The Queens Medical Center
The Queens Medical Center in Ewa Beach, HI publishes cash prices for 377 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Hawaii median for 109 of 370 procedures and below it for 41. By typical cash price it ranks #5 of 10 Hawaii hospitals and #5 of 7 hospitals in the Urban Honolulu, HI area, cheapest first. Click a procedure to compare it with other hospitals nearby.
91-2301 Old Fort Weaver Rd,Ewa Beach,HI,96706 Collected Sep 27, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Hawaii | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS | $241.50 | $345.00 | $18.95–$286.47 | at median | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $267.40 | $382.00 | $81.54–$437.95 | 1% below | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ULTRASOUND STUDY OF ARM AND LEG ARTERIES | $340.20 | $486.00 | $81.54–$437.95 | 26% above | 30% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 SINGLE CONTRAST X-RAY OF ESOPHAGUS | $490.00 | $700.00 | $42.37–$577.33 | at median | 30% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NUCLEAR MEDICINE STUDY OF BONE AND/OR JOINT WHOLE BODY | $1,080.10 | $1,543.00 | $152.96–$1,315.89 | at median | 30% |
| Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE | $454.30 | $649.00 | $37.51–$344.09 | 16% above | 30% |
| Breast ultrasound, complete, one breast CPT 76641 COMPLETE ULTRASOUND SCAN OF 1 BREAST | $455.00 | $650.00 | $37.51–$344.09 | 17% above | 30% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED | $480.20 | $686.00 | $37.51–$286.47 | 7% above | 30% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST | $480.90 | $687.00 | $37.51–$286.47 | 7% above | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT SCAN OF BLOOD VESSELS OF CHEST WITH CONTRAST | $1,749.30 | $2,499.00 | $206.19–$962.58 | at median | 30% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT SCAN OF BLOOD VESSELS AND GRAFTS OF HEART WITH CONTRAST | $2,122.40 | $3,032.00 | $257.71–$1,148.34 | at median | 30% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT SCAN OF HEART WITH EVALUATION OF BLOOD VESSEL CALCIUM | $92.40 | $132.00 | $50.09–$286.47 | 26% below | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT SCAN OF ABDOMEN AND PELVIS WITHOUT CONTRAST | $2,087.40 | $2,982.00 | $175.88–$785.37 | at median | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST | $2,359.00 | $3,370.00 | $175.88–$785.37 | 13% above | 30% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST | $2,323.30 | $3,319.00 | $257.71–$1,148.34 | at median | 30% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST | $2,625.00 | $3,750.00 | $257.71–$1,148.34 | 13% above | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT SCAN OF ABDOMEN AND PELVIS BEFORE AND AFTER CONTRAST | $3,430.00 | $4,900.00 | $257.71–$1,148.34 | 6% above | 30% |
| CT scan of the abdomen with contrast CPT 74160 CT SCAN OF ABDOMEN WITH CONTRAST | $1,817.20 | $2,596.00 | $206.19–$676.44 | at median | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT SCAN OF ABDOMEN WITHOUT CONTRAST | $1,499.40 | $2,142.00 | $122.89–$559.44 | 7% above | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN OF FACE WITHOUT CONTRAST | $1,194.20 | $1,706.00 | $122.89–$466.59 | at median | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD OR BRAIN WITHOUT CONTRAST | $1,284.50 | $1,835.00 | $113.45–$417.30 | at median | 30% |
| CT scan of the head with contrast CPT 70460 CT SCAN HEAD OR BRAIN WITH CONTRAST | $1,824.90 | $2,607.00 | $166.41–$577.33 | at median | 30% |
| CT scan of the head without and with contrast CPT 70470 CT SCAN OF HEAD OR BRAIN BEFORE AND AFTER CONTRAST | $1,876.70 | $2,681.00 | $199.30–$698.70 | at median | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN OF LOWER SPINE WITHOUT CONTRAST | $1,365.00 | $1,950.00 | $122.89–$533.88 | at median | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN OF UPPER SPINE WITHOUT CONTRAST | $1,365.00 | $1,950.00 | $122.89–$584.52 | at median | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN OF PELVIS WITH CONTRAST | $1,431.50 | $2,045.00 | $206.19–$676.44 | at median | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 ULTRASOUND OF BOTH SIDES OF HEAD AND NECK BLOOD FLOW | $710.50 | $1,015.00 | $135.54–$785.37 | at median | 30% |
| Chest X-ray, 2 views CPT 71046 X-RAY OF CHEST; 2 VIEWS | $256.90 | $367.00 | $23.07–$286.47 | at median | 30% |
| Chest X-ray, single view CPT 71045 X-RAY OF CHEST; 1 VIEW | $217.70 | $311.00 | $17.41–$286.47 | at median | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 COMPLETE ULTRASOUND SCAN BEHIND ABDOMINAL CAVITY | $687.40 | $982.00 | $70.56–$344.09 | 2% above | 30% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY MEASUREMENT OF HIP; PELVIS; SPINE | $290.50 | $415.00 | $46.02–$344.09 | at median | 30% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY MEASUREMENT OF FOREARM; FINGER; HAND; OR FOOT | $106.40 | $152.00 | $25.87–$286.47 | 27% below | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 ULTRASOUND SCAN OF PREGNANT UTERUS WITH DETAILED FETAL ANATOMIC EXAMINATION; SINGLE OR FIRST FETUS | $632.80 | $904.00 | $129.38–$785.37 | at median | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN OF CHEST WITHOUT CONTRAST | $1,383.20 | $1,976.00 | $122.89–$584.52 | 4% above | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN OF CHEST WITH CONTRAST | $1,493.10 | $2,133.00 | $206.19–$698.70 | at median | 30% |
| Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS | $487.90 | $697.00 | $47.19–$339.45 | at median | 30% |
| Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST | $336.70 | $481.00 | $38.37–$271.77 | 12% above | 30% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 ULTRASOUND OF LEG ARTERIES OR ARTERY GRAFTS | $749.00 | $1,070.00 | $206.69–$785.37 | at median | 30% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 ULTRASOUND STUDY OF ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS | $701.40 | $1,002.00 | $160.42–$785.37 | at median | 30% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ULTRASOUND OF HEART WITH COLOR-DEPICTED BLOOD FLOW; RATE; DIRECTION AND VALVE FUNCTION | $869.40 | $1,242.00 | $158.86–$3,113.00 | 16% below | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NUCLEAR MEDICINE STUDY OF LIVER AND BILE DUCT SYSTEM | $798.00 | $1,140.00 | $257.71–$1,315.89 | 3% above | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT&RESP EFFT | $2,002.00 | $2,860.00 | $121.44–$710.72 | at median | 30% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY IN SLEEP LAB WITH CONTINUOUS AIRWAY PRESSURE (6 YEARS OR OLDER) | $3,702.30 | $5,289.00 | $257.71–$2,826.60 | at median | 30% |
| Knee X-ray, 3 views CPT 73562 X-RAY OF KNEE; 3 VIEWS | $248.50 | $355.00 | $20.64–$286.47 | 11% below | 30% |
| Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3 | $280.70 | $401.00 | $20.64–$286.47 | 1% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ULTRASOUND SCAN OF ABDOMEN | $557.90 | $797.00 | $50.90–$344.09 | at median | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT SCAN OF CHEST FOR LUNG CANCER SCREENING | $594.30 | $849.00 | $92.52–$344.09 | 8% above | 30% |
| MRI of both breasts, without and then with contrast dye CPT 77049 MRI SCAN OF BOTH BREASTS | $2,289.70 | $3,271.00 | $107.71–$1,520.08 | at median | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST | $1,503.60 | $2,148.00 | $251.44–$1,188.30 | at median | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE | $2,606.10 | $3,723.00 | $257.71–$2,123.28 | at median | 30% |
| MRI of the abdomen without contrast CPT 74181 MRI SCAN OF ABDOMEN WITHOUT CONTRAST | $2,333.80 | $3,334.00 | $237.20–$1,107.09 | 2% above | 30% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST | $2,671.90 | $3,817.00 | $257.71–$2,127.18 | at median | 30% |
| MRI of the brain, no contrast dye CPT 70551 MRI SCAN OF BRAIN WITHOUT CONTRAST | $1,418.20 | $2,026.00 | $231.93–$1,231.62 | at median | 30% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE | $1,602.30 | $2,289.00 | $231.93–$1,231.62 | 13% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST | $1,945.30 | $2,779.00 | $257.71–$2,639.22 | at median | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE | $2,198.00 | $3,140.00 | $257.71–$2,639.22 | 13% above | 30% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST | $1,531.60 | $2,188.00 | $223.26–$1,319.13 | at median | 30% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE | $1,730.40 | $2,472.00 | $223.26–$1,319.13 | 13% above | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SCAN OF LOWER SPINAL CANAL BEFORE AND AFTER CONTRAST | $2,461.20 | $3,516.00 | $257.71–$2,459.01 | at median | 30% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SCAN OF MIDDLE SPINAL CANAL WITHOUT CONTRAST | $2,010.40 | $2,872.00 | $222.71–$1,228.77 | at median | 30% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SCAN OF UPPER SPINAL CANAL BEFORE AND AFTER CONTRAST | $2,553.60 | $3,648.00 | $257.71–$2,459.01 | at median | 30% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SCAN OF UPPER SPINAL CANAL WITHOUT CONTRAST | $1,456.70 | $2,081.00 | $222.71–$1,188.30 | at median | 30% |
| MRI of the pelvis without and with contrast CPT 72197 MRI SCAN OF PELVIS BEFORE AND AFTER CONTRAST | $2,720.90 | $3,887.00 | $257.71–$2,127.18 | at median | 30% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI SCAN OF PELVIS WITHOUT CONTRAST | $2,310.00 | $3,300.00 | $257.71–$959.22 | 1% above | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST | $2,285.50 | $3,265.00 | $251.44–$1,247.04 | at median | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NUCLEAR MEDICINE STUDIES OF HEART MUSCLE AT REST AND WITH STRESS AND SPECT | $2,334.50 | $3,335.00 | $257.71–$4,261.43 | 2% below | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT | $2,638.30 | $3,769.00 | $257.71–$4,261.43 | 10% above | 30% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 NUCLEAR MEDICINE STUDY FROM SKULL BASE TO MID-THIGH WITH CT SCAN | $3,532.20 | $5,046.00 | $257.71–$6,346.00 | at median | 30% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGE W/CT SKULL-THIGH | $3,708.60 | $5,298.00 | $257.71–$6,346.00 | 5% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 LIMITED ULTRASOUND SCAN OF PELVIS | $519.40 | $742.00 | $37.10–$344.09 | 22% above | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 COMPLETE ULTRASOUND SCAN OF PELVIS | $557.90 | $797.00 | $54.65–$344.09 | 7% above | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS | $602.70 | $861.00 | $75.32–$344.09 | at median | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND SCAN OF PREGNANT UTERUS (LESS THAN 14 WEEKS); SINGLE OR FIRST FETUS | $369.60 | $528.00 | $66.25–$344.09 | at median | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LIMITED ULTRASOUND OF PREGNANT UTERUS | $448.00 | $640.00 | $50.90–$344.09 | 9% above | 30% |
| Screening mammogram, both breasts CPT 77067 SCREENING MAMMOGRAPHY | $266.70 | $381.00 | $35.75–$279.74 | at median | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS | $219.80 | $314.00 | $20.64–$286.47 | 1% below | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER | $248.50 | $355.00 | $20.64–$286.47 | 12% above | 30% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER) | $2,606.10 | $3,723.00 | $257.71–$2,826.60 | at median | 30% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM | $2,736.30 | $3,909.00 | $257.71–$2,826.60 | 5% above | 30% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE | $1,383.90 | $1,977.00 | $173.52–$1,798.55 | 9% above | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 IMAGING FOR EVALUATION OF SWALLOWING FUNCTION | $432.60 | $618.00 | $46.81–$577.33 | at median | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+ | $488.60 | $698.00 | $46.81–$577.33 | 13% above | 30% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA | $453.60 | $648.00 | $54.65–$344.09 | at median | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 VAGINAL ULTRASOUND OF PREGNANT UTERUS | $369.60 | $528.00 | $53.86–$344.09 | 8% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC | $417.90 | $597.00 | $53.86–$344.09 | 4% above | 30% |
| Ultrasound of the abdomen, complete CPT 76700 COMPLETE ULTRASOUND SCAN OF ABDOMEN | $558.60 | $798.00 | $70.56–$344.09 | at median | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND SCAN OF SCROTUM | $453.60 | $648.00 | $54.65–$344.09 | 2% above | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SCAN OF HEAD AND NECK SOFT TISSUE | $574.70 | $821.00 | $50.90–$344.09 | 6% above | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 SINGLE CONTRAST X-RAY OF UPPER DIGESTIVE TRACT | $471.10 | $673.00 | $52.32–$577.33 | 7% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS | $539.70 | $771.00 | $109.94–$344.09 | 10% above | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS | $262.50 | $375.00 | $18.95–$286.47 | at median | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST | $296.80 | $424.00 | $18.95–$286.47 | 13% above | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY OF HIP; 2-3 VIEWS | $314.30 | $449.00 | $28.52–$286.47 | 4% above | 30% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY OF ABDOMEN; 1 VIEW | $224.00 | $320.00 | $19.68–$286.47 | 1% above | 30% |
| X-ray of the ankle, 2 views CPT 73600 X-RAY OF ANKLE; 2 VIEWS | $177.80 | $254.00 | $17.57–$286.47 | at median | 30% |
| X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE | $200.90 | $287.00 | $17.57–$286.47 | 13% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS | $157.50 | $225.00 | $15.73–$286.47 | 2% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S) | $177.80 | $254.00 | $15.73–$286.47 | 11% above | 30% |
| X-ray of the foot, 2 views CPT 73620 X-RAY OF FOOT; 2 VIEWS | $196.00 | $280.00 | $17.57–$286.47 | at median | 30% |
| X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT | $221.20 | $316.00 | $17.57–$286.47 | 13% above | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS | $231.00 | $330.00 | $20.03–$286.47 | 1% below | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT | $261.10 | $373.00 | $20.03–$286.47 | 12% above | 30% |
| X-ray of the hand, 3 or more views CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS | $231.00 | $330.00 | $20.03–$286.47 | 11% below | 30% |
| X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND | $261.10 | $373.00 | $20.03–$286.47 | 1% above | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 X-RAY OF KNEE; 1-2 VIEWS | $186.90 | $267.00 | $18.60–$286.47 | 9% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 | $211.40 | $302.00 | $18.60–$286.47 | 3% above | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY OF LOWER AND SACRAL SPINE; 2-3 VIEWS | $281.40 | $402.00 | $24.13–$344.09 | at median | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS | $441.70 | $631.00 | $33.97–$344.09 | at median | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY OF MIDDLE SPINE; 2 VIEWS | $242.90 | $347.00 | $23.43–$344.09 | at median | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS | $274.40 | $392.00 | $23.43–$344.09 | 13% above | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY OF NOSE BONES; MINIMUM OF 3 VIEWS | $252.70 | $361.00 | $18.60–$286.47 | at median | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES | $285.60 | $408.00 | $18.60–$286.47 | 13% above | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY OF UPPER SPINE; 2-3 VIEWS | $277.20 | $396.00 | $21.66–$286.47 | at median | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY OF PELVIS; 1-2 VIEWS | $192.50 | $275.00 | $19.68–$344.09 | at median | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS | $217.70 | $311.00 | $19.68–$344.09 | 13% above | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY OF SACRUM AND TAILBONE; MINIMUM OF 2 VIEWS | $227.50 | $325.00 | $20.64–$286.47 | at median | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE | $256.90 | $367.00 | $20.64–$286.47 | 13% above | 30% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Hawaii | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL | $47.60 | $68.00 | $5.30–$257.71 | at median | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL | $58.10 | $83.00 | $5.18–$257.71 | 9% above | 30% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $585.90 | $837.00 | $47.63–$257.71 | 15% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA | $44.10 | $63.00 | $5.22–$257.71 | at median | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY | $130.90 | $187.00 | $12.95–$257.71 | 8% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $151.20 | $216.00 | $12.09–$257.71 | 15% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL | $252.70 | $361.00 | $39.26–$257.71 | 44% above | 30% |
| Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) | $85.40 | $122.00 | $8.46–$257.71 | 4% above | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY | $284.20 | $406.00 | $49.53–$257.71 | 20% above | 30% |
| Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE | $197.40 | $282.00 | $10.32–$257.71 | 60% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE | $13.30 | $19.00 | $3.00–$257.71 | 19% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE | $22.40 | $32.00 | $3.00–$257.71 | 100% above | 30% |
| Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL | $60.90 | $87.00 | $3.93–$257.71 | 25% above | 30% |
| Blood lead test CPT 83655 ASSAY OF LEAD | $144.90 | $207.00 | $12.11–$257.71 | 12% above | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS | $100.80 | $144.00 | $7.52–$257.71 | 18% above | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO) | $130.90 | $187.00 | $4.33–$437.95 | 40% above | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $31.50 | $45.00 | $5.18–$257.71 | at median | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION | $58.80 | $84.00 | $5.18–$257.71 | 87% above | 30% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE | $479.50 | $685.00 | $37.27–$257.71 | 35% above | 30% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $149.10 | $213.00 | $20.81–$257.71 | 7% above | 30% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 | $149.10 | $213.00 | $20.81–$257.71 | 3% above | 30% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 AMPLIFED DNA OR RNA PROBE DETECTION OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (COVID-19) ANTIGEN | $73.50 | $105.00 | $51.31–$300.00 | at median | 30% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB | $122.50 | $175.00 | $51.31–$300.00 | 67% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE | $110.60 | $158.00 | $35.09–$257.71 | at median | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE | $339.50 | $485.00 | $35.09–$257.71 | 207% above | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) | $116.90 | $167.00 | $13.39–$257.71 | 7% above | 30% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT | $61.60 | $88.00 | $7.77–$257.71 | at median | 30% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST | $47.60 | $68.00 | $6.47–$257.71 | at median | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS | $96.60 | $138.00 | $10.56–$257.71 | at median | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE | $207.20 | $296.00 | $10.18–$257.71 | 106% above | 30% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE | $221.90 | $317.00 | $22.23–$257.71 | 10% above | 30% |
| Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL | $263.20 | $376.00 | $27.94–$257.71 | 5% above | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH) | $175.70 | $251.00 | $18.58–$257.71 | 25% above | 30% |
| Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL | $328.30 | $469.00 | $19.63–$257.71 | 196% above | 30% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL | $121.10 | $173.00 | $13.63–$257.71 | 16% above | 30% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM | $149.10 | $213.00 | $14.70–$257.71 | 9% above | 30% |
| Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3) | $227.50 | $325.00 | $16.94–$257.71 | 55% above | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE | $79.10 | $113.00 | $9.02–$257.71 | at median | 30% |
| Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE | $257.60 | $368.00 | $25.47–$257.71 | 15% above | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST | $60.90 | $87.00 | $4.75–$257.71 | at median | 30% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) | $126.00 | $180.00 | $12.87–$257.71 | 4% above | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB | $110.60 | $158.00 | $35.09–$257.71 | at median | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE | $339.50 | $485.00 | $35.09–$257.71 | 207% above | 30% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY | $144.20 | $206.00 | $16.85–$257.71 | at median | 30% |
| H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA | $499.10 | $713.00 | $14.38–$257.71 | 71% above | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ | $1,123.50 | $1,605.00 | $85.10–$352.77 | 66% above | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY | $63.70 | $91.00 | $13.71–$257.71 | at median | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1&-2 AB AG IA | $195.30 | $279.00 | $24.08–$257.71 | 1% above | 30% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 DETECTION TEST BY NUCLEIC ACID FOR HUMAN PAPILLOMAVIRUS (HPV); HIGH-RISK TYPES | $240.80 | $344.00 | $35.09–$257.71 | 66% above | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL | $105.00 | $150.00 | $9.71–$257.71 | 7% above | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY | $116.90 | $167.00 | $10.74–$257.71 | 27% above | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA | $171.50 | $245.00 | $10.33–$257.71 | 115% above | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST | $161.70 | $231.00 | $14.27–$257.71 | 49% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $352.10 | $503.00 | $42.84–$257.71 | 52% above | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST | $118.30 | $169.00 | $13.19–$257.71 | 55% above | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 1 | $160.30 | $229.00 | $13.19–$257.71 | 109% above | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST | $123.20 | $176.00 | $19.35–$257.71 | 42% above | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2 | $202.30 | $289.00 | $19.35–$257.71 | 134% above | 30% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS | $87.50 | $125.00 | $12.95–$257.71 | 16% below | 30% |
| Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE | $212.80 | $304.00 | $17.92–$257.71 | 36% above | 30% |
| Insulin blood test CPT 83525 ASSAY OF INSULIN | $88.90 | $127.00 | $11.43–$257.71 | at median | 30% |
| Iron blood test (serum iron) CPT 83540 IRON LEVEL | $39.20 | $56.00 | $6.47–$257.71 | at median | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $95.90 | $137.00 | $8.74–$257.71 | 8% above | 30% |
| Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL | $69.30 | $99.00 | $8.68–$257.71 | at median | 30% |
| LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH) | $175.70 | $251.00 | $18.52–$257.71 | 2% above | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL | $79.10 | $113.00 | $6.89–$257.71 | 10% above | 30% |
| Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL | $67.20 | $96.00 | $8.17–$257.71 | at median | 30% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $204.40 | $292.00 | $17.03–$257.71 | 45% above | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM LEVEL | $62.30 | $89.00 | $6.70–$257.71 | 1% above | 30% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY | $130.90 | $187.00 | $12.88–$257.71 | 80% above | 30% |
| Mono test (heterophile antibody, Monospot) CPT 86308 SCREENING TEST FOR MONONUCLEOSIS (MONO) | $56.70 | $81.00 | $5.18–$257.71 | 8% above | 30% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $289.10 | $413.00 | $47.81–$257.71 | 22% below | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE | $140.00 | $200.00 | $18.39–$257.71 | 46% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL | $140.00 | $200.00 | $18.39–$257.71 | 33% above | 30% |
| Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO | $196.00 | $280.00 | $26.61–$257.71 | 19% above | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP TEST; MANUAL SCREENING | $119.00 | $170.00 | $20.26–$257.71 | 28% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL | $452.90 | $647.00 | $41.28–$257.71 | 8% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD | $47.60 | $68.00 | $6.01–$257.71 | at median | 30% |
| Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE | $183.40 | $262.00 | $20.86–$257.71 | 3% above | 30% |
| Prolactin blood test CPT 84146 ASSAY OF PROLACTIN | $188.30 | $269.00 | $19.38–$257.71 | 4% above | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME | $42.00 | $60.00 | $4.29–$257.71 | 9% above | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC | $93.10 | $133.00 | $16.55–$257.71 | at median | 30% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC | $29.40 | $42.00 | $16.53–$257.71 | at median | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $65.10 | $93.00 | $5.67–$257.71 | 6% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $77.00 | $110.00 | $14.39–$257.71 | at median | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RED BLOOD CELL SEDIMENTATION RATE; TO DETECT INFLAMMATION; AUTOMATED | $52.50 | $75.00 | $2.70–$257.71 | at median | 30% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS | $91.70 | $131.00 | $8.90–$257.71 | 8% above | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES | $31.50 | $45.00 | $4.38–$257.71 | at median | 30% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL | $91.00 | $130.00 | $15.92–$257.71 | 5% below | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST | $37.10 | $53.00 | $4.27–$257.71 | at median | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE | $179.20 | $256.00 | $61.98–$257.71 | 35% below | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE | $271.60 | $388.00 | $25.81–$257.71 | 16% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH | $129.50 | $185.00 | $14.55–$257.71 | at median | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH) | $127.40 | $182.00 | $16.80–$257.71 | at median | 30% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF | $244.30 | $349.00 | $35.09–$257.71 | 46% above | 30% |
| Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD | $47.60 | $68.00 | $4.52–$257.71 | 6% above | 30% |
| Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED | $34.30 | $49.00 | $3.17–$257.71 | 7% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE | $26.60 | $38.00 | $2.25–$257.71 | 12% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST | $28.70 | $41.00 | $2.25–$257.71 | 21% above | 30% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS; MANUAL TEST | $18.20 | $26.00 | $3.48–$257.71 | at median | 30% |
| Urine culture for bacteria, with colony count CPT 87086 BACTERIAL COLONY COUNT; URINE | $138.60 | $198.00 | $8.07–$257.71 | 30% above | 30% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST | $15.40 | $22.00 | $8.61–$257.71 | 61% below | 30% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL | $151.90 | $217.00 | $15.08–$257.71 | 4% above | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL | $287.70 | $411.00 | $29.60–$257.71 | 2% above | 30% |
| Zinc blood test CPT 84630 ASSAY OF ZINC | $114.10 | $163.00 | $11.39–$257.71 | 7% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST | $16.80 | $24.00 | $15.05–$257.71 | 59% below | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL | $151.90 | $217.00 | $15.05–$257.71 | 272% above | 30% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Hawaii | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 PRIMARY REMOVAL OF ADENOIDS (YOUNGER THAN 12 YEARS) | $1,498.94 | $2,141.34 | $207.47–$10,913.03 | at median | 30% |
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 FUSION OF UPPER SPINE BONE WITH REMOVAL OF DISC AND RELEASE OF SPINAL CORD OR NERVE; 1 DISC | $22,264.20 | $31,806.00 | $257.71–$42,259.25 | at median | 30% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 NSL/SINS NDSC SURG MAX SINS | $13,956.60 | $19,938.00 | $186.00–$23,230.03 | at median | 30% |
| Botox injections for chronic migraine CPT 64615 INJECTION OF CHEMICAL FOR PARALYSIS OF FACIAL AND NECK NERVE MUSCLES ON BOTH SIDES OF FACE | $660.80 | $944.00 | $124.08–$3,113.00 | at median | 30% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING X-RAY WITH NEEDLE; FIRST GROWTH | $2,893.10 | $4,133.00 | $176.14–$5,436.34 | 38% above | 30% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC | $3,110.10 | $4,443.00 | $176.14–$5,436.34 | 48% above | 30% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE | $644.00 | $920.00 | $289.97–$2,539.00 | at median | 30% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE | $709.80 | $1,014.00 | $187.07–$996.00 | 3% below | 30% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TREATMENT OF BROKEN BONE IN FOREFOOT OR MIDFOOT | $765.10 | $1,093.00 | $215.13–$1,419.00 | 5% above | 30% |
| Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO | $9,370.20 | $13,386.00 | $257.71–$22,910.00 | 47% above | 30% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 INSERTION OF TUBE IN LEFT LOWER HEART CHAMBER AND CORONARY ARTERY FOR DIAGNOSIS WITH REVIEW BY RADIOLOGIST | $6,380.50 | $9,115.00 | $257.71–$22,910.00 | at median | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT | $1,001.00 | $1,430.00 | $116.42–$2,175.52 | 12% below | 30% |
| Catheter ablation for atrial fibrillation CPT 93656 COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH CATHETER DESTRUCTION OF ABNORMALITY CAUSING ATRIAL FIBRILLATION (UNCOORDINATED CONTRACTION OF UPPER CHAMBERS OF HEART) BY PULMONARY VEIN ISOLATION | $24,887.10 | $35,553.00 | $257.71–$86,034.26 | 8% above | 30% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX | $2,121.00 | $3,030.00 | $119.21–$3,031.70 | at median | 30% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 REMOVAL OF FORESKIN (OLDER THAN 28 DAYS) | $7,212.80 | $10,304.00 | $192.85–$6,880.61 | at median | 30% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 REMOVAL OF FORESKIN USING CLAMP OR DEVICE | $3,586.80 | $5,124.00 | $145.74–$6,880.61 | at median | 30% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 REMOVAL OF FORESKIN USING CLAMP OR DEVICE | $3,081.40 | $4,402.00 | $4,496.00–$5,269.00 | — | 30% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONL BLOCK | $3,586.80 | $5,124.00 | $4,496.00–$5,269.00 | — | 30% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION NEONATE | $1,384.60 | $1,978.00 | $4,496.00–$5,269.00 | — | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREATMENT OF BROKEN FOREARM (RADIUS) BONE AT THE WRIST AREA ON THE THUMB SIDE OF THE WRIST WITHOUT MANIPULATION | $899.50 | $1,285.00 | $270.71–$1,419.00 | 1% below | 30% |
| Colonoscopy with endoscopic ultrasound CPT 45391 ULTRASOUND EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $8,922.20 | $12,746.00 | $257.71–$4,597.00 | at median | 30% |
| Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE | $3,987.20 | $5,696.00 | $257.71–$4,597.00 | at median | 30% |
| Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $6,407.80 | $9,154.00 | $257.71–$4,597.00 | at median | 30% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY | $1,484.70 | $2,121.00 | $322.89–$3,577.00 | at median | 30% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $1,761.55 | $2,516.50 | $257.71–$4,597.00 | 19% above | 30% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BIOPSY OF CERVIX USING AN ENDOSCOPE WITH LOOP ELECTRODE | $3,438.40 | $4,912.00 | $257.71–$10,655.18 | at median | 30% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE | $597.10 | $853.00 | $144.15–$1,003.04 | at median | 30% |
| Coronary stent placement, one artery CPT 92928 PRQ TCAT PLMT NTRAC ST 1 LES | $18,438.70 | $26,341.00 | $257.71–$37,998.38 | 5% above | 30% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 DIAGNOSTIC EXAM OF BLADDER AND URETHRA USING AN ENDOSCOPE | $3,022.60 | $4,318.00 | $177.75–$3,145.00 | at median | 30% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND SCRAPING OF UTERUS | $1,992.20 | $2,846.00 | $212.99–$10,655.18 | at median | 30% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE | $6,921.60 | $9,888.00 | $244.94–$10,655.18 | 247% above | 30% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION | $380.10 | $543.00 | $47.64–$660.41 | at median | 30% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA | $1,668.80 | $2,384.00 | $173.34–$5,107.14 | at median | 30% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING | $3,208.80 | $4,584.00 | $173.34–$5,107.14 | 92% above | 30% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 INCISION OF EARDRUM WITH INSERTION OF EARDRUM TUBE UNDER LOCAL OR TOPICAL ANESTHESIA | $1,221.50 | $1,745.00 | $155.31–$1,775.23 | at median | 30% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING | $219.80 | $314.00 | $16.15–$1,419.00 | at median | 30% |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED EAR WAX | $202.30 | $289.00 | $47.66–$1,419.00 | at median | 30% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING | $562.10 | $803.00 | $96.33–$996.00 | at median | 30% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NSL/SINS NDSC W/TOT ETHMDCT | $13,956.60 | $19,938.00 | $186.00–$23,230.03 | at median | 30% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 EXPLORATION OF NASAL SINUS USING AN ENDOSCOPE | $3,540.15 | $5,057.35 | $257.71–$23,230.03 | at median | 30% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NSL/SINS NDSC FRNT TISS RMVL | $13,956.60 | $19,938.00 | $186.00–$23,230.03 | 294% above | 30% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 EXPLORATION MAXILLARY SINUS | $7,430.50 | $10,615.00 | $186.00–$12,272.06 | at median | 30% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS | $13,956.60 | $19,938.00 | $186.00–$23,230.03 | at median | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE | $1,887.20 | $2,696.00 | $110.15–$3,131.00 | at median | 30% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL | $2,048.20 | $2,926.00 | $148.47–$2,911.30 | at median | 30% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); 3 CM TO 10 CM; REDUCIBLE | $15,557.50 | $22,225.00 | $257.71–$21,308.95 | at median | 30% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); GREATER THAN 10 CM; REDUCIBLE | $15,018.51 | $21,455.01 | $257.71–$21,308.95 | at median | 30% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE | $8,159.20 | $11,656.00 | $257.71–$11,785.09 | at median | 30% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY | $1,259.30 | $1,799.00 | $108.92–$3,131.00 | at median | 30% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC EXAM OF LOWER PORTION OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $5,345.20 | $7,636.00 | $108.92–$3,131.00 | 324% above | 30% |
| Gallbladder removal, laparoscopic CPT 47562 REMOVAL OF GALLBLADDER USING AN ENDOSCOPE | $17,726.80 | $25,324.00 | $257.71–$19,899.18 | at median | 30% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 REMOVAL OF GALLBLADDER WITH X-RAY STUDY OF BILE DUCTS USING AN ENDOSCOPE | $10,504.20 | $15,006.00 | $257.71–$19,899.18 | at median | 30% |
| Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE | $8,286.60 | $11,838.00 | $257.71–$10,769.98 | at median | 30% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S) | $2,070.60 | $2,958.00 | $181.77–$3,061.02 | 12% above | 30% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVAL OF SINGLE EXTERNAL AND INTERNAL HEMORRHOID GROUP | $7,408.80 | $10,584.00 | $257.71–$9,136.23 | at median | 30% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INSERTION OF TUBE AND INTRODUCTION OF CONTRAST FOR X-RAY OF UTERUS AND FALLOPIAN TUBES | $194.60 | $278.00 | $52.70–$3,113.00 | 28% below | 30% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY | $209.30 | $299.00 | $52.70–$3,113.00 | 22% below | 30% |
| Hysteroscopy with endometrial ablation CPT 58563 EXAM OF UTERUS WITH DESTRUCTION OF LINING OF UTERUS USING AN ENDOSCOPE | $5,061.35 | $7,230.50 | $257.71–$16,465.85 | at median | 30% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE | $3,264.80 | $4,664.00 | $257.71–$10,655.18 | at median | 30% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE | $163.80 | $234.00 | $92.00–$1,419.00 | at median | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS | $307.30 | $439.00 | $99.57–$1,419.00 | at median | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE | $412.30 | $589.00 | $86.58–$996.00 | 34% above | 30% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) | $8,815.80 | $12,594.00 | $257.71–$11,785.09 | at median | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION INTO TENDON OR LIGAMENT | $651.00 | $930.00 | $69.49–$1,419.00 | at median | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT | $700.00 | $1,000.00 | $60.43–$1,010.35 | 8% above | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT | $779.80 | $1,114.00 | $61.12–$3,113.00 | at median | 30% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION OF DRUG DELIVERY IMPLANT INTO TISSUE | $238.70 | $341.00 | $106.35–$437.95 | at median | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT | $688.10 | $983.00 | $52.22–$1,010.35 | 5% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT | $703.50 | $1,005.00 | $47.04–$1,010.35 | at median | 30% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 REMOVAL OF APPENDIX USING AN ENDOSCOPE | $8,815.80 | $12,594.00 | $257.71–$19,899.18 | at median | 30% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 REMOVAL OF UTERUS; TUBES; AND/OR OVARIES THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS | $9,370.90 | $13,387.00 | $257.71–$34,988.72 | at median | 30% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE | $23,039.10 | $32,913.00 | $257.71–$19,899.18 | at median | 30% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 REPAIR OF RECURRENT GROIN HERNIA USING AN ENDOSCOPE | $20,584.20 | $29,406.00 | $257.71–$19,899.18 | at median | 30% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE | $7,011.90 | $10,017.00 | $257.71–$19,899.18 | at median | 30% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER | $2,340.80 | $3,344.00 | $243.44–$4,277.00 | at median | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $636.30 | $909.00 | $154.31–$1,419.00 | at median | 30% |
| Left heart catheterization, diagnostic one side CPT 93452 LEFT HRT CATH W/VENTRCLGRPHY | $4,827.20 | $6,896.00 | $244.81–$22,910.00 | at median | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE | $610.40 | $872.00 | $100.65–$3,131.00 | at median | 30% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL | $1,235.50 | $1,765.00 | $88.16–$3,131.00 | 4% above | 30% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL | $1,660.40 | $2,372.00 | $198.54–$2,911.30 | at median | 30% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC | $18,256.00 | $26,080.00 | $257.71–$23,884.25 | at median | 30% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD AND/OR NERVES; 1 SEGMENT | $7,964.83 | $11,378.33 | $257.71–$23,884.25 | at median | 30% |
| Lumpectomy (partial mastectomy) CPT 19301 PARTIAL REMOVAL OF BREAST | $10,785.60 | $15,408.00 | $257.71–$12,887.90 | at median | 30% |
| Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISCARRIAGE DURING FIRST TRIMESTER | $5,975.90 | $8,537.00 | $388.29–$10,655.18 | at median | 30% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REMOVAL OF NONCANCER SKIN GROWTH OF BODY; ARMS; OR LEGS; 0.5 CM OR LESS | $1,167.60 | $1,668.00 | $110.10–$2,330.86 | 8% below | 30% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM< | $1,271.90 | $1,817.00 | $95.74–$3,131.00 | at median | 30% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/< | $1,453.20 | $2,076.00 | $109.62–$2,330.86 | at median | 30% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REMOVAL OF NONCANCER SKIN GROWTH OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 0.5 CM OR LESS | $5,807.20 | $8,296.00 | $109.62–$3,131.00 | 300% above | 30% |
| Nail removal (partial or complete), one nail CPT 11730 SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL | $578.20 | $826.00 | $84.23–$1,419.00 | 1% below | 30% |
| Occipital nerve block (injection for headaches) CPT 64405 INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE | $1,472.10 | $2,103.00 | $106.11–$1,419.00 | at median | 30% |
| Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT | $6,666.10 | $9,523.00 | $257.71–$34,403.35 | at median | 30% |
| Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE | $1,242.50 | $1,775.00 | $105.07–$2,985.39 | at median | 30% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $1,335.60 | $1,908.00 | $105.07–$4,277.00 | 7% above | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 PERMANENT REMOVAL FINGERNAIL OR TOENAIL | $959.70 | $1,371.00 | $172.35–$1,419.00 | at median | 30% |
| Prostate biopsy CPT 55700 BIOPSY OF PROSTATE GLAND | $5,168.80 | $7,384.00 | $193.96–$4,597.00 | at median | 30% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH NODES USING AN ENDOSCOPE | $18,811.09 | $26,872.99 | $257.71–$34,988.72 | at median | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT | $718.90 | $1,027.00 | $257.71–$6,427.51 | 27% below | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT | $4,721.50 | $6,745.00 | $257.71–$6,427.51 | 382% above | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE | $888.30 | $1,269.00 | $131.63–$1,419.00 | at median | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL | $954.80 | $1,364.00 | $114.46–$1,338.06 | 7% above | 30% |
| Removal of one lobe of the thyroid (lobectomy) CPT 60220 REMOVAL OF THYROID LOBE ON SIDE OF NECK | $26,544.00 | $37,920.00 | $257.71–$19,899.18 | at median | 30% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK | $6,563.90 | $9,377.00 | $257.71–$4,597.00 | at median | 30% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK | $5,198.90 | $7,427.00 | $257.71–$4,597.00 | at median | 30% |
| Septoplasty to straighten the nasal septum CPT 30520 REPAIR OF NASAL SEPTUM | $5,596.50 | $7,995.00 | $186.00–$10,913.03 | at median | 30% |
| Septoplasty to straighten the nasal septum CPT 30520 RESHAPING OF NASAL CARTILAGE | $8,123.73 | $11,605.33 | $257.71–$10,913.03 | 45% above | 30% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE | $7,471.80 | $10,674.00 | $257.71–$11,602.70 | at median | 30% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 SHOCK WAVE CRUSHING OF KIDNEY STONES | $10,278.80 | $14,684.00 | $257.71–$11,602.70 | 38% above | 30% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF ELBOW TO FINGER CAST | $564.20 | $806.00 | $95.04–$920.61 | at median | 30% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT | $198.10 | $283.00 | $70.09–$1,419.00 | at median | 30% |
| Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST | $845.60 | $1,208.00 | $101.40–$920.61 | at median | 30% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT | $506.10 | $723.00 | $78.40–$1,419.00 | 1% below | 30% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE | $17,843.00 | $25,490.00 | $257.71–$10,903.00 | at median | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $364.70 | $521.00 | $114.40–$1,419.00 | at median | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< | $412.30 | $589.00 | $114.40–$1,419.00 | 13% above | 30% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH | $664.30 | $949.00 | $75.02–$1,338.06 | 18% above | 30% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAG; 1-15 SKIN TAGS | $360.50 | $515.00 | $66.72–$1,419.00 | at median | 30% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST | $1,283.10 | $1,833.00 | $101.30–$3,145.00 | at median | 30% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR | $1,379.00 | $1,970.00 | $116.50–$2,539.00 | 7% above | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM | $307.30 | $439.00 | $128.09–$1,419.00 | at median | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM | $347.20 | $496.00 | $128.09–$1,419.00 | 13% above | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS | $307.30 | $439.00 | $120.67–$1,419.00 | at median | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/< | $412.30 | $589.00 | $120.67–$1,419.00 | 34% above | 30% |
| TURP (transurethral resection of the prostate) CPT 52601 REMOVAL OF PROSTATE GLAND USING AN ELECTROCAUTERY KNIFE THROUGH URETHRA WITH CONTROL OF BLEEDING USING AN ENDOSCOPE | $7,928.20 | $11,326.00 | $257.71–$17,648.65 | at median | 30% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES | $664.30 | $949.00 | $59.65–$1,338.06 | 31% above | 30% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF RELATED SKIN GROWTH; FIRST GROWTH | $4,688.60 | $6,698.00 | $59.65–$1,338.06 | 821% above | 30% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE | $1,886.50 | $2,695.00 | $108.77–$3,131.00 | 19% above | 30% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVAL OF TONSILS AND ADENOID GLANDS (12 YEARS OR OLDER) | $4,569.60 | $6,528.00 | $257.71–$10,913.03 | at median | 30% |
| Tonsil and adenoid removal, child under 12 CPT 42820 REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) | $3,995.60 | $5,708.00 | $257.71–$19,485.45 | at median | 30% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS (12 YEARS OR OLDER) | $4,060.00 | $5,800.00 | $257.71–$10,913.03 | at median | 30% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS (YOUNGER THAN 12 YEARS) | $4,351.20 | $6,216.00 | $257.71–$19,485.45 | at median | 30% |
| Total knee replacement CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE | $25,328.10 | $36,183.00 | $257.71–$42,259.25 | at median | 30% |
| Total shoulder replacement CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER | $18,755.80 | $26,794.00 | $257.71–$57,713.54 | at median | 30% |
| Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID | $16,413.60 | $23,448.00 | $257.71–$19,899.18 | at median | 30% |
| Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH | $3,287.20 | $4,696.00 | $186.00–$5,292.78 | at median | 30% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES | $961.10 | $1,373.00 | $52.93–$1,419.00 | at median | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH | $2,229.50 | $3,185.00 | $165.34–$5,436.34 | 26% above | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG | $2,396.80 | $3,424.00 | $165.34–$5,436.34 | 36% above | 30% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM | $2,758.00 | $3,940.00 | $164.36–$6,316.18 | at median | 30% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 BALLOON DILATION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE; LESS THAN 3.0 CM | $5,907.30 | $8,439.00 | $164.36–$6,316.18 | 114% above | 30% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE | $1,871.80 | $2,674.00 | $208.29–$4,597.00 | at median | 30% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPR GI SCOPE W/SUBMUC INJ | $1,392.30 | $1,989.00 | $165.22–$4,597.00 | at median | 30% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 INJECTION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE | $3,716.65 | $5,309.50 | $165.22–$4,597.00 | 167% above | 30% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE | $2,758.00 | $3,940.00 | $208.41–$6,316.18 | at median | 30% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 REMOVAL OF POLYPS OR GROWTHS OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE | $3,429.30 | $4,899.00 | $208.41–$6,316.18 | 24% above | 30% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE INSERTION | $1,392.30 | $1,989.00 | $178.08–$4,597.00 | at median | 30% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 INSERTION OF GUIDE WIRE WITH DILATION OF ESOPHAGUS USING A FLEXIBLE ENDOSCOPE | $4,919.60 | $7,028.00 | $178.08–$4,597.00 | 253% above | 30% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH | $1,843.80 | $2,634.00 | $197.74–$4,277.00 | at median | 30% |
| Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE | $3,375.40 | $4,822.00 | $197.74–$4,277.00 | 83% above | 30% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 EGD W/TRANSMURAL DRAIN CYST | $5,309.50 | $7,585.00 | $257.71–$19,982.70 | at median | 30% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CRUSHING OF STONE OF URETER USING AN ENDOSCOPE | $11,096.40 | $15,852.00 | $257.71–$17,648.65 | at median | 30% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE | $4,862.20 | $6,946.00 | $257.71–$17,648.65 | at median | 30% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT | $5,986.40 | $8,552.00 | $234.70–$6,880.61 | at median | 30% |
| Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RF 1ST VEIN | $5,376.70 | $7,681.00 | $257.71–$12,617.00 | at median | 30% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14 | $380.10 | $543.00 | $69.19–$660.41 | at median | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS | $548.80 | $784.00 | $88.29–$3,312.00 | 12% below | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/< | $620.20 | $886.00 | $88.29–$3,312.00 | at median | 30% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Hawaii | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS | $940.10 | $1,343.00 | $43.36–$2,323.00 | at median | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT | $1,062.60 | $1,518.00 | $43.36–$2,323.00 | 13% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION | $317.10 | $453.00 | $4,496.00–$5,269.00 | — | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION OF CHEMOTHERAPY INTO VEIN; 1 HOUR OR LESS | $752.50 | $1,075.00 | $140.42–$1,087.21 | 3% above | 30% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE HEARING AND SPEECH RECOGNITION TEST | $275.10 | $393.00 | $34.66–$423.56 | at median | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; FIRST 30-74 MINUTES | $4,407.90 | $6,297.00 | $229.14–$3,385.00 | at median | 30% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 MEASUREMENT OF BRAIN WAVE ACTIVITY (EEG); AWAKE AND DROWSY | $836.50 | $1,195.00 | $145.63–$710.72 | 8% above | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING | $250.60 | $358.00 | $9.71–$257.71 | at median | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD SEVERITY | $391.30 | $559.00 | $21.64–$1,419.00 | 1% above | 30% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY | $679.00 | $970.00 | $42.14–$1,419.00 | 1% above | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY | $1,508.50 | $2,155.00 | $62.90–$1,419.00 | 1% above | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY | $2,195.20 | $3,136.00 | $119.20–$2,119.00 | 1% above | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM | $2,891.70 | $4,131.00 | $175.39–$3,385.00 | 9% above | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY | $5,086.90 | $7,267.00 | $175.39–$3,385.00 | 92% above | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG) | $945.00 | $1,350.00 | $39.83–$710.72 | at median | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES | $462.00 | $660.00 | $53.19–$700.14 | at median | 30% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS | $462.00 | $660.00 | $71.73–$700.14 | at median | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE | $233.10 | $333.00 | $13.50–$257.71 | 9% above | 30% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION; 7-8 STUDIES | $515.20 | $736.00 | $76.76–$1,228.28 | at median | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 THERAPY PROCEDURE TO RE-EDUCATE BRAIN-TO-NERVE-TO-MUSCLE FUNCTION; EACH 15 MINUTES | $87.50 | $125.00 | $30.10–$257.71 | at median | 30% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES | $266.00 | $380.00 | $70.97–$257.71 | at median | 30% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN | $279.30 | $399.00 | $70.97–$257.71 | 5% above | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES | $266.00 | $380.00 | $4,496.00–$5,269.00 | — | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE O/P NEW LOW 30 MIN | $279.30 | $399.00 | $4,496.00–$5,269.00 | — | 30% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES | $301.00 | $430.00 | $116.55–$326.34 | 7% above | 30% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45 MIN | $316.40 | $452.00 | $116.55–$326.34 | 13% above | 30% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE O/P NEW MOD 45 MIN | $316.40 | $452.00 | $4,496.00–$5,269.00 | — | 30% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES | $333.90 | $477.00 | $159.56–$446.77 | at median | 30% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE O/P NEW HI 60 MIN | $333.90 | $477.00 | $4,496.00–$5,269.00 | — | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 15-29 MINUTES | $200.20 | $286.00 | $41.15–$257.71 | at median | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN | $209.30 | $299.00 | $41.15–$257.71 | 5% above | 30% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 15-29 MINUTES | $200.20 | $286.00 | $4,496.00–$5,269.00 | — | 30% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE O/P NEW SF 15 MIN | $209.30 | $299.00 | $4,496.00–$5,269.00 | — | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 EVALUATION FOR OCCUPATIONAL THERAPY; TYPICALLY 30 MINUTES | $175.00 | $250.00 | $80.07–$299.82 | at median | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES | $350.70 | $501.00 | $75.48–$291.31 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES | $175.00 | $250.00 | $75.48–$291.31 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN | $283.50 | $405.00 | $75.48–$291.31 | 62% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES | $350.70 | $501.00 | $75.48–$291.31 | at median | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS | $158.90 | $227.00 | $23.66–$257.71 | at median | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 THERAPY PROCEDURE USING MANUAL TECHNIQUE; EACH 15 MINUTES | $317.80 | $454.00 | $23.66–$257.71 | 100% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES | $87.50 | $125.00 | $25.82–$257.71 | at median | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES | $175.00 | $250.00 | $25.82–$257.71 | 100% above | 30% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PREV VISIT EST AGE 18-39 | $106.40 | $152.00 | $105.99–$257.71 | at median | 30% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PREV VISIT EST AGE 40-64 | $106.40 | $152.00 | $112.61–$257.71 | at median | 30% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PER PM REEVAL EST PAT 65+ YR | $106.40 | $152.00 | $121.09–$257.71 | at median | 30% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING AND TOBACCO USE INTENSIVE COUNSELING; 4-10 MINUTES | $44.10 | $63.00 | $12.80–$1,419.00 | 10% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 40-54 MINUTES | $297.50 | $425.00 | $126.07–$353.00 | at median | 30% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE O/P EST HI 40 MIN | $297.50 | $425.00 | $4,496.00–$5,269.00 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES | $214.90 | $307.00 | $57.69–$257.71 | 19% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN | $225.40 | $322.00 | $57.69–$257.71 | 15% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES | $214.90 | $307.00 | $4,496.00–$5,269.00 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE O/P EST LOW 20 MIN | $225.40 | $322.00 | $4,496.00–$5,269.00 | — | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES | $244.30 | $349.00 | $84.69–$257.71 | 2% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30 MIN | $256.20 | $366.00 | $84.69–$257.71 | 3% above | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES | $244.30 | $349.00 | $4,496.00–$5,269.00 | — | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE O/P EST MOD 30 MIN | $256.20 | $366.00 | $4,496.00–$5,269.00 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES | $200.20 | $286.00 | $31.00–$257.71 | 3% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN | $210.00 | $300.00 | $31.00–$257.71 | 2% above | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES | $200.20 | $286.00 | $4,496.00–$5,269.00 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE O/P EST SF 10 MIN | $210.00 | $300.00 | $4,496.00–$5,269.00 | — | 30% |
| Speech and language evaluation CPT 92523 EVALUATION OF SPEECH SOUND PRODUCTION WITH EVALUATION OF LANGUAGE COMPREHENSION AND EXPRESSION | $312.20 | $446.00 | $198.83–$671.22 | at median | 30% |
| Speech therapy session, individual CPT 92507 TREATMENT OF SPEECH; LANGUAGE; VOICE; COMMUNICATION; AND/OR HEARING PROCESSING DISORDER | $170.80 | $244.00 | $45.39–$257.71 | at median | 30% |
| Spirometry (breathing test) CPT 94010 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME | $295.40 | $422.00 | $19.13–$710.72 | at median | 30% |
| Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION | $361.90 | $517.00 | $32.76–$1,228.28 | at median | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPY PROCEDURE USING FUNCTIONAL ACTIVITIES | $87.50 | $125.00 | $33.30–$257.71 | at median | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 DRAWING OF BLOOD FOR A MEDICAL PROBLEM | $396.90 | $567.00 | $29.99–$437.95 | at median | 30% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Hawaii | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Spikevax 2024-2025 Formula Ages 12 and up | $217.70 | $311.00 | $138.24–$158.98 | at median | 30% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Spikevax 2023-2024 Formula | $217.70 | $311.00 | $138.24–$158.98 | at median | 30% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SPIKEVAX 2023-2024 FORMULA | $246.40 | $352.00 | $2,000.00–$5,269.00 | — | 30% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Spikevax 2023-2024 Formula | $246.40 | $352.00 | $4,496.00–$5,269.00 | — | 30% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Spikevax 2025-2026 Formula Ages 12 and up | $272.97 | $389.95 | $4,496.00–$5,269.00 | — | 30% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SPIKEVAX 2024-2025 FORMULA AGES 12 AND UP | $272.97 | $389.95 | $2,000.00–$5,269.00 | — | 30% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Spikevax 2024-2025 Formula Ages 12 and up | $272.97 | $389.95 | $4,496.00–$5,269.00 | — | 30% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM | $201.60 | $288.00 | $124.20–$142.83 | at median | 30% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Comirnaty 2023-2024 Age 12 and older | $231.00 | $330.00 | $4,496.00–$5,269.00 | — | 30% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY 2023-2024 AGE 12 AND OLDER | $231.00 | $330.00 | $2,000.00–$5,269.00 | — | 30% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE | $252.70 | $361.00 | $188.14–$216.36 | at median | 30% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varivax | $252.70 | $361.00 | $188.14–$216.36 | at median | 30% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX | $368.38 | $526.26 | $2,000.00–$5,269.00 | — | 30% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varivax | $368.38 | $526.26 | $4,496.00–$5,269.00 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FluLaval 2025-2026 Formula | $31.50 | $45.00 | $19.77–$22.74 | at median | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone High-Dose 2025-2026 Formula | $31.50 | $45.00 | $19.77–$22.74 | at median | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FluLaval 2024-2025 Formula | $31.50 | $45.00 | $19.77–$22.74 | at median | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FluLaval Quadrivalent 2022-2023 Formula | $31.50 | $45.00 | $19.77–$22.74 | at median | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE; TRIVALENT; SPLIT VIRUS; PRESERVATIVE-FREE; 0.5 ML DOSAGE | $31.50 | $45.00 | $19.77–$22.74 | at median | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLULAVAL 2024-2025 FORMULA | $36.54 | $52.20 | $2,000.00–$5,269.00 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUARIX 2024-2025 FORMULA | $36.54 | $52.20 | $2,000.00–$5,269.00 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLULAVAL 2025-2026 FORMULA | $38.00 | $54.29 | $2,000.00–$5,269.00 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluarix 2025-2026 Formula | $38.00 | $54.29 | $4,496.00–$5,269.00 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUARIX 2025-2026 FORMULA | $38.00 | $54.29 | $2,000.00–$5,269.00 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FluLaval 2025-2026 Formula | $38.00 | $54.29 | $4,496.00–$5,269.00 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluzone 2025-2026 Formula PFS | $38.75 | $55.36 | $4,496.00–$5,269.00 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE 2025-2026 FORMULA PFS | $38.75 | $55.36 | $2,000.00–$5,269.00 | — | 30% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Gardasil 9 | $424.90 | $607.00 | $310.40–$350.75 | at median | 30% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE TYPES 6; 11; 16; 18; 31; 33; 45; 52; 58; NONAVALENT | $424.90 | $607.00 | $310.40–$350.75 | at median | 30% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Gardasil 9 | $632.06 | $902.94 | $4,496.00–$5,269.00 | — | 30% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 | $632.06 | $902.94 | $2,000.00–$5,269.00 | — | 30% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TWINRIX | $252.05 | $360.07 | $2,000.00–$5,269.00 | — | 30% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Twinrix | $252.05 | $360.07 | $4,496.00–$5,269.00 | — | 30% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE ADULT DOSAGE | $127.40 | $182.00 | $70.54–$96.22 | 13% below | 30% |
| Hepatitis A vaccine, adult dose CPT 90632 Havrix | $127.40 | $182.00 | $70.54–$96.22 | 13% below | 30% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Vaqta | $159.75 | $228.21 | $4,496.00–$5,269.00 | — | 30% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 VAQTA | $159.75 | $228.21 | $2,000.00–$5,269.00 | — | 30% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Havrix | $164.40 | $234.86 | $4,496.00–$5,269.00 | — | 30% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX | $164.40 | $234.86 | $2,000.00–$5,269.00 | — | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix-B | $107.10 | $153.00 | $70.38–$81.41 | 13% below | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE; ADULT DOSAGE (3 DOSE SCHEDULE) | $107.10 | $153.00 | $70.38–$81.41 | 13% below | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Boostrix | $107.10 | $153.00 | $70.38–$81.41 | 13% below | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPB VACCINE 3 DOSE ADULT IM | $137.57 | $196.53 | $2,000.00–$5,269.00 | — | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPB VACCINE 3 DOSE ADULT IM | $137.57 | $196.53 | $4,496.00–$5,269.00 | — | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Engerix-B | $137.62 | $196.60 | $4,496.00–$5,269.00 | — | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B | $137.62 | $196.60 | $2,000.00–$5,269.00 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FluLaval 2024-2025 Formula | $121.80 | $174.00 | $73.40–$84.41 | at median | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2025-2026 Formula | $121.80 | $174.00 | $73.40–$84.41 | at median | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACCINE SPLIT VIRUS; PRESERVATIVE FREE | $121.80 | $174.00 | $73.40–$84.41 | at median | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2024-2025 Formula | $121.80 | $174.00 | $73.40–$84.41 | at median | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE QUADRIVALENT 2023-2024 FORMULA | $107.13 | $153.04 | $2,000.00–$5,269.00 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE 2024-2025 FORMULA | $139.78 | $199.69 | $2,000.00–$5,269.00 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE 2025-2026 FORMULA | $164.55 | $235.07 | $2,000.00–$5,269.00 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose 2025-2026 Formula | $164.55 | $235.07 | $4,496.00–$5,269.00 | — | 30% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II | $142.80 | $204.00 | $99.49–$114.41 | 9% below | 30% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES; MUMPS; AND RUBELLA VACCINE | $142.80 | $204.00 | $99.49–$114.41 | 9% below | 30% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II | $184.30 | $263.29 | $4,496.00–$5,269.00 | — | 30% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II | $184.30 | $263.29 | $2,000.00–$5,269.00 | — | 30% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACCINE; SEROGROUPS A; C; W; Y; DIPHTHERIA TOXOID CARRIER VACCINE | $240.80 | $344.00 | $160.52–$184.60 | 13% below | 30% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENACTRA | $284.90 | $407.00 | $2,000.00–$5,269.00 | — | 30% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menactra | $284.90 | $407.00 | $4,496.00–$5,269.00 | — | 30% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO | $319.55 | $456.50 | $2,000.00–$5,269.00 | — | 30% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menveo | $319.55 | $456.50 | $4,496.00–$5,269.00 | — | 30% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL RECOMBINANT PROTEIN AND OUTER MEMBRANE VESICLE VACCINE; SEROGROUP B | $336.70 | $481.00 | $241.52–$257.75 | 13% below | 30% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO | $455.03 | $650.04 | $2,000.00–$5,269.00 | — | 30% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Bexsero | $455.03 | $650.04 | $4,496.00–$5,269.00 | — | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 | $527.17 | $753.10 | $2,000.00–$5,269.00 | — | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Prevnar 20 | $527.17 | $753.10 | $4,496.00–$5,269.00 | — | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23 | $196.70 | $281.00 | $133.47–$153.49 | at median | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM | $236.60 | $338.00 | $133.47–$153.49 | 20% above | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23 | $225.39 | $321.98 | $2,000.00–$5,269.00 | — | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumovax 23 | $225.39 | $321.98 | $4,496.00–$5,269.00 | — | 30% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOC ANTB SEASN .5ML IM | $831.60 | $1,188.00 | $561.33–$634.30 | 9% below | 30% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS | $1,070.55 | $1,529.36 | $2,000.00–$5,269.00 | — | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 RABAVERT | $836.63 | $1,195.18 | $2,000.00–$5,269.00 | — | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM | $836.63 | $1,195.18 | $2,000.00–$5,269.00 | — | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM | $836.63 | $1,195.18 | $4,496.00–$5,269.00 | — | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 RabAvert | $836.63 | $1,195.18 | $4,496.00–$5,269.00 | — | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 Imovax Rabies | $868.48 | $1,240.69 | $4,496.00–$5,269.00 | — | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES | $868.48 | $1,240.69 | $2,000.00–$5,269.00 | — | 30% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Shingrix | $414.86 | $592.65 | $4,496.00–$5,269.00 | — | 30% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX | $414.86 | $592.65 | $2,000.00–$5,269.00 | — | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM | $45.50 | $65.00 | $18.83–$34.16 | 21% below | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Boostrix | $45.50 | $65.00 | $18.83–$34.16 | 21% below | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TDVAX | $53.87 | $76.96 | $2,000.00–$5,269.00 | — | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TDVAX | $53.87 | $76.96 | $4,496.00–$5,269.00 | — | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tenivac | $78.44 | $112.06 | $4,496.00–$5,269.00 | — | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC | $78.44 | $112.06 | $2,000.00–$5,269.00 | — | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Kinrix | $71.40 | $102.00 | $39.09–$63.51 | 6% below | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM | $71.40 | $102.00 | $39.09–$63.51 | 6% below | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix | $75.85 | $108.35 | $39.09–$63.51 | at median | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHERIA; TETANUS; AND ACELLULAR PERTUSSIS VACCINE (7 YEARS OR OLDER) | $75.85 | $108.35 | $39.09–$63.51 | at median | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Adacel | $78.88 | $112.68 | $39.09–$63.51 | 4% above | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX | $89.51 | $127.87 | $2,000.00–$5,269.00 | — | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Boostrix | $89.51 | $127.87 | $4,496.00–$5,269.00 | — | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL | $90.38 | $129.12 | $2,000.00–$5,269.00 | — | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Adacel | $90.38 | $129.12 | $4,496.00–$5,269.00 | — | 30% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Typhim Vi | $296.26 | $423.23 | $4,496.00–$5,269.00 | — | 30% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI | $296.26 | $423.23 | $2,000.00–$5,269.00 | — | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE | $132.30 | $189.00 | $12.56–$257.71 | at median | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMINISTRATION OF VACCINE; EACH ADDITIONAL VACCINE | $69.30 | $99.00 | $6.28–$257.71 | 34% above | 30% |
Source file: https://www.queens.org/wp-content/uploads/990073524_queens-medical-center-west-oahu_standardcharges-4.csv