Hospital Bloomington, IN

Monroe Hospital

Monroe Hospital in Bloomington, IN publishes cash prices for 338 common procedures listed here, from its own machine-readable price file updated Mar 17, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Indiana median for 326 of 336 procedures and above it for 9. By typical cash price it ranks #1 of 84 Indiana hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

4011 South Monroe Medical Park Boulevard Bloomington, IN 47403 Collected Sep 22, 2026 Source price file Check a bill from this hospital (812) 825-1111

Acute care hospital For-profit hospital Emergency department CMS star rating 4 of 5 CCN 150183 · CMS hospital register NPI 1740686443

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Monroe Hospital in Bloomington, IN:

Apr 11, 2025 Met requirements

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Abdominal X-ray, 2 views CPT 74019 ABDOMEN COMPLETE	$110.00	$540.00	$110.07–$540.00	59% below	80%
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE 3 VWS BIL	$91.00	$534.96	$68.29–$754.70	54% below	83%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3 VWS RT	$91.00	$754.70	$68.29–$754.70	54% below	88%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3 VWS LT	$91.00	$534.96	$68.29–$754.70	54% below	83%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ABI ART EXTREM LTD SEGMENTAL BIL	$140.00	$520.00	$58.85–$980.85	62% below	73%
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 US ABI ART EXTREM LTD SEGMENTAL RT	$140.00	$196.17	$58.85–$980.85	62% below	29%
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 US ABI ART EXTREM LTD SEGMENTAL LT	$140.00	$980.85	$58.85–$980.85	62% below	86%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHOGRAM	$184.00	$714.28	$184.66–$714.28	60% below	74%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONEJOINT IMAGING WHOLE BODY	$420.00	$2,296.25	$420.89–$2,296.25	73% below	82%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST BILATERAL	$110.00	$814.00	$110.07–$814.00	—	86%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILATERAL LT	$110.00	$620.41	$110.07–$814.00	75% below	82%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILATERAL RT	$110.00	$620.41	$110.07–$814.00	75% below	82%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILATERAL COMPLETE.	$110.00	$495.00	$110.07–$814.00	75% below	78%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL LIMITED	$91.00	$407.00	$91.62–$407.00	72% below	78%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD AND PELVIS W WO CONTRAST	$367.00	$6,221.43	$367.30–$6,221.43	81% below	94%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart evaluation of coronary calcium	$91.00	$399.05	$91.62–$399.05	51% below	77%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD AND PEL WO	$251.00	$4,802.13	$251.20–$4,802.13	79% below	95%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDPEL WO RENAL COLIC	$251.00	$4,802.13	$251.20–$4,802.13	79% below	95%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD AND PEL W CONTRAST	$367.00	$5,307.25	$367.30–$5,307.25	79% below	93%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ENTEROGRAPHY	$367.00	$5,307.25	$367.30–$5,307.25	79% below	93%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDPEL W WO	$367.00	$6,511.00	$367.30–$6,511.00	79% below	94%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W	$184.00	$3,382.99	$184.66–$3,382.99	83% below	95%
CT scan of the head with contrast CPT 70460 CT HEAD WITH	$184.00	$2,594.43	$184.66–$2,594.43	78% below	93%
CT scan of the head without and with contrast CPT 70470 CT HEAD WO AND W	$184.00	$3,152.00	$184.66–$3,152.00	82% below	94%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W	$184.00	$2,978.46	$184.66–$2,978.46	80% below	94%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US DUP ART CAROTID BILAT COMPLETE	$251.00	$1,570.00	$251.20–$1,570.00	—	84%
Chest X-ray, 2 views CPT 71046 FLUORO LEAD CHECK	$91.00	$264.42	$26.88–$480.70	56% below	66%
Chest X-ray, 2 views CPT 71046 CHEST EMPLOYEE PA AND LAT	$91.00	$89.60	$26.88–$480.70	56% below	-2%
Chest X-ray, 2 views CPT 71046 CHEST PA AND LATERAL	$91.00	$480.70	$26.88–$480.70	56% below	81%
Chest X-ray, 2 views one side CPT 71046 CHEST RT LT DECUB	$91.00	$440.71	$26.88–$480.70	56% below	79%
Chest X-ray, single view CPT 71045 CHEST SINGLE VIEW	$91.00	$376.92	$26.88–$376.92	44% below	76%
Chest X-ray, single view CPT 71045 CHEST AP PORTABLE	$91.00	$376.92	$26.88–$376.92	44% below	76%
Chest X-ray, single view CPT 71045 EMPLOYEE CHEST X-RAY -PPD	$91.00	$89.60	$26.88–$376.92	44% below	-2%
Chest X-ray, single view CPT 71045 PICC CHEST AP PORTABLE	$91.00	$376.92	$26.88–$376.92	44% below	76%
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE BIL	$91.00	$927.58	$56.67–$927.58	53% below	90%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE COMPLETE RT	$91.00	$927.58	$56.67–$927.58	53% below	90%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE COMPLETE LT	$91.00	$927.58	$56.67–$927.58	53% below	90%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE	$110.00	$1,022.71	$110.07–$1,022.71	78% below	89%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$110.00	$555.95	$104.99–$555.95	62% below	80%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG WDETAILED ANAT 1ST GESTA	$251.00	$456.39	$136.92–$456.39	55% below	45%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W	$184.00	$3,000.00	$184.66–$3,000.00	80% below	94%
Diagnostic mammogram, both breasts CPT 77066 MM BIL DIAG MAMMO	$102.00	$860.00	$102.19–$860.00	77% below	88%
Diagnostic mammogram, both breasts CPT 77066 MM IMPLANT BIL DIAG	$102.00	$860.00	$102.19–$860.00	77% below	88%
Diagnostic mammogram, one breast one side CPT 77065 MM IMPLANT DIAG LT	$79.00	$690.00	$79.74–$690.00	64% below	89%
Diagnostic mammogram, one breast one side CPT 77065 MM IMPLANT DIAG RT	$79.00	$690.00	$79.74–$690.00	64% below	89%
Diagnostic mammogram, one breast one side CPT 77065 MM UNI DIAG MAMMO RT	$79.00	$690.00	$79.74–$690.00	64% below	89%
Diagnostic mammogram, one breast one side CPT 77065 MM UNI DIAG MAMMO LT	$79.00	$690.00	$79.74–$690.00	64% below	89%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US DUP ART LOW EXTREM BILATCOMP	$251.00	$1,373.00	$251.20–$1,373.00	73% below	82%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUP VNS UP EXT BILATERAL	$251.00	$1,680.00	$251.20–$1,680.00	—	85%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUP VNS LOW EXT BILATERAL	$251.00	$1,680.00	$251.20–$1,680.00	—	85%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CS ECHO COMPLETE (COLOR & DOPPLER FLOW)	$575.00	$2,703.06	$575.28–$2,703.06	65% below	79%
Elbow X-ray, 2 views CPT 73070 ELBOW 2 VWS BIL	$91.00	$378.00	$55.69–$672.57	45% below	76%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VWS LT	$91.00	$672.57	$55.69–$672.57	45% below	86%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VWS RT	$91.00	$672.57	$55.69–$672.57	45% below	86%
Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW MIN 3 VWS BIL	$91.00	$897.65	$68.29–$897.65	64% below	90%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW MIN 3 VWS LT	$91.00	$624.72	$68.29–$897.65	64% below	85%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW MIN 3 VWS RT	$91.00	$624.72	$68.29–$897.65	64% below	85%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES 3 VWS	$110.00	$645.00	$81.78–$645.00	60% below	83%
Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM 2 VWS BIL	$91.00	$378.00	$53.78–$756.49	51% below	76%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM 2 VWS LT	$91.00	$756.49	$53.78–$756.49	51% below	88%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM 2 VWS RT	$91.00	$756.49	$53.78–$756.49	51% below	88%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY SYSTEM IMAGING	$420.00	$1,924.95	$420.89–$1,924.95	68% below	78%
Hand X-ray, 2 views CPT 73120 HAND 2 VWS BIL	$110.00	$378.00	$52.81–$669.00	36% below	71%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VWS LT	$110.00	$669.00	$52.81–$669.00	36% below	84%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VWS RT	$110.00	$669.00	$52.81–$669.00	36% below	84%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 CALCANEOUS MIN 2 VWS BIL	$91.00	$605.51	$55.69–$605.51	57% below	85%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEOUS MIN 2 VWS RT	$91.00	$393.43	$55.69–$605.51	57% below	77%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEOUS MIN 2 VWS LT	$91.00	$393.43	$55.69–$605.51	57% below	77%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRPHY, SLP STGING WCPAP PROF	$904.00	$560.00	$168.00–$3,830.00	72% below	-61%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRPHY, SLEEP STAGING WCPAP	$904.00	$3,308.00	$168.00–$3,830.00	72% below	73%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRPHY, WCPAP GLOBAL	$904.00	$3,830.00	$168.00–$3,830.00	72% below	76%
Knee X-ray, 3 views CPT 73562 KNEE 3 VWS BIL	$91.00	$856.51	$75.04–$856.51	60% below	89%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VWS LT	$91.00	$493.00	$75.04–$856.51	60% below	82%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VWS RT	$91.00	$493.00	$75.04–$856.51	60% below	82%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE 4+VWS BIL	$110.00	$977.96	$86.62–$977.96	58% below	89%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE 4+VWS LT	$110.00	$607.36	$86.62–$977.96	58% below	82%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE 4+VWS RT	$110.00	$607.36	$86.62–$977.96	58% below	82%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LMTD 1 ORGANQUAD FU	$110.00	$903.00	$110.07–$903.00	76% below	88%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LDCT SCREENING	$110.00	$2,462.00	$110.07–$2,462.00	42% below	96%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIBIAFIBULA 2 VWS BIL	$91.00	$720.00	$51.83–$720.00	54% below	87%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIAFIBULA 2 VWS RT	$91.00	$469.27	$51.83–$720.00	54% below	81%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIAFIBULA 2 VWS LT	$91.00	$469.27	$51.83–$720.00	54% below	81%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO	$251.00	$4,510.00	$251.20–$4,510.00	78% below	94%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXTREM ANY JOINT WO BIL	$251.00	$1,015.23	$251.20–$3,309.00	76% below	75%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOW EXTREM ANY JOINT WO LT	$251.00	$3,309.00	$251.20–$3,309.00	76% below	92%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE PRE-OP RT	$251.00	$1,015.23	$251.20–$3,309.00	76% below	75%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOW EXTREM ANY JOINT WO RT	$251.00	$3,309.00	$251.20–$3,309.00	76% below	92%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE PRE-OP LT	$251.00	$1,015.23	$251.20–$3,309.00	76% below	75%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXTREM ANY JOINT WO&W BIL	$367.00	$1,602.09	$367.30–$4,780.00	75% below	77%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOW EXTREM ANY JOINT WO and W LT	$367.00	$4,780.00	$367.30–$4,780.00	75% below	92%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOW EXTREM ANY JOINT WO and W RT	$367.00	$4,780.00	$367.30–$4,780.00	75% below	92%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO	$251.00	$3,499.44	$251.20–$3,499.44	77% below	93%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W and WO	$367.00	$4,733.77	$367.30–$4,733.77	77% below	92%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO	$251.00	$4,390.00	$251.20–$4,390.00	75% below	94%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WWO CONTRAST	$367.00	$5,940.00	$367.30–$5,940.00	72% below	94%
MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE WO	$251.00	$3,900.00	$251.20–$3,900.00	75% below	94%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE WO and W	$367.00	$5,840.00	$367.30–$5,840.00	75% below	94%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE WO	$251.00	$3,950.00	$251.20–$3,950.00	75% below	94%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE WO and W	$367.00	$5,930.00	$367.30–$5,930.00	75% below	94%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE WO	$251.00	$3,920.00	$251.20–$3,920.00	76% below	94%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO and W	$367.00	$6,100.00	$367.30–$6,100.00	75% below	94%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO	$251.00	$4,360.00	$251.20–$4,360.00	76% below	94%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UP EXTREM ANY JOINT WO BIL	$251.00	$1,015.23	$251.20–$3,352.69	76% below	75%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXTREM ANY JOINT WO RT	$251.00	$3,352.69	$251.20–$3,352.69	76% below	93%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXTREM ANY JOINT WO LT	$251.00	$3,352.69	$251.20–$3,352.69	76% below	93%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-SPINE MIN 4 VWS	$110.00	$718.00	$89.51–$718.00	68% below	85%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W	$184.00	$3,304.50	$184.66–$3,304.50	81% below	94%
Neck soft tissue X-ray CPT 70360 SOFT TISSUE NECK	$91.00	$417.04	$56.67–$417.04	47% below	78%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial SPECT multiple	$1,363.00	$5,297.75	$1,095.24–$5,297.75	65% below	74%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED	$110.00	$1,022.71	$86.68–$1,022.71	69% below	89%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED FOLLICLE STUDY	$110.00	$288.93	$86.68–$1,022.71	69% below	62%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE	$110.00	$1,066.00	$110.07–$1,066.00	76% below	90%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG > 14 WKS SINGLE	$110.00	$1,054.94	$110.07–$1,054.94	80% below	90%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG < 14 WKS SINGLE	$110.00	$851.00	$110.07–$851.00	79% below	87%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREG LMTD, SIZEHEART	$110.00	$767.90	$110.07–$767.90	71% below	86%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT 2 VWS RT	$91.00	$483.18	$59.59–$483.18	56% below	81%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT 2 VWS LT	$91.00	$483.18	$59.59–$483.18	56% below	81%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNILAT W PA CXR RT	$110.00	$550.00	$73.09–$550.00	55% below	80%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNILAT W PA	$110.00	$550.00	$73.09–$550.00	55% below	80%
Screening mammogram, both breasts CPT 77067 MM BIL SCRN MAMMO	$84.00	$860.00	$84.38–$860.00	66% below	90%
Screening mammogram, both breasts CPT 77067 MM IMPLANT BIL SCRN	$84.00	$860.00	$84.38–$860.00	66% below	90%
Screening mammogram, both breasts one side CPT 77067 MM IMPLANT UNIL SCRN LT	$84.00	$384.00	$84.38–$860.00	66% below	78%
Screening mammogram, both breasts one side CPT 77067 MM UNIL SCRN MAMMO RT	$84.00	$690.00	$84.38–$860.00	66% below	88%
Screening mammogram, both breasts one side CPT 77067 MM UNIL SCRN MAMMO LT	$84.00	$690.00	$84.38–$860.00	66% below	88%
Screening mammogram, both breasts one side CPT 77067 MM IMPLANT UNIL SCRN RT	$84.00	$690.00	$84.38–$860.00	66% below	88%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN 2 VWS BIL	$91.00	$806.08	$57.64–$806.08	56% below	89%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER MIN 2 VWS LT	$91.00	$806.08	$57.64–$806.08	56% below	89%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER MIN 2 VWS RT	$91.00	$806.08	$57.64–$806.08	56% below	89%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES 3 + VWS	$91.00	$655.00	$72.15–$655.00	68% below	86%
Skull X-ray, fewer than 4 views CPT 70250 SKULL LMTD < 4 VWS	$110.00	$89.60	$26.88–$89.60	53% below	-23%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRPHY, SLP STGING W4 PROF	$904.00	$522.00	$156.60–$3,830.00	66% below	-73%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRPHY,ANTHEM	$904.00	$3,308.00	$156.60–$3,830.00	66% below	73%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRPHY GLOBAL	$904.00	$3,830.00	$156.60–$3,830.00	66% below	76%
Swallow study (modified barium swallow, video X-ray) CPT 74230 ESOPHAGRAMDYSPHAGIA EVAL W VIDEO	$184.00	$412.00	$123.60–$412.00	49% below	55%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 FEMUR 2 VWS BIL	$91.00	$720.00	$61.50–$720.00	55% below	87%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR 2 VWS RT	$91.00	$469.27	$61.50–$720.00	55% below	81%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR 2 VWS LT	$91.00	$469.27	$61.50–$720.00	55% below	81%
Toe X-ray, 2 or more views CPT 73660 TOES MIN 2 VWS BIL	$91.00	$378.00	$65.36–$378.00	41% below	76%
Toe X-ray, 2 or more views one side CPT 73660 TOES MIN 2 VWS LT	$91.00	$304.00	$65.36–$378.00	41% below	70%
Toe X-ray, 2 or more views one side CPT 73660 TOES MIN 2 VWS RT	$91.00	$304.00	$65.36–$378.00	41% below	70%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$110.00	$810.00	$110.07–$810.00	73% below	86%
Transvaginal ultrasound during pregnancy CPT 76817 US PREG TRANSVAGINAL	$110.00	$820.00	$110.07–$820.00	70% below	87%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$110.00	$1,293.73	$110.07–$1,293.73	79% below	91%
Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR	$110.00	$827.00	$110.07–$827.00	74% below	87%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID OR SOFT TISSUE	$110.00	$1,026.83	$110.07–$1,026.83	74% below	89%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W KUB	$184.00	$1,106.29	$184.66–$1,106.29	65% below	83%
Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS 2 VWS BIL	$91.00	$808.45	$55.69–$808.45	53% below	89%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS 2 VWS LT	$91.00	$547.04	$55.69–$808.45	53% below	83%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS 2 VWS RT	$91.00	$547.04	$55.69–$808.45	53% below	83%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 IR VENOUS DOPPLER IMAGING LTD	$110.00	$831.42	$110.07–$1,107.77	83% below	87%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VNS LOW EXT LEFT UNILAT	$110.00	$1,107.77	$110.07–$1,107.77	83% below	90%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VNS UP EXT LEFT UNILAT	$110.00	$1,107.77	$110.07–$1,107.77	83% below	90%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VNS UP EXT RIGHT UNILAT	$110.00	$1,107.77	$110.07–$1,107.77	83% below	90%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VNS LOW EXT RIGHT UNILAT	$110.00	$1,107.77	$110.07–$1,107.77	83% below	90%
Wrist X-ray, 2 views CPT 73100 WRIST 2 VWS BIL	$91.00	$378.00	$61.50–$643.16	42% below	76%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VWS LT	$91.00	$643.16	$61.50–$643.16	42% below	86%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VWS RT	$91.00	$643.16	$61.50–$643.16	42% below	86%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST 3 VIEWS BIL	$91.00	$817.11	$79.87–$817.11	64% below	89%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS LT	$91.00	$600.40	$79.87–$817.11	64% below	85%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS RT	$91.00	$600.40	$79.87–$817.11	64% below	85%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 INFANTCHILD PELVISHIPS MIN 2 VWS	$91.00	$191.00	$57.30–$459.60	66% below	52%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP COMPLETE 2 VIEWS-LT	$91.00	$459.60	$57.30–$459.60	66% below	80%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP COMPLETE 2 VIEWS-RT	$91.00	$459.60	$57.30–$459.60	66% below	80%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP COMPLETE 2 VIEWS-UNILAT LT	$91.00	$459.60	$57.30–$459.60	66% below	80%
X-ray of the abdomen, 1 view CPT 74018 ABD XRAY 1 VIEW	$91.00	$413.05	$91.62–$413.05	58% below	78%
X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VWS BIL	$91.00	$639.67	$55.69–$639.67	43% below	86%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VWS RT	$91.00	$462.35	$55.69–$639.67	43% below	80%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VWS LT	$91.00	$462.35	$55.69–$639.67	43% below	80%
X-ray of the finger(s), 2 or more views CPT 73140 FINGER MIN 2 VWS BIL	$91.00	$626.29	$72.15–$626.29	43% below	85%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2 VWS LT	$91.00	$570.94	$72.15–$626.29	43% below	84%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2 VWS RT	$91.00	$570.94	$72.15–$626.29	43% below	84%
X-ray of the foot, 2 views CPT 73620 FOOT 2 VWS BIL	$91.00	$688.38	$53.78–$688.38	44% below	87%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VWS RT	$91.00	$401.00	$53.78–$688.38	44% below	77%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VWS LT	$91.00	$401.00	$53.78–$688.38	44% below	77%
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT MIN 3 VWS BIL	$91.00	$756.50	$63.45–$756.50	55% below	88%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT MIN 3 VWS RT	$91.00	$452.00	$63.45–$756.50	55% below	80%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT MIN 3 VWS LT	$91.00	$452.00	$63.45–$756.50	55% below	80%
X-ray of the hand, 3 or more views CPT 73130 HAND MIN 3 VWS BIL	$91.00	$794.29	$66.34–$794.29	55% below	89%
X-ray of the hand, 3 or more views one side CPT 73130 HAND MIN 3 VWS RT	$91.00	$541.18	$66.34–$794.29	55% below	83%
X-ray of the hand, 3 or more views one side CPT 73130 HAND MIN 3 VWS LT	$91.00	$541.18	$66.34–$794.29	55% below	83%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1 OR 2 VWS BIL	$91.00	$670.59	$58.62–$670.59	56% below	86%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1 OR 2 VWS LT	$91.00	$413.00	$58.62–$670.59	56% below	78%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1 OR 2 VWS RT	$91.00	$413.00	$58.62–$670.59	56% below	78%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 L-SPINE 2 or 3 VWS	$110.00	$544.00	$66.34–$544.00	56% below	80%
X-ray of the lower back, 4 or more views CPT 72110 L-SPINE MIN 4 VWS	$110.00	$814.00	$91.46–$814.00	68% below	86%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE 2 VWS	$110.00	$517.00	$61.50–$517.00	53% below	79%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES COMPLT	$91.00	$474.00	$69.23–$474.00	55% below	81%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-SPINE 2 or 3 VWS	$91.00	$504.92	$66.34–$504.92	64% below	82%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VWS	$110.00	$503.45	$53.78–$503.45	44% below	78%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUMCOCCYX MIN 2 VWS	$91.00	$488.50	$55.69–$488.50	58% below	81%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
ACTH blood test CPT 82024 ACTH	$38.00	$57.50	$17.25–$57.50	85% below	34%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 CL ALTSGPT	$5.00	$10.00	$3.00–$50.00	82% below	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 LC ALTSGPT	$5.00	$50.00	$3.00–$50.00	82% below	90%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT	$5.00	$50.00	$3.00–$50.00	82% below	90%
AST (aspartate aminotransferase) enzyme test CPT 84450 CL ASTSGOT	$5.00	$9.00	$2.70–$103.00	83% below	44%
AST (aspartate aminotransferase) enzyme test CPT 84450 LC ASTSGOT	$5.00	$103.00	$2.70–$103.00	83% below	95%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$5.00	$103.00	$2.70–$103.00	83% below	95%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 CHRONIC HEPATITIS PANEL	$47.00	$78.70	$23.61–$78.70	85% below	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE	$47.00	$78.70	$23.61–$78.70	85% below	40%
Albumin blood test CPT 82040 ALBUMIN SERUM CHARGE ONLY	$4.00	$62.16	$2.40–$110.90	82% below	94%
Albumin blood test CPT 82040 CL ALBUMIN	$4.00	$8.00	$2.40–$110.90	82% below	50%
Albumin blood test CPT 82040 LC ALBUMIN	$4.00	$110.90	$2.40–$110.90	82% below	96%
Albumin blood test CPT 82040 OTHER SOURCE QUANT CHARGE ONLY EACH	$4.00	$62.17	$2.40–$110.90	82% below	94%
Albumin blood test CPT 82040 ALBUMIN	$4.00	$110.90	$2.40–$110.90	82% below	96%
Aldosterone blood test CPT 82088 *RL HISTAMINE DETERMINATION, URINE	$40.00	$100.00	$12.69–$100.00	81% below	60%
Aldosterone blood test CPT 82088 ALDOSTERONE	$40.00	$42.30	$12.69–$100.00	81% below	5%
Aldosterone blood test CPT 82088 ALDOSTERONE 24 HR URINE	$40.00	$100.00	$12.69–$100.00	81% below	60%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOS	$5.00	$108.00	$2.70–$108.00	84% below	95%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOS CHARGE ONLY	$5.00	$25.00	$2.70–$108.00	84% below	80%
Alkaline phosphatase (ALP) blood test CPT 84075 CL ALKALINE PHOS	$5.00	$9.00	$2.70–$108.00	84% below	44%
Alkaline phosphatase (ALP) blood test CPT 84075 LC ALKALINE PHOSPHATASE	$5.00	$108.00	$2.70–$108.00	84% below	95%
Allergy blood test, specific IgE, per allergen CPT 86003 ROUGH MARSHELDER IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 YELLOWJACKET IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT TREE IGE	$5.00	$50.00	$2.10–$293.40	74% below	90%
Allergy blood test, specific IgE, per allergen CPT 86003 VENISON IGE	$5.00	$30.00	$2.10–$293.40	74% below	83%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE BEAN ALLERGEN	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS	$5.00	$22.17	$2.10–$293.40	74% below	77%
Allergy blood test, specific IgE, per allergen CPT 86003 SYCAMORE TREE IGE	$5.00	$50.00	$2.10–$293.40	74% below	90%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN ALLERGEN	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 STACHYBOTRYS CHARTARUM SEROLOGY	$5.00	$9.78	$2.10–$293.40	74% below	49%
Allergy blood test, specific IgE, per allergen CPT 86003 SORRELLDOCK IGE	$5.00	$9.00	$2.10–$293.40	74% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED IGE ALLERGEN	$5.00	$22.12	$2.10–$293.40	74% below	77%
Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOPS IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 RAGWEED (GIANT)IGE	$5.00	$50.00	$2.10–$293.40	74% below	90%
Allergy blood test, specific IgE, per allergen CPT 86003 PORK IGE	$5.00	$22.00	$2.10–$293.40	74% below	77%
Allergy blood test, specific IgE, per allergen CPT 86003 PIGWEED COMMON IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM NOTATUM IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN G	$5.00	$22.17	$2.10–$293.40	74% below	77%
Allergy blood test, specific IgE, per allergen CPT 86003 PINTO BEAN ALLERGEN	$5.00	$9.00	$2.10–$293.40	74% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 PAPER WASP IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 OYSTER IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN V IGE AB	$5.00	$22.17	$2.10–$293.40	74% below	77%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT ALLERGEN	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 ONION ALLERGEN	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 OAK WHITE IGE	$5.00	$50.00	$2.10–$293.40	74% below	90%
Allergy blood test, specific IgE, per allergen CPT 86003 NUT PROFILE CHARGE ONLY	$5.00	$7.00	$2.10–$293.40	74% below	29%
Allergy blood test, specific IgE, per allergen CPT 86003 MUCOR RACEMOSUS IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 MULBERRY WHITE TREE IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 MOLD IGE CHARGE ONLY	$5.00	$195.60	$2.10–$293.40	74% below	97%
Allergy blood test, specific IgE, per allergen CPT 86003 MUSSEL IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK-IGE	$5.00	$84.86	$2.10–$293.40	74% below	94%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK ALLERGEN WITH REFLEX	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 MELONS IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 MAPLEBOX TREE IGE	$5.00	$50.00	$2.10–$293.40	74% below	90%
Allergy blood test, specific IgE, per allergen CPT 86003 M035-IGE SPOROBOLOMYCES ROSEU	$5.00	$9.00	$2.10–$293.40	74% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 M209-IGE STACHYBOTRYS CHARTAT	$5.00	$9.00	$2.10–$293.40	74% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 M010-IGE STEMPHYLIUM BOTRYOSU	$5.00	$32.60	$2.10–$293.40	74% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER IGE	$5.00	$50.00	$2.10–$293.40	74% below	90%
Allergy blood test, specific IgE, per allergen CPT 86003 M071-IGE SPONDYLOCLADIUM	$5.00	$9.00	$2.10–$293.40	74% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 LATEX ANTIBODIES	$5.00	$9.00	$2.10–$293.40	74% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 LAMBS QUARTER IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 GREENBEANS IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN	$5.00	$15.00	$2.10–$293.40	74% below	67%
Allergy blood test, specific IgE, per allergen CPT 86003 GARLIC IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 FEATHER IGE	$5.00	$9.00	$2.10–$293.40	74% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 FLAXSEED IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 ELM AMERICAN TREE IGE	$5.00	$50.00	$2.10–$293.40	74% below	90%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG ( WHOLE ) ALLERGEN	$5.00	$50.00	$2.10–$293.40	74% below	90%
Allergy blood test, specific IgE, per allergen CPT 86003 ENGLISH PLANTAIN IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER IGE	$5.00	$50.00	$2.10–$293.40	74% below	90%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG EPHE IGE	$5.00	$9.00	$2.10–$293.40	74% below	44%
Allergy blood test, specific IgE, per allergen CPT 86003 D FARINAE IGE	$5.00	$50.00	$2.10–$293.40	74% below	90%
Allergy blood test, specific IgE, per allergen CPT 86003 DERMATOPHAGOIDES PTERONYSSINUS	$5.00	$22.17	$2.10–$293.40	74% below	77%
Allergy blood test, specific IgE, per allergen CPT 86003 D PTERONYSSINUS IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 DERMATOPHAGOIDES FARINAE	$5.00	$22.17	$2.10–$293.40	74% below	77%
Allergy blood test, specific IgE, per allergen CPT 86003 CRAYFISH FRESHWATER IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 COTTONSEED IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 CORN ALLERGEN	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT IGE ALLERGEN	$5.00	$22.12	$2.10–$293.40	74% below	77%
Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH AMERICAN IGE	$5.00	$50.00	$2.10–$293.40	74% below	90%
Allergy blood test, specific IgE, per allergen CPT 86003 CRAB IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 CLAM IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 CELERY ALLERGEN	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 CHOCOLATE ALLERGEN	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 CINNAMON ALLERGEN	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER IGE	$5.00	$32.60	$2.10–$293.40	74% below	85%
Allergy blood test, specific IgE, per allergen CPT 86003 CARROT ALLERGEN	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 BIRCH COMMON SILVER TREE IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 BEEF ALLERGEN	$5.00	$22.00	$2.10–$293.40	74% below	77%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA TENUIS IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE REGION ALLERGEN ZON 8a	$5.00	$293.40	$2.10–$293.40	74% below	98%
Allergy blood test, specific IgE, per allergen CPT 86003 ALFALFA IGE	$5.00	$27.00	$2.10–$293.40	74% below	81%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY IGEEACH	$5.00	$22.17	$2.10–$293.40	74% below	77%
Allergy blood test, specific IgE, per allergen CPT 86003 *RL ALLERGEN PROFILE - FOOD - BASIC	$5.00	$97.80	$2.10–$293.40	74% below	95%
Allergy blood test, specific IgE, per allergen CPT 86003 *RL ALLERGEN PROFILE 6 FOOD BASIC	$5.00	$97.80	$2.10–$293.40	74% below	95%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT ALLERGEN	$5.00	$27.00	$2.10–$293.40	74% below	81%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN WITH AFP L3%, SERUM	$16.00	$61.10	$12.21–$89.60	84% below	74%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN TUMOR MARKER	$16.00	$40.70	$12.21–$89.60	84% below	61%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN MATERNAL	$16.00	$89.60	$12.21–$89.60	84% below	82%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP MATERNAL SERUM FOR OPEN SPINA BIFIDA	$16.00	$89.60	$12.21–$89.60	84% below	82%
Ammonia blood test CPT 82140 AMMONIA	$14.00	$130.00	$14.57–$130.00	88% below	89%
Amylase blood test CPT 82150 CL AMYLASE	$6.00	$12.00	$3.60–$153.75	88% below	50%
Amylase blood test CPT 82150 IU AMYLASE BODY FLUID	$6.00	$90.00	$3.60–$153.75	88% below	93%
Amylase blood test CPT 82150 LC AMYLASE	$6.00	$60.00	$3.60–$153.75	88% below	90%
Amylase blood test CPT 82150 AMYLASE BODY FLUID	$6.00	$36.70	$3.60–$153.75	88% below	84%
Amylase blood test CPT 82150 AMYLASE	$6.00	$60.00	$3.60–$153.75	88% below	90%
Amylase blood test CPT 82150 AMYLASE 24HR URINE	$6.00	$37.20	$3.60–$153.75	88% below	84%
Amylase blood test CPT 82150 PANCREATIC AMYLASE, S	$6.00	$153.75	$3.60–$153.75	88% below	96%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE AB	$12.00	$101.20	$12.95–$101.20	77% below	88%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI-NUCLEAR ANTIBODY 164855	$12.00	$24.40	$7.32–$100.00	80% below	51%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA REFLEX PANEL 164962	$12.00	$24.40	$7.32–$100.00	80% below	51%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA 164947	$12.00	$28.20	$7.32–$100.00	80% below	57%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA REFLEX CASADE	$12.00	$100.00	$7.32–$100.00	80% below	88%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA IFA REFLEX TO 9-BIOMARKER PROFILE	$12.00	$28.20	$7.32–$100.00	80% below	57%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 proBNP	$39.00	$314.63	$39.26–$314.63	77% below	88%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EAR	$8.00	$80.00	$4.50–$80.00	91% below	90%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ..TEST CULTURE PERTUSSIS	$8.00	$61.05	$4.50–$80.00	91% below	87%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE LOWER RESPIRATORY	$8.00	$80.00	$4.50–$80.00	91% below	90%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID	$8.00	$80.00	$4.50–$80.00	91% below	90%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF	$8.00	$80.00	$4.50–$80.00	91% below	90%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE UPPER RESPIRATORY	$8.00	$80.00	$4.50–$80.00	91% below	90%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE PERTUSSIS	$8.00	$61.05	$4.50–$80.00	91% below	87%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL	$8.00	$80.00	$4.50–$80.00	91% below	90%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE PENILE	$8.00	$15.00	$4.50–$80.00	91% below	47%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE LEGIONELLA	$8.00	$80.00	$4.50–$80.00	91% below	90%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE	$8.00	$80.00	$4.50–$80.00	91% below	90%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE RESPIRATORY	$8.00	$15.00	$4.50–$80.00	91% below	47%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND	$8.00	$80.00	$4.50–$80.00	91% below	90%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATHETER TIP IV	$8.00	$80.00	$4.50–$80.00	91% below	90%
Basic metabolic panel (blood test) CPT 80048 CL BASIC METABOLIC PANEL	$8.00	$99.00	$8.46–$262.00	90% below	92%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$8.00	$262.00	$8.46–$262.00	90% below	97%
Basic metabolic panel (blood test) CPT 80048 LC BMP	$8.00	$262.00	$8.46–$262.00	90% below	97%
Bilirubin blood test, total CPT 82247 CL BILIRUBIN NEONATAL	$5.00	$9.00	$2.70–$99.50	86% below	44%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$5.00	$96.00	$2.70–$99.50	86% below	95%
Bilirubin blood test, total CPT 82247 BBTR BILIRUBIN PRE	$5.00	$96.00	$2.70–$99.50	86% below	95%
Bilirubin blood test, total CPT 82247 BBTR BILIRUBIN POST	$5.00	$96.00	$2.70–$99.50	86% below	95%
Bilirubin blood test, total CPT 82247 BILIRUBIN BODY FLUID	$5.00	$99.50	$2.70–$99.50	86% below	95%
Bilirubin blood test, total CPT 82247 LC BILIRUBIN TOTAL	$5.00	$96.00	$2.70–$99.50	86% below	95%
Bilirubin blood test, total CPT 82247 CL BILIRUBIN TOTAL	$5.00	$9.00	$2.70–$99.50	86% below	44%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAMINE TC LEVEL IV	$54.00	$62.00	$18.60–$281.00	79% below	13%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 IU TISSUE EXAM IV	$54.00	$130.00	$18.60–$281.00	79% below	58%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAMINE LEVEL IV	$54.00	$281.00	$18.60–$281.00	79% below	81%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE	$9.00	$4.00	$1.20–$200.00	46% below	-125%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE COLLECT	$9.00	$40.92	$1.20–$200.00	46% below	78%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE 10	$9.00	$40.92	$1.20–$200.00	46% below	78%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HRP VENIPUNCTURE	$9.00	$25.00	$1.20–$200.00	46% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD COLLECTION INDWELLING VENOUS	$9.00	$200.00	$1.20–$200.00	46% below	96%
Blood glucose (sugar) test CPT 82947 GLUCOSE 1HR PP	$3.00	$7.00	$2.10–$80.10	89% below	57%
Blood glucose (sugar) test CPT 82947 CL GLUCOSE RANDOM	$3.00	$7.00	$2.10–$80.10	89% below	57%
Blood glucose (sugar) test CPT 82947 CL GLUCOSE FASTING	$3.00	$7.00	$2.10–$80.10	89% below	57%
Blood glucose (sugar) test CPT 82947 GESTATIONAL FASTING GLUCOSE	$3.00	$7.00	$2.10–$80.10	89% below	57%
Blood glucose (sugar) test CPT 82947 *POC GLUCOSE	$3.00	$80.10	$2.10–$80.10	89% below	96%
Blood glucose (sugar) test CPT 82947 CL GLUCOSE 2HR PP	$3.00	$7.00	$2.10–$80.10	89% below	57%
Blood glucose (sugar) test CPT 82947 GLUCOSE RANDOM	$3.00	$80.10	$2.10–$80.10	89% below	96%
Blood glucose (sugar) test CPT 82947 LC GLUCOSE	$3.00	$80.10	$2.10–$80.10	89% below	96%
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING	$3.00	$80.10	$2.10–$80.10	89% below	96%
Blood lead test CPT 83655 LEAD URINE	$12.00	$36.50	$9.78–$36.50	83% below	67%
Blood lead test CPT 83655 LEAD VENOUS BLOOD PEDIATRIC	$12.00	$32.60	$9.78–$36.50	83% below	63%
Blood lead test CPT 83655 LEAD BLOOD	$12.00	$32.60	$9.78–$36.50	83% below	63%
Blood lead test CPT 83655 LEAD CAPILLARY BLOOD PEDIATRIC	$12.00	$32.60	$9.78–$36.50	83% below	63%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM	$7.00	$198.92	$3.90–$198.92	90% below	96%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 * STATUS URINE PREGNANCY TEST	$7.00	$50.00	$3.90–$198.92	90% below	86%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CL HCG SERUM (QUAL)	$7.00	$13.00	$3.90–$198.92	90% below	46%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO GROUP	$140.00	$85.00	$2.99–$85.00	185% above	-65%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BBR ABO GROUP	$140.00	$83.91	$2.99–$85.00	185% above	-67%
Blood urea nitrogen (BUN) test CPT 84520 BUN BODY FLUID	$3.00	$22.50	$2.10–$85.00	87% below	87%
Blood urea nitrogen (BUN) test CPT 84520 *POC BUN	$3.00	$85.00	$2.10–$85.00	87% below	96%
Blood urea nitrogen (BUN) test CPT 84520 *POC BUNCREA	$3.00	$85.00	$2.10–$85.00	87% below	96%
Blood urea nitrogen (BUN) test CPT 84520 LC BUN	$3.00	$85.00	$2.10–$85.00	87% below	96%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$3.00	$85.00	$2.10–$85.00	87% below	96%
Blood urea nitrogen (BUN) test CPT 84520 CL BUN	$3.00	$7.00	$2.10–$85.00	87% below	57%
C-peptide blood test CPT 84681 C PEPTIDE	$20.00	$36.50	$10.95–$36.50	85% below	45%
C-peptide blood test CPT 84681 C PEPTIDE ULTRA SENSITIVE	$20.00	$36.50	$10.95–$36.50	85% below	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN QUANTITATIVE	$5.00	$50.00	$5.18–$50.00	93% below	90%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CL C REACTIVE PROTEIN QUANTITATIVE	$5.00	$31.80	$5.18–$50.00	93% below	84%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 LC CRP	$5.00	$50.00	$5.18–$50.00	93% below	90%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 RCRP	$5.00	$50.00	$5.18–$50.00	93% below	90%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF HDA	$37.00	$171.00	$37.27–$171.00	72% below	78%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE TOXIGENIC ASSAY	$37.00	$171.00	$37.27–$171.00	72% below	78%
C. difficile toxin gene test (stool PCR) one side CPT 87493 C DIFF BY RT-PCR REVOGENE	$37.00	$171.00	$37.27–$171.00	72% below	78%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$20.00	$40.00	$12.00–$40.00	86% below	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$20.00	$47.00	$14.10–$47.00	88% below	57%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID 19-ID NOW	$51.00	$150.00	$45.00–$150.00	52% below	66%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 COVID 19 RT-PCR BY MDX	$51.00	$150.00	$45.00–$150.00	52% below	66%
Calcium blood test, total CPT 82310 CALCIUM	$5.00	$360.00	$2.70–$360.00	81% below	99%
Calcium blood test, total CPT 82310 CL CALCIUM	$5.00	$9.00	$2.70–$360.00	81% below	44%
Calcium blood test, total CPT 82310 LC CALCIUM	$5.00	$360.00	$2.70–$360.00	81% below	99%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$18.00	$40.00	$12.00–$40.00	85% below	55%
Chickenpox (varicella) immunity blood test CPT 86787 EMPLOYEE VARICELLA ZOSTER IGG	$12.00	$34.60	$10.38–$67.45	88% below	65%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG	$12.00	$34.60	$10.38–$67.45	88% below	65%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM	$12.00	$67.45	$10.38–$67.45	88% below	82%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA PAP CHARGE ONLY	$35.00	$27.50	$8.25–$310.00	64% below	-27%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA LCR PROBE	$35.00	$310.00	$8.25–$310.00	64% below	89%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA LCR URINE	$35.00	$100.00	$8.25–$310.00	64% below	65%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CL LIPID PROFILE	$13.00	$263.80	$13.39–$263.80	88% below	95%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$13.00	$263.80	$13.39–$263.80	88% below	95%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LC LIPID PANEL	$13.00	$263.80	$13.39–$263.80	88% below	95%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 NMR LIPOPROFILE 884000	$13.00	$240.84	$13.39–$263.80	88% below	95%
Complete blood count (CBC) with differential CPT 85025 CBC wAUTO D	$7.00	$174.17	$4.20–$174.17	83% below	96%
Complete blood count (CBC) with differential CPT 85025 CHARGE CBC WAUTO DIFF	$7.00	$14.00	$4.20–$174.17	83% below	50%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM	$6.00	$154.76	$3.60–$154.76	80% below	96%
Complete blood count (CBC), no differential CPT 85027 CL HEMOGRAM	$6.00	$12.00	$3.60–$154.76	80% below	50%
Comprehensive metabolic panel (blood test) CPT 80053 CL COMP MET PANEL	$10.00	$370.00	$10.56–$370.00	89% below	97%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE MET PANEL	$10.00	$370.00	$10.56–$370.00	89% below	97%
Comprehensive metabolic panel (blood test) CPT 80053 LC CMP	$10.00	$370.00	$10.56–$370.00	89% below	97%
Cortisol blood test, total CPT 82533 CORTISOL 60 MINUTE	$16.00	$22.80	$6.84–$90.00	83% below	30%
Cortisol blood test, total CPT 82533 CL CORTISOL SERUM	$16.00	$22.80	$6.84–$90.00	83% below	30%
Cortisol blood test, total CPT 82533 CORTISOL SERUM	$16.00	$22.80	$6.84–$90.00	83% below	30%
Cortisol blood test, total CPT 82533 CORTISOL SERUM - AM	$16.00	$22.80	$6.84–$90.00	83% below	30%
Cortisol blood test, total CPT 82533 CORTISOL SERUM - PM	$16.00	$26.30	$6.84–$90.00	83% below	39%
Cortisol blood test, total CPT 82533 CORTISOL 30 MINUTE	$16.00	$22.80	$6.84–$90.00	83% below	30%
Cortisol blood test, total CPT 82533 DEXAMETHASONE SUPPRESSION	$16.00	$90.00	$6.84–$90.00	83% below	82%
Cortisol blood test, total CPT 82533 SALIVARY CORTISOL	$16.00	$60.00	$6.84–$90.00	83% below	73%
Creatine kinase (CK) blood test, total CPT 82550 LC CK	$6.00	$60.00	$6.51–$60.00	85% below	90%
Creatine kinase (CK) blood test, total CPT 82550 CL CPK	$6.00	$30.00	$6.51–$60.00	85% below	80%
Creatine kinase (CK) blood test, total CPT 82550 CK	$6.00	$60.00	$6.51–$60.00	85% below	90%
Creatinine blood test CPT 82565 LC CREATININE	$5.00	$40.00	$5.12–$40.00	83% below	88%
Creatinine blood test CPT 82565 CREATININE, BLOOD	$5.00	$40.00	$5.12–$40.00	83% below	88%
Creatinine blood test CPT 82565 GLOMERULAR FILTRATION RATE	$5.00	$40.00	$5.12–$40.00	83% below	88%
Creatinine blood test CPT 82565 *POC CREATININE	$5.00	$40.00	$5.12–$40.00	83% below	88%
Creatinine blood test CPT 82565 CL CREATININE	$5.00	$40.00	$5.12–$40.00	83% below	88%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG	$14.00	$46.00	$13.80–$46.00	82% below	70%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$10.00	$90.00	$5.40–$90.00	92% below	89%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER DILUTED	$10.00	$18.00	$5.40–$90.00	92% below	44%
DHEA sulfate (DHEA-S) blood test CPT 82627 *RL DHEA SULFATE	$22.00	$162.90	$22.23–$162.90	85% below	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 *RL DRUG SCREEN WOUND CENTER	$62.00	$150.00	$4.50–$280.95	46% below	59%
Drug screen by lab instrument (any number of drug classes) CPT 80307 RL DRUG PANEL(12 DRUGS)	$62.00	$270.00	$4.50–$280.95	46% below	77%
Drug screen by lab instrument (any number of drug classes) CPT 80307 *RL DRUG SCREEN	$62.00	$40.00	$4.50–$280.95	46% below	-55%
Drug screen by lab instrument (any number of drug classes) CPT 80307 RL DRUG PANEL(10 DRUGS + OXY, AL)	$62.00	$161.64	$4.50–$280.95	46% below	62%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN PRIVATE	$62.00	$271.00	$4.50–$280.95	46% below	77%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TRIAGE DRUG SCREEN	$62.00	$124.00	$4.50–$280.95	46% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TRAMADOL - 80307 - 5080928	$62.00	$118.10	$4.50–$280.95	46% below	48%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PAIN MANAGEMENT SCREENING (11 DRUG URIN	$62.00	$161.64	$4.50–$280.95	46% below	62%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PHENCYCLIDINE SCRN W CONF WB	$62.00	$244.86	$4.50–$280.95	46% below	75%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OPIATESOXYCODONE SCREEN	$62.00	$118.10	$4.50–$280.95	46% below	48%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OPIATES SCREEN BLOOD 1 OR 2	$62.00	$118.10	$4.50–$280.95	46% below	48%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OPIATES SCREEN BLOOD	$62.00	$118.10	$4.50–$280.95	46% below	48%
Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE SCREEN	$62.00	$78.10	$4.50–$280.95	46% below	21%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHANOL, URINE	$62.00	$65.20	$4.50–$280.95	46% below	5%
Drug screen by lab instrument (any number of drug classes) CPT 80307 EACH DRUG CLASS	$62.00	$244.86	$4.50–$280.95	46% below	75%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN ORAL FLUID	$62.00	$180.00	$4.50–$280.95	46% below	66%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG PROFILE URINE (9 DRUGS) W METHAQU*	$62.00	$63.15	$4.50–$280.95	46% below	2%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG PROFILE URINE (9 DRUGS)*	$62.00	$62.14	$4.50–$280.95	46% below	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG PROFILE PANEL 13 URINE	$62.00	$161.64	$4.50–$280.95	46% below	62%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG CONFIRMATION EACH PROCEDURE	$62.00	$244.86	$4.50–$280.95	46% below	75%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN - MECONIUM	$62.00	$24.00	$4.50–$280.95	46% below	-158%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG PROFILE BLOOD (8 DRUGS)*	$62.00	$180.00	$4.50–$280.95	46% below	66%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG PROFILE BLOOD (13 DRUGS)*	$62.00	$180.00	$4.50–$280.95	46% below	66%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG PRESUMPTIVE SCREENING	$62.00	$75.00	$4.50–$280.95	46% below	17%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DIAZEPAM (VALIUM)	$62.00	$171.57	$4.50–$280.95	46% below	64%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COTININE SCREEN	$62.00	$78.10	$4.50–$280.95	46% below	21%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COTININE LEVEL URINE	$62.00	$15.00	$4.50–$280.95	46% below	-313%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BUPRENORPHINE URINE	$62.00	$75.00	$4.50–$280.95	46% below	17%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BENZODIAZEPINE SCREEN WITH CONFIR WB	$62.00	$280.95	$4.50–$280.95	46% below	78%
Drug screen by lab instrument (any number of drug classes) CPT 80307 *RL ETHYL GLUCURONIDE	$62.00	$175.00	$4.50–$280.95	46% below	65%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 CL ELECTROLYTES	$7.00	$11.00	$3.30–$203.00	89% below	36%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES	$7.00	$203.00	$3.30–$203.00	89% below	97%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 LC ELECTROLYTE PANEL	$7.00	$203.00	$3.30–$203.00	89% below	97%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGG CAPSID AG	$18.00	$81.50	$18.14–$81.50	78% below	78%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGM CAPSID AG	$18.00	$61.10	$18.14–$81.50	78% below	71%
Estradiol blood test CPT 82670 ESTRADIOL SENSITIVE	$27.00	$50.00	$15.00–$122.80	79% below	46%
Estradiol blood test CPT 82670 ESTRADIOL	$27.00	$50.00	$15.00–$122.80	79% below	46%
Estradiol blood test CPT 82670 ESTRADIOL FREE	$27.00	$50.00	$15.00–$122.80	79% below	46%
Estradiol blood test CPT 82670 CL ESTRADIOL	$27.00	$50.00	$15.00–$122.80	79% below	46%
Estradiol blood test CPT 82670 ESTRADIOL ENDO SCIENCE	$27.00	$122.80	$15.00–$122.80	79% below	78%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$18.00	$81.10	$9.60–$81.10	86% below	78%
FSH (follicle-stimulating hormone) test CPT 83001 FSH 24HR URINE	$18.00	$32.00	$9.60–$81.10	86% below	44%
FSH (follicle-stimulating hormone) test CPT 83001 CL FOLLICLE STIMULATING HORMONE	$18.00	$81.10	$9.60–$81.10	86% below	78%
Fecal calprotectin (stool inflammation test) CPT 83993 *RL CALPROTECTIN, FECAL	$19.00	$300.00	$19.63–$300.00	90% below	94%
Ferritin blood test (iron stores) CPT 82728 LC FERRITN	$13.00	$120.00	$13.63–$120.00	84% below	89%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$13.00	$120.00	$13.63–$120.00	84% below	89%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$9.00	$40.00	$9.72–$40.00	85% below	78%
Folate (folic acid) blood test CPT 82746 CL FOLATE SERUM - 82746 - 5000980	$14.00	$28.50	$8.55–$192.00	82% below	51%
Folate (folic acid) blood test CPT 82746 FOLATE SERUM - 82746 - 5016806	$14.00	$28.50	$8.55–$192.00	82% below	51%
Folate (folic acid) blood test CPT 82746 FOLATE SERUM - 82746 - 5016805	$14.00	$192.00	$8.55–$192.00	82% below	93%
Folate (folic acid) blood test CPT 82746 CL FOLATE SERUM - 82746 - 5001040	$14.00	$130.00	$8.55–$192.00	82% below	89%
Free T3 thyroid hormone test CPT 84481 LC T3 FREE	$16.00	$56.20	$16.86–$56.20	88% below	72%
Free T3 thyroid hormone test CPT 84481 CL T3 FREE	$16.00	$56.20	$16.86–$56.20	88% below	72%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$16.00	$56.20	$16.86–$56.20	88% below	72%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$9.00	$172.00	$6.60–$172.00	89% below	95%
Free T4 (free thyroxine) thyroid blood test CPT 84439 LC T4 FREE	$9.00	$172.00	$6.60–$172.00	89% below	95%
Free T4 (free thyroxine) thyroid blood test CPT 84439 *RL FREE T4 BY DIALYSISMASS SPEC	$9.00	$130.30	$6.60–$172.00	89% below	93%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (T4) FREE, DIRECT	$9.00	$22.00	$6.60–$172.00	89% below	59%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROID CASCADE PROFILE -REFLEX-T4 FREE	$9.00	$24.40	$6.60–$172.00	89% below	63%
Free T4 (free thyroxine) thyroid blood test CPT 84439 CL T4 FREE	$9.00	$172.00	$6.60–$172.00	89% below	95%
Free testosterone test CPT 84402 CL TESTOSTERONE FREE	$25.00	$32.60	$9.78–$65.20	70% below	23%
Free testosterone test CPT 84402 CL TESTOSTERONE TOTAL AND FREE	$25.00	$65.20	$9.78–$65.20	70% below	62%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$25.00	$32.60	$9.78–$65.20	70% below	23%
Free testosterone test CPT 84402 TESTOSTERONE, FREETOTAL EQUILIB	$25.00	$32.60	$9.78–$65.20	70% below	23%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$7.00	$60.00	$7.20–$60.00	78% below	88%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 LC GGT	$7.00	$60.00	$7.20–$60.00	78% below	88%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 CL GGT	$7.00	$60.00	$7.20–$60.00	78% below	88%
Glucose tolerance test, 3 samples CPT 82951 GTT 2 HOUR	$12.00	$154.00	$6.90–$154.00	84% below	92%
Glucose tolerance test, 3 samples CPT 82951 CL GTT 3HR GEST	$12.00	$23.00	$6.90–$154.00	84% below	48%
Glucose tolerance test, 3 samples CPT 82951 LACTOSE TOLERANCE 3 HOUR	$12.00	$23.00	$6.90–$154.00	84% below	48%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 HOUR	$12.00	$120.00	$6.90–$154.00	84% below	90%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE RECTAL SWAB	$35.00	$100.00	$8.25–$310.00	64% below	65%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC LCR-URINE	$35.00	$310.00	$8.25–$310.00	64% below	89%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE PHARYNGEAL SWAB	$35.00	$100.00	$8.25–$310.00	64% below	65%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC PAP CHARGE	$35.00	$27.50	$8.25–$310.00	64% below	-27%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC LCR PROBE	$35.00	$100.00	$8.25–$310.00	64% below	65%
H. pylori antibody blood test CPT 86677 H PYLORI IGM	$16.00	$57.00	$16.85–$100.00	83% below	72%
H. pylori antibody blood test CPT 86677 H PYLORI IGG	$16.00	$100.00	$16.85–$100.00	83% below	84%
H. pylori antibody blood test CPT 86677 H PYLORI IGA	$16.00	$58.05	$16.85–$100.00	83% below	72%
H. pylori antibody blood test CPT 86677 H PYLORI IGG (IN HOUSE)	$16.00	$100.00	$16.85–$100.00	83% below	84%
H. pylori stool antigen test CPT 87338 H PYLORI AG FECES	$14.00	$150.00	$14.38–$150.00	89% below	91%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA PCR QUANT ULTRASENSITIVE	$85.00	$147.00	$44.10–$224.79	76% below	42%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA PCR QUANT	$85.00	$224.79	$44.10–$224.79	76% below	62%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV 1 RNA RT PCR 2	$85.00	$147.00	$44.10–$224.79	76% below	42%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 102 AB, PRELIMINARY TEST W CONFIR	$13.00	$56.40	$7.20–$56.40	78% below	77%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1&2 CONFIRMATION SBMF	$13.00	$24.00	$7.20–$56.40	78% below	46%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV AG WHIV-1 AND HIV-2 AB	$24.00	$69.50	$20.85–$69.50	60% below	65%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 102 ANTIGENANTIBODY REF (4TH GENE	$24.00	$69.50	$20.85–$69.50	60% below	65%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV- APTIMA	$35.00	$140.00	$15.00–$162.90	66% below	75%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV LOW AND HIGH RISK CHARGE ONLY	$35.00	$50.00	$15.00–$162.90	66% below	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH AND LOW RISK	$35.00	$162.90	$15.00–$162.90	66% below	79%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$9.00	$149.00	$5.10–$149.00	86% below	94%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C WITH eAG	$9.00	$149.00	$5.10–$149.00	86% below	94%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 CL HEMOGLOBIN A1C	$9.00	$17.00	$5.10–$149.00	86% below	47%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB TOTAL	$12.00	$50.00	$12.05–$50.00	82% below	76%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 EMPLOYEE HEPATITIS B SURFACE AB	$10.00	$50.00	$5.70–$159.00	85% below	80%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HIV SCREEN ABAG	$10.00	$159.00	$5.70–$159.00	85% below	94%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$10.00	$50.00	$5.70–$159.00	85% below	80%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS BS AB-QUANTITATIVE	$10.00	$19.00	$5.70–$159.00	85% below	47%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBV GENOTYPE	$10.00	$610.89	$7.05–$610.89	84% below	98%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG	$10.00	$23.50	$7.05–$610.89	84% below	57%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS DIAGNOSTIC (PROF I)	$10.00	$98.70	$7.05–$610.89	84% below	90%
Hepatitis C antibody blood test (screening) CPT 86803 HCV AB WREFLEX TO VERIFICATUA	$14.00	$51.90	$7.50–$51.90	86% below	73%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS CRIBA REFLEX	$14.00	$51.90	$7.50–$51.90	86% below	73%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$14.00	$51.90	$7.50–$51.90	86% below	73%
Hepatitis C antibody blood test (screening) one side CPT 86803 HCV ANTIBODY REFLEX TO QUANT RT PCR	$14.00	$25.00	$7.50–$51.90	86% below	44%
Hepatitis C viral load (HCV RNA) test CPT 87522 *RL HEPATITIS C RNA BY PCR	$42.00	$163.71	$42.84–$222.00	81% below	74%
Hepatitis C viral load (HCV RNA) test CPT 87522 *RL HCV QUANT, RNA RFLX TO GENOTY 550090	$42.00	$200.37	$42.84–$222.00	81% below	79%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 *RL HCV RT-PCR QUANT (NON-GRAPH) 550080	$42.00	$222.00	$42.84–$222.00	81% below	81%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES AB TYPE I IGM	$13.00	$171.41	$13.19–$171.41	74% below	92%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES AB TYPE I IGG	$13.00	$100.00	$13.19–$171.41	74% below	87%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES AB TYPE I IGG, TYPE SPECIFIC	$13.00	$120.00	$13.19–$171.41	74% below	89%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES AB TYPE 2 IGM	$19.00	$176.00	$19.35–$203.00	74% below	89%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES AB TYPE 2 IGG, TYPE SPECIFIC CHAR	$19.00	$203.00	$19.35–$203.00	74% below	91%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES AB TYPE 2 IGG	$19.00	$100.00	$19.35–$203.00	74% below	81%
High-sensitivity CRP (hs-CRP) test CPT 86141 C REACTIVE PROTEIN HIGH SENSITIVITY	$12.00	$69.20	$12.95–$69.20	84% below	83%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$17.00	$61.10	$17.92–$66.10	87% below	72%
Homocysteine blood test CPT 83090 CL HOMOCYSTEINE	$17.00	$66.10	$17.92–$66.10	87% below	74%
Insulin blood test CPT 83525 INSULIN TOTAL CHARGE ONLY	$11.00	$33.70	$10.11–$33.70	85% below	67%
Insulin blood test CPT 83525 INSULIN	$11.00	$33.70	$10.11–$33.70	85% below	67%
Iron blood test (serum iron) CPT 83540 IRON	$6.00	$123.12	$6.47–$123.12	88% below	95%
Iron blood test (serum iron) CPT 83540 LC IRON	$6.00	$123.12	$6.47–$123.12	88% below	95%
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$8.00	$122.00	$8.74–$122.00	82% below	93%
LH (luteinizing hormone) test CPT 83002 LH 24 HR URINE	$18.00	$32.00	$9.60–$105.90	87% below	44%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$18.00	$105.90	$9.60–$105.90	87% below	83%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$11.00	$100.00	$11.57–$100.00	88% below	89%
Lactate (lactic acid) blood test CPT 83605 *POC LACTIC ACID	$11.00	$100.00	$11.57–$100.00	88% below	89%
Lactate dehydrogenase (LDH) blood test CPT 83615 CL LDH	$6.00	$50.00	$6.04–$100.00	86% below	88%
Lactate dehydrogenase (LDH) blood test CPT 83615 IU LDH BODY FLUID	$6.00	$100.00	$6.04–$100.00	86% below	94%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$6.00	$50.00	$6.04–$100.00	86% below	88%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID	$6.00	$22.50	$6.04–$100.00	86% below	73%
Lipase blood test (pancreas enzyme) CPT 83690 LC LIPASE	$6.00	$162.00	$6.89–$162.00	93% below	96%
Lipase blood test (pancreas enzyme) CPT 83690 *LIPASE	$6.00	$162.00	$6.89–$162.00	93% below	96%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE BODY FLUID	$6.00	$106.25	$6.89–$162.00	93% below	94%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE SERUM	$6.00	$162.00	$6.89–$162.00	93% below	96%
Lyme disease antibody test CPT 86618 LYME DISEASE CHARGE ONLY	$17.00	$75.00	$17.03–$155.00	86% below	77%
Lyme disease antibody test CPT 86618 B BURGDORFERI IGG ANTIBODY	$17.00	$75.00	$17.03–$155.00	86% below	77%
Lyme disease antibody test CPT 86618 LYMES IGM EIA	$17.00	$93.65	$17.03–$155.00	86% below	82%
Lyme disease antibody test CPT 86618 LYME DISEASE BORRELIA BURGDORFERI C6 ANT	$17.00	$155.00	$17.03–$155.00	86% below	89%
Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL ANTIBODY RFX TO IMMUN	$17.00	$100.00	$17.03–$155.00	86% below	83%
Magnesium blood test CPT 83735 MAGNESIUM - RBC	$6.00	$168.60	$6.70–$168.60	87% below	96%
Magnesium blood test CPT 83735 MAGNESIUM 24HR URINE	$6.00	$32.60	$6.70–$168.60	87% below	82%
Magnesium blood test CPT 83735 LC MAGNESIUM	$6.00	$133.90	$6.70–$168.60	87% below	96%
Magnesium blood test CPT 83735 MAGNESIUM	$6.00	$133.90	$6.70–$168.60	87% below	96%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG AB	$12.00	$28.50	$6.90–$28.50	85% below	58%
Measles (rubeola) antibody test CPT 86765 EMPLOYEE RUBEOLA IGG AB	$12.00	$28.50	$6.90–$28.50	85% below	58%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM	$12.00	$23.00	$6.90–$28.50	85% below	48%
Mumps immunity blood test CPT 86735 MUMPS IGM AB	$13.00	$24.40	$7.32–$24.40	83% below	47%
Mumps immunity blood test CPT 86735 EMPLOYEE MUMPS IGG	$13.00	$24.40	$7.32–$24.40	83% below	47%
Mumps immunity blood test CPT 86735 MUMPS IGG	$13.00	$24.40	$7.32–$24.40	83% below	47%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$18.00	$178.16	$18.39–$178.16	74% below	90%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA ULTRASENSITIVE	$18.00	$65.20	$18.39–$178.16	74% below	72%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$18.00	$206.99	$9.60–$206.99	77% below	91%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL-DIAGNOSTIC - 84153 - 5080110	$18.00	$32.00	$9.60–$206.99	77% below	44%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL-DIAGNOSTIC - 84153 - 5001992	$18.00	$206.99	$9.60–$206.99	77% below	91%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC -ALL COMMERCIAL PAYERS	$18.00	$206.99	$9.60–$206.99	77% below	91%
PSA (prostate-specific antigen) blood test, total CPT 84153 LC PSA	$18.00	$206.99	$9.60–$206.99	77% below	91%
PSA (prostate-specific antigen) blood test, total CPT 84153 CL PSA DIAGNOSTIC	$18.00	$206.99	$9.60–$206.99	77% below	91%
PSA (prostate-specific antigen) blood test, total CPT 84153 CHARGE ONLY PSA TOTAL-DIAGNOSTIC ONLY	$18.00	$32.00	$9.60–$206.99	77% below	44%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH CV AUTO FLUID REDO	$26.00	$240.00	$13.50–$240.00	69% below	89%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP DIAG WHPV HIGH & LOW RISK	$26.00	$45.00	$13.50–$240.00	69% below	42%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATHOLOGY CERVICAL OR VAGINAL CHARGE	$26.00	$50.00	$13.50–$240.00	69% below	48%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP IG WITH RFLX HIGH RISK HPV WHEN ASCU	$26.00	$45.00	$13.50–$240.00	69% below	42%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP DIAGNOSTIC WHPV HIGH RISK	$26.00	$45.00	$13.50–$240.00	69% below	42%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP LB, RFX HPV ASCU	$20.00	$85.50	$12.60–$144.00	71% below	77%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP THIN PREP CHARGE ONLY	$20.00	$42.00	$12.60–$144.00	71% below	52%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SCREENING THIN PREP	$20.00	$144.00	$12.60–$144.00	71% below	86%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTACT	$41.00	$48.00	$14.40–$48.00	79% below	15%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT PLASMA	$6.00	$164.19	$6.01–$164.19	88% below	96%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$4.00	$84.30	$4.74–$84.30	86% below	95%
Phosphorus (phosphate) blood test CPT 84100 CL PHOSPHORUS	$4.00	$84.30	$4.74–$84.30	86% below	95%
Phosphorus (phosphate) blood test CPT 84100 LC PHOSPHORUS	$4.00	$84.30	$4.74–$84.30	86% below	95%
Potassium blood test CPT 84132 POTASSIUM BODY FLUID	$4.00	$8.00	$2.40–$80.00	86% below	50%
Potassium blood test CPT 84132 POTASSIUM	$4.00	$80.00	$2.40–$80.00	86% below	95%
Potassium blood test CPT 84132 CL POTASSIUM	$4.00	$8.00	$2.40–$80.00	86% below	50%
Potassium blood test CPT 84132 *POC POTASSIUM	$4.00	$80.00	$2.40–$80.00	86% below	95%
Progesterone blood test CPT 84144 *RL PROGESTERONE	$20.00	$33.70	$10.11–$33.70	85% below	41%
Progesterone blood test CPT 84144 CL PROGESTERONE	$20.00	$33.70	$10.11–$33.70	85% below	41%
Prolactin blood test CPT 84146 PROLACTIN	$19.00	$32.60	$9.78–$32.60	81% below	42%
Prothrombin time (PT/INR) clotting test CPT 85610 PTINR - CAPILLARY	$4.00	$40.00	$2.10–$134.60	85% below	90%
Prothrombin time (PT/INR) clotting test CPT 85610 CL PT	$4.00	$7.00	$2.10–$134.60	85% below	43%
Prothrombin time (PT/INR) clotting test CPT 85610 PT	$4.00	$134.60	$2.10–$134.60	85% below	97%
Prothrombin time (PT/INR) clotting test CPT 85610 PTINR - CC	$4.00	$40.00	$2.10–$134.60	85% below	90%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 TRICYCLICATES URINE SCREEN	$12.00	$159.33	$7.20–$271.00	88% below	92%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 GHB ACID SCREEN	$12.00	$130.00	$7.20–$271.00	88% below	91%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 FLUNITRAZEPAM URINE SCREEN	$12.00	$25.00	$7.20–$271.00	88% below	52%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN DOT	$12.00	$25.00	$7.20–$271.00	88% below	52%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN MEDICAL	$12.00	$271.00	$7.20–$271.00	88% below	96%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG PROFILE BLOOD (11 DRUGS)*	$12.00	$102.80	$7.20–$271.00	88% below	88%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 COCAINE URINE SCREEN	$12.00	$159.33	$7.20–$271.00	88% below	92%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 METHADONE SCREEN AND CONFIRMATION, URINE	$12.00	$24.00	$7.20–$271.00	88% below	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 CL STREP A SCREEN	$16.00	$21.00	$6.30–$172.06	79% below	24%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID GROUP B	$16.00	$21.00	$6.30–$172.06	79% below	24%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP POSITIVE CHARGE	$16.00	$30.00	$6.30–$172.06	79% below	47%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID GROUP A	$16.00	$172.06	$6.30–$172.06	79% below	91%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 CL RAPID GROUP A	$16.00	$21.00	$6.30–$172.06	79% below	24%
Renin blood test CPT 84244 RENIN	$21.00	$86.85	$21.99–$86.85	81% below	76%
Rh blood typing CPT 86901 BB RH	$39.00	$152.55	$2.99–$152.55	1% above	74%
Rh blood typing CPT 86901 BBR RH	$39.00	$45.77	$2.99–$152.55	1% above	15%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID ARTHRITIS (RA) FACTOR	$5.00	$30.00	$3.00–$43.49	90% below	83%
Rheumatoid factor (RF) test CPT 86431 LUPUS PANEL 2	$5.00	$10.00	$3.00–$43.49	90% below	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR, IgA	$5.00	$43.49	$3.00–$43.49	90% below	89%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR, IgG	$5.00	$43.49	$3.00–$43.49	90% below	89%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR, IgM	$5.00	$43.49	$3.00–$43.49	90% below	89%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM AB	$14.00	$25.00	$7.32–$25.00	79% below	44%
Rubella antibody test (immunity check) CPT 86762 RUBELLA QUANTITATIVE	$14.00	$25.00	$7.32–$25.00	79% below	44%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG	$14.00	$24.40	$7.32–$25.00	79% below	43%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM	$14.00	$24.40	$7.32–$25.00	79% below	43%
Rubella antibody test (immunity check) CPT 86762 EMPLOYEE RUBELLA IGG	$14.00	$24.40	$7.32–$25.00	79% below	43%
Sodium blood test CPT 84295 SODIUM	$4.00	$84.00	$2.40–$84.00	89% below	95%
Sodium blood test CPT 84295 CL SODIUM	$4.00	$8.00	$2.40–$84.00	89% below	50%
Sodium blood test CPT 84295 *POC SODIUM	$4.00	$84.00	$2.40–$84.00	89% below	95%
Stool ova and parasites exam CPT 87177 *RL OVA & PARASIT URINE	$8.00	$72.50	$8.90–$72.50	84% below	89%
Stool ova and parasites exam CPT 87177 ..TEST OVA & PARASITE*	$8.00	$72.50	$8.90–$72.50	84% below	89%
Stool ova and parasites exam CPT 87177 OVA & PARASITE*	$8.00	$72.50	$8.90–$72.50	84% below	89%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD, FECES, SCREEN #1	$4.00	$59.30	$4.38–$59.30	89% below	93%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLO, OCC FECAL HEMO QUALI FECES 1-3 DET	$15.00	$49.00	$14.70–$88.35	71% below	69%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD FECAL IMMUNOASSAY	$15.00	$88.35	$14.70–$88.35	71% below	83%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM IGM ELISA	$13.00	$175.00	$13.24–$180.00	81% below	93%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM IGG ELISA	$13.00	$180.00	$13.24–$180.00	81% below	93%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS	$13.00	$48.90	$13.24–$180.00	81% below	73%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM ANTIBODIES	$13.00	$48.90	$13.24–$180.00	81% below	73%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM SCREENING CASCADE	$13.00	$48.90	$13.24–$180.00	81% below	73%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR WREFLEX QUANT RPR AND CONF TP-PA	$4.00	$16.30	$3.00–$81.90	90% below	75%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL WITH REFLEX TO TITER	$4.00	$81.90	$3.00–$81.90	90% below	95%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$4.00	$16.30	$3.00–$81.90	90% below	75%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 CSF-VDRL	$4.00	$10.00	$3.00–$81.90	90% below	60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD PLUS	$61.00	$550.00	$60.00–$550.00	59% below	89%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 EMP INCUBATED QUANTIFERON TB GOLD PLUS	$61.00	$200.00	$60.00–$550.00	59% below	70%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 EMPL QUANTIFERON TB GOLD PLUS	$61.00	$340.20	$60.00–$550.00	59% below	82%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 INCUBATED QUANTIFERON TB GOLD	$61.00	$200.00	$60.00–$550.00	59% below	70%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 INCUBATED QUANTIFERON TB GOLD PLUS	$61.00	$200.00	$60.00–$550.00	59% below	70%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$61.00	$550.00	$60.00–$550.00	59% below	89%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE WOMENCHILD	$25.00	$66.50	$19.95–$66.50	79% below	62%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$25.00	$66.50	$19.95–$66.50	79% below	62%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL LCMS	$25.00	$66.50	$19.95–$66.50	79% below	62%
Testosterone blood test, total (not free testosterone) CPT 84403 CL TESTOSTERONE TOTAL	$25.00	$66.50	$19.95–$66.50	79% below	62%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB	$14.00	$48.90	$7.80–$62.45	85% below	71%
Thyroid peroxidase (TPO) antibody test CPT 86376 LUPUS PANEL 8	$14.00	$26.00	$7.80–$62.45	85% below	46%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOME AB	$14.00	$62.45	$7.80–$62.45	85% below	78%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID CASCADE PROFILE -REFLEX TO TPO	$14.00	$37.10	$7.80–$62.45	85% below	62%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 LC TSH	$16.00	$211.92	$11.13–$211.92	80% below	92%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$16.00	$211.92	$11.13–$211.92	80% below	92%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 CL TSH	$16.00	$211.92	$11.13–$211.92	80% below	92%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w reflex to FT4	$16.00	$211.92	$11.13–$211.92	80% below	92%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID CASCADE PROFILE - T3 FREE	$16.00	$103.80	$11.13–$211.92	80% below	85%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID CASCADE PROFILE INITIAL	$16.00	$37.10	$11.13–$211.92	80% below	57%
Total IgE blood test CPT 82785 IGE	$16.00	$42.50	$12.75–$42.50	79% below	62%
Total cholesterol blood test CPT 82465 CL CHOLESTEROL	$4.00	$8.00	$2.40–$40.00	87% below	50%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$4.00	$40.00	$2.40–$40.00	87% below	90%
Total thyroxine (T4) blood test CPT 84436 LC T4	$6.00	$133.43	$3.60–$133.43	87% below	96%
Total thyroxine (T4) blood test CPT 84436 CL T4	$6.00	$133.43	$3.60–$133.43	87% below	96%
Total thyroxine (T4) blood test CPT 84436 CL T4 TOTAL T4 FREE	$6.00	$12.00	$3.60–$133.43	87% below	50%
Total thyroxine (T4) blood test CPT 84436 T4 TOTAL	$6.00	$133.43	$3.60–$133.43	87% below	96%
Total triiodothyronine (T3) blood test CPT 84480 CL T3 TOTAL	$14.00	$36.70	$11.01–$36.70	88% below	62%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$14.00	$36.70	$11.01–$36.70	88% below	62%
Transferrin blood test CPT 84466 TRANSFERRIN	$12.00	$24.40	$7.32–$24.40	86% below	51%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS NAA	$35.00	$100.00	$10.50–$100.00	63% below	65%
Trichomonas test (NAAT) CPT 87661 TRICH PAP CHARGE ONLY	$35.00	$35.00	$10.50–$100.00	63% below	—
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$5.00	$116.00	$5.74–$116.00	86% below	96%
Triglycerides blood test CPT 84478 TRIGLYCERIDES BODY FLUID	$5.00	$22.50	$5.74–$116.00	86% below	78%
Troponin test, quantitative CPT 84484 * TRIAGE TROPONIN I	$12.00	$90.00	$12.47–$90.00	90% below	87%
Troponin test, quantitative CPT 84484 TROPONIN HS	$12.00	$90.00	$12.47–$90.00	90% below	87%
Troponin test, quantitative CPT 84484 TROPONIN I	$12.00	$90.00	$12.47–$90.00	90% below	87%
Urinalysis without microscope exam, manual CPT 81002 ACETONE URINE, DIPSTICK	$3.00	$5.00	$1.50–$6.00	81% below	40%
Urinalysis without microscope exam, manual CPT 81002 CL CLINITEST CHARGE	$3.00	$6.00	$1.50–$6.00	81% below	50%
Urinalysis without microscope exam, manual CPT 81002 CL ICTOTEST	$3.00	$6.00	$1.50–$6.00	81% below	50%
Urinalysis without microscope exam, manual CPT 81002 SP GRAVITY, URINE	$3.00	$5.00	$1.50–$6.00	81% below	40%
Urinalysis without microscope exam, manual CPT 81002 CL CLINITEST	$3.00	$5.00	$1.50–$6.00	81% below	40%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$8.00	$70.00	$8.07–$70.00	82% below	89%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN SCREEN	$5.00	$50.00	$5.78–$50.00	86% below	90%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN 24HR URINE	$5.00	$44.80	$5.78–$50.00	86% below	89%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMINCREATININE RATIO URINE	$5.00	$50.00	$5.78–$50.00	86% below	90%
Urine microalbumin (albumin) test CPT 82043 ALBUMINCREATININE RATIO URINE	$5.00	$50.00	$5.78–$50.00	86% below	90%
Urine pregnancy test, read by color change CPT 81025 CL HCG URINE	$8.00	$11.00	$3.30–$198.92	85% below	27%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE	$8.00	$198.92	$3.30–$198.92	85% below	96%
Vitamin B12 (cobalamin) blood test CPT 82607 B-12	$15.00	$192.63	$15.08–$192.63	80% below	92%
Vitamin B12 (cobalamin) blood test CPT 82607 CL VIT B-12	$15.00	$192.63	$15.08–$192.63	80% below	92%
Vitamin B12 (cobalamin) blood test CPT 82607 LC VIT B12	$15.00	$192.63	$15.08–$192.63	80% below	92%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-OH	$29.00	$314.00	$23.85–$314.00	78% below	91%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CL VITAMIN D 25-HYDROXY	$29.00	$236.20	$23.85–$314.00	78% below	88%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITD	$29.00	$314.00	$23.85–$314.00	78% below	91%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 LC VITAMIN D 25-HYDROXY	$29.00	$314.00	$23.85–$314.00	78% below	91%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D,25-HYDROXY, FRACTIONATED (D,D2,D3)	$29.00	$79.50	$23.85–$314.00	78% below	64%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D	$29.00	$314.00	$23.85–$314.00	78% below	91%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1 25-DIHYDROXY	$38.00	$157.60	$38.50–$157.60	79% below	76%
Zinc blood test CPT 84630 ZINC - PLASMA	$11.00	$125.00	$11.39–$125.00	87% below	91%
Zinc blood test CPT 84630 ZINC - WHOLE BLOOD	$11.00	$125.00	$11.39–$125.00	87% below	91%
Zinc blood test CPT 84630 ZINC - RBC	$11.00	$125.00	$11.39–$125.00	87% below	91%
Zinc blood test CPT 84630 ZINC - URINE	$11.00	$125.00	$11.39–$125.00	87% below	91%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TUMOR MARKER MALE	$15.00	$50.00	$3.90–$130.00	81% below	70%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANT	$15.00	$130.00	$3.90–$130.00	81% below	88%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG MARKER	$15.00	$13.00	$3.90–$130.00	81% below	-15%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Appendectomy, open surgery CPT 44950 Appendectomy	$6,815.00	$4,903.50	$1,471.05–$4,903.50	at median	-39%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 US BREAST VACUUM ASSIST	$1,738.00	$3,221.37	$966.41–$3,221.37	31% below	46%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX DISTAL FIBULAR FX (LAT MAL)WO	$259.00	$230.00	$69.00–$230.00	34% below	-13%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Cor hlx vlgs dstl mtar osteo	$3,444.00	$6,627.80	$1,905.42–$6,627.80	64% below	48%
Bunion correction with removal of part of the big toe joint CPT 28292 Cor hlx vlgs rsc prx phlx bs	$3,444.00	$7,970.50	$2,391.15–$7,970.50	38% below	57%
Cardiac catheterization with coronary angiogram one side CPT 93458 LEFT HRT CATH WITH CORONARY ANGIO	$3,413.00	$15,951.70	$3,413.18–$15,951.70	65% below	79%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL	$695.00	$1,795.84	$538.75–$1,795.84	50% below	61%
Colonoscopy with tissue sample CPT 45380 Colonoscopy and biopsy	$1,259.00	$2,495.41	$748.62–$2,495.41	57% below	50%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLX DX WCOLL SPEC	$979.00	$3,368.68	$979.08–$3,368.68	52% below	71%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT - 52332 -	$3,711.00	$8,988.00	$1,728.79–$8,988.00	47% below	59%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$734.00	$3,500.00	$734.13–$3,500.00	73% below	79%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL FB FROM EXTERNAL AUDITORY CANAL	$62.00	$278.30	$38.10–$278.30	65% below	78%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN WIRRIGATIONLA	$62.00	$127.00	$38.10–$278.30	65% below	51%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN WINST	$62.00	$127.00	$38.10–$127.00	61% below	51%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ EPI SUARACH CT W IMG GD	$743.00	$3,221.70	$743.16–$3,221.70	30% below	77%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT FAC JT LS 1 LVL	$931.00	$4,260.90	$931.19–$4,260.90	19% below	78%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Rpr aa hrn 1st 3-10 rdc	$6,815.00	$11,644.33	$3,493.30–$11,644.33	64% below	41%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 Rpr aa hrn 1st > 10 rdc	$6,815.00	$12,004.00	$3,571.00–$12,004.00	78% below	43%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Rpr aa hrn 1st < 3 cm rdc	$3,769.00	$10,280.38	$3,084.11–$10,280.38	58% below	63%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Diagnostic sigmoidoscopy	$979.00	$1,711.50	$513.45–$1,711.50	53% below	43%
Gallbladder removal, laparoscopic CPT 47562 Laparoscopic cholecystectomy	$6,364.00	$13,365.02	$4,009.51–$13,365.02	61% below	52%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Laparo cholecystectomygraph	$6,364.00	$12,836.00	$3,850.80–$12,836.00	63% below	50%
Hammertoe correction surgery CPT 28285 Repair of hammertoe	$3,444.00	$6,466.55	$1,905.42–$6,466.55	72% below	47%
Hemorrhoid banding (rubber band ligation) CPT 46221 Ligation of hemorrhoid(s)	$979.00	$1,687.75	$506.33–$1,687.75	55% below	42%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D SIMPLE	$211.00	$589.15	$176.75–$589.15	54% below	64%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Prp ihern init reduc >5 yr	$3,769.00	$9,416.67	$2,273.62–$9,416.67	57% below	60%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDONLIGAMENTGANGL CYST.	$323.00	$647.00	$194.10–$1,359.45	40% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ(S) SNGL TENDON SHEATH	$323.00	$1,359.45	$194.10–$1,359.45	40% below	76%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 ARTHROCENTESIS MAJOR JT PERCUTA BI	$323.00	$1,118.80	$109.64–$1,359.45	—	71%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAININJECT MAJOR JOINTBURSA WO USG	$323.00	$365.46	$109.64–$1,359.45	22% below	12%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAININJ LG INTBURSA WO US	$323.00	$1,359.45	$109.64–$1,359.45	22% below	76%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHROCENTESIS MAJ JOINT PERCUTA RT WSG	$323.00	$771.50	$109.64–$1,359.45	22% below	58%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHROCENTESIS MAJOR JT PERCUTA LT WOUG	$323.00	$771.50	$109.64–$1,359.45	22% below	58%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPINJ INTERMED JNTBURSA	$323.00	$1,359.45	$194.10–$1,359.45	24% below	76%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAININJECT INTERMED JOINTBURSA	$323.00	$647.00	$194.10–$1,359.45	24% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ARTHROCENTESIS MEDIUM JOINT PERCUTA RT	$323.00	$651.00	$194.10–$1,359.45	24% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ARTHROCENTESIS MEDIUM JOINT PERCUTA LT	$323.00	$651.00	$194.10–$1,359.45	24% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAININJECT SMALL JOINT OR BURSA	$323.00	$647.00	$109.46–$647.00	10% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTISIS SMALL JOINT OR BURSA	$323.00	$364.86	$109.46–$647.00	10% above	11%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Laparoscopy appendectomy	$6,364.00	$15,723.12	$1,905.42–$15,723.12	55% below	60%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Lap ing hernia repair init	$6,364.00	$14,810.18	$2,273.62–$14,810.18	62% below	57%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Lap ing hernia repair recur	$6,364.00	$14,064.50	$3,957.76–$14,064.50	60% below	55%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC REPAIR INTERM <2.5, SATE NO HNDFT	$427.00	$1,040.00	$312.00–$1,040.00	41% below	59%
Left heart catheterization, diagnostic CPT 93452 L HRT CATH WVENTRCLGRPHY	$3,413.00	$12,272.00	$3,413.18–$12,272.00	56% below	72%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ SPINE LS WFL	$743.00	$3,221.70	$743.16–$3,221.70	42% below	77%
Lower-back epidural injection, without imaging guidance CPT 62322 INJECT SPINE LUMBARSACRAL	$931.00	$1,714.00	$514.20–$1,714.00	34% below	46%
Lower-back epidural injection, without imaging guidance CPT 62322 LUMBAR EPIDURAL INJ	$931.00	$1,714.00	$514.20–$1,714.00	34% below	46%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ AASTRD LUMBARSACRAL ADDL - 64483 - 13064483	$931.00	$4,260.90	$931.19–$4,260.90	43% below	78%
Lumpectomy (partial mastectomy) CPT 19301 Partial mastectomy	$4,122.00	$6,145.00	$1,843.50–$6,145.00	47% below	33%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BEN LES TAL 0.5CM OR LESS	$745.00	$2,896.70	$381.15–$2,896.70	67% below	74%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL-SIMPLE,SINGLE	$211.00	$589.15	$176.75–$589.15	47% below	64%
Occipital nerve block (injection for headaches) CPT 64405 INJECTIONS ANESTHETIC GRTR OCCIPITAL NER	$323.00	$647.00	$194.10–$1,359.45	47% below	50%
Occipital nerve block (injection for headaches) CPT 64405 INJ AASTRD GR OCCIPITAL NRV	$323.00	$1,359.45	$194.10–$1,359.45	47% below	76%
Pacemaker implant (dual chamber) CPT 33208 BIVENTRICULAR PACEMAKER	$11,004.00	$29,054.20	$2,601.00–$29,054.20	9% below	62%
Pacemaker implant (dual chamber) CPT 33208 CRT-P INSRTRPL PACER ATRVENT	$11,004.00	$29,054.20	$2,601.00–$29,054.20	9% below	62%
Paracentesis with imaging guidance CPT 49083 CT PERCU ABD PARACENTESIS INITIAL	$954.00	$1,155.90	$346.77–$2,435.87	31% below	17%
Paracentesis with imaging guidance CPT 49083 US PERCU ABD PARACENTESIS INITIAL	$954.00	$2,435.87	$346.77–$2,435.87	31% below	61%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal of nail bed	$427.00	$6,205.50	$427.98–$6,205.50	39% below	93%
Prostate biopsy CPT 55700 US PERCU PROSTATE BIOPSY	$2,111.00	$2,904.51	$871.35–$2,904.51	41% below	27%
Prostate biopsy CPT 55700 BIOPSY PROSTATE	$2,111.00	$2,904.51	$871.35–$2,904.51	41% below	27%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DSTR LS FA JT FLCT	$2,055.00	$8,987.60	$2,055.88–$8,987.60	38% below	77%
Removal of a breast lump, open surgery CPT 19120 Removal of breast lesion	$4,122.00	$46,328.10	$1,905.42–$46,328.10	18% below	91%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FB SUB Q SIMPLE	$427.00	$1,127.75	$338.33–$1,127.75	31% below	62%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 TOTAL THYROID LOBECTOMY,UNILATERAL	$6,364.00	$19,884.00	$1,728.79–$19,884.00	36% below	68%
Short arm cast (elbow to hand) CPT 29075 CAST - SHORT ARM	$294.00	$574.00	$172.20–$574.00	19% below	49%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT (FOREARM-H)	$140.00	$530.00	$140.07–$530.00	23% below	74%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST BELOW KNEE	$294.00	$1,231.90	$194.84–$1,231.90	22% below	76%
Short leg cast (below the knee) CPT 29405 CAST - SHORT LEG	$294.00	$649.46	$194.84–$1,231.90	22% below	55%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT (CALF-FOOT)	$171.00	$596.20	$171.08–$596.20	29% below	71%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC REPAIR SIMPLE<2.5CM, SNAGTE	$211.00	$700.00	$210.00–$700.00	52% below	70%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN; SINGLE LESION	$427.00	$360.00	$108.00–$360.00	5% below	-19%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION OF MALIGNANT LESION 0.5CM OR <	$745.00	$3,351.80	$648.18–$3,351.80	54% above	78%
Skin tag removal, up to 15 tags CPT 11200 RMVL SKN TAGS MLT FIBRQ TAGS ANY AREA UP	$211.00	$917.00	$211.23–$917.00	25% below	77%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMB DX	$743.00	$1,160.31	$348.09–$1,160.31	28% below	36%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC	$743.00	$1,160.31	$348.09–$1,160.31	28% below	36%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$743.00	$1,160.31	$348.09–$1,160.31	28% below	36%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC REPAIR SIMPLE2.6-7.5CM, SNAGTE	$211.00	$740.00	$211.23–$740.00	47% below	71%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC REPAIR SIMPLE 2.5CM OR LESS, FEENM	$211.00	$1,531.00	$86.70–$1,531.00	51% below	86%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 WOUND REPAIR COMPLEX	$211.00	$289.00	$86.70–$1,531.00	51% below	27%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC REPAIR SIMPLE-F,E,E,N,L<2.5CM	$211.00	$1,531.00	$86.70–$1,531.00	51% below	86%
TURP (transurethral resection of the prostate) CPT 52601 TRANSURET ELECTROSURG RESECT OF PROSTATE	$5,645.00	$12,290.00	$2,273.62–$12,290.00	65% below	54%
Thoracentesis with imaging guidance CPT 32555 CT PERCU THORACENTESIS	$660.00	$1,155.90	$346.77–$2,760.20	40% below	43%
Thoracentesis with imaging guidance CPT 32555 US PERCU THORACENTESIS	$660.00	$2,760.20	$346.77–$2,760.20	40% below	76%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ(S) TRIGGER PT 1 OR 2 MUSC	$323.00	$1,359.45	$194.10–$1,359.45	43% below	76%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT (1-2 MUSCLE GRPS)	$323.00	$647.00	$194.10–$1,359.45	43% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US PERCU BREAST BIOPSYCORE	$1,738.00	$4,709.90	$1,412.97–$4,709.90	25% below	63%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD - FLEX TR ORAL W BALLOON DIL <30MM	$2,020.00	$1,065.00	$319.50–$1,065.00	37% below	-90%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD - FLEX TR ORAL WBIOPSY	$954.00	$937.00	$281.10–$937.00	68% below	-2%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD - FLEXIBLE TRANSORAL - 43236 - 1420007	$954.00	$1,323.00	$396.90–$1,323.00	75% below	28%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD - FLEX TR ORAL W SNARE REMOVAL	$2,020.00	$1,212.00	$363.60–$1,212.00	49% below	-67%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD - FLEX TR ORAL WGUIDE WIRE	$954.00	$974.00	$292.20–$974.00	65% below	2%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD - FLEXIBLE TRANSORAL - 43235 - 1420006	$954.00	$808.00	$242.40–$808.00	60% below	-18%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 EGD - FLEX TR ORAL WDRAINAGE	$6,391.00	$1,212.00	$363.60–$1,212.00	45% below	-427%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTOURETERO WLITHOTRIPSY	$5,645.00	$11,336.00	$3,400.80–$11,336.00	65% below	50%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$2,200.00	$9,807.00	$1,283.57–$9,807.00	55% below	78%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14	$211.00	$339.02	$101.71–$339.02	29% below	38%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 SKIN DEBRIDEMENT TO SUBQ LAYERS <20cm	$427.00	$1,127.75	$338.33–$1,127.75	45% below	62%

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 TRANSFUSION UP TO 6 HRS	$464.00	$402.00	$90.00–$1,940.20	48% below	-15%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION UP TO 4 HRS	$464.00	$300.00	$90.00–$1,940.20	48% below	-55%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION UP TO 8 HRS	$464.00	$539.00	$90.00–$1,940.20	48% below	14%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION UP TO 24HR	$464.00	$1,940.20	$90.00–$1,940.20	48% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION UP TO 2 HRS	$464.00	$1,745.70	$90.00–$1,940.20	48% below	73%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ADD NEB TREATMENT	$230.00	$747.30	$15.90–$747.30	104% above	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB TX SUB	$230.00	$350.50	$15.90–$747.30	104% above	34%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MINI NEB TX SUBSEQUENT	$230.00	$97.00	$15.90–$747.30	104% above	-137%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MINI NEB TX INITIAL	$230.00	$108.00	$15.90–$747.30	104% above	-113%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INITAL NEB TREATMENT	$230.00	$747.30	$15.90–$747.30	104% above	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHAL TX ACUTE AIRWAY OB	$230.00	$53.00	$15.90–$747.30	104% above	-334%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALER (MDI) TX INITIAL	$230.00	$448.38	$15.90–$747.30	104% above	49%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZ PAP SUBSEQUENT	$230.00	$350.50	$15.90–$747.30	104% above	34%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION INITIAL	$230.00	$350.50	$15.90–$747.30	104% above	34%
Chemotherapy IV infusion, first hour CPT 96413 INITAL HOUR CHEMOTHERAPY INFUSION	$347.00	$623.85	$187.16–$623.85	49% below	44%
Critical care, first 30 to 74 minutes CPT 99291 ER CRITICAL CARE 30-74 MIN - 99291 - 1600062	$869.00	$3,503.18	$295.62–$3,503.18	59% below	75%
Critical care, first 30 to 74 minutes CPT 99291 ER CRITICAL CARE 30-74 MIN - 99291 - 1605009	$869.00	$2,007.00	$295.62–$3,503.18	59% below	57%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$227.00	$1,261.55	$227.32–$1,261.55	67% below	82%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ROUTINE TRACING WO I&R	$62.00	$368.00	$62.10–$368.00	69% below	83%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CS 12 LEAD EKG	$62.00	$368.00	$62.10–$368.00	69% below	83%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL 1 WPROC	$88.00	$296.50	$30.00–$296.50	60% below	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL 1	$88.00	$296.50	$30.00–$296.50	60% below	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER SCREENING	$88.00	$100.00	$30.00–$296.50	60% below	12%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2	$161.00	$576.50	$161.65–$576.50	62% below	72%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2 WPROC	$161.00	$576.50	$161.65–$576.50	62% below	72%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3 WPROC	$287.00	$1,041.62	$287.39–$1,041.62	63% below	72%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3	$287.00	$1,041.62	$287.39–$1,041.62	63% below	72%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4	$439.00	$1,777.65	$295.62–$1,777.65	63% below	75%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4 WPROC	$439.00	$1,634.95	$295.62–$1,777.65	63% below	73%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL 5	$626.00	$2,231.00	$295.62–$2,231.00	64% below	72%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL 5 WPROC	$626.00	$2,231.00	$295.62–$2,231.00	64% below	72%
Exercise stress test, tracing only, the hospital charge CPT 93017 CS STRESS TEST (TREADMILL ONLY)	$227.00	$1,437.63	$227.32–$1,437.63	70% below	84%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INITIAL INFUSION HYDRATION 30MIN TO 1 HR	$223.00	$935.90	$61.80–$935.90	39% below	76%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION UP TO 1HR	$223.00	$522.09	$61.80–$935.90	39% below	57%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION UP TO 1 HR	$223.00	$206.00	$61.80–$935.90	39% below	-8%
IV infusion of a medicine, first hour CPT 96365 TREATMENT ROOM	$223.00	$240.00	$72.00–$935.90	45% below	7%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THXDX UP TO 1 HR	$223.00	$576.00	$72.00–$935.90	45% below	61%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION OBS	$223.00	$253.28	$72.00–$935.90	45% below	12%
IV infusion of a medicine, first hour CPT 96365 IV INF THERAPYDX UP TO 1 HR	$223.00	$551.00	$72.00–$935.90	45% below	60%
IV infusion of a medicine, first hour CPT 96365 INITIAL INFUSION THERAPY UP TO 1 HR	$223.00	$935.90	$72.00–$935.90	45% below	76%
IV infusion of a medicine, first hour CPT 96365 INITIAL IV INFUSION THXDX UP TO 1 HR	$223.00	$865.90	$72.00–$935.90	45% below	74%
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE OR INITIAL	$223.00	$87.00	$26.10–$935.90	5% above	-156%
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE LR INTITIAL	$223.00	$935.90	$26.10–$935.90	5% above	76%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THERAPYPROPHYLXDX SQIM - 96372 - 8000028	$75.00	$69.00	$20.70–$298.08	29% below	-9%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SUBQ	$75.00	$251.15	$20.70–$298.08	29% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THERAPYPROPHYLXDX SQIM - 96372 - 1605403	$75.00	$298.08	$20.70–$298.08	29% below	75%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC RE-ED EA 15	$31.00	$171.76	$30.00–$171.76	59% below	82%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC RE-ED PTA COMPLEX EA	$31.00	$171.76	$30.00–$171.76	59% below	82%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSC REEDUC EA 15 MIN	$31.00	$100.00	$30.00–$171.76	59% below	69%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSC RE-ED OTA COMPLEX EA	$31.00	$100.00	$30.00–$171.76	59% below	69%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 DIET INST INITIAL 2-REF 15 MIN	$25.00	$175.00	$21.30–$175.00	27% below	86%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRIT THX INITIAL 15 MIN	$25.00	$71.00	$21.30–$175.00	27% below	65%
Occupational therapy evaluation, low complexity CPT 97165 OT INITIAL EVAL - SIMPLE	$96.00	$560.00	$96.81–$560.00	40% below	83%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL - EXTENDED	$94.00	$853.41	$94.35–$853.41	60% below	89%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL - SIMPLE	$94.00	$510.00	$94.33–$510.00	34% below	82%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL - INTERMEDIATE	$94.00	$681.70	$94.34–$681.70	50% below	86%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THER TECH EA 15 MIN	$26.00	$118.00	$26.60–$118.00	70% below	78%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THER TECH EA 15	$26.00	$118.00	$26.60–$118.00	70% below	78%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THER EX EA 15	$27.00	$172.97	$27.89–$172.97	64% below	84%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT EXERCISE PTA COMPLEX EA 15	$27.00	$172.97	$27.89–$172.97	64% below	84%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THER EXERCISES OTA COMPLEX EA 15	$27.00	$172.97	$27.89–$172.97	64% below	84%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THER EXERCISES EA 15	$27.00	$172.97	$27.89–$172.97	64% below	84%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKETOBACCO COUNSELING 3-10	$39.00	$135.60	$39.45–$135.60	30% above	71%
Speech and language evaluation CPT 92523 SPEECHLANGUAGE EVALUATION	$219.00	$220.00	$66.00–$220.00	7% above	—
Spirometry (breathing test) CPT 94010 PS PFT SPIROMETRY INC GRAPHIC RECORDING	$227.00	$679.75	$24.84–$679.75	7% below	67%
Spirometry (breathing test) CPT 94010 INCENTIVE SPIROMETRY	$227.00	$648.75	$24.84–$679.75	7% below	65%
Spirometry before and after a bronchodilator CPT 94060 PS PRE & POST BRONCHODILATOR ADMIN	$392.00	$1,261.55	$141.84–$1,261.55	28% below	69%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THER ACTIVITY EA 15	$33.00	$167.08	$33.44–$167.08	56% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THR ACTIVITY OTA COMPLEX EA 15	$33.00	$167.08	$33.44–$167.08	56% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THR ACTIVITY PTA COMPLEX EA 15	$33.00	$167.08	$33.44–$167.08	56% below	80%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THER ACT EA 15	$33.00	$167.08	$33.44–$167.08	56% below	80%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 BB PHLEBOTOMY	$140.00	$63.00	$18.90–$63.00	33% below	-122%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (IMOVAX), IM	$319.00	—	—	60% below	—
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (RABAVERT), 2.5IUMLIM	$319.00	—	—	60% below	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN (SUBQIMIDPERCUT) SINGLE - 90471 - 1604929	$75.00	$211.55	$19.50–$211.55	22% above	65%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN (SUBQIMIDPERCUT) SINGLE - 90471 - 2404929	$75.00	$114.00	$19.50–$211.55	22% above	34%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TETANUS SHOT ADMINISTRATION	$75.00	$65.00	$19.50–$211.55	22% above	-15%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://monroehospital.com/wp-content/uploads/2026/09/250139071_MonroeHospital_standardcharges.json