515-0810-52 - influenza virus vaccine, inactivat	$52.26	$193.55	$22.06–$181.94	31% above	73%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 49281-0424-50 - 2024-2025 influenza virus vaccine,	$52.26	$193.55	$22.06–$181.94	31% above	73%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 19515-0810-52 - influenza virus vaccine, inactivat	$106.45	$193.55	$64.84–$181.94	—	45%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 49281-0424-50 - 2024-2025 influenza virus vaccine,	$106.45	$193.55	$64.84–$181.94	—	45%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 00006-4121-02 - human papillomavirus vaccine 9-val	$934.73	$3,461.98	$331.40–$3,461.98	48% above	73%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 00006-4121-02 - human papillomavirus vaccine 9-val	$1,904.09	$3,461.98	$1,159.76–$3,254.26	—	45%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 58160-0815-46 - hepatitis A-hepatitis B vaccine 72	$423.36	$1,568.00	$133.36–$1,473.92	77% above	73%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 58160-0815-46 - hepatitis A-hepatitis B vaccine 72	$862.40	$1,568.00	$525.28–$1,473.92	—	45%
Hepatitis A vaccine, adult dose CPT 90632 00006-4841-00 - hepatitis A adult vaccine 50. Sus	$233.10	$863.32	$224.46–$811.52	37% above	73%
Hepatitis A vaccine, adult dose CPT 90632 00006-4096-02 - hepatitis A adult vaccine 50 units	$233.10	$863.32	$224.46–$811.52	37% above	73%
Hepatitis A vaccine, adult dose CPT 90632 00006-4841-41 - hepatitis A adult vaccine 50 units	$233.10	$863.32	$224.46–$811.52	37% above	73%
Hepatitis A vaccine, adult dose CPT 90632 00006-4096-09 - hepatitis A adult vaccine 50 units	$233.10	$863.32	$224.46–$811.52	37% above	73%
Hepatitis A vaccine, adult dose CPT 90632 58160-0826-48 - hepatitis A adult vaccine 1440 uni	$277.93	$1,029.37	$267.64–$967.61	63% above	73%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4841-00 - hepatitis A adult vaccine 50. Sus	$474.83	$863.32	$289.21–$811.52	—	45%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4096-02 - hepatitis A adult vaccine 50 units	$474.83	$863.32	$289.21–$811.52	—	45%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4096-09 - hepatitis A adult vaccine 50 units	$474.83	$863.32	$289.21–$811.52	—	45%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4841-41 - hepatitis A adult vaccine 50 units	$474.83	$863.32	$289.21–$811.52	—	45%
Hepatitis A vaccine, adult dose inpatient CPT 90632 58160-0826-48 - hepatitis A adult vaccine 1440 uni	$566.15	$1,029.37	$344.84–$967.61	—	45%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-11 - hepatitis B adult vaccine Susp	$241.40	$894.07	$66.86–$840.43	37% above	73%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-32 - hepatitis B adult vaccine 20 mcg/m	$241.40	$894.07	$66.86–$840.43	37% above	73%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-52 - hepatitis B adult vaccine 20 mcg/m	$241.40	$894.07	$66.86–$840.43	37% above	73%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0857-01 - hepatitis B adult vaccine Susp	$241.40	$894.07	$66.86–$840.43	37% above	73%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0857-01 - hepatitis B adult vaccine Susp	$491.74	$894.07	$299.51–$840.43	—	45%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0821-52 - hepatitis B adult vaccine 20 mcg/m	$491.74	$894.07	$299.51–$840.43	—	45%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0821-11 - hepatitis B adult vaccine Susp	$491.74	$894.07	$299.51–$840.43	—	45%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0821-32 - hepatitis B adult vaccine 20 mcg/m	$491.74	$894.07	$299.51–$840.43	—	45%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0403-65 - influenza virus vaccine, inactivat	$193.52	$716.75	$93.25–$673.74	8% above	73%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0124-65 - 2024-2025 influenza virus vaccine,	$193.52	$716.75	$93.25–$673.74	8% above	73%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0405-65 - 2019-2020 influenza virus vaccine,	$193.52	$716.75	$93.25–$673.74	8% above	73%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0124-65 - 2024-2025 influenza virus vaccine,	$394.21	$716.75	$240.11–$673.74	—	45%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0403-65 - influenza virus vaccine, inactivat	$394.21	$716.75	$240.11–$673.74	—	45%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0405-65 - 2019-2020 influenza virus vaccine,	$394.21	$716.75	$240.11–$673.74	—	45%
MMR vaccine (measles, mumps and rubella), live CPT 90707 49999-0422-01 - measles/mumps/rubella virus vaccin	$289.40	$1,071.87	$278.69–$1,007.56	25% above	73%
MMR vaccine (measles, mumps and rubella), live CPT 90707 00006-4681-00 - measles/mumps/rubella virus vaccin	$289.40	$1,071.87	$278.69–$1,007.56	25% above	73%
MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine Powder-Inj 0.	$289.40	$1,071.87	$278.69–$1,007.56	25% above	73%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine Powder-Inj 0.	$589.53	$1,071.87	$359.08–$1,007.56	—	45%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 00006-4681-00 - measles/mumps/rubella virus vaccin	$589.53	$1,071.87	$359.08–$1,007.56	—	45%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 49999-0422-01 - measles/mumps/rubella virus vaccin	$589.53	$1,071.87	$359.08–$1,007.56	—	45%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 49281-0589-05 - meningococcal conjugate vaccine So	$365.47	$1,353.59	$167.91–$1,353.59	52% above	73%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 46028-0208-01 - meningococcal conjugate vaccine RE	$497.86	$1,843.91	$167.91–$1,843.91	108% above	73%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 49281-0589-05 - meningococcal conjugate vaccine So	$744.47	$1,353.59	$453.45–$1,272.37	—	45%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 46028-0208-01 - meningococcal conjugate vaccine RE	$1,014.15	$1,843.91	$617.71–$1,733.28	—	45%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 46028-0114-01 - meningococcal group B vaccine reco	$719.88	$2,666.22	$238.78–$2,666.22	86% above	73%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 46028-0114-01 - meningococcal group B vaccine reco	$1,466.42	$2,666.22	$893.18–$2,506.25	—	45%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 00005-2000-02 - pneumococcal 20-valent conjugate v	$864.41	$3,201.52	$287.54–$3,009.43	42% above	73%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 00005-2000-10 - pneumococcal 20-valent conjugate v	$864.41	$3,201.52	$287.54–$3,009.43	42% above	73%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 00005-2000-10 - pneumococcal 20-valent conjugate v	$1,760.84	$3,201.52	$1,072.51–$3,009.43	—	45%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 00005-2000-02 - pneumococcal 20-valent conjugate v	$1,760.84	$3,201.52	$1,072.51–$3,009.43	—	45%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4837-02 - pneumococcal 23-polyvalent vaccine	$376.53	$1,394.56	$122.94–$1,310.89	126% above	73%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4837-03 - pneumococcal 23-polyvalent vaccine	$376.53	$1,394.56	$122.94–$1,310.89	126% above	73%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4943-00 - pneumococcal 23-valent vaccine Sol	$376.53	$1,394.56	$122.94–$1,310.89	126% above	73%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4943-01 - pneumococcal 23-polyvalent vaccine	$376.53	$1,394.56	$122.94–$1,310.89	126% above	73%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4943-01 - pneumococcal 23-polyvalent vaccine	$767.01	$1,394.56	$467.18–$1,310.89	—	45%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4943-00 - pneumococcal 23-valent vaccine Sol	$767.01	$1,394.56	$467.18–$1,310.89	—	45%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4837-03 - pneumococcal 23-polyvalent vaccine	$767.01	$1,394.56	$467.18–$1,310.89	—	45%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4837-02 - pneumococcal 23-polyvalent vaccine	$767.01	$1,394.56	$467.18–$1,310.89	—	45%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 49281-0575-00 - nirsevimab (cvx 306) alip preserva	$1,441.11	$5,337.43	$560.03–$5,337.43	27% above	73%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 49281-0575-15 - nirsevimab (cvx 306) alip preserva	$1,441.11	$5,337.43	$560.03–$5,337.43	27% above	73%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 49281-0575-00 - nirsevimab (cvx 306) alip preserva	$2,935.59	$5,337.43	$1,788.04–$5,017.18	—	45%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 49281-0575-15 - nirsevimab (cvx 306) alip preserva	$2,935.59	$5,337.43	$1,788.04–$5,017.18	—	45%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 00069-0344-01 - RSV vaccine, preF A-preF B, recomb	$925.45	$3,427.59	$308.95–$3,427.59	48% above	73%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 00069-0344-05 - RSV vaccine, preF A-preF B, recomb	$925.45	$3,427.59	$308.95–$3,427.59	48% above	73%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 00069-0344-05 - RSV vaccine, preF A-preF B, recomb	$1,885.17	$3,427.59	$1,148.24–$3,221.93	—	45%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 00069-0344-01 - RSV vaccine, preF A-preF B, recomb	$1,885.17	$3,427.59	$1,148.24–$3,221.93	—	45%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 58160-0848-11 - RSV vaccine preF3, recombinant pre	$925.63	$3,428.26	$308.49–$3,428.26	31% above	73%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 58160-0848-11 - RSV vaccine preF3, recombinant pre	$1,885.54	$3,428.26	$1,148.47–$3,222.56	—	45%
Rabies vaccine, one dose CPT 90675 49999-0414-01 - rabies vaccine, human diploid cell	$1,174.50	$4,350.00	$1,174.50–$4,089.00	44% above	73%
Rabies vaccine, one dose CPT 90675 49281-0250-51 - rabies vaccine, human diploid cell	$1,174.50	$4,350.00	$1,174.50–$4,089.00	44% above	73%
Rabies vaccine, one dose CPT 90675 rabies vaccine human diploid cell 2.5 IntlUnit(s)	$1,174.50	$4,350.00	$1,174.50–$4,089.00	44% above	73%
Rabies vaccine, one dose CPT 90675 49281-0252-51 - rabies vaccine, human diploid cell	$1,174.50	$4,350.00	$1,174.50–$4,089.00	44% above	73%
Rabies vaccine, one dose CPT 90675 63851-0501-02 - rabies vaccine, purified chick emb	$1,401.20	$5,189.64	$1,401.20–$4,878.26	72% above	73%
Rabies vaccine, one dose CPT 90675 rabies vaccine purified chick embryo cell 2.5 Intl	$1,401.20	$5,189.64	$1,401.20–$4,878.26	72% above	73%
Rabies vaccine, one dose CPT 90675 58160-0964-12 - rabies vaccine, purified chick emb	$1,401.20	$5,189.64	$1,401.20–$4,878.26	72% above	73%
Rabies vaccine, one dose CPT 90675 63851-0501-01 - rabies vaccine, purified chick emb	$1,401.20	$5,189.64	$1,401.20–$4,878.26	72% above	73%
Rabies vaccine, one dose CPT 90675 50632-0010-01 - rabies vaccine, purified chick emb	$1,401.20	$5,189.64	$1,401.20–$4,878.26	72% above	73%
Rabies vaccine, one dose inpatient CPT 90675 49281-0250-51 - rabies vaccine, human diploid cell	$2,392.50	$4,350.00	$1,457.25–$4,089.00	—	45%
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine human diploid cell 2.5 IntlUnit(s)	$2,392.50	$4,350.00	$1,457.25–$4,089.00	—	45%
Rabies vaccine, one dose inpatient CPT 90675 49281-0252-51 - rabies vaccine, human diploid cell	$2,392.50	$4,350.00	$1,457.25–$4,089.00	—	45%
Rabies vaccine, one dose inpatient CPT 90675 49999-0414-01 - rabies vaccine, human diploid cell	$2,392.50	$4,350.00	$1,457.25–$4,089.00	—	45%
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine purified chick embryo cell 2.5 Intl	$2,854.30	$5,189.64	$1,738.53–$4,878.26	—	45%
Rabies vaccine, one dose inpatient CPT 90675 50632-0010-01 - rabies vaccine, purified chick emb	$2,854.30	$5,189.64	$1,738.53–$4,878.26	—	45%
Rabies vaccine, one dose inpatient CPT 90675 63851-0501-01 - rabies vaccine, purified chick emb	$2,854.30	$5,189.64	$1,738.53–$4,878.26	—	45%
Rabies vaccine, one dose inpatient CPT 90675 63851-0501-02 - rabies vaccine, purified chick emb	$2,854.30	$5,189.64	$1,738.53–$4,878.26	—	45%
Rabies vaccine, one dose inpatient CPT 90675 58160-0964-12 - rabies vaccine, purified chick emb	$2,854.30	$5,189.64	$1,738.53–$4,878.26	—	45%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 58160-0823-11 - zoster vaccine, inactivated adjuva	$669.26	$2,478.73	$217.02–$2,478.73	71% above	73%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 58160-0819-12 - zoster vaccine, inactivated adjuva	$669.26	$2,478.73	$217.02–$2,478.73	71% above	73%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 58160-0819-12 - zoster vaccine, inactivated adjuva	$1,363.30	$2,478.73	$830.37–$2,330.01	—	45%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 58160-0823-11 - zoster vaccine, inactivated adjuva	$1,363.30	$2,478.73	$830.37–$2,330.01	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 00006-4133-41 - tetanus-diphtheria toxoids 2 units	$80.02	$296.36	$35.50–$278.58	21% below	73%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 00006-4133-01 - tetanus-diphth toxoids (Td) adult/	$80.02	$296.36	$35.50–$278.58	21% below	73%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 17478-0131-01 - tetanus-diphth toxoids (Td) adult/	$80.02	$296.36	$35.50–$278.58	21% below	73%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0291-83 - tetanus-diphtheria toxoids 5 units	$104.02	$385.25	$35.50–$362.14	3% above	73%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0215-10 - tetanus-diphtheria toxoids 5 units	$104.02	$385.25	$35.50–$362.14	3% above	73%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0291-10 - tetanus-diphtheria toxoids 5 units	$104.02	$385.25	$35.50–$362.14	3% above	73%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 13533-0131-01 - tetanus-diphth toxoids (Td) adult/	$104.02	$385.25	$35.50–$362.14	3% above	73%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0215-15 - tetanus-diphtheria toxoids 5 units	$104.02	$385.25	$35.50–$362.14	3% above	73%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0225-10 - diphtheria-tetanus toxoids (DT) pe	$183.39	$679.23	$35.50–$638.48	81% above	73%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 17478-0131-01 - tetanus-diphth toxoids (Td) adult/	$163.00	$296.36	$99.28–$278.58	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 00006-4133-01 - tetanus-diphth toxoids (Td) adult/	$163.00	$296.36	$99.28–$278.58	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 00006-4133-41 - tetanus-diphtheria toxoids 2 units	$163.00	$296.36	$99.28–$278.58	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0291-10 - tetanus-diphtheria toxoids 5 units	$211.89	$385.25	$129.06–$362.14	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0215-15 - tetanus-diphtheria toxoids 5 units	$211.89	$385.25	$129.06–$362.14	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0291-83 - tetanus-diphtheria toxoids 5 units	$211.89	$385.25	$129.06–$362.14	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 13533-0131-01 - tetanus-diphth toxoids (Td) adult/	$211.89	$385.25	$129.06–$362.14	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0215-10 - tetanus-diphtheria toxoids 5 units	$211.89	$385.25	$129.06–$362.14	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0225-10 - diphtheria-tetanus toxoids (DT) pe	$373.58	$679.23	$227.54–$638.48	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2	$131.82	$488.21	$126.93–$458.92	7% above	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-10 - tetanus/diphtheria/pertussis, acel	$131.82	$488.21	$126.93–$458.92	7% above	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-15 - tetanus/diphtheria/pertussis, acel	$131.82	$488.21	$126.93–$458.92	7% above	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-11 - tetanus/diphtheria/pertussis, acel	$159.47	$590.62	$153.56–$555.18	30% above	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-52 - tetanus/diphtheria/pertussis, acel	$159.47	$590.62	$153.56–$555.18	30% above	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphtheria/pertussis acel (Tdap) 5 units-2	$159.47	$590.62	$153.56–$555.18	30% above	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-43 - tetanus/diphth/pertuss (Tdap) adul	$159.47	$590.62	$153.56–$555.18	30% above	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-46 - tetanus/diphth/pertuss (Tdap) adul	$159.47	$590.62	$153.56–$555.18	30% above	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 49281-0400-10 - tetanus/diphtheria/pertussis, acel	$268.52	$488.21	$163.55–$458.92	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2	$268.52	$488.21	$163.55–$458.92	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 49281-0400-15 - tetanus/diphtheria/pertussis, acel	$268.52	$488.21	$163.55–$458.92	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-46 - tetanus/diphth/pertuss (Tdap) adul	$324.84	$590.62	$197.86–$555.18	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphtheria/pertussis acel (Tdap) 5 units-2	$324.84	$590.62	$197.86–$555.18	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-52 - tetanus/diphtheria/pertussis, acel	$324.84	$590.62	$197.86–$555.18	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-11 - tetanus/diphtheria/pertussis, acel	$324.84	$590.62	$197.86–$555.18	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-43 - tetanus/diphth/pertuss (Tdap) adul	$324.84	$590.62	$197.86–$555.18	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Infusion Center	$37.09	$137.36	$72.25–$298.99	36% below	73%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - In House/Observati	$37.09	$137.36	$72.25–$298.99	36% below	73%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Emergency Departme	$37.09	$137.36	$72.25–$298.99	36% below	73%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Emergency Departme	$75.55	$137.36	$46.02–$129.12	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - In House/Observati	$75.55	$137.36	$46.02–$129.12	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Infusion Center	$75.55	$137.36	$46.02–$129.12	—	45%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pt. Location - Vaccine Charge - ED Additional	$30.38	$112.51	$15.08–$105.76	18% below	73%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pt. Location - Vaccine Charge - Obs/OP Additional	$30.38	$112.51	$15.08–$105.76	18% below	73%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Pt. Location - Vaccine Charge - ED Additional	$61.88	$112.51	$37.69–$105.76	—	45%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Pt. Location - Vaccine Charge - Obs/OP Additional	$61.88	$112.51	$37.69–$105.76	—	45%

Source file: https://www.nwhealthstarke.com/Uploads/Public/Documents/charge-masters/charge-masters-2024/272691760_northwest-health-starke_standardcharges.csv