Newark-Wayne Community Hospital
Newark-Wayne Community Hospital in Newark, NY publishes cash prices for 473 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the New York median for 224 of 470 procedures and below it for 209. By typical cash price it ranks #60 of 115 New York hospitals and #6 of 10 hospitals in the Rochester, NY area, cheapest first. Select a procedure to compare it with other hospitals nearby.
1200 Driving Park Avenue, Newark, NY 14513 Collected Sep 22, 2026 Source price file Check a bill from this hospital (315) 332-2022
Acute care hospital Nonprofit hospital Emergency department CMS star rating 2 of 5 CCN 330030 · CMS hospital register NPI 1770671182
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Newark-Wayne Community Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
State law
This state limits hospital bills for lower-income patients
New York law (Public Health Law §2807-k(9-a), as amended in October 2024): uninsured patients with income below 200% of the federal poverty level owe nothing for emergency and medically necessary hospital care; up to 400% they pay on a sliding scale of at most 10% or 20% of what Medicaid would pay. Emergency care is covered for New York residents, other care for people living in the hospital's service area; immigration status does not count. Ask for the Uniform Hospital Financial Assistance form. Other states' laws.
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 Newark-Wayne Community Hospital in Newark, NY:
- Jun 5, 2026 Warning notice
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules.
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 New York | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN WO _ W CONTRAST | $845.92 | $1,301.42 | — | 36% below | 35% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN WO _ W CONTRAST | $845.92 | $1,301.42 | — | — | 35% |
| Abdominal X-ray, 2 views CPT 74019 HC XR ABDOMEN 2 VIEWS | $275.16 | $423.33 | — | 7% above | 35% |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC XR ABDOMEN 2 VIEWS | $275.16 | $423.33 | — | — | 35% |
| Ankle X-ray, complete, 3 or more views CPT 73610 HC XR ANKLE_ COMPLETE_ MIN 3 VIEWS | $201.75 | $310.38 | — | at median | 35% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC XR ANKLE_ COMPLETE_ MIN 3 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC LIMITED BILATERAL NONINVASIVE PHYSIOLOGIC STUDIES OF UPPER_LOWER EXPREMITY ARTERIES | $335.52 | $516.18 | — | — | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC LIMITED BILATERAL NON INVASIVE VASCULAR STUDY_ 1_2 LEVELS | $335.52 | $516.18 | — | — | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC LIMITED BILATERAL NON INVASIVE VASCULAR STUDY_ 1_2 LEVELS | $335.52 | $516.18 | — | — | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC LIMITED BILATERAL NONINVASIVE PHYSIOLOGIC STUDIES OF UPPER_LOWER EXPREMITY ARTERIES | $335.52 | $516.18 | — | — | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST | $660.65 | $1,016.39 | — | 11% below | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST | $660.65 | $1,016.39 | — | — | 35% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY | $336.54 | $517.76 | — | 2% below | 35% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY | $336.54 | $517.76 | — | — | 35% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC NUC BONE AND_OR JOINT IMAGING_WHOLE BODY | $1,067.57 | $1,642.41 | — | 8% above | 35% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NUC BONE AND_OR JOINT IMAGING_WHOLE BODY | $1,067.57 | $1,642.41 | — | — | 35% |
| Breast ultrasound, complete, one breast CPT 76641 HC US BREAST_ UNILATERAL_ REAL TIME W_IMAGE DOCUMENTATION_ COMPLETE | $425.45 | $654.54 | — | 31% above | 35% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 HC US BREAST_ UNILATERAL_ REAL TIME W_IMAGE DOCUMENTATION_ COMPLETE | $425.45 | $654.54 | — | — | 35% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST_ UNILATERAL_ REAL TIME W_IMAGE DOC INCLUDING AXILLA WHEN PERFORMED_ LIMITED | $222.56 | $342.40 | — | 12% below | 35% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US BREAST_ UNILATERAL_ REAL TIME W_IMAGE DOC INCLUDING AXILLA WHEN PERFORMED_ LIMITED | $222.56 | $342.40 | — | — | 35% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT ANGIOGRAPHY_ ABDOMEN AND PELVIS _ ADD | $1,266.07 | $1,947.80 | — | 28% below | 35% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT ANGIOGRAPHY_ ABDOMEN AND PELVIS _ ADD | $1,266.07 | $1,947.80 | — | — | 35% |
| CT angiography (CTA) of the head CPT 70496 HC CT ANGIOGRAPHY HEAD WO _ W CONTRAST | $845.92 | $1,301.42 | — | 31% below | 35% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIOGRAPHY HEAD WO _ W CONTRAST | $845.92 | $1,301.42 | — | — | 35% |
| CT angiography (CTA) of the neck CPT 70498 HC CT ANGIOGRAPHY NECK WO _ W CONTRAST | $845.92 | $1,301.42 | — | 32% below | 35% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIOGRAPHY NECK WO _ W CONTRAST | $845.92 | $1,301.42 | — | — | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST WO _ W CONTRAST | $845.92 | $1,301.42 | — | 35% below | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIOGRAPHY CHEST WO _ W CONTRAST | $845.92 | $1,301.42 | — | — | 35% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT ANGIO HEART CORONARY ART _ BYPASS GRAFT W CONTST 3D POSTPRO | $845.92 | $1,301.42 | — | 35% below | 35% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CT ANGIO HEART CORONARY ART _ BYPASS GRAFT W CONTST 3D POSTPRO | $845.92 | $1,301.42 | — | — | 35% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HEART WO CONTRAST_ W EVAL CORONARY CALCIUM | $100.75 | $155.00 | — | 53% below | 35% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HEART WO CONTRAST_ W EVAL CORONARY CALCIUM | $100.75 | $155.00 | — | — | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC COMPUTED TOMOGRAPHY_ ABD _ PELVIS_ WO CONTRAST | $699.10 | $1,075.54 | — | 39% below | 35% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC COMPUTED TOMOGRAPHY_ ABD _ PELVIS_ WO CONTRAST | $699.10 | $1,075.54 | — | — | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC COMPUTED TOMOGRAPHY_ ABD _ PELVIS_ W CONTRAST | $1,266.07 | $1,947.80 | — | 19% below | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC COMPUTED TOMOGRAPHY_ ABD _ PELVIS_ W CONTRAST | $1,266.07 | $1,947.80 | — | — | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC COMPUTED TOMOGRAPHY_ ABD _PELVIS_ W _ WO CONTRAST IN ONE OR BOTH BODY REGIONS | $1,266.07 | $1,947.80 | — | 39% below | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC COMPUTED TOMOGRAPHY_ ABD _PELVIS_ W _ WO CONTRAST IN ONE OR BOTH BODY REGIONS | $1,266.07 | $1,947.80 | — | — | 35% |
| CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST | $845.92 | $1,301.42 | — | 27% below | 35% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST | $845.92 | $1,301.42 | — | — | 35% |
| CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST | $520.31 | $800.48 | — | 43% below | 35% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST | $520.31 | $800.48 | — | — | 35% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST | $520.31 | $800.48 | — | 34% below | 35% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST | $520.31 | $800.48 | — | — | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD_BRAIN WO CONTRAST | $520.31 | $800.48 | — | 37% below | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD_BRAIN WO CONTRAST | $520.31 | $800.48 | — | — | 35% |
| CT scan of the head with contrast CPT 70460 HC CT HEAD_BRAIN W CONTRAST | $845.92 | $1,301.42 | — | 13% below | 35% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD_BRAIN W CONTRAST | $845.92 | $1,301.42 | — | — | 35% |
| CT scan of the head without and with contrast CPT 70470 HC CT HEAD OR BRAIN WO _ W CONTRAST | $845.92 | $1,301.42 | — | 20% below | 35% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD OR BRAIN WO _ W CONTRAST | $845.92 | $1,301.42 | — | — | 35% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST | $520.31 | $800.48 | — | 41% below | 35% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE WO CONTRAST | $520.31 | $800.48 | — | — | 35% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE WO CONTRAST | $520.31 | $800.48 | — | 44% below | 35% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE WO CONTRAST | $520.31 | $800.48 | — | — | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST | $845.92 | $1,301.42 | — | 18% below | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST | $845.92 | $1,301.42 | — | — | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HC US DUPLEX SCAN_EXTRACRANIAL ARTERIES_BILATERAL | $875.65 | $1,347.15 | — | 35% above | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 HC US DUPLEX SCAN_EXTRACRANIAL ARTERIES_BILATERAL | $875.65 | $1,347.15 | — | — | 35% |
| Chest CT scan without and with contrast CPT 71270 HC CT THORAX WO _ W CONTRAST | $845.92 | $1,301.42 | — | 35% below | 35% |
| Chest CT scan without and with contrast inpatient CPT 71270 HC CT THORAX WO _ W CONTRAST | $845.92 | $1,301.42 | — | — | 35% |
| Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS | $201.75 | $310.38 | — | at median | 35% |
| Chest X-ray, 2 views inpatient CPT 71046 HC XR CHEST 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Chest X-ray, single view CPT 71045 HC XR CHEST SINGLE VIEW | $201.75 | $310.38 | — | 2% above | 35% |
| Chest X-ray, single view inpatient CPT 71045 HC XR CHEST SINGLE VIEW | $201.75 | $310.38 | — | — | 35% |
| Collarbone (clavicle) X-ray, complete CPT 73000 HC XR CLAVICLE_ COMPLETE | $201.75 | $310.38 | — | at median | 35% |
| Collarbone (clavicle) X-ray, complete CPT 73000 HC XR CLAVICLE_ COMPLETE_ PORT | $201.75 | $310.38 | — | at median | 35% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC XR CLAVICLE_ COMPLETE | $201.75 | $310.38 | — | — | 35% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC XR CLAVICLE_ COMPLETE_ PORT | $201.75 | $310.38 | — | — | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US ECHOGRAPHY_ RETROPERITONEAL_RENAL__ COMPLETE | $425.45 | $654.54 | — | 1% above | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US ECHOGRAPHY_ RETROPERITONEAL_RENAL__ COMPLETE | $425.45 | $654.54 | — | — | 35% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY STUDY 1_MORE SITES_AXIAL SKELETON | $275.16 | $423.33 | — | at median | 35% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA BONE DENSITY STUDY 1_MORE SITES_AXIAL SKELETON | $275.16 | $423.33 | — | — | 35% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC LO DXA BONE DENSITY STUDY_ 1_MORE SITES_ APPENDICULAR SKELETON | $201.75 | $310.38 | — | 40% above | 35% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC LO DXA BONE DENSITY STUDY_ 1_MORE SITES_ APPENDICULAR SKELETON | $201.75 | $310.38 | — | — | 35% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US PG UTERUS_FETAL ANATOMIC EXAM_SINGLE_1ST GESTATION | $646.80 | $995.08 | — | 14% above | 35% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US PG UTERUS_FETAL ANATOMIC EXAM_SINGLE_1ST GESTATION | $646.80 | $995.08 | — | — | 35% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST | $520.31 | $800.48 | — | 40% below | 35% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX WO CONTRAST | $520.31 | $800.48 | — | — | 35% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST | $845.92 | $1,301.42 | — | 35% below | 35% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX W CONTRAST | $845.92 | $1,301.42 | — | — | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI | $311.47 | $479.18 | — | — | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI | $311.47 | $479.18 | — | — | 35% |
| Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI | $248.64 | $382.53 | — | 11% below | 35% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI | $248.64 | $382.53 | — | — | 35% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX SCAN LOW EXTREM_ARTERIAL BYPASS GRAFTS_ COMPLETE BILATERAL STUDY | $875.65 | $1,347.15 | — | — | 35% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 HC US DUPLEX_LWR ARTERIES_BILATERAL_ PORTABLE | $875.65 | $1,347.15 | — | 70% above | 35% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 HC US DUPLEX_LWR EXTREMITY ARTERIES_BILATERAL | $875.65 | $1,347.15 | — | 70% above | 35% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX SCAN LOW EXTREM_ARTERIAL BYPASS GRAFTS_ COMPLETE BILATERAL STUDY | $875.65 | $1,347.15 | — | — | 35% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC US DUPLEX_LWR ARTERIES_BILATERAL_ PORTABLE | $875.65 | $1,347.15 | — | — | 35% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC US DUPLEX_LWR EXTREMITY ARTERIES_BILATERAL | $875.65 | $1,347.15 | — | — | 35% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 HC US DUPLEX_EXTREMITY VEINS_BILATERAL | $875.65 | $1,347.15 | — | 16% above | 35% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 HC US DUPLEX_EXTREMITY VEINS_BILATERAL_PORTABLE | $875.65 | $1,347.15 | — | 16% above | 35% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC US DUPLEX_EXTREMITY VEINS_BILATERAL_PORTABLE | $875.65 | $1,347.15 | — | — | 35% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC US DUPLEX_EXTREMITY VEINS_BILATERAL | $875.65 | $1,347.15 | — | — | 35% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TRANSTH COMPLETE W_2D_M_MODE_SPECT DOP_COLOR FLOW DOP | $1,734.50 | $2,668.46 | — | 57% above | 35% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO TRANSTH COMPLETE W_2D_M_MODE_SPECT DOP_COLOR FLOW DOP | $1,734.50 | $2,668.46 | — | — | 35% |
| Elbow X-ray, 2 views CPT 73070 HC XR ELBOW AP _ LAT_ 2 VIEWS | $201.75 | $310.38 | — | 1% above | 35% |
| Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW AP _ LAT_ 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC XR ELBOW AP _ LAT_ MIN 3 VIEWS | $201.75 | $310.38 | — | at median | 35% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC XR ELBOW AP _ LAT_ MIN 3 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT_POSTERIOR FOSSA WO CONTRAST | $520.31 | $800.48 | — | 30% below | 35% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT_POSTERIOR FOSSA WO CONTRAST | $520.31 | $800.48 | — | — | 35% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS | $275.16 | $423.33 | — | 2% above | 35% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS | $275.16 | $423.33 | — | — | 35% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC RADEX FOREARM 2 VIEWS | $201.75 | $310.38 | — | at median | 35% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC RADEX FOREARM 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBILIARY SYSTEM IMAGING_ INCLUDING GALLBLADDER WHEN PRESENT | $1,067.57 | $1,642.41 | — | 4% above | 35% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC HEPATOBILIARY SYSTEM IMAGING_ INCLUDING GALLBLADDER WHEN PRESENT | $1,067.57 | $1,642.41 | — | — | 35% |
| Hand X-ray, 2 views CPT 73120 HC XR HAND 2 VIEWS | $275.16 | $423.33 | — | 32% above | 35% |
| Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 2 VIEWS | $275.16 | $423.33 | — | — | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC XR OS CALCIS_HEEL__ MIN 2 VIEWS | $201.75 | $310.38 | — | 5% above | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC XR OS CALCIS_HEEL__ MIN 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STD AIRFLOW HRT RATE_O2 SAT EFFORT UNATT | $328.15 | $504.84 | — | 17% below | 35% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STD AIRFLOW HRT RATE_O2 SAT EFFORT UNATT | $328.15 | $504.84 | — | — | 35% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY 6YRS OLDER SLEEP STAGING W_ INITIATION OF CPAP | $3,243.02 | $4,989.26 | — | 52% above | 35% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRAPHY 6YRS OLDER SLEEP STAGING W_ INITIATION OF CPAP | $3,243.02 | $4,989.26 | — | — | 35% |
| Knee X-ray, 3 views CPT 73562 HC XR KNEE_ 3 VIEWS | $201.75 | $310.38 | — | 2% below | 35% |
| Knee X-ray, 3 views inpatient CPT 73562 HC XR KNEE_ 3 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE_ COMPLETE _ 4 OR MORE VIEWS | $275.16 | $423.33 | — | at median | 35% |
| Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE_ COMPLETE _ 4 OR MORE VIEWS_ PORT | $275.16 | $423.33 | — | at median | 35% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC XR KNEE_ COMPLETE _ 4 OR MORE VIEWS | $275.16 | $423.33 | — | — | 35% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC XR KNEE_ COMPLETE _ 4 OR MORE VIEWS_ PORT | $275.16 | $423.33 | — | — | 35% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST | $520.31 | $800.48 | — | 30% below | 35% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST | $520.31 | $800.48 | — | — | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMINAL_ LIMITED | $425.45 | $654.54 | — | 12% above | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMINAL_ LIMITED | $425.45 | $654.54 | — | — | 35% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US EXTREMITY NONVASCULAR_ REAL_TIME_ W IMAGE DOC_ LIMITED_ ANATOMIC SPECIFIC | $425.45 | $654.54 | — | 58% above | 35% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US EXTREMITY NONVASCULAR_ REAL_TIME_ W IMAGE DOC_ LIMITED_ ANATOMIC SPECIFIC | $425.45 | $654.54 | — | — | 35% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LOW DOSE FOR LUNG CANCER SCREENING WO CONTRAST | $215.09 | $330.91 | — | 51% below | 35% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX LOW DOSE FOR LUNG CANCER SCREENING WO CONTRAST | $215.09 | $330.91 | — | — | 35% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC RADIOLOGIC EXAMINATION TIBIA _ FIBULA 2 VIEWS PORT | $201.75 | $310.38 | — | at median | 35% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC RADIOLOGIC EXAMINATION TIBIA _ FIBULA 2 VIEWS | $201.75 | $310.38 | — | at median | 35% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC RADIOLOGIC EXAMINATION TIBIA _ FIBULA 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC RADIOLOGIC EXAMINATION TIBIA _ FIBULA 2 VIEWS PORT | $201.75 | $310.38 | — | — | 35% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC MRA_ HEAD WO CONTRAST | $1,006.36 | $1,548.25 | — | 20% below | 35% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA_ HEAD WO CONTRAST | $1,006.36 | $1,548.25 | — | — | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY ANY JOINT WO CONTRAST | $1,006.36 | $1,548.25 | — | 16% below | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY ANY JOINT WO CONTRAST | $1,006.36 | $1,548.25 | — | — | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY ANY JOINT WO _ W CONTRAST | $1,648.98 | $2,536.89 | — | 19% below | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY ANY JOINT WO _ W CONTRAST | $1,648.98 | $2,536.89 | — | — | 35% |
| MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST | $1,006.36 | $1,548.25 | — | 8% below | 35% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN WO CONTRAST | $1,006.36 | $1,548.25 | — | — | 35% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN WO _ W CONTRAST | $1,648.98 | $2,536.89 | — | 2% below | 35% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN WO _ W CONTRAST | $1,648.98 | $2,536.89 | — | — | 35% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN INCLUDING BRAIN STEM WO CONTRAST | $1,006.36 | $1,548.25 | — | 14% below | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN INCLUDING BRAIN STEM WO CONTRAST | $1,006.36 | $1,548.25 | — | — | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN WO _ W CONTRAST | $1,648.98 | $2,536.89 | — | 7% below | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN WO _ W CONTRAST | $1,648.98 | $2,536.89 | — | — | 35% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINE LUMBAR WO CONTRAST | $1,006.36 | $1,548.25 | — | 23% below | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINE LUMBAR WO CONTRAST | $1,006.36 | $1,548.25 | — | — | 35% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI SPINE LUMBAR WO _ W CONTRAST | $1,648.98 | $2,536.89 | — | 7% below | 35% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI SPINE LUMBAR WO _ W CONTRAST | $1,648.98 | $2,536.89 | — | — | 35% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI SPINE THORACIC WO CONTRAST | $1,006.36 | $1,548.25 | — | 22% below | 35% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI SPINE THORACIC WO CONTRAST | $1,006.36 | $1,548.25 | — | — | 35% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI SPINE CERVICAL WO AND W CONTRAST | $1,648.98 | $2,536.89 | — | at median | 35% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI SPINE CERVICAL WO AND W CONTRAST | $1,648.98 | $2,536.89 | — | — | 35% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI SPINE CERVICAL WO CONTRAST | $1,006.36 | $1,548.25 | — | 24% below | 35% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI SPINE CERVICAL WO CONTRAST | $1,006.36 | $1,548.25 | — | — | 35% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WO _ W CONTRAST | $1,648.98 | $2,536.89 | — | 3% above | 35% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS WO _ W CONTRAST | $1,648.98 | $2,536.89 | — | — | 35% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST | $1,006.36 | $1,548.25 | — | 6% below | 35% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS WO CONTRAST | $1,006.36 | $1,548.25 | — | — | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREMITY ANY JOINT WO CONTRAST | $1,006.36 | $1,548.25 | — | 22% below | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTREMITY ANY JOINT WO CONTRAST | $1,006.36 | $1,548.25 | — | — | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC RADEX SPINE CERVICAL 4 OR 5 VIEWS | $275.16 | $423.33 | — | 3% below | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC RADEX SPINE CERVICAL 4 OR 5 VIEWS | $275.16 | $423.33 | — | — | 35% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST | $845.92 | $1,301.42 | — | 16% below | 35% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST | $845.92 | $1,301.42 | — | — | 35% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST | $520.31 | $800.48 | — | 36% below | 35% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST | $520.31 | $800.48 | — | — | 35% |
| Neck soft tissue X-ray CPT 70360 HC XR NECK SOFT TISSUE | $201.75 | $310.38 | — | at median | 35% |
| Neck soft tissue X-ray inpatient CPT 70360 HC XR NECK SOFT TISSUE | $201.75 | $310.38 | — | — | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC MYOCARDIAL PERFUSION IMAGE_TOMOGRAPHIC_MULTI STUDY_REST_STRESS | $3,133.32 | $4,820.50 | — | 17% above | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC MYOCARDIAL PERFUSION IMAGE_TOMOGRAPHIC_MULTI STUDY_REST_STRESS | $3,133.32 | $4,820.50 | — | — | 35% |
| OCT scan of the retina (optical coherence tomography) CPT 92134 HC SCANNING COMPUTERIZED OPHTHALMIC DIAGNOSTIC IMAGING POSTERIOR SEGMENT W I_R UNI_BILATERAL_ RETINA | $192.19 | $295.67 | — | 173% above | 35% |
| OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 HC SCANNING COMPUTERIZED OPHTHALMIC DIAGNOSTIC IMAGING POSTERIOR SEGMENT W I_R UNI_BILATERAL_ RETINA | $192.19 | $295.67 | — | — | 35% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET W_CT_ SKULL BASE TO MID_THIGH | $4,004.95 | $6,161.46 | — | at median | 35% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET W_CT_ SKULL BASE TO MID_THIGH | $4,004.95 | $6,161.46 | — | — | 35% |
| Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST | $520.31 | $800.48 | — | 38% below | 35% |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS WO CONTRAST | $520.31 | $800.48 | — | — | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC ULTRASOUND PELVIC _NONOBSTETRIC_ LIMITED OR F_U | $425.45 | $654.54 | — | 41% above | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC ULTRASOUND PELVIC _NONOBSTETRIC_ LIMITED OR F_U | $425.45 | $654.54 | — | — | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC ULTRASOUND_ PELVIC _NONOBSTETRIC__ COMPLETE | $425.45 | $654.54 | — | 6% above | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC ULTRASOUND_ PELVIC _NONOBSTETRIC__ COMPLETE | $425.45 | $654.54 | — | — | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREGNANT UTERUS_ AFTER 1ST TRIMESTER_ SINGLE OR 1ST GESTATION | $425.45 | $654.54 | — | 13% above | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREGNANT UTERUS_ AFTER 1ST TRIMESTER_ SINGLE OR 1ST GESTATION | $425.45 | $654.54 | — | — | 35% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US PREGNANT UTERUS_ 1ST TRIMESTER_ TRANSABD APPROACH_ SINGLE OR 1ST GESTATION | $425.45 | $654.54 | — | 21% above | 35% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US PREGNANT UTERUS_ 1ST TRIMESTER_ TRANSABD APPROACH_ SINGLE OR 1ST GESTATION | $425.45 | $654.54 | — | — | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US PREGNANT UTERUS_ LIMITED_ 1_MORE FETUSES | $425.45 | $654.54 | — | 47% above | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US PREGNANT UTERUS_ LIMITED_ 1_MORE FETUSES | $425.45 | $654.54 | — | — | 35% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC XR RIBS 2 VIEWS_ UNILATERAL | $201.75 | $310.38 | — | 4% below | 35% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC XR RIBS 2 VIEWS_ UNILATERAL | $201.75 | $310.38 | — | — | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC XR RIBS UNILATERAL W CHEST MIN 3 VIEWS | $275.16 | $423.33 | — | 5% above | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC XR RIBS UNILATERAL W CHEST MIN 3 VIEWS | $275.16 | $423.33 | — | — | 35% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $284.38 | $437.51 | — | — | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $284.38 | $437.51 | — | — | 35% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS | $201.75 | $310.38 | — | 4% below | 35% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS | $201.75 | $310.38 | — | 3% below | 35% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Skull X-ray, fewer than 4 views CPT 70250 HC XR SKULL _ 4 VIEWS | $275.16 | $423.33 | — | 19% above | 35% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HC XR SKULL _ 4 VIEWS | $275.16 | $423.33 | — | — | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY_ AGE 6 OR OLDER_ SLEEP STAGING W 4_MORE PARAMETERS_ TECH ATTENDED | $3,243.02 | $4,989.26 | — | 55% above | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY_ AGE 6 OR OLDER_ SLEEP STAGING W 4_MORE PARAMETERS_ TECH ATTENDED | $3,243.02 | $4,989.26 | — | — | 35% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC ECHOCARDIOGRAPHY TRANSTHORACIC REAL TIME W_IMAGE DOC_W_PERFORMANCE CONTINUOUS ELECTRO | $1,734.50 | $2,668.46 | — | 50% above | 35% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC ECHOCARDIOGRAPHY TRANSTHORACIC REAL TIME W_IMAGE DOC_W_PERFORMANCE CONTINUOUS ELECTRO | $1,734.50 | $2,668.46 | — | — | 35% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY | $336.54 | $517.76 | — | 7% below | 35% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY | $336.54 | $517.76 | — | — | 35% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS | $201.75 | $310.38 | — | 3% above | 35% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SPINE WO CONTRAST | $520.31 | $800.48 | — | 42% below | 35% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT THORACIC SPINE WO CONTRAST | $520.31 | $800.48 | — | — | 35% |
| Toe X-ray, 2 or more views CPT 73660 HC RADEX TOE MINIMUM 2 VIEWS | $201.75 | $310.38 | — | 20% above | 35% |
| Toe X-ray, 2 or more views inpatient CPT 73660 HC RADEX TOE MINIMUM 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Transvaginal pelvic ultrasound CPT 76830 HC US ECHOGRAPHY_TRANSVAGINAL | $425.45 | $654.54 | — | 12% above | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US ECHOGRAPHY_TRANSVAGINAL | $425.45 | $654.54 | — | — | 35% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US PREGNANT UTERUS_ TRANSVAGINAL | $425.45 | $654.54 | — | 45% above | 35% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US PREGNANT UTERUS_ TRANSVAGINAL | $425.45 | $654.54 | — | — | 35% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ECHOGRAPHY_ ABDOMINAL_ COMPLETE | $425.45 | $654.54 | — | 9% below | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ECHOGRAPHY_ ABDOMINAL_ COMPLETE | $425.45 | $654.54 | — | — | 35% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US ECHOGRAPHY SCROTUM _ CONTENTS | $425.45 | $654.54 | — | 16% above | 35% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US ECHOGRAPHY SCROTUM _ CONTENTS | $425.45 | $654.54 | — | — | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC 76536 US ECHOGRAPHY_SOFT TISSUES HEAD_NECK | $425.45 | $654.54 | — | 16% above | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US SOFT TISSUES OF HEAD _ NECK | $425.45 | $654.54 | — | 16% above | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US SOFT TISSUES OF HEAD _ NECK | $425.45 | $654.54 | — | — | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC 76536 US ECHOGRAPHY_SOFT TISSUES HEAD_NECK | $425.45 | $654.54 | — | — | 35% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY | $336.54 | $517.76 | — | 20% below | 35% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY | $336.54 | $517.76 | — | — | 35% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS_ MIN 2 VIEWS | $201.75 | $310.38 | — | at median | 35% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS_ MIN 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC US DUPLEX_EXTREMITY VEINS_UNILATERAL | $425.45 | $654.54 | — | 17% above | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC US DUPLEX_EXTREMITY VEINS_UNILATERAL | $425.45 | $654.54 | — | — | 35% |
| Wrist X-ray, 2 views CPT 73100 HC RADEX WRIST 2 VIEWS | $201.75 | $310.38 | — | 3% above | 35% |
| Wrist X-ray, 2 views inpatient CPT 73100 HC RADEX WRIST 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC XR WRIST_ COMPLETE_ MIN 3 VIEWS | $201.75 | $310.38 | — | at median | 35% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC XR WRIST_ COMPLETE_ MIN 3 VIEWS | $201.75 | $310.38 | — | — | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC RADEX HIP UNILATERAL WITH PELVIS 2_3 VIEWS | $201.75 | $310.38 | — | 12% below | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC RADEX HIP UNILATERAL WITH PELVIS 2_3 VIEWS | $201.75 | $310.38 | — | — | 35% |
| X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW | $201.75 | $310.38 | — | 3% below | 35% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN 1 VIEW | $201.75 | $310.38 | — | — | 35% |
| X-ray of the ankle, 2 views CPT 73600 HC RADIOLOGIC EXAMINATION ANKLE 2 VIEWS | $201.75 | $310.38 | — | 5% above | 35% |
| X-ray of the ankle, 2 views inpatient CPT 73600 HC RADIOLOGIC EXAMINATION ANKLE 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGER_S__ MIN 2 VIEWS | $201.75 | $310.38 | — | 12% above | 35% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XR FINGER_S__ MIN 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| X-ray of the foot, 2 views CPT 73620 HC RADIOLOGIC EXAMINATION FOOT 2 VIEWS | $201.75 | $310.38 | — | 2% above | 35% |
| X-ray of the foot, 2 views inpatient CPT 73620 HC RADIOLOGIC EXAMINATION FOOT 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC XR FOOT_ COMPLETE_ MIN 3 VIEWS | $201.75 | $310.38 | — | at median | 35% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC XR FOOT_ COMPLETE_ MIN 3 VIEWS | $201.75 | $310.38 | — | — | 35% |
| X-ray of the hand, 3 or more views CPT 73130 HC XR HAND_ MIN 3 VIEWS | $201.75 | $310.38 | — | 4% below | 35% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HC XR HAND_ MIN 3 VIEWS | $201.75 | $310.38 | — | — | 35% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC XR KNEE _ONE OR TWO VIEWS | $201.75 | $310.38 | — | 1% below | 35% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC XR KNEE _ONE OR TWO VIEWS | $201.75 | $310.38 | — | — | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC RADEX SPINE LUMBOSACRAL 2_3 VIEWS | $275.16 | $423.33 | — | at median | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC RADEX SPINE LUMBOSACRAL 2_3 VIEWS | $275.16 | $423.33 | — | — | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 HC RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $275.16 | $423.33 | — | 9% below | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $275.16 | $423.33 | — | — | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC RADEX SPINE THORACIC 2 VIEWS | $275.16 | $423.33 | — | 24% above | 35% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC RADEX SPINE THORACIC 2 VIEWS | $275.16 | $423.33 | — | — | 35% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC XR NASAL BONES MIN 3 VIEWS | $201.75 | $310.38 | — | at median | 35% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC XR NASAL BONES MIN 3 VIEWS | $201.75 | $310.38 | — | — | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS | $201.75 | $310.38 | — | 5% below | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS | $201.75 | $310.38 | — | — | 35% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC RADIOLOGIC EXAMINATION PELVIS 1_2 VIEWS | $275.16 | $423.33 | — | 21% above | 35% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC RADIOLOGIC EXAMINATION PELVIS 1_2 VIEWS | $275.16 | $423.33 | — | — | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC RADEX SACRUM _ COCCYX MINIMUM 2 VIEWS | $201.75 | $310.38 | — | at median | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC RADEX SACRUM _ COCCYX MINIMUM 2 VIEWS | $201.75 | $310.38 | — | — | 35% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 HC ACTH_ADRENOCORTICOTROPC HORM | $139.77 | $215.03 | — | 2% below | 35% |
| ACTH blood test inpatient CPT 82024 HC ACTH_ADRENOCORTICOTROPC HORM | $139.77 | $215.03 | — | — | 35% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE_ ALANINE AMINO _ALT_ _SGPT_ | $19.18 | $29.50 | — | 17% below | 35% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE_ ALANINE AMINO _ALT_ _SGPT_ | $19.18 | $29.50 | — | — | 35% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE_ ASPARTATE AMINO _AST_ _SGOT_ | $18.74 | $28.83 | — | 22% below | 35% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE_ ASPARTATE AMINO _AST_ _SGOT_ | $18.74 | $28.83 | — | — | 35% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS PANEL _ ACUTE | $172.39 | $265.21 | — | 1% below | 35% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS PANEL _ ACUTE | $172.39 | $265.21 | — | — | 35% |
| Albumin blood test CPT 82040 HC ALBUMIN SERUM | $17.91 | $27.56 | — | 2% below | 35% |
| Albumin blood test inpatient CPT 82040 HC ALBUMIN SERUM | $17.91 | $27.56 | — | — | 35% |
| Aldosterone blood test CPT 82088 HC ALDOSTERONE | $147.47 | $226.88 | — | 18% above | 35% |
| Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE | $147.47 | $226.88 | — | — | 35% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC PHOSPHATASE_ ALKALINE | $18.74 | $28.83 | — | 7% below | 35% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC PHOSPHATASE_ ALKALINE | $18.74 | $28.83 | — | — | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC RAST _ IGE | $18.88 | $29.05 | — | 18% above | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC RAST _ IGE | $18.88 | $29.05 | — | — | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA_FETOPROTEIN _AFP__ SERUM | $60.71 | $93.40 | — | 2% below | 35% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA_FETOPROTEIN _AFP__ SERUM | $60.71 | $93.40 | — | — | 35% |
| Ammonia blood test CPT 82140 HC AMMONIA | $52.74 | $81.14 | — | 2% below | 35% |
| Ammonia blood test inpatient CPT 82140 HC AMMONIA | $52.74 | $81.14 | — | — | 35% |
| Amylase blood test CPT 82150 HC AMYLASE | $23.45 | $36.07 | — | 22% below | 35% |
| Amylase blood test CPT 82150 HC AMYLASE_SENDOUT | $425.41 | $654.48 | — | 1307% above | 35% |
| Amylase blood test inpatient CPT 82150 HC AMYLASE | $23.45 | $36.07 | — | — | 35% |
| Amylase blood test inpatient CPT 82150 HC AMYLASE_SENDOUT | $425.41 | $654.48 | — | — | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRUL PEPTIDE AB _CCP_ | $46.85 | $72.07 | — | 2% below | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRUL PEPTIDE AB _CCP_ | $46.85 | $72.07 | — | — | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTI NUCLEAR ABS | $43.74 | $67.30 | — | 2% below | 35% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTI NUCLEAR ABS | $43.74 | $67.30 | — | — | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE _BNP_ | $122.82 | $188.96 | — | at median | 35% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE _BNP_ | $122.82 | $188.96 | — | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC BACTERIAL CULTURE AEROBIC_ OTHER THAN URINE_ BLOOD OR STOOL_ W ISOLATION _ PRESUMPTIVE ID | $31.19 | $47.98 | — | 2% below | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC BACTERIAL CULTURE AEROBIC_ OTHER THAN URINE_ BLOOD OR STOOL_ W ISOLATION _ PRESUMPTIVE ID | $31.19 | $47.98 | — | — | 35% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL _8_ | $30.61 | $47.09 | — | 47% below | 35% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL _8_ | $30.61 | $47.09 | — | — | 35% |
| Bilirubin blood test, total CPT 82247 HC BILIRUBIN_ TOTAL | $18.15 | $27.92 | — | 19% below | 35% |
| Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN_ TOTAL | $18.15 | $27.92 | — | — | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC TISSUE LEVEL IV_ GROSS _ MICROSCOPIC EXAMINATION | $130.14 | $200.22 | — | 15% below | 35% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC TISSUE LEVEL IV_ GROSS _ MICROSCOPIC EXAMINATION | $130.14 | $200.22 | — | — | 35% |
| Blood culture for bacteria CPT 87040 HC BLOOD CULTURE | $37.35 | $57.46 | — | 41% below | 35% |
| Blood culture for bacteria inpatient CPT 87040 HC BLOOD CULTURE | $37.35 | $57.46 | — | — | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC 36415 COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE ED_OBS | $22.86 | $35.17 | — | 52% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE | $22.86 | $35.17 | — | 52% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE | $22.86 | $35.17 | — | — | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC 36415 COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE ED_OBS | $22.86 | $35.17 | — | — | 35% |
| Blood glucose (sugar) test CPT 82947 HC GLUCOSE_ QUANTITATIVE_ POINT OF CARE | $14.21 | $21.86 | — | 21% below | 35% |
| Blood glucose (sugar) test CPT 82947 HC GLUCOSE_ QUANTITATIVE_ BLOOD | $14.21 | $21.86 | — | 21% below | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE_ QUANTITATIVE_ POINT OF CARE | $14.21 | $21.86 | — | — | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE_ QUANTITATIVE_ BLOOD | $14.21 | $21.86 | — | — | 35% |
| Blood lead test CPT 83655 HC LEAD | $43.81 | $67.40 | — | at median | 35% |
| Blood lead test inpatient CPT 83655 HC LEAD | $43.81 | $67.40 | — | — | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN_ CHORIONIC _HCG__ QUAL _PREGNANCY TEST_ | $27.24 | $41.90 | — | 15% below | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN_ CHORIONIC _HCG__ QUAL _PREGNANCY TEST_ | $27.24 | $41.90 | — | — | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC ABO BLOOD TYPING | $273.52 | $420.80 | — | 79% above | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC ABO BLOOD TYPING | $273.52 | $420.80 | — | — | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 HC BUN _UREA NITROGEN_ | $14.31 | $22.01 | — | 36% below | 35% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC BUN _UREA NITROGEN_ | $14.31 | $22.01 | — | — | 35% |
| C-peptide blood test CPT 84681 HC C_PEPTIDE | $75.34 | $115.91 | — | 12% below | 35% |
| C-peptide blood test inpatient CPT 84681 HC C_PEPTIDE | $75.34 | $115.91 | — | — | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C REACTIVE PROTEIN | $18.74 | $28.83 | — | 29% below | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C REACTIVE PROTEIN | $18.74 | $28.83 | — | — | 35% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC CDIFF TOXIN B BY PCR | $127.02 | $195.41 | — | at median | 35% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC CDIFF TOXIN B BY PCR | $127.02 | $195.41 | — | — | 35% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY FOR TUMOR ANTIGEN_ QUANTITATIVE_ CA 19_9 | $75.34 | $115.91 | — | at median | 35% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY FOR TUMOR ANTIGEN_ QUANTITATIVE_ CA 19_9 | $75.34 | $115.91 | — | — | 35% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY FOR TUMOR ANTIGEN_ QUANTITATIVE_ CA 125 | $75.34 | $115.91 | — | 2% below | 35% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY FOR TUMOR ANTIGEN_ QUANTITATIVE_ CA 125 | $75.34 | $115.91 | — | — | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS_COV_2 COVID_19 AMPLIFIED PROBE TQ | $143.24 | $220.37 | — | 46% above | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS_COV_2 COVID_19 AMPLIFIED PROBE TQ | $143.24 | $220.37 | — | — | 35% |
| Calcium blood test, total CPT 82310 HC CALCIUM | $18.67 | $28.73 | — | 26% below | 35% |
| Calcium blood test, total inpatient CPT 82310 HC CALCIUM | $18.67 | $28.73 | — | — | 35% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC CEA _CARCINOEMBRYONIC ANTIGEN_ | $68.63 | $105.58 | — | 15% below | 35% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC CEA FLUID | $407.82 | $627.42 | — | 405% above | 35% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CEA _CARCINOEMBRYONIC ANTIGEN_ | $68.63 | $105.58 | — | — | 35% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CEA FLUID | $407.82 | $627.42 | — | — | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER ANTIBODY | $46.60 | $71.70 | — | 3% above | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER ANTIBODY | $46.60 | $71.70 | — | — | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS DNA BY PCR | $127.02 | $195.41 | — | 27% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS DNA BY PCR | $127.02 | $195.41 | — | — | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PROFILE | $48.45 | $74.54 | — | 29% below | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PROFILE | $48.45 | $74.54 | — | — | 35% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC WITH AUTO DIFFERENTIAL | $28.12 | $43.26 | — | 31% below | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC WITH AUTO DIFFERENTIAL | $28.12 | $43.26 | — | — | 35% |
| Complete blood count (CBC), no differential CPT 85027 HC CBC _HEMOGRAM _ PLT_ | $23.40 | $36.00 | — | 19% below | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC _HEMOGRAM _ PLT_ | $23.40 | $36.00 | — | — | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL _14_ | $38.23 | $58.81 | — | 35% below | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL _14_ | $38.23 | $58.81 | — | — | 35% |
| Cortisol blood test, total CPT 82533 HC CORTISOL_ TOTAL | $58.99 | $90.75 | — | 20% above | 35% |
| Cortisol blood test, total inpatient CPT 82533 HC CORTISOL_ TOTAL | $58.99 | $90.75 | — | — | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE _CK__ _CPK__ TOTAL | $23.57 | $36.26 | — | 6% below | 35% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE _CK__ _CPK__ TOTAL | $23.57 | $36.26 | — | — | 35% |
| Creatinine blood test CPT 82565 HC CREATININE_ BLOOD | $18.56 | $28.56 | — | 25% below | 35% |
| Creatinine blood test inpatient CPT 82565 HC CREATININE_ BLOOD | $18.56 | $28.56 | — | — | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC CYTOMEGALOVIRUS_IGG | $52.10 | $80.15 | — | at median | 35% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CYTOMEGALOVIRUS_IGG | $52.10 | $80.15 | — | — | 35% |
| D-dimer blood test (blood clot marker) CPT 85379 HC D_DIMER_ QUANTITATIVE | $36.82 | $56.64 | — | 2% below | 35% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D_DIMER_ QUANTITATIVE | $36.82 | $56.64 | — | — | 35% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC DHEA_S | $80.47 | $123.80 | — | 5% below | 35% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DHEA_S | $80.47 | $123.80 | — | — | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TESTS_ PRESUMPTIVE_ BY INSTRUMENTED CHEMISTRY ANALYZERS | $121.92 | $187.57 | — | at median | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TESTS_ PRESUMPTIVE_ BY INSTRUMENTED CHEMISTRY ANALYZERS | $121.92 | $187.57 | — | — | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTES _ SERUM | $25.38 | $39.05 | — | 19% below | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTES _ SERUM | $25.38 | $39.05 | — | — | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBV VCA | $65.66 | $101.02 | — | 44% above | 35% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EBV VCA | $65.66 | $101.02 | — | — | 35% |
| Estradiol blood test CPT 82670 HC ESTRADIOL_ SERUM | $101.09 | $155.52 | — | 1% below | 35% |
| Estradiol blood test inpatient CPT 82670 HC ESTRADIOL_ SERUM | $101.09 | $155.52 | — | — | 35% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC FOLICAL STIMULATING HORMONE _FSH_ | $67.23 | $103.43 | — | 11% below | 35% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC FOLICAL STIMULATING HORMONE _FSH_ | $67.23 | $103.43 | — | — | 35% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC CALPROTECTIN_ FECAL | $71.06 | $109.32 | — | 22% below | 35% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC CALPROTECTIN_ FECAL | $71.06 | $109.32 | — | — | 35% |
| Ferritin blood test (iron stores) CPT 82728 HC FERRITIN | $49.33 | $75.89 | — | 19% below | 35% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN | $49.33 | $75.89 | — | — | 35% |
| Fibrinogen blood test CPT 85384 HC FIBRINOGEN BIOLOGIC ACTIVITY | $30.74 | $47.29 | — | 19% below | 35% |
| Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN BIOLOGIC ACTIVITY | $30.74 | $47.29 | — | — | 35% |
| Folate (folic acid) blood test CPT 82746 HC FOLATE _ SERUM | $53.21 | $81.86 | — | 3% below | 35% |
| Folate (folic acid) blood test inpatient CPT 82746 HC FOLATE _ SERUM | $53.21 | $81.86 | — | — | 35% |
| Free T3 thyroid hormone test CPT 84481 HC FREE T_3 | $61.33 | $94.35 | — | 3% below | 35% |
| Free T3 thyroid hormone test inpatient CPT 84481 HC FREE T_3 | $61.33 | $94.35 | — | — | 35% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC FREE THYROXINE | $32.62 | $50.19 | — | 32% below | 35% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC FREE THYROXINE | $32.62 | $50.19 | — | — | 35% |
| Free testosterone test CPT 84402 HC TESTOSTERONE_ FREE | $92.19 | $141.83 | — | at median | 35% |
| Free testosterone test inpatient CPT 84402 HC TESTOSTERONE_ FREE | $92.19 | $141.83 | — | — | 35% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GGTP _G_GLUTAMYLTRANSPEPTIDASE_ | $26.05 | $40.08 | — | 3% below | 35% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GGTP _G_GLUTAMYLTRANSPEPTIDASE_ | $26.05 | $40.08 | — | — | 35% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL | $56.84 | $87.44 | — | 64% below | 35% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL | $56.84 | $87.44 | — | — | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE_ POST GLUCOSE DOSE _INCLUDES GLUCOSE_ | $17.18 | $26.43 | — | 19% below | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE_ POST GLUCOSE DOSE _INCLUDES GLUCOSE_ | $17.18 | $26.43 | — | — | 35% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE_ TOLERANCE TEST _GTT__ 3 SPECIMENS _INCLUDES GLUCOSE_ | $46.58 | $71.66 | — | 19% below | 35% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE_ TOLERANCE TEST _GTT__ 3 SPECIMENS _INCLUDES GLUCOSE_ | $46.58 | $71.66 | — | — | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N. GONORROHEAE RNA | $127.02 | $195.41 | — | 26% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N. GONORROHEAE RNA | $127.02 | $195.41 | — | — | 35% |
| H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI ANTIBODY | $52.51 | $80.78 | — | at median | 35% |
| H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI ANTIBODY | $52.51 | $80.78 | — | — | 35% |
| H. pylori stool antigen test CPT 87338 HC HELICOBACTER PYLORI ANTIGEN_ STOOL | $52.06 | $80.09 | — | 3% below | 35% |
| H. pylori stool antigen test inpatient CPT 87338 HC HELICOBACTER PYLORI ANTIGEN_ STOOL | $52.06 | $80.09 | — | — | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC RNA NY 1 | $307.96 | $473.78 | — | 32% above | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC RNA NY 1 | $307.96 | $473.78 | — | — | 35% |
| HIV-1 and HIV-2 antibody test CPT 86703 HC HIV_1 AND HIV_2_ SINGLE ASSAY | $49.61 | $76.32 | — | 1% below | 35% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV_1 AND HIV_2_ SINGLE ASSAY | $49.61 | $76.32 | — | — | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV_1 ANTIGENS_ WITH HIB_1 AND HIB_2 ANTIBODIES_ SINGLE RESULT | $87.15 | $134.08 | — | 21% above | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV_1 ANTIGENS_ WITH HIB_1 AND HIB_2 ANTIBODIES_ SINGLE RESULT | $87.15 | $134.08 | — | — | 35% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC HPV HIGH RISK | $127.02 | $195.41 | — | 34% above | 35% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC HPV HIGH RISK | $127.02 | $195.41 | — | — | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSOLATED HGB | $35.15 | $54.07 | — | 2% below | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSOLATED HGB | $35.15 | $54.07 | — | — | 35% |
| Hemoglobin blood test CPT 85018 HC HEMOGLOBIN BLOOD | $8.57 | $13.19 | — | 41% below | 35% |
| Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN BLOOD | $8.57 | $13.19 | — | — | 35% |
| Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY | $43.62 | $67.10 | — | at median | 35% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY | $43.62 | $67.10 | — | — | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE ANTIBODY | $38.86 | $59.79 | — | 2% below | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURFACE ANTIBODY | $38.86 | $59.79 | — | — | 35% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE ANTIGEN | $37.38 | $57.51 | — | at median | 35% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEPATITIS B SURFACE ANTIGEN | $37.38 | $57.51 | — | — | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY | $51.62 | $79.41 | — | 3% below | 35% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY | $51.62 | $79.41 | — | — | 35% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C_ QUANTIFICATION | $155.01 | $238.47 | — | 14% above | 35% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEPATITIS C_ QUANTIFICATION | $155.01 | $238.47 | — | — | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX VIRUS 1 ANTIBODY | $47.72 | $73.41 | — | 18% above | 35% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX VIRUS 1 ANTIBODY | $47.72 | $73.41 | — | — | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX VIRUS 2 ANTIBODY | $70.06 | $107.79 | — | 21% above | 35% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX VIRUS 2 ANTIBODY | $70.06 | $107.79 | — | — | 35% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC CRP_ HIGH SENSITIVITY | $46.85 | $72.07 | — | 2% below | 35% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC CRP_ HIGH SENSITIVITY | $46.85 | $72.07 | — | — | 35% |
| Homocysteine blood test CPT 83090 HC HOMOCYSTEINE | $61.05 | $93.92 | — | 16% below | 35% |
| Homocysteine blood test inpatient CPT 83090 HC HOMOCYSTEINE | $61.05 | $93.92 | — | — | 35% |
| Insulin blood test CPT 83525 HC INSULIN LEVEL_ SERUM | $41.36 | $63.63 | — | 2% below | 35% |
| Insulin blood test inpatient CPT 83525 HC INSULIN LEVEL_ SERUM | $41.36 | $63.63 | — | — | 35% |
| Iron blood test (serum iron) CPT 83540 HC IRON | $23.42 | $36.03 | — | 9% below | 35% |
| Iron blood test (serum iron) CPT 83540 HC IRON 24 HR URINE | $23.42 | $36.03 | — | 9% below | 35% |
| Iron blood test (serum iron) CPT 83540 HC IRON_ LIVER BIOPSY | $23.42 | $36.03 | — | 9% below | 35% |
| Iron blood test (serum iron) inpatient CPT 83540 HC IRON_ LIVER BIOPSY | $23.42 | $36.03 | — | — | 35% |
| Iron blood test (serum iron) inpatient CPT 83540 HC IRON | $23.42 | $36.03 | — | — | 35% |
| Iron blood test (serum iron) inpatient CPT 83540 HC IRON 24 HR URINE | $23.42 | $36.03 | — | — | 35% |
| Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY _TIBC_ | $31.63 | $48.66 | — | 21% below | 35% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY _TIBC_ | $31.63 | $48.66 | — | — | 35% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $31.42 | $48.34 | — | 53% below | 35% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL | $31.42 | $48.34 | — | — | 35% |
| LH (luteinizing hormone) test CPT 83002 HC LUTEINIZING HORMONE | $67.00 | $103.08 | — | 13% below | 35% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC LUTEINIZING HORMONE | $67.00 | $103.08 | — | — | 35% |
| Lactate (lactic acid) blood test CPT 83605 HC LACTATE _LACTIC ACID_ | $38.67 | $59.49 | — | 4% below | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTATE _LACTIC ACID_ | $38.67 | $59.49 | — | — | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE _LD__ _LDH_ | $21.83 | $33.59 | — | 2% below | 35% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE _LD__ _LDH_ | $21.83 | $33.59 | — | — | 35% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE | $24.96 | $38.40 | — | 11% below | 35% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE | $24.96 | $38.40 | — | — | 35% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL _7_ | $29.58 | $45.50 | — | 48% below | 35% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL _7_ | $29.58 | $45.50 | — | — | 35% |
| Lyme disease antibody test CPT 86618 HC LYME ANTIBODY | $61.62 | $94.80 | — | 27% above | 35% |
| Lyme disease antibody test inpatient CPT 86618 HC LYME ANTIBODY | $61.62 | $94.80 | — | — | 35% |
| Magnesium blood test CPT 83735 HC MAGNESIUM | $24.24 | $37.29 | — | 2% below | 35% |
| Magnesium blood test inpatient CPT 83735 HC MAGNESIUM | $24.24 | $37.29 | — | — | 35% |
| Measles (rubeola) antibody test CPT 86765 HC RUBEOLA ANTIBODY | $46.60 | $71.70 | — | 1% above | 35% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA ANTIBODY | $46.60 | $71.70 | — | — | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC HETERO _ MONO SCREEN | $18.74 | $28.83 | — | 46% below | 35% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETERO _ MONO SCREEN | $18.74 | $28.83 | — | — | 35% |
| Mumps immunity blood test CPT 86735 HC MUMPS ANTIBIODY | $47.22 | $72.65 | — | 11% above | 35% |
| Mumps immunity blood test inpatient CPT 86735 HC MUMPS ANTIBIODY | $47.22 | $72.65 | — | — | 35% |
| Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL | $105.99 | $163.06 | — | at median | 35% |
| Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL | $105.99 | $163.06 | — | — | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA_ FREE | $66.59 | $102.44 | — | at median | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA_ FREE | $66.59 | $102.44 | — | — | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA_ TOTAL | $66.59 | $102.44 | — | at median | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA_ TOTAL | $66.59 | $102.44 | — | — | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC GYN CYTOPATH_THIN LAYER _ DIAGNOSTIC PAP | $73.31 | $112.79 | — | 4% above | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC GYN CYTOPATH_THIN LAYER _ DIAGNOSTIC PAP | $73.31 | $112.79 | — | — | 35% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC PTH_ INTACT | $149.38 | $229.81 | — | 2% above | 35% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PTH_ INTACT | $149.38 | $229.81 | — | — | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT | $21.75 | $33.46 | — | 8% below | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT | $21.75 | $33.46 | — | — | 35% |
| Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHORUS SERUM | $17.15 | $26.39 | — | 16% below | 35% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHORUS SERUM | $17.15 | $26.39 | — | — | 35% |
| Potassium blood test CPT 84132 HC POTASSIUM_ SERUM_ PLASMA OR WHOLE BLOOD | $16.65 | $25.61 | — | 28% below | 35% |
| Potassium blood test inpatient CPT 84132 HC POTASSIUM_ SERUM_ PLASMA OR WHOLE BLOOD | $16.65 | $25.61 | — | — | 35% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS | $2,113.85 | $3,252.07 | — | 85% above | 35% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS | $2,113.85 | $3,252.07 | — | — | 35% |
| Progesterone blood test CPT 84144 HC PROGESTERONE | $75.51 | $116.17 | — | 12% below | 35% |
| Progesterone blood test inpatient CPT 84144 HC PROGESTERONE | $75.51 | $116.17 | — | — | 35% |
| Prolactin blood test CPT 84146 HC PROLACTIN | $70.12 | $107.88 | — | 3% below | 35% |
| Prolactin blood test inpatient CPT 84146 HC PROLACTIN | $70.12 | $107.88 | — | — | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $14.21 | $21.86 | — | 8% below | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $14.21 | $21.86 | — | — | 35% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TESTS_ PRESUMPTIVE READ BY DIRECT OPTICAL OBSERVATION ONLY | $35.17 | $54.11 | — | 1% above | 35% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TESTS_ PRESUMPTIVE READ BY DIRECT OPTICAL OBSERVATION ONLY | $35.17 | $54.11 | — | — | 35% |
| Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA ASSAY W_OPTIC | $48.52 | $74.64 | — | 18% above | 35% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA ASSAY W_OPTIC | $48.52 | $74.64 | — | — | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREPTOCOCCUS GROUP A_ ANTIGEN DETECTION BY IMMUNOASSAY | $48.45 | $74.54 | — | 21% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREPTOCOCCUS GROUP A_ ANTIGEN DETECTION BY IMMUNOASSAY | $48.45 | $74.54 | — | — | 35% |
| Renin blood test CPT 84244 HC RENIN _ANGIOTENSIN I_ | $79.59 | $122.44 | — | 2% below | 35% |
| Renin blood test inpatient CPT 84244 HC RENIN _ANGIOTENSIN I_ | $79.59 | $122.44 | — | — | 35% |
| Rh blood typing CPT 86901 HC RH_D_ TYPING | $92.99 | $143.06 | — | 69% above | 35% |
| Rh blood typing inpatient CPT 86901 HC RH_D_ TYPING | $92.99 | $143.06 | — | — | 35% |
| Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR | $20.51 | $31.56 | — | 2% below | 35% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR | $20.51 | $31.56 | — | — | 35% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY | $52.10 | $80.15 | — | 17% above | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY | $52.10 | $80.15 | — | — | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC SED RATE | $9.76 | $15.02 | — | 61% below | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC SED RATE | $9.76 | $15.02 | — | — | 35% |
| Sodium blood test CPT 84295 HC SODIUM SERUM | $17.41 | $26.79 | — | 20% below | 35% |
| Sodium blood test inpatient CPT 84295 HC SODIUM SERUM | $17.41 | $26.79 | — | — | 35% |
| Stool ova and parasites exam CPT 87177 HC OVA PARASITES | $32.21 | $49.55 | — | 2% below | 35% |
| Stool ova and parasites exam inpatient CPT 87177 HC OVA PARASITES | $32.21 | $49.55 | — | — | 35% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD_ FECAL SCREEN | $12.84 | $19.75 | — | 10% below | 35% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC OCCULT BLOOD_ FECAL SCREEN | $12.84 | $19.75 | — | — | 35% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD_ OCCULT_ BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOSASSY | $57.57 | $88.57 | — | 17% above | 35% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD_ OCCULT_ BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOSASSY | $57.57 | $88.57 | — | — | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM AB | $47.89 | $73.68 | — | 13% above | 35% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC TREPONEMA PALLIDUM AB | $47.89 | $73.68 | — | — | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC NONTREALNEMIA ANTIBODY_ QUAL | $15.44 | $23.76 | — | 2% below | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC NONTREALNEMIA ANTIBODY_ QUAL | $15.44 | $23.76 | — | — | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC QUANTIFERON _ TB GOLD IN TUBE | $224.30 | $345.07 | — | 37% above | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC QUANTIFERON _ TB GOLD IN TUBE | $224.30 | $345.07 | — | — | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE_ TOTAL | $93.42 | $143.73 | — | at median | 35% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE_ TOTAL | $93.42 | $143.73 | — | — | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODIES_ EACH | $52.64 | $80.99 | — | 1% below | 35% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODIES_ EACH | $52.64 | $80.99 | — | — | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE _TSH_ | $60.82 | $93.57 | — | 17% below | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE _TSH_ | $60.82 | $93.57 | — | — | 35% |
| Total IgE blood test CPT 82785 HC GAMMAGLOBULIN _IMMUNOGLOBULIN__ IGE | $59.56 | $91.63 | — | 2% below | 35% |
| Total IgE blood test inpatient CPT 82785 HC GAMMAGLOBULIN _IMMUNOGLOBULIN__ IGE | $59.56 | $91.63 | — | — | 35% |
| Total cholesterol blood test CPT 82465 HC CHOLESTEROL T_ SERUM | $15.75 | $24.23 | — | 30% below | 35% |
| Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL T_ SERUM | $15.75 | $24.23 | — | — | 35% |
| Total thyroxine (T4) blood test CPT 84436 HC THYROXINE _TT4_ | $24.86 | $38.25 | — | 15% below | 35% |
| Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE _TT4_ | $24.86 | $38.25 | — | — | 35% |
| Total triiodothyronine (T3) blood test CPT 84480 HC TRIIODOTHYRONINE | $51.34 | $78.98 | — | 19% below | 35% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 HC TRIIODOTHYRONINE | $51.34 | $78.98 | — | — | 35% |
| Transferrin blood test CPT 84466 HC TRANSFERRIN | $46.19 | $71.06 | — | 2% below | 35% |
| Transferrin blood test inpatient CPT 84466 HC TRANSFERRIN | $46.19 | $71.06 | — | — | 35% |
| Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS_ AMPLIFIED PROBE | $68.43 | $105.27 | — | 10% below | 35% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC TRICHOMONAS VAGINALIS_ AMPLIFIED PROBE | $68.43 | $105.27 | — | — | 35% |
| Triglycerides blood test CPT 84478 HC TRIGLYCERIDE TOTAL | $20.78 | $31.97 | — | 15% below | 35% |
| Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDE TOTAL | $20.78 | $31.97 | — | — | 35% |
| Troponin test, quantitative CPT 84484 HC TROPONIN I_ QUANTITATIVE | $36.55 | $56.23 | — | 16% below | 35% |
| Troponin test, quantitative inpatient CPT 84484 HC TROPONIN I_ QUANTITATIVE | $36.55 | $56.23 | — | — | 35% |
| Uric acid blood test CPT 84550 HC URIC ACID_ BLOOD | $16.35 | $25.16 | — | 19% below | 35% |
| Uric acid blood test inpatient CPT 84550 HC URIC ACID_ BLOOD | $16.35 | $25.16 | — | — | 35% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS _ ROUTINE | $11.50 | $17.69 | — | 65% below | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS _ ROUTINE | $11.50 | $17.69 | — | — | 35% |
| Urinalysis with microscope exam, manual CPT 81000 HC URINALYSIS_ NON_AUTOMATED | $11.78 | $18.13 | — | at median | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINALYSIS_ NON_AUTOMATED | $11.78 | $18.13 | — | — | 35% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS WO MICROSCOPY | $8.13 | $12.51 | — | 52% below | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS WO MICROSCOPY | $8.13 | $12.51 | — | — | 35% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINE DIPSTICK_ NON_AUTOMATED | $10.20 | $15.70 | — | 2% below | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINE DIPSTICK_ NON_AUTOMATED | $10.20 | $15.70 | — | — | 35% |
| Urine culture for bacteria, with colony count CPT 87086 HC URINE CULTURE WITH COLONY COUNT | $29.19 | $44.91 | — | 23% below | 35% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC URINE CULTURE WITH COLONY COUNT | $29.19 | $44.91 | — | — | 35% |
| Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN_ URINE | $20.93 | $32.20 | — | 30% below | 35% |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN_ URINE | $20.93 | $32.20 | — | — | 35% |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST_ VISUAL COLOR COMPARISON METHODS | $25.23 | $38.82 | — | 13% below | 35% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST_ VISUAL COLOR COMPARISON METHODS | $25.23 | $38.82 | — | — | 35% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC CYANOCOBALAMIN _VITAMIN B12_ | $54.55 | $83.93 | — | 2% below | 35% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC CYANOCOBALAMIN _VITAMIN B12_ | $54.55 | $83.93 | — | — | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D 25_OH | $107.13 | $164.82 | — | at median | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D 25_OH | $107.13 | $164.82 | — | — | 35% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VITAMIN D 1_25 OH | $139.33 | $214.35 | — | 30% above | 35% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VITAMIN D 1_25 OH | $139.33 | $214.35 | — | — | 35% |
| Zinc blood test CPT 84630 HC ZINC | $41.22 | $63.41 | — | 2% above | 35% |
| Zinc blood test inpatient CPT 84630 HC ZINC | $41.22 | $63.41 | — | — | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN_ CHORIONIC _HCG__ QUANTITATIVE | $54.49 | $83.83 | — | 2% below | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN_ CHORIONIC _HCG__ QUANTITATIVE | $54.49 | $83.83 | — | — | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC NASAL_SINUS NDSC SURG W_DILATION MAXILLARY SINUS | $12,181.98 | $18,741.50 | — | 49% above | 35% |
| Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 HC NASAL_SINUS NDSC SURG W_DILATION MAXILLARY SINUS | $12,181.98 | $18,741.50 | — | — | 35% |
| Botox injections for chronic migraine CPT 64615 HC CHEMODENERVATION MUSCLE_S__INNERVATED FACIAL TRIGEMINAL CERVICAL SPINAL ACCESSORY NERVES BIL | $418.44 | $643.75 | — | 4% below | 35% |
| Botox injections for chronic migraine inpatient CPT 64615 HC CHEMODENERVATION MUSCLE_S__INNERVATED FACIAL TRIGEMINAL CERVICAL SPINAL ACCESSORY NERVES BIL | $418.44 | $643.75 | — | — | 35% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST_ PLACE LOCALIZATION DEVICE. PC_ 1ST LESION_ INC STEROTACTIC GUIDANCE | $4,582.16 | $7,049.47 | — | 49% above | 35% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST_ PLACE LOCALIZATION DEVICE. PC_ 1ST LESION_ INC STEROTACTIC GUIDANCE | $4,582.16 | $7,049.47 | — | — | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CLOSED TREATMENT DISTAL FIBULAR FX_ WO MANIPULATION | $763.42 | $1,174.50 | — | 45% above | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC 27786 CLOSED TREATMENT DISTAL FIBULAR FRACTURE _LATERAL MALLEOLUS_ WO MANIPULATION | $763.42 | $1,174.50 | — | 45% above | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC 27786 CLOSED TREATMENT DISTAL FIBULAR FRACTURE _LATERAL MALLEOLUS_ WO MANIPULATION | $763.42 | $1,174.50 | — | — | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CLOSED TREATMENT DISTAL FIBULAR FX_ WO MANIPULATION | $763.42 | $1,174.50 | — | — | 35% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CLOSED TX METATARSAL FX WO MANIPULATION | $763.42 | $1,174.50 | — | 67% above | 35% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CLOSED TREATMENT METATARSAL FX_ WO MANIPULATION_ EACH | $763.42 | $1,174.50 | — | 67% above | 35% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CLOSED TREATMENT METATARSAL FX_ WO MANIPULATION_ EACH | $763.42 | $1,174.50 | — | — | 35% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CLOSED TX METATARSAL FX WO MANIPULATION | $763.42 | $1,174.50 | — | — | 35% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 HC CATH PLACEMENT CORONARY ART W INTRAPROCEDURAL INJ CORONARY ANGIO W LEFT HEART CATH | $8,273.02 | $12,727.73 | — | 36% above | 35% |
| Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 HC CATH PLACEMENT CORONARY ART W INTRAPROCEDURAL INJ CORONARY ANGIO W LEFT HEART CATH | $8,273.02 | $12,727.73 | — | — | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION _ ECG | $1,700.22 | $2,615.73 | — | 64% above | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION_ ELECTRICAL CONVERSION OF ARRHYTHMIA_EXTERNAL | $1,700.22 | $2,615.73 | — | 64% above | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION_ELECTIVE_ELECTRICAL CONVERSION OF ARRHYTHMIA_EXTERNAL | $1,700.22 | $2,615.73 | — | 64% above | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION_ ELECTIVE_ ELECTRICAL CONVERSION OF ARRHYTHMIA_ EXTERNAL | $1,700.22 | $2,615.73 | — | 64% above | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC 92960 CARDIOVERSION_ ELECTIVE_ ELECTR. CONVERSION EXTERNAL ARRHYTHMIA | $1,700.22 | $2,615.73 | — | 64% above | 35% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION_ELECTIVE_ELECTRICAL CONVERSION OF ARRHYTHMIA_EXTERNAL | $1,700.22 | $2,615.73 | — | — | 35% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION_ ELECTIVE_ ELECTRICAL CONVERSION OF ARRHYTHMIA_ EXTERNAL | $1,700.22 | $2,615.73 | — | — | 35% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC 92960 CARDIOVERSION_ ELECTIVE_ ELECTR. CONVERSION EXTERNAL ARRHYTHMIA | $1,700.22 | $2,615.73 | — | — | 35% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION _ ECG | $1,700.22 | $2,615.73 | — | — | 35% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION_ ELECTRICAL CONVERSION OF ARRHYTHMIA_EXTERNAL | $1,700.22 | $2,615.73 | — | — | 35% |
| Cataract surgery with lens implant CPT 66984 HC EXTRACAPSULAR CATARACT EXTRACTION W IOL_1ST SAGE_ MANUAL OR MECHANICAL_ W_O ECP | $4,946.91 | $7,610.63 | — | 83% above | 35% |
| Cataract surgery with lens implant inpatient CPT 66984 HC EXTRACAPSULAR CATARACT EXTRACTION W IOL_1ST SAGE_ MANUAL OR MECHANICAL_ W_O ECP | $4,946.91 | $7,610.63 | — | — | 35% |
| Catheter ablation for atrial fibrillation CPT 93656 HC EP EVAL INSERT ELEC CATH INDUCT ARRHY_ HIS BUND AF ARRHYTHMOGENIC FOCUS. TX AF ABLAT PULM VEIN | $37,561.02 | $57,786.18 | — | 29% above | 35% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 HC EP EVAL INSERT ELEC CATH INDUCT ARRHY_ HIS BUND AF ARRHYTHMOGENIC FOCUS. TX AF ABLAT PULM VEIN | $37,561.02 | $57,786.18 | — | — | 35% |
| Cervical biopsy CPT 57500 HC BX OF CERVIX_ SINGLE_MULT_LOCAL EXC OF LESION_ W_WO FULGRATION | $1,569.72 | $2,414.96 | — | 5% above | 35% |
| Cervical biopsy CPT 57500 HC BIOPSY OF CERVIX_ SINGLE OR MULTIPLE_ OR LOCAL EXCISION OF LESION_ W_WO FULGURATION | $1,927.04 | $2,964.68 | — | 29% above | 35% |
| Cervical biopsy inpatient CPT 57500 HC BX OF CERVIX_ SINGLE_MULT_LOCAL EXC OF LESION_ W_WO FULGRATION | $1,569.72 | $2,414.96 | — | — | 35% |
| Cervical biopsy inpatient CPT 57500 HC BIOPSY OF CERVIX_ SINGLE OR MULTIPLE_ OR LOCAL EXCISION OF LESION_ W_WO FULGURATION | $1,927.04 | $2,964.68 | — | — | 35% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W_CLAMP OR OTH DEV W_BLOCK | $279.18 | $429.50 | — | 88% below | 35% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION W_CLAMP OR OTH DEV W_BLOCK | $279.18 | $429.50 | — | — | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC 25600 CLOSED TREATMENT DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEPARATION_ WO MANIPULATION | $763.42 | $1,174.50 | — | 36% above | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLOSED TX DISTAL RADIAL FX_ EPIPHYSEAL SEPARATION_ WO MANIPULATION | $763.42 | $1,174.50 | — | 36% above | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC 25600 CLOSED TREATMENT DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEPARATION_ WO MANIPULATION | $763.42 | $1,174.50 | — | — | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLOSED TX DISTAL RADIAL FX_ EPIPHYSEAL SEPARATION_ WO MANIPULATION | $763.42 | $1,174.50 | — | — | 35% |
| Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY_ FLEXIBLE_ PROXIMAL TO SPLENIC FLEXURE_ DIAGNOSTIC | $2,393.41 | $3,682.17 | — | 23% above | 35% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY_ FLEXIBLE_ PROXIMAL TO SPLENIC FLEXURE_ DIAGNOSTIC | $2,393.41 | $3,682.17 | — | — | 35% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC BX OF CERVIX W_SCOPE LEEP | $5,900.14 | $9,077.14 | — | 56% above | 35% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 HC BX OF CERVIX W_SCOPE LEEP | $5,900.14 | $9,077.14 | — | — | 35% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC COLOPOSCOPY OF THE CERVIX INC UPPER_ADJ VAGINA_W BIOPSY OF CERVIX_ENDOCERVICAL CURETTAGE | $958.48 | $1,474.58 | — | 43% above | 35% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC COLOPOSCOPY OF THE CERVIX INC UPPER_ADJ VAGINA_W BIOPSY OF CERVIX_ENDOCERVICAL CURETTAGE | $958.48 | $1,474.58 | — | — | 35% |
| Complex cataract surgery with lens implant CPT 66982 HC XCAPSULAR CATARACT RMVL INSJ LENS PROSTH 1 STG_ W_O ECP | $4,946.91 | $7,610.63 | — | 83% above | 35% |
| Complex cataract surgery with lens implant inpatient CPT 66982 HC XCAPSULAR CATARACT RMVL INSJ LENS PROSTH 1 STG_ W_O ECP | $4,946.91 | $7,610.63 | — | — | 35% |
| Coronary stent placement, one artery CPT 92928 HC PRQ TRLUML CORONARY STENT W_ANGIOPLASTY WHEN PERFORMED_ONE ART_BRA | $20,251.58 | $31,156.28 | — | 45% above | 35% |
| Coronary stent placement, one artery inpatient CPT 92928 HC PRQ TRLUML CORONARY STENT W_ANGIOPLASTY WHEN PERFORMED_ONE ART_BRA | $20,251.58 | $31,156.28 | — | — | 35% |
| Cystoscopy with ureteral stent placement CPT 52332 HC CYSTOURETHROSCOPY_ W_INSERTION INDWELLING URETERAL STENT | $8,076.85 | $12,425.93 | — | 84% above | 35% |
| Cystoscopy with ureteral stent placement CPT 52332 HC CYSTOURETHROSCOPY W_INSERTION OF INDWELLING URETERAL STENT | $8,076.85 | $12,425.93 | — | 84% above | 35% |
| Cystoscopy with ureteral stent placement CPT 52332 HC CYSTOURETHROSCOPY W INSERTION OF INDWELLING URETERAL STENT | $8,076.85 | $12,425.93 | — | 84% above | 35% |
| Cystoscopy with ureteral stent placement CPT 52332 HC CYSTOURETHROSCOPY WITH INSERTION STENT | $8,076.85 | $12,425.93 | — | 84% above | 35% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 HC CYSTOURETHROSCOPY W_INSERTION OF INDWELLING URETERAL STENT | $8,076.85 | $12,425.93 | — | — | 35% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 HC CYSTOURETHROSCOPY_ W_INSERTION INDWELLING URETERAL STENT | $8,076.85 | $12,425.93 | — | — | 35% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 HC CYSTOURETHROSCOPY WITH INSERTION STENT | $8,076.85 | $12,425.93 | — | — | 35% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 HC CYSTOURETHROSCOPY W INSERTION OF INDWELLING URETERAL STENT | $8,076.85 | $12,425.93 | — | — | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY _SEPARATE PROCEDURE_ | $1,966.48 | $3,025.35 | — | 36% above | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY | $1,966.48 | $3,025.35 | — | 36% above | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY _SEPARATE PROCEDURE_ | $1,966.48 | $3,025.35 | — | — | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY | $1,966.48 | $3,025.35 | — | — | 35% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCTION BENIGN_PREMALIGNANT LESIONS_ FIRST LESION | $584.21 | $898.79 | — | 101% above | 35% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUCTION BENIGN_PREMALIGNANT LESIONS_ FIRST LESION | $584.21 | $898.79 | — | — | 35% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC CREATE EARDRUM OPENING_ LOCAL ANESTHESIA | $1,152.40 | $1,772.93 | — | 6% above | 35% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 HC CREATE EARDRUM OPENING_ LOCAL ANESTHESIA | $1,152.40 | $1,772.93 | — | — | 35% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION_LVG UNILAT | $192.19 | $295.67 | — | 59% above | 35% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVAL IMPACTED CERUMEN USING IRRIGATION_LAVAGE_ UNILATERAL | $192.19 | $295.67 | — | 59% above | 35% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION_LVG UNILAT | $192.19 | $295.67 | — | — | 35% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMOVAL IMPACTED CERUMEN USING IRRIGATION_LAVAGE_ UNILATERAL | $192.19 | $295.67 | — | — | 35% |
| Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION_ UNILATERAL | $192.19 | $295.67 | — | 48% above | 35% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION_ UNILATERAL | $192.19 | $295.67 | — | — | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ENDOMETRIAL SAMPLING _BIOPSY_ W_O CERVICAL DILATION_ ANY METHOD SEPARATE PROCEDURE | $558.63 | $859.43 | — | 21% above | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ENDOMETRIAL BIOPSY WO CERVICAL DILATION_ ANY METHOD | $558.63 | $859.43 | — | 21% above | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC 58100 ENDOMETRIAL BIOPSY_ W_WO ENDOCERVICAL BIOPSY_ WO CERVICAL DILATION_ ANY METHOD | $558.63 | $859.43 | — | 21% above | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC 58100 ENDOMETRIAL BIOPSY_ W_WO ENDOCERVICAL BIOPSY_ WO CERVICAL DILATION_ ANY METHOD | $558.63 | $859.43 | — | — | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ENDOMETRIAL BIOPSY WO CERVICAL DILATION_ ANY METHOD | $558.63 | $859.43 | — | — | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ENDOMETRIAL SAMPLING _BIOPSY_ W_O CERVICAL DILATION_ ANY METHOD SEPARATE PROCEDURE | $558.63 | $859.43 | — | — | 35% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 HC NASAL_SINUS NDSC W_TOTAL ETHOIDECTOMY | $12,181.98 | $18,741.50 | — | 49% above | 35% |
| Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 HC NASAL_SINUS NDSC W_TOTAL ETHOIDECTOMY | $12,181.98 | $18,741.50 | — | — | 35% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 HC NASAL_SINUS NDSC W_RMVL TISS FROM FRONTAL SINUS | $12,181.98 | $18,741.50 | — | 49% above | 35% |
| Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 HC NASAL_SINUS NDSC W_RMVL TISS FROM FRONTAL SINUS | $12,181.98 | $18,741.50 | — | — | 35% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 HC NASAL SCOPY_OPEN MAXILL SINUS | $7,364.23 | $11,329.58 | — | 69% above | 35% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 HC NASAL SCOPY_OPEN MAXILL SINUS | $7,364.23 | $11,329.58 | — | — | 35% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 HC NASAL SCOPY_RMV TISS MAXILL SINUS | $12,181.98 | $18,741.50 | — | 49% above | 35% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 HC NASAL SCOPY_RMV TISS MAXILL SINUS | $12,181.98 | $18,741.50 | — | — | 35% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC INJECTION EPIDURAL_SUBARACHNOID CERVICAL_THORACIC WITH IMAGING | $852.20 | $1,311.08 | — | 39% below | 35% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC INJECTION EPIDURAL_SUBARACHNOID CERVICAL_THORACIC WITH IMAGING | $852.20 | $1,311.08 | — | — | 35% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 HC INTRAVITREAL INJECTION OF A PHARMACOLOGIC AGENT | $842.09 | $1,295.53 | — | 17% above | 35% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HC INTRAVITREAL INJECTION OF A PHARMACOLOGIC AGENT | $842.09 | $1,295.53 | — | — | 35% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJECTION_S__ DX_THERA AGENT_ PARAVERTEBRAL FACET JOINT_ LUMBAR_SACRAL_ SINGLE LEVEL | $2,188.39 | $3,366.76 | — | 9% above | 35% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJECTION_S__ DX_THERA AGENT_ PARAVERTEBRAL FACET JOINT_ LUMBAR_SACRAL_ SINGLE LEVEL | $2,188.39 | $3,366.76 | — | — | 35% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC SIGMOIDOSCOPY FLX DX W_COLLJ SPEC BR_WA IF PFRMD | $2,393.41 | $3,682.17 | — | 20% above | 35% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC SIGMOIDOSCOPY FLX DX W_COLLJ SPEC BR_WA IF PFRMD | $2,393.41 | $3,682.17 | — | — | 35% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC HEMORRHOIDECTOMY SIMPLE LIGATURE _EG RUBBER BAND_ | $2,393.41 | $3,682.17 | — | 110% above | 35% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC HEMORRHOIDECTOMY SIMPLE LIGATURE _EG RUBBER BAND_ | $2,393.41 | $3,682.17 | — | — | 35% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC XR CATH_INTRO FOR HYSTEROSONOGRAPHY_HYSTEROSALPINOGRAPHY | $91.08 | $140.13 | — | 70% below | 35% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC XR CATH_INTRO FOR HYSTEROSONOGRAPHY_HYSTEROSALPINOGRAPHY | $91.08 | $140.13 | — | — | 35% |
| Hysteroscopy with endometrial ablation CPT 58563 HC HYSTEROSCOPY SURGICAL_ WITH ENDOMETRIAL ABLATION | $11,325.89 | $17,424.44 | — | 94% above | 35% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HC HYSTEROSCOPY SURGICAL_ WITH ENDOMETRIAL ABLATION | $11,325.89 | $17,424.44 | — | — | 35% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC HYSTEROSCOPY_ SURGICAL_ W BIOPSY ENDOMETRIUM __OR POLYPECTOMY | $7,627.40 | $11,734.46 | — | 78% above | 35% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HC HYSTEROSCOPY_ SURGICAL_ W BIOPSY ENDOMETRIUM __OR POLYPECTOMY | $7,627.40 | $11,734.46 | — | — | 35% |
| IUD insertion (the device itself billed separately) CPT 58300 HC INSERTION OF INTRAUTERINE DEVICE _IUD_ | $199.89 | $307.53 | — | 51% below | 35% |
| IUD insertion (the device itself billed separately) CPT 58300 HC INSERTION INTRAUTERINE DEVICE IUD | $199.89 | $307.53 | — | 51% below | 35% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERTION OF INTRAUTERINE DEVICE _IUD_ | $199.89 | $307.53 | — | — | 35% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERTION INTRAUTERINE DEVICE IUD | $199.89 | $307.53 | — | — | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I_D OF ABSCESS SIMPLE_SINGLE | $384.21 | $591.09 | — | 5% below | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I_D ABSCESS_SIMPLE_SINGLE | $584.21 | $898.79 | — | 44% above | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I_D ABSCESS_ SIMPLE OR SINGLE | $584.21 | $898.79 | — | 44% above | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I_D OF ABSCESS_ SIMPLE_ SINGLE | $584.21 | $898.79 | — | 44% above | 35% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I_D OF ABSCESS SIMPLE_SINGLE | $384.21 | $591.09 | — | — | 35% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I_D OF ABSCESS_ SIMPLE_ SINGLE | $584.21 | $898.79 | — | — | 35% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I_D ABSCESS_SIMPLE_SINGLE | $584.21 | $898.79 | — | — | 35% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I_D ABSCESS_ SIMPLE OR SINGLE | $584.21 | $898.79 | — | — | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ TENDON SHEATH_LIGAMENT | $418.44 | $643.75 | — | 15% below | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECTION_ SINGLE TENDON SHEATH_LIGAMENT_ APONEUROSIS | $418.44 | $643.75 | — | 15% below | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJ TENDON SHEATH_LIGAMENT | $418.44 | $643.75 | — | — | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECTION_ SINGLE TENDON SHEATH_LIGAMENT_ APONEUROSIS | $418.44 | $643.75 | — | — | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS_ ASPIRATION __OR INJECTION_ MAJOR JOINT OR BURSA | $418.44 | $643.75 | — | 17% below | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC 20610 ARTHROCENTESIS_ ASPIRATION_INJECTION_ MAJOR JOINT OR BURSA | $418.44 | $643.75 | — | 17% below | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS_ ASPIRATION_INJECTION_ MAJOR JOINT_BURSA | $418.44 | $643.75 | — | 17% below | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS_ ASPIRATION_INJECTION_ MAJOR JOINT_BURSA | $418.44 | $643.75 | — | — | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS_ ASPIRATION __OR INJECTION_ MAJOR JOINT OR BURSA | $418.44 | $643.75 | — | — | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC 20610 ARTHROCENTESIS_ ASPIRATION_INJECTION_ MAJOR JOINT OR BURSA | $418.44 | $643.75 | — | — | 35% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT | $335.52 | $516.18 | — | 19% above | 35% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT | $335.52 | $516.18 | — | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHOCENTESIS INTERMEDIATE JOINT_BURSA | $277.89 | $427.53 | — | 39% below | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASPIR__INJ INTERM JT_BURS W_O US | $332.02 | $510.80 | — | 27% below | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS_ ASPIRATION_INJECTION_ INTERMEDIATE JOINT_BURSA | $418.44 | $643.75 | — | 9% below | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS_ ASPIRATION __OR INJECTION_ INTERMEDIATE JOINT OR BURSA | $418.44 | $643.75 | — | 9% below | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC 20605 ARTHROCENTESIS_ ASPIRATION_INJECTION_ INTERMEDIATE JOINT OR BURSA | $418.44 | $643.75 | — | 9% below | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHOCENTESIS_ ASPIRATON_INJ_ INTERMEDIATE JNT_BURSA | $418.44 | $643.75 | — | 9% below | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHOCENTESIS INTERMEDIATE JOINT_BURSA | $277.89 | $427.53 | — | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS ASPIR__INJ INTERM JT_BURS W_O US | $332.02 | $510.80 | — | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS_ ASPIRATION_INJECTION_ INTERMEDIATE JOINT_BURSA | $418.44 | $643.75 | — | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS_ ASPIRATION __OR INJECTION_ INTERMEDIATE JOINT OR BURSA | $418.44 | $643.75 | — | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC 20605 ARTHROCENTESIS_ ASPIRATION_INJECTION_ INTERMEDIATE JOINT OR BURSA | $418.44 | $643.75 | — | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHOCENTESIS_ ASPIRATON_INJ_ INTERMEDIATE JNT_BURSA | $418.44 | $643.75 | — | — | 35% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS_ ASPIRATION_INJECTION_ SMALL JOINT_BURSA | $418.44 | $643.75 | — | 7% below | 35% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC 20600 ARTHROCENTESIS_ ASPIRATION_INJECTION_ SMALL JOINT OR BURSA | $418.44 | $643.75 | — | 7% below | 35% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC 20600 ARTHROCENTESIS_ ASPIRATION_INJECTION_ SMALL JOINT OR BURSA | $418.44 | $643.75 | — | — | 35% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ARTHROCENTESIS_ ASPIRATION_INJECTION_ SMALL JOINT_BURSA | $418.44 | $643.75 | — | — | 35% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC DISCISSION SECONDARY MEMBRANOUS CATARACT_ LASER SURGERY | $1,639.22 | $2,521.88 | — | 31% above | 35% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 HC DISCISSION SECONDARY MEMBRANOUS CATARACT_ LASER SURGERY | $1,639.22 | $2,521.88 | — | — | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC REPAIR INTERMEDIATE S_A_T_E 2.5 CM__ | $1,054.58 | $1,622.43 | — | 78% above | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC REPAIR INTERMEDIATE S_A_T_E 2.5 CM_ | $1,107.30 | $1,703.54 | — | 87% above | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC 12031 LAYER CLOSURE OF WOUNDS_ 2.5 CM OR LESS_ SCALP_ AXILLAE_ TRUNK _EXC HANDS _ FEET_ | $1,107.30 | $1,703.54 | — | 87% above | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC REPAIR_ INTERMEDIATE_ 2.5CM OR LESS_ SCALP_ AXILLAE_ TRUNK_ __OR EXTREMITIES _EXC HANDS_FEET_ | $1,107.30 | $1,703.54 | — | 87% above | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC REPAIR INTERMEDIATE S_A_T_E 2.5 CM__ | $1,054.58 | $1,622.43 | — | — | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC 12031 LAYER CLOSURE OF WOUNDS_ 2.5 CM OR LESS_ SCALP_ AXILLAE_ TRUNK _EXC HANDS _ FEET_ | $1,107.30 | $1,703.54 | — | — | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC REPAIR INTERMEDIATE S_A_T_E 2.5 CM_ | $1,107.30 | $1,703.54 | — | — | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC REPAIR_ INTERMEDIATE_ 2.5CM OR LESS_ SCALP_ AXILLAE_ TRUNK_ __OR EXTREMITIES _EXC HANDS_FEET_ | $1,107.30 | $1,703.54 | — | — | 35% |
| Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH W_VENTRCLGRPHY | $8,273.02 | $12,727.73 | — | 19% above | 35% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HRT CATH W_VENTRCLGRPHY | $8,273.02 | $12,727.73 | — | — | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJECTION EPIDURAL_SUBARACHNOID LUMBAR_SACRAL WITH IMAGING | $852.20 | $1,311.08 | — | 43% below | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJECTION EPIDURAL_SUBARACHNOID LUMBAR_SACRAL WITH IMAGING | $852.20 | $1,311.08 | — | — | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX_THER SBST INTRLMNR LMBR_SAC W_O IMG GDN | $1,129.76 | $1,738.10 | — | 22% below | 35% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX DX_THER SBST INTRLMNR LMBR_SAC W_O IMG GDN | $1,129.76 | $1,738.10 | — | — | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC NJX AA__STRD TFRML EPI LUMBAR_SACRAL 1 LEVEL | $2,188.39 | $3,366.76 | — | 42% above | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ ANESTH__STEROID_TRANSFORAMINAL EPIDURAL_IMAGE GUIDE_FLUOR_CT__LUMBAR_SACARAL_SINGLE LVL | $2,188.39 | $3,366.76 | — | 42% above | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ ANESTH__STEROID_TRANSFORAMINAL EPIDURAL_IMAGE GUIDE_FLUOR_CT__LUMBAR_SACARAL_SINGLE LVL | $2,188.39 | $3,366.76 | — | — | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC NJX AA__STRD TFRML EPI LUMBAR_SACRAL 1 LEVEL | $2,188.39 | $3,366.76 | — | — | 35% |
| Miscarriage treatment with D&C, first trimester CPT 59820 HC TX MISSED ABORTION FIRST TRIMESTER SURGICAL | $6,478.78 | $9,967.35 | — | 59% above | 35% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC TX MISSED ABORTION FIRST TRIMESTER SURGICAL | $6,478.78 | $9,967.35 | — | — | 35% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 HC MOHS MICROGRAPHIC H_N_H_F_G 1ST STAGE 5 BLOCKS | $1,351.65 | $2,079.46 | — | 10% above | 35% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 HC MOHS MICROGRAPHIC H_N_H_F_G 1ST STAGE 5 BLOCKS | $1,351.65 | $2,079.46 | — | — | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC 11400 EXCISE BENIGN LESION 0.5 CM OR LESS | $1,994.36 | $3,068.25 | — | 85% above | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXCISE BENIGN LESION W MARGINS_ 0.5CM_LESS_ NOT SKIN TAG | $1,994.36 | $3,068.25 | — | 85% above | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC 11400 EXCISE BENIGN LESION 0.5 CM OR LESS | $1,994.36 | $3,068.25 | — | — | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXCISE BENIGN LESION W MARGINS_ 0.5CM_LESS_ NOT SKIN TAG | $1,994.36 | $3,068.25 | — | — | 35% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXCISION_ OTHER BENIGN LESION_ 0.5 CM_LESS | $1,994.36 | $3,068.25 | — | 89% above | 35% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXCISION_ OTHER BENIGN LESION_ 0.5 CM_LESS | $1,994.36 | $3,068.25 | — | — | 35% |
| Nail removal (partial or complete), one nail CPT 11730 HC 11730 AVULSION OF NAIL PLATE_ PARTIAL OR COMPLETE_ SIMPLE_ SINGLE | $584.21 | $898.79 | — | 75% above | 35% |
| Nail removal (partial or complete), one nail CPT 11730 HC AVULSION OF NAIL PLATE_ PARTIAL_COMPLETE_ SIMPLE_ SINGLE | $584.21 | $898.79 | — | 75% above | 35% |
| Nail removal (partial or complete), one nail CPT 11730 HC AVULSION OF NAIL PLATE_ PARTIAL OR COMPLETE_ SIMPLE_ SINGLE | $584.21 | $898.79 | — | 75% above | 35% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC 11730 AVULSION OF NAIL PLATE_ PARTIAL OR COMPLETE_ SIMPLE_ SINGLE | $584.21 | $898.79 | — | — | 35% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION OF NAIL PLATE_ PARTIAL OR COMPLETE_ SIMPLE_ SINGLE | $584.21 | $898.79 | — | — | 35% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION OF NAIL PLATE_ PARTIAL_COMPLETE_ SIMPLE_ SINGLE | $584.21 | $898.79 | — | — | 35% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV | $332.02 | $510.80 | — | 30% below | 35% |
| Occipital nerve block (injection for headaches) CPT 64405 HC N BLOCK INJ OCCIPITAL | $418.44 | $643.75 | — | 12% below | 35% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV | $332.02 | $510.80 | — | — | 35% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC N BLOCK INJ OCCIPITAL | $418.44 | $643.75 | — | — | 35% |
| Pacemaker implant (dual chamber) CPT 33208 HC INSERT NEW_REPLACEMENT PERM PACEMAKER W TRANSVENOUS ELECTRODE_S__ ATRIAL _ VENTRICULAR | $11,881.43 | $18,279.12 | — | 4% below | 35% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 HC INSERT NEW_REPLACEMENT PERM PACEMAKER W TRANSVENOUS ELECTRODE_S__ ATRIAL _ VENTRICULAR | $11,881.43 | $18,279.12 | — | — | 35% |
| Paracentesis with imaging guidance CPT 49083 HC 49083 ABDOMINAL PARACENTESIS _DIAGNOSTIC OR THERAPEUTIC__ W IMAGING GUIDANCE | $2,195.76 | $3,378.09 | — | 54% above | 35% |
| Paracentesis with imaging guidance CPT 49083 HC ABDOMINAL PARACENTESIS W_ IMAGING GUIDANCE | $2,195.76 | $3,378.09 | — | 54% above | 35% |
| Paracentesis with imaging guidance CPT 49083 HC ABDOMINAL PARACENTESIS _DIAG OR THERAPEUTIC_ WITH IMAGING GUIDANCE | $2,195.76 | $3,378.09 | — | 54% above | 35% |
| Paracentesis with imaging guidance CPT 49083 HC ABDOMINAL PARACENTESIS _DIAGNOSTIC OR THERAPEUTIC__ W IMAGING GUIDANCE | $2,195.76 | $3,378.09 | — | 54% above | 35% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC 49083 ABDOMINAL PARACENTESIS _DIAGNOSTIC OR THERAPEUTIC__ W IMAGING GUIDANCE | $2,195.76 | $3,378.09 | — | — | 35% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOMINAL PARACENTESIS _DIAG OR THERAPEUTIC_ WITH IMAGING GUIDANCE | $2,195.76 | $3,378.09 | — | — | 35% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOMINAL PARACENTESIS _DIAGNOSTIC OR THERAPEUTIC__ W IMAGING GUIDANCE | $2,195.76 | $3,378.09 | — | — | 35% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOMINAL PARACENTESIS W_ IMAGING GUIDANCE | $2,195.76 | $3,378.09 | — | — | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC 11750 EXCISION NAIL _ NAIL MATRIX_ PARTIAL OR COMPLETE_ PERMAMENT REMOVAL | $1,054.58 | $1,622.43 | — | 44% above | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC EXCISION NAIL AND NAIL MATRIX_ PARTIAL_COMPLETE FOR PERMANENT REMOVAL_ | $1,107.30 | $1,703.54 | — | 51% above | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC EXCISION NAIL _ MATRIX PARTIAL_COMPLETE_ PERMANENT REMOVAL | $1,107.30 | $1,703.54 | — | 51% above | 35% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC 11750 EXCISION NAIL _ NAIL MATRIX_ PARTIAL OR COMPLETE_ PERMAMENT REMOVAL | $1,054.58 | $1,622.43 | — | — | 35% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC EXCISION NAIL AND NAIL MATRIX_ PARTIAL_COMPLETE FOR PERMANENT REMOVAL_ | $1,107.30 | $1,703.54 | — | — | 35% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC EXCISION NAIL _ MATRIX PARTIAL_COMPLETE_ PERMANENT REMOVAL | $1,107.30 | $1,703.54 | — | — | 35% |
| Prostate biopsy CPT 55700 HC BIOPSY PROSTATE_ NEEDLE OR PUNCH SINGLE OR MULTIPLE ANY APPROACH | $5,191.40 | $7,986.77 | — | 114% above | 35% |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY PROSTATE_ NEEDLE OR PUNCH SINGLE OR MULTIPLE ANY APPROACH | $5,191.40 | $7,986.77 | — | — | 35% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR_SACRAL | $5,482.43 | $8,434.51 | — | 61% above | 35% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DESTRUCTION BY NEUROLYTIC AGNT PARVERTEB FCT NRV_SNGL JNT LUMBAR_SACRAL W IMAGE GUIDE | $5,482.43 | $8,434.51 | — | 61% above | 35% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR_SACRAL | $5,482.43 | $8,434.51 | — | — | 35% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DESTRUCTION BY NEUROLYTIC AGNT PARVERTEB FCT NRV_SNGL JNT LUMBAR_SACRAL W IMAGE GUIDE | $5,482.43 | $8,434.51 | — | — | 35% |
| Removal of a breast lump, open surgery CPT 19120 HC EXC CYST_ABERRANT BREAST TISSUE OPEN 1__ LESION | $7,392.41 | $11,372.94 | — | 63% above | 35% |
| Removal of a breast lump, open surgery CPT 19120 HC EXCISION OF CYST_FIBROADENOMA_BENIGH OR MALIGNANT TUMOR_ BREAST TISSUE_ MALE_FEMALE_ 1 OR MORE | $9,100.68 | $14,001.05 | — | 101% above | 35% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC EXC CYST_ABERRANT BREAST TISSUE OPEN 1__ LESION | $7,392.41 | $11,372.94 | — | — | 35% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC EXCISION OF CYST_FIBROADENOMA_BENIGH OR MALIGNANT TUMOR_ BREAST TISSUE_ MALE_FEMALE_ 1 OR MORE | $9,100.68 | $14,001.05 | — | — | 35% |
| Removal of a foreign object under the skin, simple CPT 10120 HC INCISION _ REMOVAL FOREIGN BODY SUBQ TISS SIMPLE | $883.77 | $1,359.65 | — | 37% above | 35% |
| Removal of a foreign object under the skin, simple CPT 10120 HC INCISION REMOVE FB FROM SUBCUTANEOUS TISSUE_ SIMPLE | $1,107.30 | $1,703.54 | — | 72% above | 35% |
| Removal of a foreign object under the skin, simple CPT 10120 HC INCISION _ REMOVAL OF FB_ SC TISSUES_ SIMPLE | $1,107.30 | $1,703.54 | — | 72% above | 35% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC INCISION _ REMOVAL FOREIGN BODY SUBQ TISS SIMPLE | $883.77 | $1,359.65 | — | — | 35% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC INCISION REMOVE FB FROM SUBCUTANEOUS TISSUE_ SIMPLE | $1,107.30 | $1,703.54 | — | — | 35% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC INCISION _ REMOVAL OF FB_ SC TISSUES_ SIMPLE | $1,107.30 | $1,703.54 | — | — | 35% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC COLORECTAL CANCER SCREENING COLONOSCOPY NOT HIGH RISK PT | $2,393.41 | $3,682.17 | — | 55% above | 35% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC COLORECTAL CANCER SCREENING COLONOSCOPY NOT HIGH RISK PT | $2,393.41 | $3,682.17 | — | — | 35% |
| Septoplasty to straighten the nasal septum CPT 30520 HC REPAIR OF NASAL SEPTUM | $6,419.65 | $9,876.39 | — | 66% above | 35% |
| Septoplasty to straighten the nasal septum inpatient CPT 30520 HC REPAIR OF NASAL SEPTUM | $6,419.65 | $9,876.39 | — | — | 35% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC LITHOTRIPSY_ EXTRACORPOREAL SHOCK WAVE | $11,985.71 | $18,439.55 | — | 121% above | 35% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 HC LITHOTRIPSY_ EXTRACORPOREAL SHOCK WAVE | $11,985.71 | $18,439.55 | — | — | 35% |
| Short arm cast (elbow to hand) CPT 29075 HC 29075 APPLICATION_ CAST_ SHORT ARM _ELBOW TO FINGER_ | $850.82 | $1,308.96 | — | 99% above | 35% |
| Short arm cast (elbow to hand) CPT 29075 HC APPLICATION_ CAST_ ELBOW TO FINGER _SHORT ARM_ | $850.82 | $1,308.96 | — | 99% above | 35% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLICATION_ CAST_ ELBOW TO FINGER _SHORT ARM_ | $850.82 | $1,308.96 | — | — | 35% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC 29075 APPLICATION_ CAST_ SHORT ARM _ELBOW TO FINGER_ | $850.82 | $1,308.96 | — | — | 35% |
| Short arm splint (forearm and hand) CPT 29125 HC 29125 APPLICATION OF SHORT ARM SPLINT _FOREARM TO HAND__ STATIC | $335.52 | $516.18 | — | 59% above | 35% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLICATION OF SHORT ARM SPLINT _FOREARM TO HAND__ STATIC | $335.52 | $516.18 | — | 59% above | 35% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLY SHORT ARM SPLINT _SHOULDER TO HAND_ | $335.52 | $516.18 | — | 59% above | 35% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY SHORT ARM SPLINT _SHOULDER TO HAND_ | $335.52 | $516.18 | — | — | 35% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC 29125 APPLICATION OF SHORT ARM SPLINT _FOREARM TO HAND__ STATIC | $335.52 | $516.18 | — | — | 35% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLICATION OF SHORT ARM SPLINT _FOREARM TO HAND__ STATIC | $335.52 | $516.18 | — | — | 35% |
| Short leg cast (below the knee) CPT 29405 HC APPLICATION OF SHORT LEG CAST _BELOW KNEE TO TOES_ | $850.82 | $1,308.96 | — | 73% above | 35% |
| Short leg cast (below the knee) CPT 29405 HC 29405 APPLICATION OF SHORT LEG CAST _BELOW KNEE TO TOES__ ED | $850.82 | $1,308.96 | — | 73% above | 35% |
| Short leg cast (below the knee) inpatient CPT 29405 HC APPLICATION OF SHORT LEG CAST _BELOW KNEE TO TOES_ | $850.82 | $1,308.96 | — | — | 35% |
| Short leg cast (below the knee) inpatient CPT 29405 HC 29405 APPLICATION OF SHORT LEG CAST _BELOW KNEE TO TOES__ ED | $850.82 | $1,308.96 | — | — | 35% |
| Short leg splint (calf to foot) CPT 29515 HC APPLICATION SHORT LEG SPLINT CALF FOOT | $484.07 | $744.72 | — | 69% above | 35% |
| Short leg splint (calf to foot) CPT 29515 HC APPLICATION OF SHORT LEG SPLINT | $484.07 | $744.72 | — | 69% above | 35% |
| Short leg splint (calf to foot) CPT 29515 HC 29515 APPLICATION SHORT LEG SPLINT _CALF TO FOOT_ | $484.07 | $744.72 | — | 69% above | 35% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC 29515 APPLICATION SHORT LEG SPLINT _CALF TO FOOT_ | $484.07 | $744.72 | — | — | 35% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC APPLICATION OF SHORT LEG SPLINT | $484.07 | $744.72 | — | — | 35% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC APPLICATION SHORT LEG SPLINT CALF FOOT | $484.07 | $744.72 | — | — | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC SIMPLE REPAIR SCALP_NECK_AXILLAE_GENIT_TRUNK_EXTREMITIES 2.5CM OR LESS | $584.21 | $898.79 | — | 55% above | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC SIMPLE REPAIR WOUND 2.5_LESS_ SCALP_ NECK_ AXILLAE_ EXT GENITALIA_ TRUNK __OR EXTREMITIES | $584.21 | $898.79 | — | 55% above | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC 12001 SIMPLE REPAIR_ SUPERFICIAL_ 2.5 CM OR LESS_ SCALP_ NECK_ AXILLAE_ TRUNK_ HANDS_FEET | $584.21 | $898.79 | — | 55% above | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC SIMPLE REPAIR SCALP_NECK_AXILLAE_GENIT_TRUNK_EXTREMITIES 2.5CM OR LESS | $584.21 | $898.79 | — | — | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC 12001 SIMPLE REPAIR_ SUPERFICIAL_ 2.5 CM OR LESS_ SCALP_ NECK_ AXILLAE_ TRUNK_ HANDS_FEET | $584.21 | $898.79 | — | — | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC SIMPLE REPAIR WOUND 2.5_LESS_ SCALP_ NECK_ AXILLAE_ EXT GENITALIA_ TRUNK __OR EXTREMITIES | $584.21 | $898.79 | — | — | 35% |
| Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION | $497.06 | $764.71 | — | 28% below | 35% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION | $497.06 | $764.71 | — | — | 35% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC EXCISION MALIGNANT LESION_ 0.5 CM OR LESS_ TRUNK_ ARMS_ LEGS | $1,994.36 | $3,068.25 | — | 132% above | 35% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC EXCISION MALIGNANT LESION_ 0.5 CM OR LESS_ TRUNK_ ARMS_ LEGS | $1,994.36 | $3,068.25 | — | — | 35% |
| Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS UP TO _ INCLUDE 15_LESS | $584.21 | $898.79 | — | 61% above | 35% |
| Skin tag removal, up to 15 tags CPT 11200 HC 11200 REMOVAL OF SKIN TAGS_ ANY AREA_ 15 LESIONS_LESS | $584.21 | $898.79 | — | 61% above | 35% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVAL OF SKIN TAGS UP TO _ INCLUDE 15_LESS | $584.21 | $898.79 | — | — | 35% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC 11200 REMOVAL OF SKIN TAGS_ ANY AREA_ 15 LESIONS_LESS | $584.21 | $898.79 | — | — | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE_ LUMBAR DIAGNOSIS | $852.20 | $1,311.08 | — | 28% below | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE_ LUMBAR_ DX | $852.20 | $1,311.08 | — | 28% below | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE DIAGNOSTIC | $852.20 | $1,311.08 | — | 28% below | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC 62270 SPINAL PUNCTURE_ LUMBAR DIAGNOSTIC | $852.20 | $1,311.08 | — | 28% below | 35% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE_ LUMBAR DIAGNOSIS | $852.20 | $1,311.08 | — | — | 35% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC 62270 SPINAL PUNCTURE_ LUMBAR DIAGNOSTIC | $852.20 | $1,311.08 | — | — | 35% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE_ LUMBAR_ DX | $852.20 | $1,311.08 | — | — | 35% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE DIAGNOSTIC | $852.20 | $1,311.08 | — | — | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC SMPL REPAIR SCALP_NECK_AX_GENIT_TRUNK 2.6_7.5CM | $497.06 | $764.71 | — | 25% above | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC SIMPLE REPAIR SCALP_NECK_AXILLAE_GENIT_TRUNK_EXTREMITIES 2.6CM_7.5CM | $584.21 | $898.79 | — | 47% above | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC SIMPLE REPAIR WOUND 2.6_7.5 CM_ SCALP_ NECK_ AXILLAE_ EXT GENITALIA_ TRUNK __OR EXTREMITIES | $584.21 | $898.79 | — | 47% above | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC 12002 SIMPLE REPAIR_ SUPERFICIAL_ 2.6 _ 7.5 CM_ SCALP_ NECK_ AXILLAE_ TRUNK_ HANDS_FEET | $584.21 | $898.79 | — | 47% above | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC SMPL REPAIR SCALP_NECK_AX_GENIT_TRUNK 2.6_7.5CM | $497.06 | $764.71 | — | — | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC 12002 SIMPLE REPAIR_ SUPERFICIAL_ 2.6 _ 7.5 CM_ SCALP_ NECK_ AXILLAE_ TRUNK_ HANDS_FEET | $584.21 | $898.79 | — | — | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC SIMPLE REPAIR WOUND 2.6_7.5 CM_ SCALP_ NECK_ AXILLAE_ EXT GENITALIA_ TRUNK __OR EXTREMITIES | $584.21 | $898.79 | — | — | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC SIMPLE REPAIR SCALP_NECK_AXILLAE_GENIT_TRUNK_EXTREMITIES 2.6CM_7.5CM | $584.21 | $898.79 | — | — | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC SIMPLE REPAIR_SUPERFICIAL_ 2.5 CM OR LESS_FACE_EARS_EYELIDS_NOSE_LIPS __OR MUCOUS MEMBRANES | $584.21 | $898.79 | — | 55% above | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC 12011 SIMPLE REPAIR_ SUPERFICIAL_ 2.5 CM OR LESS_FACE_EYELIDS_EARS_NOSE_LIPS_MUCOUS MEMB | $584.21 | $898.79 | — | 55% above | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC SIMPLE REPAIR OF SUP WOUNDS FACE_EARS_EYELIDS_NOSE_LIPS_MUCOUS MEMB_ 2.5CM OR LESS | $584.21 | $898.79 | — | 55% above | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC SIMPLE REPAIR_SUPERFICIAL_ 2.5 CM OR LESS_FACE_EARS_EYELIDS_NOSE_LIPS __OR MUCOUS MEMBRANES | $584.21 | $898.79 | — | — | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC SIMPLE REPAIR OF SUP WOUNDS FACE_EARS_EYELIDS_NOSE_LIPS_MUCOUS MEMB_ 2.5CM OR LESS | $584.21 | $898.79 | — | — | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC 12011 SIMPLE REPAIR_ SUPERFICIAL_ 2.5 CM OR LESS_FACE_EYELIDS_EARS_NOSE_LIPS_MUCOUS MEMB | $584.21 | $898.79 | — | — | 35% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION | $497.06 | $764.71 | — | at median | 35% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION | $497.06 | $764.71 | — | at median | 35% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION | $497.06 | $764.71 | — | — | 35% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION | $497.06 | $764.71 | — | — | 35% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS_ ASPIRATION OF PLEURAL SPACE_ WITH IMAGING GUIDANCE | $2,053.14 | $3,158.68 | — | 60% above | 35% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS_ASPIRATION OF PLEURAL SPACE_WITH IMAGING GUIDANCE | $2,053.14 | $3,158.68 | — | 60% above | 35% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS_ASPIRATION OF PLEURAL SPACE_WITH IMAGING GUIDANCE | $2,053.14 | $3,158.68 | — | — | 35% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS_ ASPIRATION OF PLEURAL SPACE_ WITH IMAGING GUIDANCE | $2,053.14 | $3,158.68 | — | — | 35% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 HC TONSILLECTOMY_ PRIMARY_SECONDARY_ AGE 12 OR OVER | $7,267.74 | $11,181.14 | — | 89% above | 35% |
| Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 HC TONSILLECTOMY_ PRIMARY_SECONDARY_ AGE 12 OR OVER | $7,267.74 | $11,181.14 | — | — | 35% |
| Total knee replacement CPT 27447 HC ARTHRP KHC NE CONDYLE_PLATU MEDIAL_LAT COMPARTMENTS | $13,931.12 | $21,432.50 | — | 9% below | 35% |
| Total knee replacement inpatient CPT 27447 HC ARTHRP KHC NE CONDYLE_PLATU MEDIAL_LAT COMPARTMENTS | $13,931.12 | $21,432.50 | — | — | 35% |
| Trigger finger release surgery CPT 26055 HC TENDON SHEATH INCISION | $3,251.90 | $5,002.93 | — | 25% above | 35% |
| Trigger finger release surgery inpatient CPT 26055 HC TENDON SHEATH INCISION | $3,251.90 | $5,002.93 | — | — | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ_ SINGLE_MULTI TRIGGER POINTS_S_ 1_2 MUSCLE_S_ | $418.44 | $643.75 | — | at median | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC 20552 INJECTION_S__ SINGLE OR MULTIPLE TRIGGER POINT_S__ 1 OR 2 MUSCLE_S_ | $418.44 | $643.75 | — | at median | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJECTION_ SINGLE_MULTIPLE TRIGGER POINT_S__ 1 OR 2 MUSCLE_S_ | $418.44 | $643.75 | — | at median | 35% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ_ SINGLE_MULTI TRIGGER POINTS_S_ 1_2 MUSCLE_S_ | $418.44 | $643.75 | — | — | 35% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC 20552 INJECTION_S__ SINGLE OR MULTIPLE TRIGGER POINT_S__ 1 OR 2 MUSCLE_S_ | $418.44 | $643.75 | — | — | 35% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJECTION_ SINGLE_MULTIPLE TRIGGER POINT_S__ 1 OR 2 MUSCLE_S_ | $418.44 | $643.75 | — | — | 35% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST LOCALIZATION DEVICE PC_ 1ST LESION US GUIDANCE | $4,582.16 | $7,049.47 | — | 58% above | 35% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST LOCALIZATION DEVICE PC_ 1ST LESION US GUIDANCE | $4,582.16 | $7,049.47 | — | — | 35% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC EGD BALLOON DILATION ESOPHAGUS _30 MM DIAM | $3,520.58 | $5,416.28 | — | 44% above | 35% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC EGD BALLOON DILATION ESOPHAGUS _30 MM DIAM | $3,520.58 | $5,416.28 | — | — | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD TRANSORAL BIOPSY SINGLE_MULTIPLE | $1,574.62 | $2,422.49 | — | 6% below | 35% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD TRANSORAL BIOPSY SINGLE_MULTIPLE | $1,574.62 | $2,422.49 | — | — | 35% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS | $1,574.63 | $2,422.51 | — | 27% above | 35% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC EGD INSERT GRIDE WIRE DILATE ESOPHAGUS OVER WIRE | $2,195.76 | $3,378.09 | — | 77% above | 35% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS | $1,574.63 | $2,422.51 | — | — | 35% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC EGD INSERT GRIDE WIRE DILATE ESOPHAGUS OVER WIRE | $2,195.76 | $3,378.09 | — | — | 35% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $1,706.99 | $2,626.14 | — | 4% above | 35% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $1,706.99 | $2,626.14 | — | — | 35% |
| Vein ablation, radiofrequency, first vein CPT 36475 HC ENDOVENOUS RF 1ST VEIN | $6,509.50 | $10,014.62 | — | 44% above | 35% |
| Vein ablation, radiofrequency, first vein CPT 36475 HC ENDOVENOUS ABLATION THERAPY_ FIRST VEIN TREATED | $6,509.50 | $10,014.62 | — | 44% above | 35% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC ENDOVENOUS RF 1ST VEIN | $6,509.50 | $10,014.62 | — | — | 35% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC ENDOVENOUS ABLATION THERAPY_ FIRST VEIN TREATED | $6,509.50 | $10,014.62 | — | — | 35% |
| Wart removal, up to 14 warts CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14 | $497.06 | $764.71 | — | 43% above | 35% |
| Wart removal, up to 14 warts CPT 17110 HC DESTRUCTION BENIGN LESIONS OTHER THAN SKIN TAGS | $497.06 | $764.71 | — | 43% above | 35% |
| Wart removal, up to 14 warts CPT 17110 HC DESTROY FLAT WARTS_UP TO 14 LESIONS | $584.21 | $898.79 | — | 68% above | 35% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCTION BENIGN LESIONS OTHER THAN SKIN TAGS | $497.06 | $764.71 | — | — | 35% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14 | $497.06 | $764.71 | — | — | 35% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC DESTROY FLAT WARTS_UP TO 14 LESIONS | $584.21 | $898.79 | — | — | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM__ | $911.47 | $1,402.26 | — | 8% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDEMENT SKIN _ SC TISSUE | $1,054.58 | $1,622.43 | — | 25% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC 11042 DEBRIDEMENT SKIN AND SUBCUTANEOUS TISSUE | $1,107.30 | $1,703.54 | — | 31% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDEMENT_ SC TISSUE_ 1ST 20 SQ CM_LESS | $1,107.30 | $1,703.54 | — | 31% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM__ | $911.47 | $1,402.26 | — | — | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDEMENT SKIN _ SC TISSUE | $1,054.58 | $1,622.43 | — | — | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC 11042 DEBRIDEMENT SKIN AND SUBCUTANEOUS TISSUE | $1,107.30 | $1,703.54 | — | — | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDEMENT_ SC TISSUE_ 1ST 20 SQ CM_LESS | $1,107.30 | $1,703.54 | — | — | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC TRANSFUSION OF BLOOD OR BLOOD COMPONENT | $1,049.07 | $1,613.95 | — | 43% above | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC TRANSFUSION OF BLOOD OR BLOOD COMPONENT | $1,049.07 | $1,613.95 | — | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC PRESSURIZED_NONPRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION_ FOR THERAP | $258.91 | $398.32 | — | 16% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC PRESS_NONPRESS INHALER TRTMT FOR AC AWY OBS_SI FOR DIAG PUR_MDI_AERSL GEN_NEB_IPPB DEV_ | $258.91 | $398.32 | — | 16% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC COUGH ASSIST TREATMENT | $258.91 | $398.32 | — | 16% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC NEBULIZER TX WITH MECH VENT | $258.91 | $398.32 | — | 16% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT FOR AIRWAY OBSTRUCTION | $258.91 | $398.32 | — | 16% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC 94640 INHALATION TREATMENT ACUTE AIRWAY OBSTRUCTION_ SPUTUM INDUCTION | $258.91 | $398.32 | — | 16% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC PRESURIZED_NONPRESSURIZED INHALATION TX FOR ACUTE AIRWAY OBSTRUCTION OR SPUTUM INDUCTION | $258.91 | $398.32 | — | 16% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC PRESS_NONPRESS INHALER TRTMT FOR AC AWY OBS_SI FOR DIAG PUR_MDI_AERSL GEN_NEB_IPPB DEV_ | $258.91 | $398.32 | — | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT FOR AIRWAY OBSTRUCTION | $258.91 | $398.32 | — | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC PRESSURIZED_NONPRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION_ FOR THERAP | $258.91 | $398.32 | — | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC 94640 INHALATION TREATMENT ACUTE AIRWAY OBSTRUCTION_ SPUTUM INDUCTION | $258.91 | $398.32 | — | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC NEBULIZER TX WITH MECH VENT | $258.91 | $398.32 | — | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC COUGH ASSIST TREATMENT | $258.91 | $398.32 | — | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC PRESURIZED_NONPRESSURIZED INHALATION TX FOR ACUTE AIRWAY OBSTRUCTION OR SPUTUM INDUCTION | $258.91 | $398.32 | — | — | 35% |
| Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO ADMIN IV INFUS UP TO 1 HR SINGLE_INITIAL SUB_DRUG | $611.62 | $940.96 | — | at median | 35% |
| Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO ADMIN IV INF_ UP TO ONE HOUR_ SINGLE_INITIAL SUBSTANCE_DRUG | $611.62 | $940.96 | — | at median | 35% |
| Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO IV ADMIN MONOCLONAL ANTIBODY AGENT_ UP TO 1HR_INIT_SIN | $636.72 | $979.57 | — | 4% above | 35% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO ADMIN IV INFUS UP TO 1 HR SINGLE_INITIAL SUB_DRUG | $611.62 | $940.96 | — | — | 35% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO ADMIN IV INF_ UP TO ONE HOUR_ SINGLE_INITIAL SUBSTANCE_DRUG | $611.62 | $940.96 | — | — | 35% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO IV ADMIN MONOCLONAL ANTIBODY AGENT_ UP TO 1HR_INIT_SIN | $636.72 | $979.57 | — | — | 35% |
| Comprehensive eye exam by an eye doctor, new patient CPT 92004 HC OPH MED EXAM _ EVAL W INIT DX TR PROG COMP NEW PT 1_MORE VISIT | $391.06 | $601.63 | — | 70% above | 35% |
| Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 HC OPH MED EXAM _ EVAL W INIT DX TR PROG COMP NEW PT 1_MORE VISIT | $391.06 | $601.63 | — | — | 35% |
| Comprehensive eye exam, returning patient CPT 92014 HC OPHTHALMOLOGICAL SERVICES_ MED EXAM_EVAL_W INIT_CONT DX_TX PROG_COMPREHENSIVE_ EST PT | $391.06 | $601.63 | — | 100% above | 35% |
| Comprehensive eye exam, returning patient inpatient CPT 92014 HC OPHTHALMOLOGICAL SERVICES_ MED EXAM_EVAL_W INIT_CONT DX_TX PROG_COMPREHENSIVE_ EST PT | $391.06 | $601.63 | — | — | 35% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC COMPREHENSIVE HEARING TEST | $356.57 | $548.57 | — | 93% above | 35% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC COMPREHENSIVE HEARING TEST | $356.57 | $548.57 | — | — | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE_ E_M OF CRITICALLY ILL_INJURED_ FIRST 30 _74 MINUTES | $1,830.98 | $2,816.89 | — | 7% above | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE_ E_M OF CRITICALLY ILL_INJURED_ FIRST 30 _74 MINUTES | $2,233.36 | $3,435.94 | — | 30% above | 35% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE_ E_M OF CRITICALLY ILL_INJURED_ FIRST 30 _74 MINUTES | $1,830.98 | $2,816.89 | — | — | 35% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE_ E_M OF CRITICALLY ILL_INJURED_ FIRST 30 _74 MINUTES | $2,233.36 | $3,435.94 | — | — | 35% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE _ DROWSY 20_40 MIN | $870.76 | $1,339.63 | — | 26% above | 35% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE _ DROWSY 20_40 MIN | $870.76 | $1,339.63 | — | — | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC 93005 ELECTROCARDIOGRAM_TRACING ONLY_ WO INTER_REPORT | $192.19 | $295.67 | — | 34% above | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC 93005 ELECTROCARDIOGRAM_TRACING ONLY_ WO INTER_REPORT ED_OBS | $192.19 | $295.67 | — | 34% above | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC 93005 ELECTROCARDIOGRAM_TRACING ONLY_ WO INTER_REPORT ED_OBS | $192.19 | $295.67 | — | — | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC 93005 ELECTROCARDIOGRAM_TRACING ONLY_ WO INTER_REPORT | $192.19 | $295.67 | — | — | 35% |
| Electroconvulsive therapy (ECT), one session CPT 90870 HC ECT INITIAL LEVEL | $1,362.80 | $2,096.61 | — | 58% above | 35% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HC ECT INITIAL LEVEL | $1,362.80 | $2,096.61 | — | — | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY DEPT E_M VISIT_LEVEL I | $348.97 | $536.88 | — | 40% above | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMERGENCY DEPT E_M VISIT_LEVEL I | $348.97 | $536.88 | — | — | 35% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY DEPT E_M VISIT_LEVEL II | $502.50 | $773.08 | — | 49% above | 35% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY DEPT E_M VISIT_LEVEL II | $502.50 | $773.08 | — | — | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY DEPT E_M VISIT_LEVEL III | $1,149.29 | $1,768.14 | — | 104% above | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMERGENCY DEPT E_M VISIT_LEVEL III | $1,149.29 | $1,768.14 | — | — | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY DEPT E_M VISIT_LEVEL IV | $1,763.01 | $2,712.33 | — | 109% above | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMERGENCY DEPT E_M VISIT_LEVEL IV | $1,763.01 | $2,712.33 | — | — | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY DEPT E_M VISIT_LEVEL V | $2,140.30 | $3,292.77 | — | 81% above | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMERGENCY DEPT E_M VISIT_LEVEL V | $2,140.30 | $3,292.77 | — | — | 35% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC STRESS TEST_ EKG_TRACING ONLY WO INTERPRETATION _ REPORT | $870.76 | $1,339.63 | — | 58% above | 35% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC STRESS TEST_ EKG_TRACING ONLY WO INTERPRETATION _ REPORT | $870.76 | $1,339.63 | — | — | 35% |
| Eye exam, returning patient, intermediate CPT 92012 HC OPHTHALMOLOGICAL SERVICES_ MED EXAM_EVAL_ W INIT_CONT DX_TX PROGRAM_ INTERMEDIATE_ EST PT | $391.06 | $601.63 | — | 70% above | 35% |
| Eye exam, returning patient, intermediate inpatient CPT 92012 HC OPHTHALMOLOGICAL SERVICES_ MED EXAM_EVAL_ W INIT_CONT DX_TX PROGRAM_ INTERMEDIATE_ EST PT | $391.06 | $601.63 | — | — | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC OASAS FAMILY PSYCHOTHERAPY W_PATIENT PRESENT 50 MINS | $321.46 | $494.55 | — | 15% above | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC BHN FAMILY PSYCHOTHERAPY W PATIENT PRESENT | $386.94 | $595.30 | — | 38% above | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT | $386.94 | $595.30 | — | 38% above | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC OMH FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT | $386.94 | $595.30 | — | 38% above | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY THERAPY W_PATIENT PRESENT | $415.97 | $639.96 | — | 49% above | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC OASAS FAMILY PSYCHOTHERAPY W_PATIENT PRESENT 50 MINS | $321.46 | $494.55 | — | — | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC BHN FAMILY PSYCHOTHERAPY W PATIENT PRESENT | $386.94 | $595.30 | — | — | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC OMH FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT | $386.94 | $595.30 | — | — | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT | $386.94 | $595.30 | — | — | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY THERAPY W_PATIENT PRESENT | $415.97 | $639.96 | — | — | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC OASAS_ FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $337.53 | $519.27 | — | 28% above | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC OMH FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $386.94 | $595.30 | — | 47% above | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC BHN FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $386.94 | $595.30 | — | 47% above | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ WO PATIENT PRESENT | $386.94 | $595.30 | — | 47% above | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY THERAPY W_OUT PATIENT PRESENT | $415.97 | $639.96 | — | 58% above | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC OASAS_ FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $337.53 | $519.27 | — | — | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC BHN FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $386.94 | $595.30 | — | — | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ WO PATIENT PRESENT | $386.94 | $595.30 | — | — | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC OMH FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $386.94 | $595.30 | — | — | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY THERAPY W_OUT PATIENT PRESENT | $415.97 | $639.96 | — | — | 35% |
| Group psychotherapy session CPT 90853 HC OASAS GROUP PSYCHOTHERAPY | $225.39 | $346.75 | — | 78% above | 35% |
| Group psychotherapy session CPT 90853 HC OMH GROUP PSYCHOTHERAPY_ OTHER THAN OF A MULTI_FAMILY GROUP | $225.39 | $346.75 | — | 78% above | 35% |
| Group psychotherapy session CPT 90853 HC BHN GROUP PSYCHOTHERAPY | $225.39 | $346.75 | — | 78% above | 35% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY _OTHER THAN OF A MULTIPLE_FAMILY GROUP_ | $225.39 | $346.75 | — | 78% above | 35% |
| Group psychotherapy session inpatient CPT 90853 HC OASAS GROUP PSYCHOTHERAPY | $225.39 | $346.75 | — | — | 35% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY _OTHER THAN OF A MULTIPLE_FAMILY GROUP_ | $225.39 | $346.75 | — | — | 35% |
| Group psychotherapy session inpatient CPT 90853 HC BHN GROUP PSYCHOTHERAPY | $225.39 | $346.75 | — | — | 35% |
| Group psychotherapy session inpatient CPT 90853 HC OMH GROUP PSYCHOTHERAPY_ OTHER THAN OF A MULTI_FAMILY GROUP | $225.39 | $346.75 | — | — | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INFUSION_ HYDRATION_ INITIAL 31 MINUTES TO 1 HOUR | $348.36 | $535.94 | — | 6% below | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC 96360 IV INFUSION HYDRATION_ INITIAL_ 31 MIN TO 1 HR | $348.36 | $535.94 | — | 6% below | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INF HYDRATION_ INITIAL_ 31 MIN TO 1 HOUR | $348.36 | $535.94 | — | 6% below | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INFUSION_ HYDRATION_ INITIAL 31 MINUTES TO 1 HOUR | $348.36 | $535.94 | — | — | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC 96360 IV INFUSION HYDRATION_ INITIAL_ 31 MIN TO 1 HR | $348.36 | $535.94 | — | — | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INF HYDRATION_ INITIAL_ 31 MIN TO 1 HOUR | $348.36 | $535.94 | — | — | 35% |
| IV infusion of a medicine, first hour CPT 96365 HC _ IV INFUSION THERAPY_PROPH_DIAG_INITIAL UP TO 1 HR | $348.36 | $535.94 | — | 17% below | 35% |
| IV infusion of a medicine, first hour CPT 96365 HC 96365 IV INFUSION THERAPY_PROPH_DIAG_ INITIAL_ UP TO ONE HOUR | $348.36 | $535.94 | — | 17% below | 35% |
| IV infusion of a medicine, first hour CPT 96365 HC IV INF THERAPY_PROPH_DIAG_ INITIAL UP TO 1 HOUR | $348.36 | $535.94 | — | 17% below | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC _ IV INFUSION THERAPY_PROPH_DIAG_INITIAL UP TO 1 HR | $348.36 | $535.94 | — | — | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INF THERAPY_PROPH_DIAG_ INITIAL UP TO 1 HOUR | $348.36 | $535.94 | — | — | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC 96365 IV INFUSION THERAPY_PROPH_DIAG_ INITIAL_ UP TO ONE HOUR | $348.36 | $535.94 | — | — | 35% |
| IV push of a medicine, first drug CPT 96374 HC THERAPEUTIC_ PROPH_DX INJ_IV PUSH SING_INIT SUBSTANCE_DRUG | $348.36 | $535.94 | — | 36% above | 35% |
| IV push of a medicine, first drug CPT 96374 HC THER_PROPH_DIAG INJ_ IV PUSH_ SINGLE_INITIAL SUBSTANCE_DRUG | $348.36 | $535.94 | — | 36% above | 35% |
| IV push of a medicine, first drug CPT 96374 HC THERA_PROPH_DIAG INJ_IV PUSH_SINGLE _ INITIAL SUBSTANCE_DRUG | $348.36 | $535.94 | — | 36% above | 35% |
| IV push of a medicine, first drug CPT 96374 HC THERAPEUTIC_PROPH_DX INJ_IV PUSH_SINGLE_INIT SUBSTANCE_DRUG | $348.36 | $535.94 | — | 36% above | 35% |
| IV push of a medicine, first drug CPT 96374 HC 96374 THER_PROPH_DIAG INJ_ IV PUSH_ SINGLE_INITIAL_ SUBSTANCE_DRUG | $348.36 | $535.94 | — | 36% above | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 HC THERAPEUTIC_PROPH_DX INJ_IV PUSH_SINGLE_INIT SUBSTANCE_DRUG | $348.36 | $535.94 | — | — | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 HC 96374 THER_PROPH_DIAG INJ_ IV PUSH_ SINGLE_INITIAL_ SUBSTANCE_DRUG | $348.36 | $535.94 | — | — | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 HC THER_PROPH_DIAG INJ_ IV PUSH_ SINGLE_INITIAL SUBSTANCE_DRUG | $348.36 | $535.94 | — | — | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 HC THERAPEUTIC_ PROPH_DX INJ_IV PUSH SING_INIT SUBSTANCE_DRUG | $348.36 | $535.94 | — | — | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 HC THERA_PROPH_DIAG INJ_IV PUSH_SINGLE _ INITIAL SUBSTANCE_DRUG | $348.36 | $535.94 | — | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THER_PROPH_DIAG INJ SC_IM | $80.28 | $123.50 | — | 28% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THERA_PROPH_DIAG INJ_SUBCUTANEOUS OR INTRAMUSCULAR | $80.28 | $123.50 | — | 28% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THERA_PROPH_DX INJ_SC_IM | $80.28 | $123.50 | — | 28% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THER_PROPH_DIAG INJ_ SC_IM | $80.28 | $123.50 | — | 28% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC 96372 THER_PROPH_DIAG INJ_ SC_IM | $80.28 | $123.50 | — | 28% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC OMH COMPREHENSIVE MEDICATION SERVICES _INJECTION__ W MONITORING_ PER 15 MINS | $98.96 | $152.24 | — | 11% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC BHN THERAPEUTIC PROPHYLACTIC_DX INJ_ SC_IM | $98.96 | $152.24 | — | 11% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC OMH THERAPEUTIC_ PROPHYLACTIC OR DIAGNOSTIC INJECTION_ SUBCUTANEOUS_INTRAMUSCULAR | $98.96 | $152.24 | — | 11% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC OASAS THERAPEUTIC_ PROPHYLACTIC OR DIAGNOSTIC INJECTION_ SUBCUTANEOUS_INTRAMUSCULAR | $113.56 | $174.71 | — | 2% above | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THERA_PROPH_DX INJ_SC_IM | $80.28 | $123.50 | — | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THERA_PROPH_DIAG INJ_SUBCUTANEOUS OR INTRAMUSCULAR | $80.28 | $123.50 | — | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THER_PROPH_DIAG INJ_ SC_IM | $80.28 | $123.50 | — | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THER_PROPH_DIAG INJ SC_IM | $80.28 | $123.50 | — | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC 96372 THER_PROPH_DIAG INJ_ SC_IM | $80.28 | $123.50 | — | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC OMH THERAPEUTIC_ PROPHYLACTIC OR DIAGNOSTIC INJECTION_ SUBCUTANEOUS_INTRAMUSCULAR | $98.96 | $152.24 | — | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC OMH COMPREHENSIVE MEDICATION SERVICES _INJECTION__ W MONITORING_ PER 15 MINS | $98.96 | $152.24 | — | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC BHN THERAPEUTIC PROPHYLACTIC_DX INJ_ SC_IM | $98.96 | $152.24 | — | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC OASAS THERAPEUTIC_ PROPHYLACTIC OR DIAGNOSTIC INJECTION_ SUBCUTANEOUS_INTRAMUSCULAR | $113.56 | $174.71 | — | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC OMH PSYCHIATRIC DIAGNOSTIC EVAL 2ND ASSESSEMENTMINIMUM 45 MINUTES | $368.52 | $566.96 | — | 45% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC OASAS FIRST ASSESSMENT 30 MINS | $372.68 | $573.35 | — | 47% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC OASAS THIRD ASSESSMENT 30 MINS | $372.68 | $573.35 | — | 47% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC OASAS SECOND ASSESSMENT 30 MINS | $372.68 | $573.35 | — | 47% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC BHN DIAGNOSTIC EVALUATION | $384.66 | $591.79 | — | 51% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC OMH PSYCHIATRIC DIAGNOSTIC EVALUATION_ 1ST ASSESSMENT | $384.66 | $591.79 | — | 51% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC OMH BARIATRIC CONSULT | $386.94 | $595.30 | — | 52% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCHIATRIC DIAGNOSTIC EVALUATION | $386.94 | $595.30 | — | 52% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC OASAS SECOND DIAGNOSTIC EVALUATION 75 MINS | $424.36 | $652.86 | — | 67% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC OASAS THIRD DIAGNOSTIC EVALUATION 75 MINS | $424.36 | $652.86 | — | 67% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC OASAS FIRST DIAGNOSTIC EVALUATION 75 MINS | $424.36 | $652.86 | — | 67% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC OMH PSYCHIATRIC DIAGNOSTIC EVAL 2ND ASSESSEMENTMINIMUM 45 MINUTES | $368.52 | $566.96 | — | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC OASAS THIRD ASSESSMENT 30 MINS | $372.68 | $573.35 | — | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC OASAS SECOND ASSESSMENT 30 MINS | $372.68 | $573.35 | — | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC OASAS FIRST ASSESSMENT 30 MINS | $372.68 | $573.35 | — | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC OMH PSYCHIATRIC DIAGNOSTIC EVALUATION_ 1ST ASSESSMENT | $384.66 | $591.79 | — | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC BHN DIAGNOSTIC EVALUATION | $384.66 | $591.79 | — | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCHIATRIC DIAGNOSTIC EVALUATION | $386.94 | $595.30 | — | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC OMH BARIATRIC CONSULT | $386.94 | $595.30 | — | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC OASAS THIRD DIAGNOSTIC EVALUATION 75 MINS | $424.36 | $652.86 | — | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC OASAS FIRST DIAGNOSTIC EVALUATION 75 MINS | $424.36 | $652.86 | — | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC OASAS SECOND DIAGNOSTIC EVALUATION 75 MINS | $424.36 | $652.86 | — | — | 35% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC 7_8 NERVE CONDUCTION STUDIES | $870.76 | $1,339.63 | — | 90% above | 35% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC 7_8 NERVE CONDUCTION STUDIES | $870.76 | $1,339.63 | — | — | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCULAR RE_EDUCATION_ EA 15 MIN | $108.48 | $166.90 | — | 32% above | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCULAR RE_EDUCATION_ EA 15 MIN_ 1 OR MORE AREAS | $108.48 | $166.90 | — | 32% above | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCULAR RE_EDUCATION_ EA 15 MIN_ 1 OR MORE AREAS | $108.48 | $166.90 | — | — | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCULAR RE_EDUCATION_ EA 15 MIN | $108.48 | $166.90 | — | — | 35% |
| New patient office visit, about 30 minutes CPT 99203 HC OFFICE_OUTPATIENT NEW LOW MDM 30 MINUTES | $182.57 | $280.87 | — | 18% below | 35% |
| New patient office visit, about 30 minutes CPT 99203 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 3 | $277.97 | $427.64 | — | 25% above | 35% |
| New patient office visit, about 30 minutes CPT 99203 HC BHN E_M NEW PATIENT LEVEL 3 | $277.97 | $427.64 | — | 25% above | 35% |
| New patient office visit, about 30 minutes CPT 99203 HC OMH E_M NEW PATIENT LEVEL 3 | $277.97 | $427.64 | — | 25% above | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE_OUTPATIENT NEW LOW MDM 30 MINUTES | $182.57 | $280.87 | — | — | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OMH E_M NEW PATIENT LEVEL 3 | $277.97 | $427.64 | — | — | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 3 | $277.97 | $427.64 | — | — | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC BHN E_M NEW PATIENT LEVEL 3 | $277.97 | $427.64 | — | — | 35% |
| New patient office visit, about 45 minutes CPT 99204 HC OFFICE_OUTPATIENT NEW MODERATE MDM 45 MINUTES | $224.39 | $345.22 | — | 25% below | 35% |
| New patient office visit, about 45 minutes CPT 99204 HC BHN E_M NEW PATIENT LEVEL 4 | $291.87 | $449.03 | — | 2% below | 35% |
| New patient office visit, about 45 minutes CPT 99204 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 4 | $291.87 | $449.03 | — | 2% below | 35% |
| New patient office visit, about 45 minutes CPT 99204 HC OMH E_M NEW PATIENT LEVEL 4 | $291.87 | $449.03 | — | 2% below | 35% |
| New patient office visit, about 45 minutes CPT 99204 HC OASAS ALCOHOL_ MED MANAGEMENT NEW PATIENT LEVEL 4 | $313.76 | $482.70 | — | 5% above | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE_OUTPATIENT NEW MODERATE MDM 45 MINUTES | $224.39 | $345.22 | — | — | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 4 | $291.87 | $449.03 | — | — | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OMH E_M NEW PATIENT LEVEL 4 | $291.87 | $449.03 | — | — | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC BHN E_M NEW PATIENT LEVEL 4 | $291.87 | $449.03 | — | — | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OASAS ALCOHOL_ MED MANAGEMENT NEW PATIENT LEVEL 4 | $313.76 | $482.70 | — | — | 35% |
| New patient office visit, about 60 minutes CPT 99205 HC OFFICE_OUTPATIENT NEW HIGH MDM 60 MINUTES | $281.00 | $432.31 | — | 25% below | 35% |
| New patient office visit, about 60 minutes CPT 99205 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 5 | $306.46 | $471.48 | — | 19% below | 35% |
| New patient office visit, about 60 minutes CPT 99205 HC OMH E_M NEW PATIENT LEVEL 5 | $306.46 | $471.48 | — | 19% below | 35% |
| New patient office visit, about 60 minutes CPT 99205 HC BHN E_M NEW PATIENT LEVEL 5 | $306.46 | $471.48 | — | 19% below | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE_OUTPATIENT NEW HIGH MDM 60 MINUTES | $281.00 | $432.31 | — | — | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OMH E_M NEW PATIENT LEVEL 5 | $306.46 | $471.48 | — | — | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC BHN E_M NEW PATIENT LEVEL 5 | $306.46 | $471.48 | — | — | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 5 | $306.46 | $471.48 | — | — | 35% |
| New patient office visit, straightforward problem or 15+ minutes both sides CPT 99202 HC OPHTHALMOSCOPY_ EXTENDED_ OPTIC NRV_MACULAR DRAWING_ I_R_ UNILATERAL OR BILATERAL | $149.13 | $229.43 | — | — | 35% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OFFICE_OUTPATIENT NEW SF MDM 15 MINUTES | $157.39 | $242.14 | — | 10% below | 35% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 2 | $264.73 | $407.28 | — | 52% above | 35% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC BHN E_M NEW PATIENT LEVEL 2 | $264.73 | $407.28 | — | 52% above | 35% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OMH E_M NEW PATIENT LEVEL 2 | $264.73 | $407.28 | — | 52% above | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient both sides CPT 99202 HC OPHTHALMOSCOPY_ EXTENDED_ OPTIC NRV_MACULAR DRAWING_ I_R_ UNILATERAL OR BILATERAL | $149.13 | $229.43 | — | — | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC OFFICE_OUTPATIENT NEW SF MDM 15 MINUTES | $157.39 | $242.14 | — | — | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC OMH E_M NEW PATIENT LEVEL 2 | $264.73 | $407.28 | — | — | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC BHN E_M NEW PATIENT LEVEL 2 | $264.73 | $407.28 | — | — | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 2 | $264.73 | $407.28 | — | — | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MNT_INITIAL INDIVIDUAL_ EACH 15 MINUTES | $78.65 | $121.00 | — | 48% above | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICAL NUTRITION THERAPY_ INITIAL_ INDIVIDUAL_ EACH 15 MINUTES | $78.65 | $121.00 | — | 48% above | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MNT IND INITIAL_MVP SESSION | $78.65 | $121.00 | — | 48% above | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICAL NUTRITION THERAPY_ INITIAL_ INDIVIDUAL_ EACH 15 MINUTES | $78.65 | $121.00 | — | — | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MNT IND INITIAL_MVP SESSION | $78.65 | $121.00 | — | — | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MNT_INITIAL INDIVIDUAL_ EACH 15 MINUTES | $78.65 | $121.00 | — | — | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEX | $181.16 | $278.70 | — | 6% above | 35% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEX | $181.16 | $278.70 | — | — | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEX | $361.30 | $555.84 | — | 37% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEX | $361.30 | $555.84 | — | — | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEX | $181.16 | $278.70 | — | 1% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEX | $181.16 | $278.70 | — | — | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MOD COMPLEX | $272.25 | $418.85 | — | 13% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL MOD COMPLEX | $272.25 | $418.85 | — | — | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TECHNIQUES_ EA 15 MIN_ 1 OR MORE REGIONS | $86.00 | $132.31 | — | 3% above | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TECHNIQUES_ EA 15 MIN | $86.00 | $132.31 | — | 3% above | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TECHNIQUES_ EA 15 MIN_ 1 OR MORE REGIONS | $86.00 | $132.31 | — | — | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TECHNIQUES_ EA 15 MIN | $86.00 | $132.31 | — | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PULMONARY REHABILITATION THERAPEUTIC EXCERCISES EA 15 MINUTES | $44.55 | $68.54 | — | 41% below | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS | $93.49 | $143.83 | — | 24% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS | $93.49 | $143.83 | — | 24% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PULMONARY REHABILITATION THERAPEUTIC EXCERCISES EA 15 MINUTES | $44.55 | $68.54 | — | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS | $93.49 | $143.83 | — | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS | $93.49 | $143.83 | — | — | 35% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 18 THROUGH 39 YEARS | $323.10 | $497.07 | — | 60% above | 35% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 18 THROUGH 39 YEARS | $323.10 | $497.07 | — | — | 35% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 40 THROUGH 64 YEARS | $374.22 | $575.73 | — | 66% above | 35% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 40 THROUGH 64 YEARS | $374.22 | $575.73 | — | — | 35% |
| Preventive checkup, new patient aged 65 or older CPT 99387 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 65 YEARS AND OLDER | $406.48 | $625.36 | — | 58% above | 35% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 65 YEARS AND OLDER | $406.48 | $625.36 | — | — | 35% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 HC PERIODIC PREVENTIVE E_M_ ESTABLISHED PATIENT_ AGE 18 THROUGH 39 YEARS | $291.41 | $448.33 | — | 44% above | 35% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 HC PERIODIC PREVENTIVE E_M_ ESTABLISHED PATIENT_ AGE 18 THROUGH 39 YEARS | $291.41 | $448.33 | — | — | 35% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 HC PERIODIC PREVENTIVE E_M_ ESTABLISHED PATIENT_ AGE 40 THROUGH 64 YEARS | $310.26 | $477.32 | — | 32% above | 35% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 HC PERIODIC PREVENTIVE E_M_ ESTABLISHED PATIENT_ AGE 40 THROUGH 64 YEARS | $310.26 | $477.32 | — | — | 35% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 HC PERIODIC PREVENTIVE E_M_ ESTABLISHED PATIENT_ AGE 65 YEARS AND OLDER | $333.37 | $512.88 | — | 64% above | 35% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 HC PERIODIC PREVENTIVE E_M_ ESTABLISHED PATIENT_ AGE 65 YEARS AND OLDER | $333.37 | $512.88 | — | — | 35% |
| Psychiatric evaluation with medical services CPT 90792 HC OMH PSYCHIATRIC DIAGNOSTIC EVALUATION W MEDICAL SERVICES | $386.94 | $595.30 | — | 30% above | 35% |
| Psychiatric evaluation with medical services CPT 90792 HC PSYCHIATRIC DIAGNOSTIC EVALUATION W MEDICAL SERVICES | $386.94 | $595.30 | — | 30% above | 35% |
| Psychiatric evaluation with medical services CPT 90792 HC BHN DIAGNOSTIC EVALUATION W MEDICAL | $386.94 | $595.30 | — | 30% above | 35% |
| Psychiatric evaluation with medical services inpatient CPT 90792 HC PSYCHIATRIC DIAGNOSTIC EVALUATION W MEDICAL SERVICES | $386.94 | $595.30 | — | — | 35% |
| Psychiatric evaluation with medical services inpatient CPT 90792 HC BHN DIAGNOSTIC EVALUATION W MEDICAL | $386.94 | $595.30 | — | — | 35% |
| Psychiatric evaluation with medical services inpatient CPT 90792 HC OMH PSYCHIATRIC DIAGNOSTIC EVALUATION W MEDICAL SERVICES | $386.94 | $595.30 | — | — | 35% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 HC PSYCL TST EVAL PHYS_QHP 1ST HOUR | $341.19 | $524.91 | — | 2% below | 35% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 HC PSYCHOLOGICAL TST EVAL SVC PHYS_QHP FIRST HOUR | $391.54 | $602.37 | — | 13% above | 35% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 HC PSYCL TST EVAL PHYS_QHP 1ST HOUR | $341.19 | $524.91 | — | — | 35% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 HC PSYCHOLOGICAL TST EVAL SVC PHYS_QHP FIRST HOUR | $391.54 | $602.37 | — | — | 35% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 HC PSYCHOTHERAPY FOR CRISIS_ FIRST 60 MINUTES | $386.94 | $595.30 | — | 45% above | 35% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 HC BHN PSYCHOTHERAPY FOR CRISIS | $386.94 | $595.30 | — | 45% above | 35% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 HC BHN PSYCHOTHERAPY FOR CRISIS OFF SITE | $386.94 | $595.30 | — | 45% above | 35% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC BHN PSYCHOTHERAPY FOR CRISIS | $386.94 | $595.30 | — | — | 35% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PSYCHOTHERAPY FOR CRISIS_ FIRST 60 MINUTES | $386.94 | $595.30 | — | — | 35% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC BHN PSYCHOTHERAPY FOR CRISIS OFF SITE | $386.94 | $595.30 | — | — | 35% |
| Psychotherapy session, 30 minutes CPT 90832 HC OMH PSYCHOTHERAPY_ 30 MINS_ W PATIENT AND_OR FAMILY MEMBER | $239.82 | $368.96 | — | 21% above | 35% |
| Psychotherapy session, 30 minutes CPT 90832 HC BHN PSYCHOTHERAPY 30 MINS | $239.82 | $368.96 | — | 21% above | 35% |
| Psychotherapy session, 30 minutes CPT 90832 HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ UP TO 44 MINS | $269.31 | $414.32 | — | 36% above | 35% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY 30 MINUTES WITH PATIENT AND_OR FAMILY MEMBER | $386.94 | $595.30 | — | 95% above | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC BHN PSYCHOTHERAPY 30 MINS | $239.82 | $368.96 | — | — | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC OMH PSYCHOTHERAPY_ 30 MINS_ W PATIENT AND_OR FAMILY MEMBER | $239.82 | $368.96 | — | — | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ UP TO 44 MINS | $269.31 | $414.32 | — | — | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY 30 MINUTES WITH PATIENT AND_OR FAMILY MEMBER | $386.94 | $595.30 | — | — | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HC OMH PSYCHOTHERAPY_ 45 MINS_ W PATIENT AND_OR FAMILY MEMBER | $312.24 | $480.37 | — | 19% above | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HC BHN PSYCHOTHERAPY 45MINS | $312.24 | $480.37 | — | 19% above | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ 45_ MINS | $346.84 | $533.60 | — | 33% above | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY 45 MINUTES W PATIENT AND_OR FAMILY MEMBER | $386.94 | $595.30 | — | 48% above | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC OMH PSYCHOTHERAPY_ 45 MINS_ W PATIENT AND_OR FAMILY MEMBER | $312.24 | $480.37 | — | — | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC BHN PSYCHOTHERAPY 45MINS | $312.24 | $480.37 | — | — | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ 45_ MINS | $346.84 | $533.60 | — | — | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY 45 MINUTES W PATIENT AND_OR FAMILY MEMBER | $386.94 | $595.30 | — | — | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HC OASAS PSYCHOTHERAPY 60 MINS W PATIENT AND_OR FAMILY MEMBER | $300.20 | $461.85 | — | at median | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY 60 MINUTES W PATIENT | $386.94 | $595.30 | — | 29% above | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HC BHN PSYCHOTHERAPY 60 MINS | $386.94 | $595.30 | — | 29% above | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HC OMH PSYCHOTHERAPY_ 60 MINS_ W PATIENT AND_OR FAMILY MEMBER | $386.94 | $595.30 | — | 29% above | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC OASAS PSYCHOTHERAPY 60 MINS W PATIENT AND_OR FAMILY MEMBER | $300.20 | $461.85 | — | — | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC BHN PSYCHOTHERAPY 60 MINS | $386.94 | $595.30 | — | — | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC OMH PSYCHOTHERAPY_ 60 MINS_ W PATIENT AND_OR FAMILY MEMBER | $386.94 | $595.30 | — | — | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY 60 MINUTES W PATIENT | $386.94 | $595.30 | — | — | 35% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC SMOKING _ TOBACCO USE CESSATION COUNSELING VISIT_ INTERMEDIATE_ _ 3 MINS UP TO 10 MINS | $109.25 | $168.07 | — | 134% above | 35% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC SMOKE_TOBACCO USE CESSATION COUNSELING_ INTERMEDIATE_ 3 _ 10 MINUTES | $109.25 | $168.07 | — | 134% above | 35% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC SMOKING _ TOBACCO USE CESSATION COUNSELING VISIT_ INTERMEDIATE_ _ 3 MINS UP TO 10 MINS | $109.25 | $168.07 | — | — | 35% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC SMOKE_TOBACCO USE CESSATION COUNSELING_ INTERMEDIATE_ 3 _ 10 MINUTES | $109.25 | $168.07 | — | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OFFICE_OUTPATIENT ESTABLISHED HIGH MDM 40 MIN | $234.16 | $360.25 | — | at median | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OASAS HISTORY _ PHYSICAL EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | 9% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OASAS ACUTE MEDICAL EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | 9% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OMH E_M MED MANAGEMENT EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | 9% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OASAS PYSCH EVALUATION EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | 9% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OASAS E_M MED INDUCTION EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | 9% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OMH E_M EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | 9% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OASAS MED MANAGEMENT EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | 9% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC BHN E_M EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | 9% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OFFICE_OUTPATIENT ESTABLISHED HIGH MDM 40 MIN | $234.16 | $360.25 | — | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OASAS MED MANAGEMENT EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OASAS HISTORY _ PHYSICAL EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OASAS ACUTE MEDICAL EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OMH E_M MED MANAGEMENT EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OMH E_M EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OASAS E_M MED INDUCTION EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC BHN E_M EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OASAS PYSCH EVALUATION EST PATIENT LEVEL 5 | $255.38 | $392.89 | — | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE_OUTPATIENT ESTABLISHED LOW MDM 20 MIN | $152.13 | $234.05 | — | 17% below | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OMH E_M EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | 27% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC BHN MED MANAGEMENT EST PT LEVEL 3 | $231.64 | $356.37 | — | 27% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OASAS PYSCH EVALUATION EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | 27% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OASAS E_M MED INDUCTION EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | 27% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC BHN E_M EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | 27% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OASAS ACUTE MEDICAL EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | 27% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OASAS HISTORY _ PHYSICAL EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | 27% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OASAS MED MANAGEMENT EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | 27% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OMH E_M MED MANAGEMENT EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | 27% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OFFICE_OUTPATIENT ESTABLISHED LOW MDM 20 MIN | $152.13 | $234.05 | — | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OMH E_M MED MANAGEMENT EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OASAS ACUTE MEDICAL EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OASAS PYSCH EVALUATION EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OASAS E_M MED INDUCTION EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OASAS MED MANAGEMENT EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OMH E_M EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC BHN E_M EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OASAS HISTORY _ PHYSICAL EST PATIENT LEVEL 3 | $231.64 | $356.37 | — | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC BHN MED MANAGEMENT EST PT LEVEL 3 | $231.64 | $356.37 | — | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE_OUTPATIENT ESTABLISHED MOD MDM 30 MIN | $187.00 | $287.69 | — | 5% below | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OASAS E_M MED INDUCTION EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | 23% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC BHN E_M EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | 23% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OASAS PYSCH EVALUATION EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | 23% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OASAS MED MANAGEMENT EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | 23% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OASAS HISTORY _ PHYSICAL EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | 23% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OASAS ACUTE MEDICAL EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | 23% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OMH E_M MED MANAGEMENT EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | 23% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OMH E_M EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | 23% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OFFICE_OUTPATIENT ESTABLISHED MOD MDM 30 MIN | $187.00 | $287.69 | — | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OMH E_M MED MANAGEMENT EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OASAS HISTORY _ PHYSICAL EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OASAS E_M MED INDUCTION EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OMH E_M EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OASAS PYSCH EVALUATION EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OASAS MED MANAGEMENT EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OASAS ACUTE MEDICAL EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC BHN E_M EST PATIENT LEVEL 4 | $243.22 | $374.19 | — | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFICE_OUTPATIENT ESTABLISHED SF MDM 10 MIN POST_OP | $123.44 | $189.91 | — | 26% below | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFICE_OUTPATIENT ESTABLISHED SF MDM 10 MIN | $131.16 | $201.78 | — | 22% below | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC BHN E_M EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | 32% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OASAS PYSCH EVALUATION EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | 32% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OASAS MED MANAGEMENT EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | 32% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OASAS HISTORY _ PHYSICAL EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | 32% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OASAS ACUTE MEDICAL EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | 32% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OMH E_M MED MANAGEMENT EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | 32% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OMH E_M EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | 32% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OASAS E_M MED INDUCTION EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | 32% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OFFICE_OUTPATIENT ESTABLISHED SF MDM 10 MIN POST_OP | $123.44 | $189.91 | — | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OFFICE_OUTPATIENT ESTABLISHED SF MDM 10 MIN | $131.16 | $201.78 | — | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OASAS MED MANAGEMENT EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OMH E_M MED MANAGEMENT EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OMH E_M EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OASAS HISTORY _ PHYSICAL EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC BHN E_M EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OASAS ACUTE MEDICAL EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OASAS E_M MED INDUCTION EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OASAS PYSCH EVALUATION EST PATIENT LEVEL 2 | $220.60 | $339.39 | — | — | 35% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE_ 40 MIN FACE_TO_FACE | $116.27 | $178.88 | — | 61% below | 35% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE_ 40 MIN FACE_TO_FACE | $116.27 | $178.88 | — | — | 35% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE TO HIGH_ 60 MIN FACE_TO_FACE | $168.98 | $259.97 | — | 43% below | 35% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE TO HIGH_ 60 MIN FACE_TO_FACE | $168.98 | $259.97 | — | — | 35% |
| Speech and language evaluation CPT 92523 HC EVALUATION OF SPEECH SOUND PRODUCTION_ W EVALUATION LANGUAGE COMPREHENSION_ EXPRESSION | $726.03 | $1,116.97 | — | 85% above | 35% |
| Speech and language evaluation inpatient CPT 92523 HC EVALUATION OF SPEECH SOUND PRODUCTION_ W EVALUATION LANGUAGE COMPREHENSION_ EXPRESSION | $726.03 | $1,116.97 | — | — | 35% |
| Speech therapy session, individual CPT 92507 HC TREAT SPEECH_LANG_VOICE COMM __OR AUDITORY PROCESSING DISORDER_ IND | $241.41 | $371.40 | — | 44% above | 35% |
| Speech therapy session, individual inpatient CPT 92507 HC TREAT SPEECH_LANG_VOICE COMM __OR AUDITORY PROCESSING DISORDER_ IND | $241.41 | $371.40 | — | — | 35% |
| Spirometry (breathing test) CPT 94010 HC SPIROMETRY W GRAPHIC RECORD_ VIT CAP_ EXPIRATORY FLOW RATE | $482.35 | $742.07 | — | 117% above | 35% |
| Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY W GRAPHIC RECORD_ VIT CAP_ EXPIRATORY FLOW RATE | $482.35 | $742.07 | — | — | 35% |
| Spirometry before and after a bronchodilator CPT 94060 HC BRONCHODILATION RESPONSIVENESS_ SPIROMETRY | $870.76 | $1,339.63 | — | 124% above | 35% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC BRONCHODILATION RESPONSIVENESS_ SPIROMETRY | $870.76 | $1,339.63 | — | — | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUTIC ACTIVITIES_ DIRECT_ EA 15 MIN | $120.82 | $185.87 | — | 40% above | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPUTIC ACTIVITIES_ DIRECT_ EA 15 MIN | $120.82 | $185.87 | — | 40% above | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPUTIC ACTIVITIES_ DIRECT_ EA 15 MIN | $120.82 | $185.87 | — | — | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUTIC ACTIVITIES_ DIRECT_ EA 15 MIN | $120.82 | $185.87 | — | — | 35% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPEUTIC PHLEBOTOMY | $335.52 | $516.18 | — | 58% above | 35% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPEUTIC PHLEBOTOMY_IV THER_ SEPARATE PROCEDURE | $335.52 | $516.18 | — | 58% above | 35% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPEUTIC PHLEBOTOMY | $335.52 | $516.18 | — | — | 35% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPEUTIC PHLEBOTOMY_IV THER_ SEPARATE PROCEDURE | $335.52 | $516.18 | — | — | 35% |
| Visual field test, extended CPT 92083 HC GOLDMANN_HUMPHREY VISUAL FIELD | $335.52 | $516.18 | — | at median | 35% |
| Visual field test, extended inpatient CPT 92083 HC GOLDMANN_HUMPHREY VISUAL FIELD | $335.52 | $516.18 | — | — | 35% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC SARSCOV2 VACCINE 50 MCG_0.5ML FOR IM USE | $239.41 | $368.32 | — | 17% above | 35% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 HC SARSCOV2 VACCINE 50 MCG_0.5ML FOR IM USE | $239.41 | $368.32 | — | — | 35% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC SARSCOV2 VACC 30MCG_0.3ML TRIS_SUCROSE IM USE | $196.27 | $301.96 | — | 2% below | 35% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC SARSCOV2 VACC 30MCG_0.3ML TRIS_SUCROSE IM USE | $196.27 | $301.96 | — | — | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC VARICELLA VIRUS VACCINE LIVE FOR SC USE | $385.63 | $593.28 | — | 46% above | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC VARICELLA VIRUS VACCINE LIVE FOR SC USE | $385.63 | $593.28 | — | — | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC DTAP_IPV 4_6 YRS OF AGE | $122.60 | $188.62 | — | 34% above | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 HC DTAP_IPV 4_6 YRS OF AGE | $122.60 | $188.62 | — | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC DTAP VACCINE FOR IM USE_ YOUNGER THAN 7 YRS OLD | $57.91 | $89.09 | — | 18% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC DTAP VACCINE FOR IM USE_ YOUNGER THAN 7 YRS OLD | $57.91 | $89.09 | — | — | 35% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC DTAP_HEB_IPVIM USE | $135.58 | $208.58 | — | 2% below | 35% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HC DTAP_HEB_IPVIM USE | $135.58 | $208.58 | — | — | 35% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC DTAP HIB IPV FOR IM USE | $226.53 | $348.51 | — | 55% above | 35% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 HC DTAP HIB IPV FOR IM USE | $226.53 | $348.51 | — | — | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 HC DTAP_IPV_HIB_HEPB VACCINE INTRAMUSCULAR | $211.02 | $324.64 | — | 8% below | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 HC DTAP_IPV_HIB_HEPB VACCINE INTRAMUSCULAR | $211.02 | $324.64 | — | — | 35% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 HC RIV3 VACCINE PRESERVATIVE FREE FOR IM USE | $169.88 | $261.36 | — | 60% above | 35% |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 HC RIV3 VACCINE PRESERVATIVE FREE FOR IM USE | $169.88 | $261.36 | — | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE | $40.94 | $62.98 | — | 44% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE | $40.94 | $62.98 | — | — | 35% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC 9VHPV VACCINE 2 OR 3 DOSE SCHEDULE IM USE | $641.57 | $987.03 | — | 29% above | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC 9VHPV VACCINE 2 OR 3 DOSE SCHEDULE IM USE | $641.57 | $987.03 | — | — | 35% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HC HEP A_HEP B VACC ADULT IM | $208.36 | $320.56 | — | 8% below | 35% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HC HEP A_HEP B VACC ADULT IM | $208.36 | $320.56 | — | — | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 HC HEP A VACCINE_ ADULT DOSAGE_ 1ST INJ_ INTRAMUSCULAR | $142.10 | $218.61 | — | 38% above | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HC HEP A VACCINE_ ADULT DOSAGE_ 1ST INJ_ INTRAMUSCULAR | $142.10 | $218.61 | — | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC HEP A VACCINE_ PEDIATRIC_ADOLESCENT DOSAGE_2 DOSE SCHEDULE_ IM | $59.94 | $92.22 | — | 6% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC HEP A VACCINE_ PEDIATRIC_ADOLESCENT DOSAGE_2 DOSE SCHEDULE_ IM | $59.94 | $92.22 | — | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC HEPATITIS B VACCINE_ ADULT _20YRS OF AGE | $78.97 | $121.49 | — | 12% below | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC HEPATITIS B VACCINE_ ADULT _20YRS OF AGE | $78.97 | $121.49 | — | — | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HC HEPATITIS B VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE | $271.43 | $417.59 | — | 12% above | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HC HEPATITIS B VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE | $271.43 | $417.59 | — | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC HEPATITIS B PED_ADOLESCENT IM USE 3 DOSE SCHEDULE. | $45.38 | $69.81 | — | at median | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC HEPATITIS B PED_ADOLESCENT IM USE 3 DOSE SCHEDULE. | $45.38 | $69.81 | — | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HC HIB PRP_OMP VACC 3 DOSE IM | $59.05 | $90.84 | — | 6% below | 35% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HC HIB PRP_OMP VACC 3 DOSE IM | $59.05 | $90.84 | — | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC HIB_ RPR_T 4 DOSE SCHEDULE_ IM | $26.03 | $40.04 | — | 19% below | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HC HIB_ RPR_T 4 DOSE SCHEDULE_ IM | $26.03 | $40.04 | — | — | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM | $169.88 | $261.36 | — | 53% above | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HC IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM | $169.88 | $261.36 | — | — | 35% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 HC MMR VACCINE SC_JET INJ USE | $183.83 | $282.81 | — | 36% above | 35% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC MMR VACCINE SC_JET INJ USE | $183.83 | $282.81 | — | — | 35% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC MMRV_ LIVE_ SC USE | $568.55 | $874.69 | — | 30% above | 35% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 HC MMRV_ LIVE_ SC USE | $568.55 | $874.69 | — | — | 35% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC MENINGOCOCCAL VACCINE FOR IM USE | $330.07 | $507.80 | — | 62% above | 35% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC MENINGOCOCCAL VACCINE FOR IM USE | $330.07 | $507.80 | — | — | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 HC MENACWY_TT CONJ VACC SEROGROUPS ACWY FOR IM USE | $315.15 | $484.85 | — | 29% above | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 HC MENACWY_TT CONJ VACC SEROGROUPS ACWY FOR IM USE | $315.15 | $484.85 | — | — | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC MENB RECOMBINANT PROT W_OUT MEMBR VESIC VACC IM | $330.07 | $507.80 | — | at median | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 HC MENB RECOMBINANT PROT W_OUT MEMBR VESIC VACC IM | $330.07 | $507.80 | — | — | 35% |
| Meningococcal B vaccine (Trumenba) CPT 90621 HC MENB_FHBP RECOMBNT LIPOPROTEIN VACC 2_3 DOSE IM | $343.22 | $528.03 | — | 1% below | 35% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 HC MENB_FHBP RECOMBNT LIPOPROTEIN VACC 2_3 DOSE IM | $343.22 | $528.03 | — | — | 35% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 HC INFLUENZA VIRUS VACCINE TRIVALENT LIVE _LAIV3_ INTRANASAL | $51.68 | $79.50 | — | 20% above | 35% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 HC INFLUENZA VIRUS VACCINE TRIVALENT LIVE _LAIV3_ INTRANASAL | $51.68 | $79.50 | — | — | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC PREVNAR | $462.57 | $711.65 | — | 41% above | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 HC PREVNAR | $462.57 | $711.65 | — | — | 35% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 HC PCV15 VACCINE FOR INTRAMUSCULAR USE | $439.52 | $676.19 | — | 25% above | 35% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 HC PCV15 VACCINE FOR INTRAMUSCULAR USE | $439.52 | $676.19 | — | — | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC PNEUMOCOCCAL CONJUGATE VACCINE 20 VALENT_PCV20_ INTRAMUSCULAR USE | $462.57 | $711.65 | — | 8% above | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HC PNEUMOCOCCAL CONJUGATE VACCINE 20 VALENT_PCV20_ INTRAMUSCULAR USE | $462.57 | $711.65 | — | — | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PNEUMOVAX _PNEUMOCCAL IMMUNIZATION_ 2YRS OR OLDER | $208.94 | $321.45 | — | 23% above | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PNEUMOVAX _PNEUMOCCAL IMMUNIZATION_ 2YRS OR OLDER | $208.94 | $321.45 | — | — | 35% |
| Polio vaccine, inactivated (IPV) CPT 90713 HC POLIOVIRUS VACCINE INACTIVATED _IPV_ SC USE | $87.84 | $135.14 | — | 3% above | 35% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC POLIOVIRUS VACCINE INACTIVATED _IPV_ SC USE | $87.84 | $135.14 | — | — | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 HC RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE | $1,031.86 | $1,587.47 | — | at median | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 HC RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE | $1,031.86 | $1,587.47 | — | — | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 HC RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE | $1,031.86 | $1,587.47 | — | at median | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 HC RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE | $1,031.86 | $1,587.47 | — | — | 35% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 HC RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE | $531.55 | $817.77 | — | 26% above | 35% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 HC RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE | $531.55 | $817.77 | — | — | 35% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 HC RSV VACC PREF RECOMBINANT ADJUVANTED FOR IM USE | $508.64 | $782.53 | — | 25% above | 35% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 HC RSV VACC PREF RECOMBINANT ADJUVANTED FOR IM USE | $508.64 | $782.53 | — | — | 35% |
| Rabies vaccine, one dose CPT 90675 HC RABIES VACCINE INTRAMUSCULAR | $791.49 | $1,217.68 | — | 68% above | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 HC RABIES VACCINE INTRAMUSCULAR | $791.49 | $1,217.68 | — | — | 35% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 HC RV1 VACC 2 DOSE LIVE ORAL | $174.28 | $268.12 | — | 19% below | 35% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 HC RV1 VACC 2 DOSE LIVE ORAL | $174.28 | $268.12 | — | — | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC ROTAVIRUS VACCINE PENTAVALANT_ 3 DOSE SCHEDULE_ ORAL USE | $174.28 | $268.12 | — | 33% above | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC ROTAVIRUS VACCINE PENTAVALANT_ 3 DOSE SCHEDULE_ ORAL USE | $174.28 | $268.12 | — | — | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC ZOSTER VACC HZV RECOMBINANT ADJUVANTED IM NJX | $394.60 | $607.08 | — | at median | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HC ZOSTER VACC HZV RECOMBINANT ADJUVANTED IM NJX | $394.60 | $607.08 | — | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC TETANUS _ DIPHTHERIA TOXOIDS_TD_ ADSORBED_PRESERVATIVE FREE_ __ 7 YEARS_ FOR IM USE | $83.37 | $128.26 | — | 57% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC TETANUS _ DIPHTHERIA TOXOIDS_TD_ ADSORBED_PRESERVATIVE FREE_ __ 7 YEARS_ FOR IM USE | $83.37 | $128.26 | — | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC TDAP FOR 7 YRS AND OLDER FOR IM USE | $97.06 | $149.33 | — | 75% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC TDAP FOR 7 YRS AND OLDER FOR IM USE | $97.06 | $149.33 | — | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMINISTRATION_ 1 VACCINE | $67.74 | $104.21 | — | 20% below | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC 90471 IMMUNIZATION ADMIN 1 VACCINE ED_OBS | $67.74 | $104.21 | — | 20% below | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN 1 VACCINE_ MENDICK OBS UNIT | $67.74 | $104.21 | — | 20% below | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC 90471 IMMUNIZATION ADMIN 1 VACCINE ED_OBS | $67.74 | $104.21 | — | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMINISTRATION_ 1 VACCINE | $67.74 | $104.21 | — | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMIN 1 VACCINE_ MENDICK OBS UNIT | $67.74 | $104.21 | — | — | 35% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMINISTRATION EACH ADDITIONAL | $80.22 | $123.41 | — | 78% above | 35% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADMINISTRATION EACH ADDITIONAL | $80.22 | $123.41 | — | — | 35% |
Dental
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| Dental implant, surgical placement CDT D6010 HC SURGICAL PLACEMENT OF IMPLANT BODY_ ENDOSTEAL IMPLANT | $520.00 | $800.00 | — | 57% below | 35% |
| Dental implant, surgical placement inpatient CDT D6010 HC SURGICAL PLACEMENT OF IMPLANT BODY_ ENDOSTEAL IMPLANT | $520.00 | $800.00 | — | — | 35% |
| Porcelain crown CDT D2740 HC CROWN_PORCELAIN_CERAMIC SUBSTRATE | $781.30 | $1,202.00 | — | 28% below | 35% |
| Porcelain crown inpatient CDT D2740 HC CROWN_PORCELAIN_CERAMIC SUBSTRATE | $781.30 | $1,202.00 | — | — | 35% |
| Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240 HC REMOVAL OF IMPACTED TOOTH_ COMPLETELY BONY | $273.00 | $420.00 | — | 70% below | 35% |
| Removal of an impacted tooth fully covered by bone, often a wisdom tooth inpatient CDT D7240 HC REMOVAL OF IMPACTED TOOTH_ COMPLETELY BONY | $273.00 | $420.00 | — | — | 35% |
| Root canal treatment on a molar (back tooth), not including the final crown CDT D3330 HC ENDODONTIC THERAPY MOLAR | $633.75 | $975.00 | — | 67% below | 35% |
| Root canal treatment on a molar (back tooth), not including the final crown inpatient CDT D3330 HC ENDODONTIC THERAPY MOLAR | $633.75 | $975.00 | — | — | 35% |
| Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 HC PROPHYLAXIS ADULT | $66.95 | $103.00 | — | 56% below | 35% |
| Routine teeth cleaning (prophylaxis), adult or teen inpatient CDT D1110 HC PROPHYLAXIS ADULT | $66.95 | $103.00 | — | — | 35% |
| Simple extraction of a tooth or exposed root that is above the gum CDT D7140 HC EXTRACTION_ ERUPTED TOOTH OR EXPOSED ROOT | $1,666.43 | $2,563.74 | — | 12% below | 35% |
| Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 HC EXTRACTION_ ERUPTED TOOTH OR EXPOSED ROOT | $1,666.43 | $2,563.74 | — | — | 35% |