Hospital Michigan City-La Porte, IN

Franciscan Health Michigan City

Listed in its price file as “FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY”.

Franciscan Health Michigan City in Michigan City, IN publishes cash prices for 354 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Indiana median for 252 of 347 procedures and above it for 87. By typical cash price it ranks #21 of 84 Indiana hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

3500 FRANCISCAN WAY MICHIGAN CITY, IN 46360 Collected Sep 27, 2026 Source price file (219) 879-8511

Acute care hospital Emergency department CMS star rating 3 of 5 CCN 150015 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 Rad Exam Ankl; Compl 3 Vw Min	$146.22	$703.00	$68.29–$1,189.62	25% below	79%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Rad Exam Ankl; Compl 3 Vw Min	$146.22	$703.00	$68.29–$1,189.62	—	79%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Noninvasive Phys Study Uea/Lea Sngl/Bilat	$269.98	$1,298.00	$131.27–$1,098.24	—	79%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 Noninvasive Phys Study Uea/Lea Sngl/Bilat	$269.98	$1,298.00	$131.27–$1,098.24	—	79%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Rad Exam; Esophagus Sngl Contrast Study	$221.31	$1,064.00	$185.58–$900.25	52% below	79%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Rad Exam; Esophagus Sngl Contrast Study	$221.31	$1,064.00	$185.58–$900.25	—	79%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone Imaging; Whole Body	$860.91	$4,139.00	$422.96–$3,502.01	44% below	79%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone Imaging; Whole Body	$860.91	$4,139.00	$422.96–$3,502.01	—	79%
Breast ultrasound, complete, one breast CPT 76641 Ultrasound Breast Complete Unil Hcode	$430.56	$2,070.00	$110.61–$3,502.85	at median	79%
Breast ultrasound, complete, one breast inpatient CPT 76641 Ultrasound Breast Complete Unil Hcode	$430.56	$2,070.00	$110.61–$3,502.85	—	79%
Breast ultrasound, limited (one breast or one area) CPT 76642 Ultrasound Breast Limited Hcode	$200.93	$966.00	$92.07–$1,634.67	32% below	79%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Ultrasound Breast Limited Hcode	$200.93	$966.00	$92.07–$1,634.67	—	79%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest; W/WO Cont	$1,004.64	$4,830.00	$185.58–$4,086.66	12% below	79%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest; W/WO Cont	$1,004.64	$4,830.00	$185.58–$4,086.66	—	79%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Hrt W/Cont & 3d	$286.83	$1,379.00	$369.11–$2,109.00	65% below	79%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Hrt W/Cont & 3d	$286.83	$1,379.00	$369.11–$2,109.00	—	79%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd & Pelvis W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	1% below	79%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd & Pelvis W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	—	79%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd & Pelvis W/Contrast	$1,148.16	$5,520.00	$369.11–$4,670.47	22% below	79%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd & Pelvis W/Contrast	$1,148.16	$5,520.00	$369.11–$4,670.47	—	79%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT-Abd/Pelvis WO/W Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	24% below	79%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT-Abd/Pelvis WO/W Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	—	79%
CT scan of the abdomen with contrast CPT 74160 CT Abd; W/Cont	$745.89	$3,586.00	$185.58–$3,034.11	17% below	79%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abd; W/Cont	$745.89	$3,586.00	$185.58–$3,034.11	—	79%
CT scan of the abdomen without contrast CPT 74150 CT Abd; W/O Cont	$631.07	$3,034.00	$110.61–$2,567.07	20% below	79%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abd; W/O Cont	$631.07	$3,034.00	$110.61–$2,567.07	—	79%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial Area; W/O Cont	$631.07	$3,034.00	$110.61–$2,567.07	20% below	79%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial Area; W/O Cont	$631.07	$3,034.00	$110.61–$2,567.07	—	79%
CT scan of the head or brain, no contrast dye CPT 70450 CT Hd/Brain; W/O Cont	$631.07	$3,034.00	$110.61–$2,567.07	13% below	79%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Hd/Brain; W/O Cont	$631.07	$3,034.00	$110.61–$2,567.07	—	79%
CT scan of the head with contrast CPT 70460 CT Hd/Brain; W/Cont	$745.89	$3,586.00	$185.58–$3,034.11	10% below	79%
CT scan of the head with contrast inpatient CPT 70460 CT Hd/Brain; W/Cont	$745.89	$3,586.00	$185.58–$3,034.11	—	79%
CT scan of the head without and with contrast CPT 70470 CT Hd/Brain; W/WO Cont	$860.91	$4,139.00	$185.58–$3,502.01	15% below	79%
CT scan of the head without and with contrast inpatient CPT 70470 CT Hd/Brain; W/WO Cont	$860.91	$4,139.00	$185.58–$3,502.01	—	79%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumb Spin; W/O Cont	$631.07	$3,034.00	$110.61–$2,567.07	24% below	79%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumb Spin; W/O Cont	$631.07	$3,034.00	$110.61–$2,567.07	—	79%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Cerv Spin; W/O Cont	$631.07	$3,034.00	$110.61–$2,567.07	20% below	79%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Cerv Spin; W/O Cont	$631.07	$3,034.00	$110.61–$2,567.07	—	79%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelv; W/Cont	$745.89	$3,586.00	$185.58–$3,034.11	17% below	79%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelv; W/Cont	$745.89	$3,586.00	$185.58–$3,034.11	—	79%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CARotid DPLX SCAN; COMPL BILAT STUDY	$401.86	$1,932.00	$252.44–$1,634.67	—	79%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CARotid DPLX SCAN; COMPL BILAT STUDY	$401.86	$1,932.00	$252.44–$1,634.67	—	79%
Chest X-ray, 2 views CPT 71046 X-Ray Exam Chest 2 Views	$135.20	$650.00	$92.07–$562.00	34% below	79%
Chest X-ray, 2 views inpatient CPT 71046 X-Ray Exam Chest 2 Views	$135.20	$650.00	$92.07–$562.00	—	79%
Chest X-ray, single view CPT 71045 Xray Exam Babyscan Chest 1 View	$55.54	$267.00	$92.07–$562.00	66% below	79%
Chest X-ray, single view CPT 71045 X-Ray Exam Chest 1 View	$100.67	$484.00	$92.07–$562.00	38% below	79%
Chest X-ray, single view inpatient CPT 71045 Xray Exam Babyscan Chest 1 View	$55.54	$267.00	$92.07–$562.00	—	79%
Chest X-ray, single view inpatient CPT 71045 X-Ray Exam Chest 1 View	$100.67	$484.00	$92.07–$562.00	—	79%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal W/Image; Compl	$315.74	$1,518.00	$110.61–$1,284.38	36% below	79%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal W/Image; Compl	$315.74	$1,518.00	$110.61–$1,284.38	—	79%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA Bone Density Study; Axial Skeleton	$160.99	$774.00	$104.99–$654.88	43% below	79%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA Bone Density Study; Axial Skeleton	$160.99	$774.00	$104.99–$654.88	—	79%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA Bn Density Study; Appendicular Skeleton	$88.19	$424.00	$45.08–$562.00	39% below	79%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA Bn Density Study; Appendicular Skeleton	$88.19	$424.00	$45.08–$562.00	—	79%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg Uterus Detailed; 1st Gestation	$373.15	$1,794.00	$244.10–$1,517.90	31% below	79%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Preg Uterus Detailed; 1st Gestation	$373.15	$1,794.00	$244.10–$1,517.90	—	79%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest; W/O Cont	$631.07	$3,034.00	$110.61–$2,567.07	20% below	79%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest; W/O Cont	$631.07	$3,034.00	$110.61–$2,567.07	—	79%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest; W/Cont	$745.89	$3,586.00	$185.58–$3,034.11	14% below	79%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest; W/Cont	$745.89	$3,586.00	$185.58–$3,034.11	—	79%
Diagnostic mammogram, both breasts both sides CPT 77066 Dx Mammo Incl Cad Bi	$129.17	$621.00	$102.19–$1,050.86	—	79%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Dx Mammo Incl Cad Bi	$129.17	$621.00	$102.19–$1,050.86	—	79%
Diagnostic mammogram, one breast CPT 77065 Dx Mammo Incl Cad Uni	$97.76	$470.00	$79.74–$397.67	50% below	79%
Diagnostic mammogram, one breast inpatient CPT 77065 Dx Mammo Incl Cad Uni	$97.76	$470.00	$79.74–$397.67	—	79%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Dplx Scan of Lea or Graft; Compl Bilat Study	$516.46	$2,483.00	$252.44–$2,100.87	—	79%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Dplx Scan of Lea or Graft; Compl Bilat Study	$516.46	$2,483.00	$252.44–$2,100.87	—	79%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Dplx Scan Ext Veins; Compl Bilat Study	$516.46	$2,483.00	$252.44–$2,100.87	—	79%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Dplx Scan Ext Veins; Compl Bilat Study	$516.46	$2,483.00	$252.44–$2,100.87	—	79%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Tte W/Doppler and Color Flow	$832.42	$4,002.00	$578.11–$3,386.09	49% below	79%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo Tte W/Doppler and Color Flow	$832.42	$4,002.00	$578.11–$3,386.09	—	79%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary System Imaging	$832.42	$4,002.00	$422.96–$3,386.09	36% below	79%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepatobiliary System Imaging	$832.42	$4,002.00	$422.96–$3,386.09	—	79%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Home Sleep Test/Type 3 Porta	$172.43	$829.00	$223.21–$787.79	34% below	79%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Home Sleep Test/Type 3 Porta	$172.43	$829.00	$223.21–$787.79	—	79%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Pss W 4/> P W Cpap/Bipap	$1,671.28	$8,035.00	$780.39–$6,798.41	45% below	79%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Pss W 4/> P W Cpap/Bipap	$1,671.28	$8,035.00	$780.39–$6,798.41	—	79%
Knee X-ray, 3 views CPT 73562 Rad Exam Knee; 3 Vw	$146.22	$703.00	$75.04–$1,189.62	36% below	79%
Knee X-ray, 3 views inpatient CPT 73562 Rad Exam Knee; 3 Vw	$146.22	$703.00	$75.04–$1,189.62	—	79%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Bedside US Echo Exam of Abdomen Limited	$206.96	$995.00	$110.61–$841.87	50% below	79%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abd W/Image; Ltd	$258.34	$1,242.00	$110.61–$1,050.86	38% below	79%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Bedside US Echo Exam of Abdomen Limited	$206.96	$995.00	$110.61–$841.87	—	79%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abd W/Image; Ltd	$258.34	$1,242.00	$110.61–$1,050.86	—	79%
MRI of both breasts, without and then with contrast dye CPT 77049 MRI Breast WO/With Contrast W/Cad Bil	$324.27	$1,559.00	$369.11–$3,375.00	21% below	79%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI Breast WO/With Contrast W/Cad Bil	$324.27	$1,559.00	$369.11–$3,375.00	—	79%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Lower Extremity Jnt; W/O Contrast	$1,004.64	$4,830.00	$252.44–$8,173.33	3% above	79%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Lower Extremity Jnt; W/O Contrast	$1,004.64	$4,830.00	$252.44–$8,173.33	—	79%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Lower Extremity Jnt; W&W/O Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	11% below	79%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Lower Extremity Jnt; W&W/O Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	—	79%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen; W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	at median	79%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen; W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	—	79%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen; W&W/O Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	2% below	79%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen; W&W/O Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	—	79%
MRI of the brain, no contrast dye CPT 70551 MRI Brain; W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	2% above	79%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain; W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	—	79%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain; W&W/O Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	1% above	79%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain; W&W/O Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	—	79%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar; W/O Contrast	$1,004.64	$4,830.00	$227.92–$4,086.66	2% above	79%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar; W/O Contrast	$1,004.64	$4,830.00	$227.92–$4,086.66	—	79%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar; W&W/O Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	2% below	79%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar; W&W/O Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	—	79%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic; W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	5% above	79%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic; W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	—	79%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical; W&W/O Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	at median	79%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical; W&W/O Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	—	79%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical; W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	2% below	79%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical; W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	—	79%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis; W&W/O Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	1% below	79%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis; W&W/O Contrast	$1,291.47	$6,209.00	$369.11–$5,253.43	—	79%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis; W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	2% below	79%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis; W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	—	79%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Upper Extremity Jnt; W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	14% below	79%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Upper Extremity Jnt; W/O Contrast	$1,004.64	$4,830.00	$252.44–$4,086.66	—	79%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial W/Spect; Multiple Studies	$1,492.40	$7,175.00	$1,095.24–$6,070.77	59% below	79%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Myocardial W/Spect; Multiple Studies	$1,492.40	$7,175.00	$1,095.24–$6,070.77	—	79%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet W/CT; Skull Base to Mid-Thigh	$2,209.38	$10,622.00	$1,512.90–$8,987.27	44% below	79%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Pet W/CT; Skull Base to Mid-Thigh	$2,209.38	$10,622.00	$1,512.90–$8,987.27	—	79%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Bedside US Exam Pelvic Limited	$212.78	$1,023.00	$94.34–$865.56	28% below	79%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Exam Pelvic Limited	$232.96	$1,120.00	$94.34–$947.63	21% below	79%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Bedside US Exam Pelvic Limited	$212.78	$1,023.00	$94.34–$865.56	—	79%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Exam Pelvic Limited	$232.96	$1,120.00	$94.34–$947.63	—	79%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelv; Compl	$344.45	$1,656.00	$110.61–$1,401.14	21% below	79%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelv; Compl	$344.45	$1,656.00	$110.61–$1,401.14	—	79%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ED US Preg Uterus >14wk; 1st Gest	$373.15	$1,794.00	$110.61–$1,517.90	30% below	79%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uterus >14wk; 1st Gest	$401.86	$1,932.00	$110.61–$1,634.67	24% below	79%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ED US Preg Uterus >14wk; 1st Gest	$373.15	$1,794.00	$110.61–$1,517.90	—	79%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Uterus >14wk; 1st Gest	$401.86	$1,932.00	$110.61–$1,634.67	—	79%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ED US Preg Uter <14wk; 1st Gest	$278.51	$1,339.00	$110.61–$1,132.93	42% below	79%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg Uter <14wk; 1st Gest	$315.74	$1,518.00	$110.61–$1,284.38	34% below	79%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ED US Preg Uter <14wk; 1st Gest	$278.51	$1,339.00	$110.61–$1,132.93	—	79%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg Uter <14wk; 1st Gest	$315.74	$1,518.00	$110.61–$1,284.38	—	79%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Uter Ltd	$221.31	$1,064.00	$110.61–$900.25	32% below	79%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Bedside US Preg Uterus Limited 1+ Fetus(S)	$221.31	$1,064.00	$110.61–$900.25	32% below	79%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Uter Ltd	$221.31	$1,064.00	$110.61–$900.25	—	79%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Bedside US Preg Uterus Limited 1+ Fetus(S)	$221.31	$1,064.00	$110.61–$900.25	—	79%
Screening mammogram, both breasts both sides CPT 77067 Scr Mammo Bi Incl Cad	$94.85	$456.00	$84.38–$771.64	—	79%
Screening mammogram, both breasts inpatient both sides CPT 77067 Scr Mammo Bi Incl Cad	$94.85	$456.00	$84.38–$771.64	—	79%
Shoulder X-ray, complete, 2 or more views CPT 73030 Rad Exam Shldr; Compl 2 Vw Min	$152.26	$732.00	$57.64–$1,238.69	24% below	79%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Rad Exam Shldr; Compl 2 Vw Min	$152.26	$732.00	$57.64–$1,238.69	—	79%
Sleep study in a lab (polysomnography) CPT 95810 Pss W 4/> Param W Tech	$1,434.58	$6,897.00	$780.39–$5,835.55	33% below	79%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Pss W 4/> Param W Tech	$1,434.58	$6,897.00	$780.39–$5,835.55	—	79%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Stress Tte Complete	$725.50	$3,488.00	$578.11–$2,951.20	59% below	79%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Stress Tte Complete	$725.50	$3,488.00	$578.11–$2,951.20	—	79%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Swallowing Function W/Video Contrast Study	$141.02	$678.00	$179.36–$811.53	53% below	79%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Swallowing Function W/Video Contrast Study	$141.02	$678.00	$179.36–$811.53	—	79%
Transvaginal pelvic ultrasound CPT 76830 US Transvag	$286.83	$1,379.00	$110.61–$1,166.77	18% below	79%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvag	$286.83	$1,379.00	$110.61–$1,166.77	—	79%
Transvaginal ultrasound during pregnancy CPT 76817 US Preg Uter Transvag	$198.22	$953.00	$110.61–$806.33	42% below	79%
Transvaginal ultrasound during pregnancy CPT 76817 ED Bedside US Preg Uterus Transvaginal	$198.22	$953.00	$110.61–$806.33	42% below	79%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 ED Bedside US Preg Uterus Transvaginal	$198.22	$953.00	$110.61–$806.33	—	79%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Uter Transvag	$198.22	$953.00	$110.61–$806.33	—	79%
Ultrasound of the abdomen, complete CPT 76700 ED Ultrasound, Abdominal;Complete	$373.15	$1,794.00	$110.61–$1,517.90	28% below	79%
Ultrasound of the abdomen, complete CPT 76700 US Abd W/Image Doc; Compl	$401.86	$1,932.00	$110.61–$1,634.67	23% below	79%
Ultrasound of the abdomen, complete inpatient CPT 76700 ED Ultrasound, Abdominal;Complete	$373.15	$1,794.00	$110.61–$1,517.90	—	79%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abd W/Image Doc; Compl	$401.86	$1,932.00	$110.61–$1,634.67	—	79%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum and Contents	$315.74	$1,518.00	$110.61–$1,284.38	25% below	79%
Ultrasound of the scrotum and testicles CPT 76870 HC US Scrotum	$315.74	$1,518.00	$110.61–$1,284.38	25% below	79%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US Scrotum	$315.74	$1,518.00	$110.61–$1,284.38	—	79%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum and Contents	$315.74	$1,518.00	$110.61–$1,284.38	—	79%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Sft Tissue Head/Neck W/Image	$286.83	$1,379.00	$110.61–$1,166.77	19% below	79%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Bedside US Exam of Head and Neck	$286.83	$1,379.00	$110.61–$1,166.77	19% below	79%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Sft Tissue Head/Neck W/Image	$286.83	$1,379.00	$110.61–$1,166.77	—	79%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Bedside US Exam of Head and Neck	$286.83	$1,379.00	$110.61–$1,166.77	—	79%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Rad Exam Upper GI Sngl Contrast Study	$344.45	$1,656.00	$185.58–$1,401.14	34% below	79%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Rad Exam Upper GI Sngl Contrast Study	$344.45	$1,656.00	$185.58–$1,401.14	—	79%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplx Scan of Ext Veins; Unilat or Ltd Study	$344.45	$1,656.00	$110.61–$1,401.14	45% below	79%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Bedside Duplx Scan of Ext Veins; Unilat or Ltd	$344.45	$1,656.00	$110.61–$1,401.14	45% below	79%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Bedside Duplx Scan of Ext Veins; Unilat or Ltd	$344.45	$1,656.00	$110.61–$1,401.14	—	79%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplx Scan of Ext Veins; Unilat or Ltd Study	$344.45	$1,656.00	$110.61–$1,401.14	—	79%
Wrist X-ray, complete, 3 or more views CPT 73110 Rad Exam Wrist; Compl 3 Vw Min	$146.22	$703.00	$79.87–$1,189.62	43% below	79%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Rad Exam Wrist; Compl 3 Vw Min	$146.22	$703.00	$79.87–$1,189.62	—	79%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-Ray Exam Hip Uni, W/Pelvis When Performed, 2-3 V	$258.34	$1,242.00	$80.85–$1,050.86	5% below	79%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-Ray Exam Hip Uni, W/Pelvis When Performed, 2-3 V	$258.34	$1,242.00	$80.85–$1,050.86	—	79%
X-ray of the abdomen, 1 view CPT 74018 Xray Exam Babyscan Abdomen 1 View	$55.54	$267.00	$92.07–$562.00	74% below	79%
X-ray of the abdomen, 1 view CPT 74018 X-Ray Exam Abdomen 1 View	$120.64	$580.00	$92.07–$562.00	43% below	79%
X-ray of the abdomen, 1 view inpatient CPT 74018 Xray Exam Babyscan Abdomen 1 View	$55.54	$267.00	$92.07–$562.00	—	79%
X-ray of the abdomen, 1 view inpatient CPT 74018 X-Ray Exam Abdomen 1 View	$120.64	$580.00	$92.07–$562.00	—	79%
X-ray of the ankle, 2 views CPT 73600 Rad Exam Ankl; 2 Vw	$92.35	$444.00	$55.69–$781.92	38% below	79%
X-ray of the ankle, 2 views inpatient CPT 73600 Rad Exam Ankl; 2 Vw	$92.35	$444.00	$55.69–$781.92	—	79%
X-ray of the finger(s), 2 or more views CPT 73140 Rad Exam Fngr(S); 2 Vw Min	$109.20	$525.00	$72.15–$888.41	29% below	79%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Rad Exam Fngr(S); 2 Vw Min	$109.20	$525.00	$72.15–$888.41	—	79%
X-ray of the foot, 2 views CPT 73620 Rad Exam Ft; 2 Vw	$86.11	$414.00	$53.78–$781.92	41% below	79%
X-ray of the foot, 2 views inpatient CPT 73620 Rad Exam Ft; 2 Vw	$86.11	$414.00	$53.78–$781.92	—	79%
X-ray of the foot, complete, 3 or more views CPT 73630 Rad Exam Ft; Compl 3 Vw Min	$149.55	$719.00	$63.45–$1,216.69	23% below	79%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Rad Exam Ft; Compl 3 Vw Min	$149.55	$719.00	$63.45–$1,216.69	—	79%
X-ray of the hand, 3 or more views CPT 73130 Rad Exam Hnd; 3 Vw Min	$143.73	$691.00	$27.10–$1,169.31	29% below	79%
X-ray of the hand, 3 or more views inpatient CPT 73130 Rad Exam Hnd; 3 Vw Min	$143.73	$691.00	$27.10–$1,169.31	—	79%
X-ray of the knee, 1 or 2 views CPT 73560 Rad Exam Knee; 1/2 Vw	$129.17	$621.00	$58.62–$1,050.86	38% below	79%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Rad Exam Knee; 1/2 Vw	$129.17	$621.00	$58.62–$1,050.86	—	79%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Rad Exam Spine Lumbosacral;2/3 Vw	$155.17	$746.00	$66.34–$631.19	36% below	79%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Rad Exam Spine Lumbosacral;2/3 Vw	$155.17	$746.00	$66.34–$631.19	—	79%
X-ray of the lower back, 4 or more views CPT 72110 Rad Exam Spine Lumbosacral; 4vw Min	$186.78	$898.00	$91.46–$759.80	45% below	79%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Rad Exam Spine Lumbosacral; 4vw Min	$186.78	$898.00	$91.46–$759.80	—	79%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Rad Exam Spine; Thor 2 Vw	$94.85	$456.00	$61.50–$562.00	58% below	79%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Rad Exam Spine; Thor 2 Vw	$94.85	$456.00	$61.50–$562.00	—	79%
X-ray of the nasal bones, 3 or more views CPT 70160 Rad Exam Nasal Bns; Compl 3 Vw Min	$135.20	$650.00	$69.23–$562.00	33% below	79%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Rad Exam Nasal Bns; Compl 3 Vw Min	$135.20	$650.00	$69.23–$562.00	—	79%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Rad Exam Cerv Spine; 2/3 Vw	$112.11	$539.00	$66.34–$562.00	55% below	79%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Rad Exam Cerv Spine; 2/3 Vw	$112.11	$539.00	$66.34–$562.00	—	79%
X-ray of the pelvis, 1 or 2 views CPT 72170 Rad Exam Pel; 1/2 Vw	$115.02	$553.00	$53.78–$562.00	40% below	79%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Rad Exam Pel; 1/2 Vw	$115.02	$553.00	$53.78–$562.00	—	79%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Rad Exam Sacrum/Coccyx 2 Vw Min	$115.02	$553.00	$55.69–$562.00	47% below	79%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Rad Exam Sacrum/Coccyx 2 Vw Min	$115.02	$553.00	$55.69–$562.00	—	79%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase; Alanine Amino	$40.14	$193.00	$4.74–$163.30	50% above	79%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Transferase; Alanine Amino	$40.14	$193.00	$4.74–$163.30	—	79%
AST (aspartate aminotransferase) enzyme test CPT 84450 Ast or Sgot	$40.14	$193.00	$4.64–$163.30	43% above	79%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Ast or Sgot	$40.14	$193.00	$4.64–$163.30	—	79%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel	$186.78	$898.00	$42.63–$759.80	33% below	79%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel	$186.78	$898.00	$42.63–$759.80	—	79%
Allergy blood test, specific IgE, per allergen CPT 86003 Allerg Sp Ige; Quan or Semiquan 493	$9.36	$45.00	$4.67–$38.07	45% below	79%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allerg Sp Ige; Quan or Semiquan 493	$9.36	$45.00	$4.67–$38.07	—	79%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibody	$83.62	$402.00	$11.59–$340.13	66% above	79%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibody	$83.62	$402.00	$11.59–$340.13	—	79%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab (Ana);	$60.32	$290.00	$10.82–$245.37	at median	79%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab (Ana);	$60.32	$290.00	$10.82–$245.37	—	79%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic Peptide	$86.11	$414.00	$35.14–$350.29	49% below	79%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Natriuretic Peptide	$86.11	$414.00	$35.14–$350.29	—	79%
Basic metabolic panel (blood test) CPT 80048 Bmp (Calcium Total)	$43.26	$208.00	$7.57–$175.99	45% below	79%
Basic metabolic panel (blood test) inpatient CPT 80048 Bmp (Calcium Total)	$43.26	$208.00	$7.57–$175.99	—	79%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Tissue Exam by Pathologist 009	$103.38	$497.00	$55.13–$420.51	59% below	79%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Tissue Exam by Pathologist 009	$103.38	$497.00	$55.13–$420.51	—	79%
Blood culture for bacteria CPT 87040 Aerob Bacterial Bld Culture	$75.09	$361.00	$9.24–$305.44	41% below	79%
Blood culture for bacteria inpatient CPT 87040 Aerob Bacterial Bld Culture	$75.09	$361.00	$9.24–$305.44	—	79%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Pace Venipuncture	$7.49	$36.00	$8.36–$38.57	43% below	79%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture	$12.06	$58.00	$8.36–$49.07	8% below	79%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Pace Venipuncture	$7.49	$36.00	$8.36–$38.57	—	79%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture	$12.06	$58.00	$8.36–$49.07	—	79%
Blood glucose (sugar) test CPT 82947 Glucose; Quan Bld 196	$20.59	$99.00	$3.52–$83.76	21% below	79%
Blood glucose (sugar) test CPT 82947 Glucose; Quan Bld 1262	$20.59	$99.00	$3.52–$83.76	21% below	79%
Blood glucose (sugar) test inpatient CPT 82947 Glucose; Quan Bld 196	$20.59	$99.00	$3.52–$83.76	—	79%
Blood glucose (sugar) test inpatient CPT 82947 Glucose; Quan Bld 1262	$20.59	$99.00	$3.52–$83.76	—	79%
Blood lead test CPT 83655 Lead 246	$40.14	$193.00	$10.84–$163.30	34% below	79%
Blood lead test inpatient CPT 83655 Lead 246	$40.14	$193.00	$10.84–$163.30	—	79%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg; Qual	$43.26	$208.00	$6.73–$175.99	43% below	79%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Hcg; Qual	$43.26	$208.00	$6.73–$175.99	—	79%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bld Typing; Abo	$28.91	$139.00	$2.99–$485.43	41% below	79%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bld Typing; Abo 641	$28.91	$139.00	$2.99–$485.43	41% below	79%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bld Typing; Abo	$28.91	$139.00	$2.99–$485.43	—	79%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bld Typing; Abo 641	$28.91	$139.00	$2.99–$485.43	—	79%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$40.14	$193.00	$4.64–$163.30	41% below	79%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein	$40.14	$193.00	$4.64–$163.30	—	79%
C. difficile toxin gene test (stool PCR) CPT 87493 C Diff Amplified Probe	$77.79	$374.00	$33.36–$316.44	41% below	79%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C Diff Amplified Probe	$77.79	$374.00	$33.36–$316.44	—	79%
CA 19-9 blood test (tumor marker) CPT 86301 Ia Quant; Ca 19-9	$66.35	$319.00	$18.62–$269.91	54% below	79%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Ia Quant; Ca 19-9	$66.35	$319.00	$18.62–$269.91	—	79%
CA-125 blood test (ovarian cancer marker) CPT 86304 Ia Quant; Ca 125	$60.32	$290.00	$18.62–$245.37	63% below	79%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Ia Quant; Ca 125	$60.32	$290.00	$18.62–$245.37	—	79%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-Cov-2 Covid-19 Amp Prb	$26.42	$127.00	$45.92–$230.90	75% below	79%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 Ncov Dx Panel	$74.67	$359.00	$45.92–$303.75	29% below	79%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 Ncov Any Technique	$74.67	$359.00	$45.92–$303.75	29% below	79%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Sars-Cov-2 Covid-19 Amp Prb	$26.42	$127.00	$45.92–$230.90	—	79%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 2019 Ncov Any Technique	$74.67	$359.00	$45.92–$303.75	—	79%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 2019 Ncov Dx Panel	$74.67	$359.00	$45.92–$303.75	—	79%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia T Amplif Na Probe 750	$92.35	$444.00	$31.41–$375.67	5% below	79%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia T Amplif Na Probe 750	$92.35	$444.00	$31.41–$375.67	—	79%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$103.38	$497.00	$11.98–$420.51	15% above	79%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$103.38	$497.00	$11.98–$420.51	—	79%
Complete blood count (CBC) with differential CPT 85025 Compl Cbc W Plt W Autom Diff	$43.26	$208.00	$6.95–$175.99	14% above	79%
Complete blood count (CBC) with differential inpatient CPT 85025 Compl Cbc W Plt W Autom Diff	$43.26	$208.00	$6.95–$175.99	—	79%
Complete blood count (CBC), no differential CPT 85027 Compl Autom Cbc W Plt	$26.00	$125.00	$5.79–$105.76	9% below	79%
Complete blood count (CBC), no differential inpatient CPT 85027 Compl Autom Cbc W Plt	$26.00	$125.00	$5.79–$105.76	—	79%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehen Metabolic Panel 004	$103.38	$497.00	$9.45–$420.51	40% above	79%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehen Metabolic Panel 004	$103.38	$497.00	$9.45–$420.51	—	79%
D-dimer blood test (blood clot marker) CPT 85379 POCT D-Dimer - Quantitative	$71.76	$345.00	$9.11–$291.90	41% below	79%
D-dimer blood test (blood clot marker) inpatient CPT 85379 POCT D-Dimer - Quantitative	$71.76	$345.00	$9.11–$291.90	—	79%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-Sulfate	$126.88	$610.00	$19.90–$516.12	13% below	79%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone-Sulfate	$126.88	$610.00	$19.90–$516.12	—	79%
Estradiol blood test CPT 82670 Estradiol	$51.79	$249.00	$25.01–$210.68	55% below	79%
Estradiol blood test inpatient CPT 82670 Estradiol	$51.79	$249.00	$25.01–$210.68	—	79%
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; Fsh	$86.11	$414.00	$16.63–$350.29	27% below	79%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Gonadotropin; Fsh	$86.11	$414.00	$16.63–$350.29	—	79%
Fecal calprotectin (stool inflammation test) CPT 83993 Assay for Calprotectin Fecal	$71.76	$345.00	$17.57–$291.90	60% below	79%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Assay for Calprotectin Fecal	$71.76	$345.00	$17.57–$291.90	—	79%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$46.18	$222.00	$12.20–$187.83	20% below	79%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$46.18	$222.00	$12.20–$187.83	—	79%
Folate (folic acid) blood test CPT 82746 Folic Acid; Serum	$69.06	$332.00	$13.16–$280.91	3% below	79%
Folate (folic acid) blood test inpatient CPT 82746 Folic Acid; Serum	$69.06	$332.00	$13.16–$280.91	—	79%
Free T3 thyroid hormone test CPT 84481 T3; Free	$63.65	$306.00	$15.16–$258.91	44% below	79%
Free T3 thyroid hormone test inpatient CPT 84481 T3; Free	$63.65	$306.00	$15.16–$258.91	—	79%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free Thyroxine 395	$80.50	$387.00	$8.07–$327.44	8% above	79%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free Thyroxine 395	$80.50	$387.00	$8.07–$327.44	—	79%
Free testosterone test CPT 84402 Testosterone; Free	$83.62	$402.00	$22.80–$340.13	3% above	79%
Free testosterone test inpatient CPT 84402 Testosterone; Free	$83.62	$402.00	$22.80–$340.13	—	79%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel	$195.52	$940.00	$253.97–$795.33	30% below	79%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel	$195.52	$940.00	$253.97–$795.33	—	79%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose; Post Glucose Dose 199	$14.56	$70.00	$4.25–$59.23	64% below	79%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose; Post Glucose Dose 199	$14.56	$70.00	$4.25–$59.23	—	79%
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance Test (Gtt)	$63.65	$306.00	$11.52–$258.91	11% below	79%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance Test (Gtt)	$63.65	$306.00	$11.52–$258.91	—	79%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Amplif Na Probe 768	$75.09	$361.00	$31.41–$305.44	23% below	79%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Amplif Na Probe 768	$75.09	$361.00	$31.41–$305.44	—	79%
H. pylori antibody blood test CPT 86677 Ab; Helicobacter Pylori	$69.06	$332.00	$15.08–$280.91	31% below	79%
H. pylori antibody blood test inpatient CPT 86677 Ab; Helicobacter Pylori	$69.06	$332.00	$15.08–$280.91	—	79%
H. pylori stool antigen test CPT 87338 Hpylori Stool Eia	$57.62	$277.00	$12.87–$234.37	54% below	79%
H. pylori stool antigen test inpatient CPT 87338 Hpylori Stool Eia	$57.62	$277.00	$12.87–$234.37	—	79%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Na Quan	$94.85	$456.00	$76.16–$385.82	74% below	79%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 Na Quan	$94.85	$456.00	$76.16–$385.82	—	79%
HIV-1 and HIV-2 antibody test CPT 86703 Ab; Hiv-1 & Hiv-2 Sgl Assay 596	$54.91	$264.00	$13.71–$223.37	8% below	79%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Ab; Hiv-1 & Hiv-2 Sgl Assay 596	$54.91	$264.00	$13.71–$223.37	—	79%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab	$37.44	$180.00	$21.55–$152.30	36% below	79%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab	$37.44	$180.00	$21.55–$152.30	—	79%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High-Risk Types	$54.91	$264.00	$31.41–$223.37	46% below	79%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Hpv High-Risk Types	$54.91	$264.00	$31.41–$223.37	—	79%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Glycosylated Hemoglobin Test	$57.62	$277.00	$8.69–$234.37	9% below	79%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Glycosylated Hemoglobin Test	$57.62	$277.00	$8.69–$234.37	—	79%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Ab: Hbsab	$51.79	$249.00	$10.74–$210.68	11% below	79%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Ab: Hbsab	$51.79	$249.00	$10.74–$210.68	—	79%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag Eia 741	$63.65	$306.00	$10.33–$258.91	30% above	79%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag Eia 741	$63.65	$306.00	$10.33–$258.91	—	79%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab 625	$94.85	$456.00	$12.77–$385.82	14% above	79%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Ab 625	$94.85	$456.00	$12.77–$385.82	—	79%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hep-C Na Quan 831	$137.70	$662.00	$38.34–$560.12	26% below	79%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hep-C Na Quan 831	$137.70	$662.00	$38.34–$560.12	—	79%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Test	$23.09	$111.00	$11.81–$93.92	53% below	79%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Test	$23.09	$111.00	$11.81–$93.92	—	79%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2	$23.09	$111.00	$17.32–$93.92	68% below	79%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Type 2	$23.09	$111.00	$17.32–$93.92	—	79%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein Hs	$60.32	$290.00	$11.59–$245.37	14% below	79%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein Hs	$60.32	$290.00	$11.59–$245.37	—	79%
Homocysteine blood test CPT 83090 Assay of Homocystine	$97.76	$470.00	$16.04–$397.67	22% below	79%
Homocysteine blood test inpatient CPT 83090 Assay of Homocystine	$97.76	$470.00	$16.04–$397.67	—	79%
Insulin blood test CPT 83525 Insulin; Total	$40.14	$193.00	$10.23–$163.30	37% below	79%
Insulin blood test inpatient CPT 83525 Insulin; Total	$40.14	$193.00	$10.23–$163.30	—	79%
Iron blood test (serum iron) CPT 83540 IRON	$26.00	$125.00	$5.79–$105.76	36% below	79%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$26.00	$125.00	$5.79–$105.76	—	79%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity	$40.14	$193.00	$7.82–$163.30	3% below	79%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity	$40.14	$193.00	$7.82–$163.30	—	79%
Kidney function blood test panel CPT 80069 Renal Function Panel	$86.11	$414.00	$7.77–$350.29	11% below	79%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel	$86.11	$414.00	$7.77–$350.29	—	79%
LH (luteinizing hormone) test CPT 83002 Gonadotropin; Luteinizing Hormone	$89.02	$428.00	$16.58–$362.13	36% below	79%
LH (luteinizing hormone) test inpatient CPT 83002 Gonadotropin; Luteinizing Hormone	$89.02	$428.00	$16.58–$362.13	—	79%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase 249	$37.44	$180.00	$6.17–$152.30	57% below	79%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase 249	$37.44	$180.00	$6.17–$152.30	—	79%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$75.09	$361.00	$7.31–$305.44	18% below	79%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$75.09	$361.00	$7.31–$305.44	—	79%
Lyme disease antibody test CPT 86618 Ab; Lyme's Disease	$60.32	$290.00	$15.24–$245.37	36% below	79%
Lyme disease antibody test inpatient CPT 86618 Ab; Lyme's Disease	$60.32	$290.00	$15.24–$245.37	—	79%
Magnesium blood test CPT 83735 Magnesium 256	$31.82	$153.00	$6.00–$129.45	28% below	79%
Magnesium blood test inpatient CPT 83735 Magnesium 256	$31.82	$153.00	$6.00–$129.45	—	79%
Measles (rubeola) antibody test CPT 86765 Ab; Rubeola	$69.06	$332.00	$11.53–$280.91	5% below	79%
Measles (rubeola) antibody test inpatient CPT 86765 Ab; Rubeola	$69.06	$332.00	$11.53–$280.91	—	79%
Mono test (heterophile antibody, Monospot) CPT 86308 Qual Heterophile Ab	$51.79	$249.00	$4.64–$210.68	29% below	79%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Qual Heterophile Ab	$51.79	$249.00	$4.64–$210.68	—	79%
Obstetric blood test panel CPT 80055 Obstetric Panel	$141.02	$678.00	$42.79–$573.66	53% below	79%
Obstetric blood test panel inpatient CPT 80055 Obstetric Panel	$141.02	$678.00	$42.79–$573.66	—	79%
PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate Specific Antigen (Psa); Free	$54.91	$264.00	$16.46–$223.37	21% below	79%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Prostate Specific Antigen (Psa); Free	$54.91	$264.00	$16.46–$223.37	—	79%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen (Psa); Total	$63.65	$306.00	$16.46–$258.91	14% below	79%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen (Psa); Total	$63.65	$306.00	$16.46–$258.91	—	79%
Pap test (liquid-based, automated screening with review) CPT 88175 Cytopath C/V Auto Fluid Redo 791	$63.65	$306.00	$23.82–$258.91	19% below	79%
Pap test (liquid-based, automated screening with review) CPT 88175 Atl Scrn Cytopath W Rvw by Tech	$63.65	$306.00	$23.71–$258.91	19% below	79%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Atl Scrn Cytopath W Rvw by Tech	$63.65	$306.00	$23.71–$258.91	—	79%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopath C/V Auto Fluid Redo 791	$63.65	$306.00	$23.82–$258.91	—	79%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cp Cerv/Vag; Atl; Manual Scrn	$43.26	$208.00	$20.26–$233.00	38% below	79%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cp Cerv/Vag; Atl; Manual Scrn	$43.26	$208.00	$20.26–$233.00	—	79%
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone 339	$86.11	$414.00	$36.95–$350.29	54% below	79%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone 339	$86.11	$414.00	$36.95–$350.29	—	79%
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt; Plasma or Whole Bld 489	$28.91	$139.00	$5.38–$117.61	41% below	79%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt; Plasma or Whole Bld 489	$28.91	$139.00	$5.38–$117.61	—	79%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Fetal Chrmoml Aneuploidy	$516.46	$2,483.00	$211.00–$3,415.73	39% below	79%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Fetal Chrmoml Aneuploidy	$516.46	$2,483.00	$211.00–$3,415.73	—	79%
Progesterone blood test CPT 84144 Progesterone Assay	$86.11	$414.00	$18.67–$350.29	37% below	79%
Progesterone blood test inpatient CPT 84144 Progesterone Assay	$86.11	$414.00	$18.67–$350.29	—	79%
Prolactin blood test CPT 84146 Prolactin Assay	$100.67	$484.00	$17.35–$409.51	3% above	79%
Prolactin blood test inpatient CPT 84146 Prolactin Assay	$100.67	$484.00	$17.35–$409.51	—	79%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Test Prsmv Dir Opt Obs	$89.65	$431.00	$11.28–$364.67	at median	79%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug Test Prsmv Dir Opt Obs	$89.65	$431.00	$11.28–$364.67	—	79%
Rapid flu test (influenza antigen) CPT 87804 Infect Agent Detect; Influenza	$43.26	$208.00	$14.81–$175.99	11% below	79%
Rapid flu test (influenza antigen) inpatient CPT 87804 Infect Agent Detect; Influenza	$43.26	$208.00	$14.81–$175.99	—	79%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infect Agent Detect; Strep	$51.79	$249.00	$14.79–$210.68	30% below	79%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Infect Agent Detect; Strep	$51.79	$249.00	$14.79–$210.68	—	79%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quant	$46.18	$222.00	$5.07–$187.83	2% below	79%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quant	$46.18	$222.00	$5.07–$187.83	—	79%
Rubella antibody test (immunity check) CPT 86762 Ab; Rubella 613	$26.00	$125.00	$12.88–$105.76	61% below	79%
Rubella antibody test (immunity check) inpatient CPT 86762 Ab; Rubella 613	$26.00	$125.00	$12.88–$105.76	—	79%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Autom Erythrocyte Sed Rate	$26.00	$125.00	$2.42–$105.76	33% below	79%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Autom Erythrocyte Sed Rate	$26.00	$125.00	$2.42–$105.76	—	79%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Anal Vol/Count/Mot	$77.79	$374.00	$11.02–$316.44	29% below	79%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen Anal Vol/Count/Mot	$77.79	$374.00	$11.02–$316.44	—	79%
Stool ova and parasites exam CPT 87177 Ova and Parasite Dir Smr W ID	$57.62	$277.00	$7.97–$234.37	22% above	79%
Stool ova and parasites exam inpatient CPT 87177 Ova and Parasite Dir Smr W ID	$57.62	$277.00	$7.97–$234.37	—	79%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Blood Occult; Qual Consecutive Specimens	$7.70	$37.00	$3.92–$31.31	78% below	79%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Blood Occult; Qual Consecutive Specimens	$7.70	$37.00	$3.92–$31.31	—	79%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Immunochemical Fecal Occult Blood	$34.94	$168.00	$14.25–$142.14	31% below	79%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Immunochemical Fecal Occult Blood	$34.94	$168.00	$14.25–$142.14	—	79%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Test Non-Trep Qual 562	$23.09	$111.00	$3.82–$93.92	42% below	79%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis Test Non-Trep Qual 562	$23.09	$111.00	$3.82–$93.92	—	79%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB Test Cell Immun Measure	$80.50	$387.00	$55.47–$327.44	47% below	79%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB Test Cell Immun Measure	$80.50	$387.00	$55.47–$327.44	—	79%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone; Total	$86.11	$414.00	$23.10–$350.29	16% below	79%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone; Total	$86.11	$414.00	$23.10–$350.29	—	79%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Ab Ea 552	$77.79	$374.00	$13.02–$316.44	7% below	79%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Ab Ea 552	$77.79	$374.00	$13.02–$316.44	—	79%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$77.79	$374.00	$15.04–$316.44	5% below	79%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$77.79	$374.00	$15.04–$316.44	—	79%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Amplif	$69.06	$332.00	$31.41–$280.91	27% below	79%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis Amplif	$69.06	$332.00	$31.41–$280.91	—	79%
Uric acid blood test CPT 84550 Uric Acid; Bld 417	$28.91	$139.00	$4.05–$117.61	37% below	79%
Uric acid blood test inpatient CPT 84550 Uric Acid; Bld 417	$28.91	$139.00	$4.05–$117.61	—	79%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Auto W/Scope	$28.91	$139.00	$2.84–$117.61	30% below	79%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Auto W/Scope	$28.91	$139.00	$2.84–$117.61	—	79%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis; Non-Auto W/Micro	$20.59	$99.00	$3.60–$83.76	2% below	79%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis; Non-Auto W/Micro	$20.59	$99.00	$3.60–$83.76	—	79%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis; Auto WO/Micro 052	$17.06	$82.00	$2.01–$69.38	12% below	79%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis; Auto WO/Micro 052	$17.06	$82.00	$2.01–$69.38	—	79%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis; Non-Auto WO/Micro	$13.52	$65.00	$3.11–$55.00	25% above	79%
Urinalysis without microscope exam, manual CPT 81002 Pace Urinalysis; Non-Auto WO/Micro	$14.56	$70.00	$3.11–$59.23	34% above	79%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis; Non-Auto WO/Micro-OB	$17.06	$82.00	$3.11–$69.38	58% above	79%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis; Non-Auto WO/Micro	$13.52	$65.00	$3.11–$55.00	—	79%
Urinalysis without microscope exam, manual inpatient CPT 81002 Pace Urinalysis; Non-Auto WO/Micro	$14.56	$70.00	$3.11–$59.23	—	79%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis; Non-Auto WO/Micro-OB	$17.06	$82.00	$3.11–$69.38	—	79%
Urine culture for bacteria, with colony count CPT 87086 Bact Culture - Urine; Quan Count	$34.94	$168.00	$7.22–$142.14	16% below	79%
Urine culture for bacteria, with colony count inpatient CPT 87086 Bact Culture - Urine; Quan Count	$34.94	$168.00	$7.22–$142.14	—	79%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test	$26.00	$125.00	$7.71–$105.76	51% below	79%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test-OP Surg	$26.00	$125.00	$7.71–$105.76	51% below	79%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test	$26.00	$125.00	$7.71–$105.76	—	79%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test-OP Surg	$26.00	$125.00	$7.71–$105.76	—	79%
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vit B-12)	$71.76	$345.00	$13.50–$291.90	12% above	79%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Cyanocobalamin (Vit B-12)	$71.76	$345.00	$13.50–$291.90	—	79%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D; 25 Hydroxy	$86.11	$414.00	$26.49–$350.29	26% below	79%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D; 25 Hydroxy	$86.11	$414.00	$26.49–$350.29	—	79%
Zinc blood test CPT 84630 ZINC	$46.18	$222.00	$10.19–$187.83	32% below	79%
Zinc blood test inpatient CPT 84630 ZINC	$46.18	$222.00	$10.19–$187.83	—	79%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg; Quan 430	$118.14	$568.00	$13.47–$480.58	54% above	79%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg; Quan 429	$120.64	$580.00	$13.47–$490.74	57% above	79%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg; Quan 430	$118.14	$568.00	$13.47–$480.58	—	79%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg; Quan 429	$120.64	$580.00	$13.47–$490.74	—	79%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 Adenoidectomy Primary <Age 12	$2,973.14	$14,293.96	$2,273.62–$10,106.00	23% below	79%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 Arthrd Ant Interbody Decompress Cervical Belw C2	$19,221.51	$92,411.10	$13,051.74–$46,840.97	8% above	79%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Arthrs Aided Ant Cruciate Ligm Rpr/Agmntj/Rcnstj	$14,492.81	$69,676.96	$1,905.42–$46,840.97	4% above	79%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 Surgical Arthroscopy Shoulder W/Rotator Cuff Rpr	$13,422.73	$64,532.34	$3,121.64–$26,473.76	185% above	79%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Bx Breast 1st Lesion Strtctc Hcode	$2,037.36	$9,795.00	$1,747.41–$8,287.55	10% below	79%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Bx Breast 1st Lesion Strtctc Hcode	$2,037.36	$9,795.00	$1,747.41–$8,287.55	—	79%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Corrj Hlx Vlgs Bncty Sesmdc Dstl Metar Osteot	$8,230.78	$39,571.04	$1,905.42–$26,473.76	276% above	79%
Cardiac catheterization with coronary angiogram CPT 93458 L Hrt Artery/Ventricle Angio	$5,738.72	$27,590.00	$3,430.00–$23,343.90	40% below	79%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 L Hrt Artery/Ventricle Angio	$5,738.72	$27,590.00	$3,430.00–$23,343.90	—	79%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion; Ext	$574.08	$2,760.00	$699.29–$2,411.39	59% below	79%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion; Ext	$574.08	$2,760.00	$699.29–$2,411.39	—	79%
Carpal tunnel release, open surgery CPT 64721 Neuroplasty &/Transpos Median Nrv Carpal Tunne	$3,444.69	$16,561.01	$1,905.42–$10,106.00	85% above	79%
Catheter ablation for atrial fibrillation CPT 93656 Comp Ep Eval Tx Atrial Fib Pulm Vein Isol	$14,060.59	$67,599.00	$26,103.48–$95,361.99	49% below	79%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Comp Ep Eval Tx Atrial Fib Pulm Vein Isol	$14,060.59	$67,599.00	$26,103.48–$95,361.99	—	79%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circumcision Age >28 Days	$3,428.24	$16,481.90	$1,728.79–$10,106.00	371% above	79%
Colonoscopy with polyp removal CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$1,717.54	$8,257.39	$153.27–$4,365.84	8% below	79%
Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy Single/Multiple	$1,876.35	$9,020.93	$153.27–$4,365.84	34% above	79%
Colonoscopy, diagnostic CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$1,439.70	$6,921.62	$153.27–$4,106.00	24% above	79%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colposcopy Cervix Bx Cervix & Endocrv Curretage	$3,371.39	$16,208.60	$322.41–$1,111.79	920% above	79%
Cystoscopy with ureteral stent placement CPT 52332 Cysto W/Insert Ureteral Stent	$5,623.11	$27,034.16	$1,728.79–$12,860.63	6% below	79%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystourethroscopy	$2,730.19	$13,125.90	$737.75–$3,057.00	327% above	79%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Tympanostomy General Anesthesia	$2,680.17	$12,885.44	$1,641.59–$5,660.84	744% above	79%
Earwax removal with instruments, one ear one side CPT 69210 Removal Impacted Cerumen Instrumentation Unilat	$2,730.92	$13,129.44	$285.87–$21,598.06	2369% above	79%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial Bx W/WO Endocervix Bx W/O Dilat Spx	$4,541.25	$21,832.91	$213.90–$737.61	3133% above	79%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 Nasal/Sinus Ndsc W/Rmvl Tiss From Frontal Sinus	$10,170.63	$48,897.28	$2,273.62–$25,748.61	838% above	79%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 Nsl/Sinus Ndsc Max Antrost W/Rmvl Tiss Max Sinus	$8,509.57	$40,911.39	$1,905.42–$25,748.61	51% above	79%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Njx Interlaminar Crv/Thrc W/Image Guidance Hcode	$1,061.63	$5,104.00	$1,905.42–$4,318.49	6% above	79%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn	$1,560.58	$7,502.78	$746.83–$3,057.00	56% above	79%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Njx Interlaminar Crv/Thrc W/Image Guidance Hcode	$1,061.63	$5,104.00	$1,905.42–$4,318.49	—	79%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Injection Facet Lumbar/Sacral; Single Lvl Hcode	$459.06	$2,207.00	$1,103.50–$3,734.69	59% below	79%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level	$1,548.78	$7,446.06	$935.78–$3,226.93	38% above	79%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Injection Facet Lumbar/Sacral; Single Lvl Hcode	$459.06	$2,207.00	$1,103.50–$3,734.69	—	79%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Rpr Aa Hernia 1st 3-10 Cm Reducible	$13,515.06	$64,976.26	$6,849.37–$23,619.25	5% above	79%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Rpr Aa Hernia 1st < 3 Cm Reducible	$6,213.88	$29,874.41	$3,788.10–$15,662.09	15% below	79%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa if Pfrmd	$1,698.57	$8,166.18	$401.86–$4,106.00	2% below	79%
Gallbladder removal, laparoscopic CPT 47562 Laparoscopy Surg Cholecystectomy	$11,538.14	$55,471.85	$4,211.34–$26,225.00	91% above	79%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Laps Surg Cholecystectomy W/Cholangiography	$12,251.24	$58,900.17	$4,211.34–$26,225.00	148% above	79%
Hammertoe correction surgery CPT 28285 Correction Hammertoe	$6,405.97	$30,797.94	$1,905.42–$26,473.76	at median	79%
Hemorrhoid banding (rubber band ligation) CPT 46221 Hemorrhoidectomy Internal Rubber Band Ligations	$1,297.12	$6,236.13	$401.86–$3,392.89	105% above	79%
Hemorrhoidectomy (internal and external), one area CPT 46255 Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group	$4,826.72	$23,205.40	$1,905.42–$10,126.77	213% above	79%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Hysterosalpingography Cath	$57.62	$277.00	$138.50–$343.04	80% below	79%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Hysterosalpingography Cath	$57.62	$277.00	$138.50–$343.04	—	79%
Hysteroscopy with endometrial ablation CPT 58563 Hysteroscopy Endometrial Ablation	$4,733.20	$22,755.77	$2,273.62–$18,251.07	27% below	79%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$4,677.79	$22,489.36	$1,905.42–$11,810.41	18% below	79%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D Absc; Smpl or Sgl Hcode	$99.01	$476.00	$207.40–$732.00	76% below	79%
Incision and drainage of a simple or single skin abscess CPT 10060 Incision and Drainage of Abscess; Smpl or Sgl	$2,464.33	$11,847.73	$212.27–$732.00	507% above	79%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D Absc; Smpl or Sgl Hcode	$99.01	$476.00	$207.40–$732.00	—	79%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$5,587.23	$26,861.70	$2,273.62–$13,183.00	6% above	79%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection 1 Tendon Sheath/Ligament Aponeurosis	$1,594.83	$7,667.46	$285.87–$1,119.89	210% above	79%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis; Maj Jt Hcode	$186.78	$898.00	$285.87–$1,519.60	51% below	79%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis; Maj Jt Hcode	$639.18	$3,073.00	$285.87–$1,119.89	67% above	79%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis; Maj Jt Hcode	$186.78	$898.00	$285.87–$1,519.60	—	79%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/Inj Interm Jnt/Bursa Hcode	$221.31	$1,064.00	$285.87–$1,119.89	38% below	79%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/Inj Interm Jnt/Bursa Hcode	$16,235.15	$78,053.59	$285.87–$11,937.66	4470% above	79%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drain/Inj Interm Jnt/Bursa Hcode	$221.31	$1,064.00	$285.87–$1,119.89	—	79%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Drain/Inject Sm Jnt/Bursa Hcode	$160.99	$774.00	$285.87–$654.88	42% below	79%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Drain/Inject Sm Jnt/Bursa Hcode	$160.99	$774.00	$285.87–$654.88	—	79%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Arthroscopy Kne Surg Meniscus Rpr Medial/Lateral	$11,895.81	$57,191.40	$1,905.42–$26,473.76	13% above	79%
Knee arthroscopy with meniscus trim CPT 29881 Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg	$4,802.18	$23,087.41	$2,273.62–$13,183.00	33% above	79%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Arthrs Knee Surg Meniscectomy Med&Lat W/Shaving	$4,853.43	$23,333.78	$2,273.62–$13,183.00	29% above	79%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Laparoscopic Appendectomy	$7,613.95	$36,605.53	$1,905.42–$26,225.00	55% above	79%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 Laps Surg Esopg/Gstr Fundoplasty	$15,778.26	$75,857.01	$1,905.42–$38,782.16	512% above	79%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 Laparoscopy W Total Hysterectomy Uterus 250 Gm/<	$14,243.66	$68,479.15	$4,315.74–$38,782.16	354% above	79%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Laps Total Hysterect 250 Gm/< W/Rmvl Tube/Ovary	$15,383.87	$73,960.93	$4,315.74–$38,782.16	196% above	79%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Laparoscopy Surg Rpr Initial Inguinal Hernia	$12,390.93	$59,571.79	$2,273.62–$26,225.00	188% above	79%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Laps Surg Rpr Recurrent Inguinal Hernia	$12,113.06	$58,235.87	$3,957.76–$26,225.00	445% above	79%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Laparoscopy W/Rmvl Adnexal Structures	$12,246.18	$58,875.85	$3,121.64–$26,225.00	513% above	79%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy	$15,972.69	$76,791.78	$401.86–$26,225.00	815% above	79%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Repair Intermediate S/a/T/E 2.5 Cm/<	$2,372.87	$11,408.05	$430.10–$3,057.00	416% above	79%
Left heart catheterization, diagnostic one side CPT 93452 Left Hrt Cath W/Ventrclgrphy	$1,836.64	$8,830.00	$3,430.00–$19,742.00	76% below	79%
Left heart catheterization, diagnostic inpatient one side CPT 93452 Left Hrt Cath W/Ventrclgrphy	$1,836.64	$8,830.00	$3,430.00–$19,742.00	—	79%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx Interlaminar Lmbr/Sac W/Image Guidance Hcode	$947.02	$4,553.00	$746.83–$7,704.59	20% below	79%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx Interlaminar Lmbr/Sac W/Image Guidance Hcode	$1,560.58	$7,502.78	$746.83–$3,057.00	32% above	79%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx Interlaminar Lmbr/Sac W/Image Guidance Hcode	$947.02	$4,553.00	$746.83–$7,704.59	—	79%
Lower-back epidural injection, without imaging guidance CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn	$15,281.88	$73,470.56	$1,905.42–$49,765.00	1076% above	79%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	$1,567.03	$7,533.78	$935.78–$3,226.93	at median	79%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Laminotomy Dcmprn Nrv Root 1 Ntrspc Lumbar	$10,153.57	$48,815.23	$4,315.74–$26,473.76	2% above	79%
Lumbar laminectomy (spinal decompression), one level CPT 63047 Lam Facetectomy & Foramotomy 1 Vrt Sgm Lumbar	$9,569.72	$46,008.29	$4,315.74–$26,473.76	3% below	79%
Lumpectomy (partial mastectomy) CPT 19301 Mastectomy Partial	$7,580.45	$36,444.48	$1,905.42–$24,226.15	411% above	79%
Mastectomy (total removal of the breast) CPT 19303 Mastectomy Simple Complete	$9,305.02	$44,735.65	$2,273.62–$24,226.15	347% above	79%
Miscarriage treatment with D&C, first trimester CPT 59820 Tx Missed Abortion First Trimester Surgical	$3,177.32	$15,275.60	$1,242.31–$11,810.41	100% above	79%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 Mohs Micrographic H/N/H/F/G 1st Stage 5 Blocks	$1,559.33	$7,496.77	$781.95–$13,183.00	—	79%
Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Partial/Complete Simple 1	$1,677.26	$8,063.75	$1,283.57–$10,106.00	414% above	79%
Occipital nerve block (injection for headaches) CPT 64405 Inject Anesthesia; Greater Occipital Nerve Hcode	$344.45	$1,656.00	$828.00–$1,490.77	at median	79%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Inject Anesthesia; Greater Occipital Nerve Hcode	$344.45	$1,656.00	$828.00–$1,490.77	—	79%
Pacemaker implant (dual chamber) CPT 33208 Insrt Heart Pm Atrial & Vent	$7,173.71	$34,489.00	$8,683.74–$77,684.00	41% below	79%
Pacemaker implant (dual chamber) inpatient CPT 33208 Insrt Heart Pm Atrial & Vent	$7,173.71	$34,489.00	$8,683.74–$77,684.00	—	79%
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis W/Imaging	$344.45	$1,656.00	$828.00–$4,106.00	74% below	79%
Paracentesis with imaging guidance inpatient CPT 49083 Abd Paracentesis W/Imaging	$344.45	$1,656.00	$828.00–$4,106.00	—	79%
Partial knee replacement (one compartment) CPT 27446 Arthrp Knee Condyle&Plateau Medial/Lat Cmprt	$16,191.14	$77,842.01	$3,121.64–$49,765.00	214% above	79%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail&Nail Matrix Prtl/Compl Perm Rmvl	$2,124.75	$10,215.13	$430.10–$1,483.13	245% above	79%
Prostate biopsy CPT 55700 Biopsy Prostate; Needle/Punch	$3,999.67	$19,229.16	$55.13–$4,106.00	25% above	79%
Prostate removal (prostatectomy), laparoscopic CPT 55866 Laps Surg Prst8ect Rpbic Rad W/Nerve Sparing	$22,761.93	$109,432.36	$401.86–$49,765.00	9% below	79%
Removal of a breast lump, open surgery CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion	$2,988.58	$14,368.16	$1,905.42–$14,285.16	169% above	79%
Removal of a foreign object under the skin, simple CPT 10120 Incision & Removal FB Sq;Simple	$247.31	$1,189.00	$381.15–$1,006.01	43% below	79%
Removal of a foreign object under the skin, simple CPT 10120 Foreign Body Removal; Simple	$3,814.00	$18,336.55	$381.15–$1,483.13	784% above	79%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision & Removal FB Sq;Simple	$247.31	$1,189.00	$381.15–$1,006.01	—	79%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 Total Thyroid Lobectomy Uni W/WO Isthmusectomy	$9,191.41	$44,189.46	$1,728.79–$26,225.00	242% above	79%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colon Ca Scrn Not Hi Rsk Ind	$1,430.39	$6,876.87	$153.27–$3,392.89	13% below	79%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colorectal Scrn; Hi Risk Ind	$1,428.49	$6,867.73	$153.27–$3,392.89	10% above	79%
Septoplasty to straighten the nasal septum CPT 30520 Septoplasty/Submucous Resecj W/WO Cartilage Grf	$5,330.06	$25,625.31	$2,273.62–$21,598.06	113% above	79%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy Xtrcorp Shock Wave	$4,000.03	$19,230.92	$3,729.47–$26,225.00	61% below	79%
Short arm splint (forearm and hand) CPT 29125 Apply Forearm Splint; Static Ot	$69.06	$332.00	$166.00–$561.81	62% below	79%
Short arm splint (forearm and hand) inpatient CPT 29125 Apply Forearm Splint; Static Ot	$69.06	$332.00	$166.00–$561.81	—	79%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 Surgical Arthroscopy Shoulder Dstl Claviculc	$9,750.77	$46,878.68	$3,121.64–$26,473.76	429% above	79%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls	$12,410.35	$59,665.15	$2,273.62–$26,473.76	72% above	79%
Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin Single Lesion Hcode	$880.46	$4,233.00	$172.04–$1,483.13	120% above	79%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Lumbar Puncture Diagnostic HCODE	$602.78	$2,898.00	$746.83–$3,057.00	37% below	79%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Lumbar Puncture Diagnostic HCODE	$602.78	$2,898.00	$746.83–$3,057.00	—	79%
TURP (transurethral resection of the prostate) CPT 52601 Trurl Electrosurg Rescj Prostate Bleed Complete	$4,655.62	$22,382.78	$2,273.62–$19,742.00	22% above	79%
Thoracentesis with imaging guidance CPT 32555 Aspirate Pleura W/ Imaging Hcode	$344.45	$1,656.00	$663.69–$3,057.00	69% below	79%
Thoracentesis with imaging guidance inpatient CPT 32555 Aspirate Pleura W/ Imaging Hcode	$344.45	$1,656.00	$663.69–$3,057.00	—	79%
Tonsil and adenoid removal, age 12 or older CPT 42821 Tonsillectomy & Adenoidectomy Age 12/>	$3,260.38	$15,674.90	$3,121.64–$12,096.21	at median	79%
Tonsil and adenoid removal, child under 12 CPT 42820 Tonsillectomy & Adenoidectomy <Age 12	$3,019.63	$14,517.44	$3,121.64–$21,598.06	at median	79%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Tonsillectomy Primary/Secondary Age 12/>	$3,450.64	$16,589.62	$2,273.62–$12,096.21	487% above	79%
Total hip replacement CPT 27130 Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	$16,731.21	$80,438.51	$13,583.45–$49,765.00	168% above	79%
Total knee replacement CPT 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments	$16,453.79	$79,104.74	$13,583.45–$49,765.00	45% above	79%
Total shoulder replacement CPT 23472 Arthroplasty Glenohumeral Joint Total Shoulder	$21,814.65	$104,878.12	$18,550.96–$63,970.82	35% above	79%
Total thyroid removal (thyroidectomy) CPT 60240 Thyroidectomy Total/Complete	$10,698.06	$51,432.96	$4,315.74–$26,225.00	387% above	79%
Trigger finger release surgery CPT 26055 Tendon Sheath Incision	$2,883.24	$13,861.75	$1,701.27–$5,866.63	44% above	79%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx Breast 1st Lesion US Imag Hcode	$1,521.10	$7,313.00	$1,747.41–$12,375.06	20% below	79%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Bx Breast 1st Lesion US Imag Hcode	$1,521.10	$7,313.00	$1,747.41–$12,375.06	—	79%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Egd Balloon Dilation Esophagus <30 Mm Diam	$1,915.52	$9,209.25	$153.27–$7,000.98	36% below	79%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd Transoral Biopsy Single/Multiple	$1,999.29	$9,611.98	$153.27–$7,000.98	2% above	79%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Esophagogastroduodenoscopy Submucosal Injection	$2,553.85	$12,278.14	$401.86–$7,000.98	108% above	79%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd Removal Tumor Polyp/Other Lesion Snare Tech	$1,980.88	$9,523.48	$153.27–$7,000.98	1% below	79%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Egd Insert Guide Wire Dilator Passage Esophagus	$2,197.39	$10,564.39	$959.60–$4,106.00	at median	79%
Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic	$1,685.28	$8,102.30	$153.27–$4,106.00	26% above	79%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 Cysto W/Ureteroscopy W/Lithotripsy	$8,000.85	$38,465.62	$2,273.62–$19,742.00	5% above	79%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 Cysto/Uretero W/Lithotripsy &Indwell Stent Insrt	$8,584.09	$41,269.67	$5,672.83–$19,742.00	25% below	79%
Vein ablation, radiofrequency, first vein CPT 36475 Endovenous Rf 1st Vein	$4,224.74	$20,311.25	$3,121.64–$13,183.00	3% below	79%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Subq Tissue 20 Sq Cm or Less Hcode	$328.22	$1,578.00	$172.04–$2,074.55	53% below	79%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 Optx Dstl Rdl X-Artic Fx/Epiphysl Separation	$9,233.96	$44,394.06	$3,121.64–$26,473.76	448% above	79%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 2 Hours	$241.49	$1,161.00	$466.77–$1,609.59	73% below	79%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 4 Hours	$344.45	$1,656.00	$466.77–$1,609.59	62% below	79%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 6 Hours	$430.56	$2,070.00	$466.77–$1,751.43	52% below	79%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood or Blood Components	$487.14	$2,342.00	$466.77–$1,981.57	46% below	79%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 10 Hours	$545.17	$2,621.00	$466.77–$2,217.63	39% below	79%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 8 Hours	$574.08	$2,760.00	$466.77–$2,335.24	36% below	79%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 12 Hours	$602.78	$2,898.00	$466.77–$2,452.00	33% below	79%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood 2 Hours	$241.49	$1,161.00	$466.77–$1,609.59	—	79%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood 4 Hours	$344.45	$1,656.00	$466.77–$1,609.59	—	79%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood 6 Hours	$430.56	$2,070.00	$466.77–$1,751.43	—	79%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood or Blood Components	$487.14	$2,342.00	$466.77–$1,981.57	—	79%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood 10 Hours	$545.17	$2,621.00	$466.77–$2,217.63	—	79%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood 8 Hours	$574.08	$2,760.00	$466.77–$2,335.24	—	79%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood 12 Hours	$602.78	$2,898.00	$466.77–$2,452.00	—	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment; E-Z Pap	$35.57	$171.00	$24.84–$798.92	68% below	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 E-Z Pap Treatment; Subseq	$35.57	$171.00	$24.84–$798.92	68% below	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment; Nebulizer	$57.62	$277.00	$24.84–$798.92	49% below	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment; Aerosol	$57.62	$277.00	$24.84–$798.92	49% below	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment; Mdi/Dpi	$57.62	$277.00	$24.84–$798.92	49% below	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Treatment; Subseq	$57.62	$277.00	$24.84–$798.92	49% below	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pep Treatment; Subseq	$57.62	$277.00	$24.84–$798.92	49% below	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi/Dpi Treatment; Subseq	$57.62	$277.00	$24.84–$798.92	49% below	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment;Subseq	$71.76	$345.00	$24.84–$798.92	36% below	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment; Pep	$71.76	$345.00	$24.84–$798.92	36% below	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Ippb Treatment; Subseq	$71.76	$345.00	$24.84–$798.92	36% below	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 E-Z Pap Treatment; Subseq	$35.57	$171.00	$24.84–$798.92	—	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment; E-Z Pap	$35.57	$171.00	$24.84–$798.92	—	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment; Mdi/Dpi	$57.62	$277.00	$24.84–$798.92	—	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment; Nebulizer	$57.62	$277.00	$24.84–$798.92	—	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Pep Treatment; Subseq	$57.62	$277.00	$24.84–$798.92	—	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment; Aerosol	$57.62	$277.00	$24.84–$798.92	—	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Treatment; Subseq	$57.62	$277.00	$24.84–$798.92	—	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Mdi/Dpi Treatment; Subseq	$57.62	$277.00	$24.84–$798.92	—	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment;Subseq	$71.76	$345.00	$24.84–$798.92	—	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment; Pep	$71.76	$345.00	$24.84–$798.92	—	79%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Ippb Treatment; Subseq	$71.76	$345.00	$24.84–$798.92	—	79%
Chemotherapy IV infusion, first hour CPT 96413 Chemo Admin IV Inf Up to 1 Hr Sgl or Init Subs	$243.98	$1,173.00	$324.60–$1,984.95	60% below	79%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Admin IV Inf Up to 1 Hr Sgl or Init Subs	$243.98	$1,173.00	$324.60–$1,984.95	—	79%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Comprehensive Audio Evaluation	$86.11	$414.00	$136.14–$469.47	48% below	79%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 Comprehensive Audio Evaluation	$86.11	$414.00	$136.14–$469.47	—	79%
Critical care, first 30 to 74 minutes CPT 99291 Emergency Visit Level 6	$1,148.16	$5,520.00	$295.62–$9,798.00	40% below	79%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Emergency Visit Level 6	$1,148.16	$5,520.00	$295.62–$9,798.00	—	79%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg; Incl Record Awake / Drowsy	$401.86	$1,932.00	$228.45–$1,634.67	38% below	79%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Eeg; Incl Record Awake / Drowsy	$401.86	$1,932.00	$228.45–$1,634.67	—	79%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg/12 Lds; Tracing Only	$103.38	$497.00	$62.41–$420.51	49% below	79%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg/12 Lds; Tracing Only	$103.38	$497.00	$62.41–$420.51	—	79%
Electroconvulsive therapy (ECT), one session CPT 90870 Electroconvulsive Therapy	$430.56	$2,070.00	$1,035.00–$1,751.43	51% below	79%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 Electroconvulsive Therapy	$430.56	$2,070.00	$1,035.00–$1,751.43	—	79%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Visit Level 1	$86.11	$414.00	$89.22–$485.00	42% below	79%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Visit Level 1	$86.11	$414.00	$89.22–$485.00	—	79%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Visit Level 2	$172.43	$829.00	$162.45–$948.00	45% below	79%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Visit Level 2	$172.43	$829.00	$162.45–$948.00	—	79%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Visit Level 3	$401.86	$1,932.00	$288.81–$1,634.67	36% below	79%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Visit Level 3	$401.86	$1,932.00	$288.81–$1,634.67	—	79%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Visit Level 4	$574.08	$2,760.00	$295.62–$2,969.00	44% below	79%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Visit Level 4	$574.08	$2,760.00	$295.62–$2,969.00	—	79%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Visit Level 5	$860.91	$4,139.00	$295.62–$4,625.00	43% below	79%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Visit Level 5	$860.91	$4,139.00	$295.62–$4,625.00	—	79%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardio Stress Test; Tracing Only	$401.86	$1,932.00	$228.45–$1,634.67	42% below	79%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardio Stress Test; Tracing Only	$401.86	$1,932.00	$228.45–$1,634.67	—	79%
Family therapy with the patient, 50 minutes CPT 90847 Family/Marital Therapy W Pt 50 Min	$94.85	$456.00	$79.56–$385.82	50% below	79%
Family therapy with the patient, 50 minutes CPT 90847 Family Therapy W Pt	$146.22	$703.00	$79.56–$594.81	23% below	79%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family/Marital Therapy W Pt 50 Min	$94.85	$456.00	$79.56–$385.82	—	79%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Therapy W Pt	$146.22	$703.00	$79.56–$594.81	—	79%
Group psychotherapy session CPT 90853 Group Therapy Not Multi-Family	$659.98	$3,173.00	$79.56–$2,684.68	227% above	79%
Group psychotherapy session inpatient CPT 90853 Group Therapy Not Multi-Family	$659.98	$3,173.00	$79.56–$2,684.68	—	79%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Inf Hydration; Init 31-60 Min	$189.70	$912.00	$73.71–$776.04	48% below	79%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Inf Hydration; Init 31-60 Min	$189.70	$912.00	$73.71–$776.04	—	79%
IV infusion of a medicine, first hour CPT 96365 IV Inf Tx/Dx/Proph; Init Up to 1 Hr	$181.17	$871.00	$73.71–$776.04	55% below	79%
IV infusion of a medicine, first hour inpatient CPT 96365 IV Inf Tx/Dx/Proph; Init Up to 1 Hr	$181.17	$871.00	$73.71–$776.04	—	79%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj Sc/Im	$17.06	$82.00	$41.00–$262.69	83% below	79%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Tx/Dx/Proph; Im	$37.44	$180.00	$76.18–$262.69	62% below	79%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Tx/Dx/Proph; Im Sq	$46.18	$222.00	$73.71–$262.69	54% below	79%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj Sc/Im	$17.06	$82.00	$41.00–$262.69	—	79%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inj Tx/Dx/Proph; Im	$37.44	$180.00	$76.18–$262.69	—	79%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inj Tx/Dx/Proph; Im Sq	$46.18	$222.00	$73.71–$262.69	—	79%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psych Diagnostic Eval	$89.02	$428.00	$159.12–$362.13	57% below	79%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psych Diagnostic Eval	$89.02	$428.00	$159.12–$362.13	—	79%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Motor&/Sens 7-8 Nrv Cndj Tst	$860.91	$4,139.00	$168.13–$3,502.01	40% above	79%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Motor&/Sens 7-8 Nrv Cndj Tst	$860.91	$4,139.00	$168.13–$3,502.01	—	79%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Ea 15 Min Ot	$31.82	$153.00	$31.57–$260.00	54% below	79%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Ea 15 Min Pt	$31.82	$153.00	$31.57–$260.00	54% below	79%
Neuromuscular re-education, 15 minutes CPT 97112 Pace Neuromuscular Reeducation 15m Ot	$51.79	$249.00	$31.57–$260.00	25% below	79%
Neuromuscular re-education, 15 minutes CPT 97112 Pace Neuromuscular Reeducation 15m Pt	$51.79	$249.00	$31.57–$260.00	25% below	79%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reeducation Ea 15 Min Ot	$31.82	$153.00	$31.57–$260.00	—	79%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reeducation Ea 15 Min Pt	$31.82	$153.00	$31.57–$260.00	—	79%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Pace Neuromuscular Reeducation 15m Ot	$51.79	$249.00	$31.57–$260.00	—	79%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Pace Neuromuscular Reeducation 15m Pt	$51.79	$249.00	$31.57–$260.00	—	79%
New patient office visit, about 30 minutes CPT 99203 Pace OP Visit E&M of New Patient; Level 3	$54.70	$263.00	$67.80–$222.52	59% below	79%
New patient office visit, about 30 minutes CPT 99203 OP Visit E&M of New Patient; Level 3	$80.50	$387.00	$135.60–$327.44	40% below	79%
New patient office visit, about 30 minutes CPT 99203 OP Visit E&M of New Patient;Level 3	$80.50	$387.00	$140.86–$327.44	40% below	79%
New patient office visit, about 30 minutes inpatient CPT 99203 Pace OP Visit E&M of New Patient; Level 3	$54.70	$263.00	$67.80–$222.52	—	79%
New patient office visit, about 30 minutes inpatient CPT 99203 OP Visit E&M of New Patient; Level 3	$80.50	$387.00	$135.60–$327.44	—	79%
New patient office visit, about 30 minutes inpatient CPT 99203 OP Visit E&M of New Patient;Level 3	$80.50	$387.00	$140.86–$327.44	—	79%
New patient office visit, about 45 minutes CPT 99204 Pace OP Visit E&M of New Patient; Level 4	$63.86	$307.00	$111.17–$259.75	58% below	79%
New patient office visit, about 45 minutes CPT 99204 OP Visit E&M of New Patient; Level 4	$106.50	$512.00	$140.86–$433.20	29% below	79%
New patient office visit, about 45 minutes CPT 99204 OP Visit E&M of New Patient;Level 4	$109.20	$525.00	$140.86–$444.20	27% below	79%
New patient office visit, about 45 minutes inpatient CPT 99204 Pace OP Visit E&M of New Patient; Level 4	$63.86	$307.00	$111.17–$259.75	—	79%
New patient office visit, about 45 minutes inpatient CPT 99204 OP Visit E&M of New Patient; Level 4	$106.50	$512.00	$140.86–$433.20	—	79%
New patient office visit, about 45 minutes inpatient CPT 99204 OP Visit E&M of New Patient;Level 4	$109.20	$525.00	$140.86–$444.20	—	79%
New patient office visit, about 60 minutes CPT 99205 Pace OP Visit E&M of New Patient; Level 5	$79.04	$380.00	$151.85–$321.52	58% below	79%
New patient office visit, about 60 minutes CPT 99205 OP Visit E&M of New Patient;Level 5	$141.02	$678.00	$142.67–$573.66	24% below	79%
New patient office visit, about 60 minutes CPT 99205 OP Visit E&M of New Patient; Level 5	$141.02	$678.00	$142.67–$573.66	24% below	79%
New patient office visit, about 60 minutes inpatient CPT 99205 Pace OP Visit E&M of New Patient; Level 5	$79.04	$380.00	$151.85–$321.52	—	79%
New patient office visit, about 60 minutes inpatient CPT 99205 OP Visit E&M of New Patient;Level 5	$141.02	$678.00	$142.67–$573.66	—	79%
New patient office visit, about 60 minutes inpatient CPT 99205 OP Visit E&M of New Patient; Level 5	$141.02	$678.00	$142.67–$573.66	—	79%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Pace OP Visit E&M of New Patient; Level 2	$45.34	$218.00	$39.32–$190.94	55% below	79%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP Visit E&M of New Patient; Level 2	$49.09	$236.00	$118.00–$285.34	51% below	79%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP Visit E&M of New Patient;Level 2	$51.79	$249.00	$124.50–$285.34	49% below	79%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Pace OP Visit E&M of New Patient; Level 2	$45.34	$218.00	$39.32–$190.94	—	79%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OP Visit E&M of New Patient; Level 2	$49.09	$236.00	$118.00–$285.34	—	79%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OP Visit E&M of New Patient;Level 2	$51.79	$249.00	$124.50–$285.34	—	79%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Mnt; Init Assmnt Ea 15 Min	$13.31	$64.00	$25.61–$54.15	60% below	79%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Medical Nutrition Indiv In	$26.00	$125.00	$25.61–$105.76	23% below	79%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Pace Mnt; Init Assmnt Ea 15 Min	$27.66	$133.00	$25.61–$112.53	18% below	79%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Mnt; Init Assmnt Ea 15 Min	$13.31	$64.00	$25.61–$54.15	—	79%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Medical Nutrition Indiv In	$26.00	$125.00	$25.61–$105.76	—	79%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Pace Mnt; Init Assmnt Ea 15 Min	$27.66	$133.00	$25.61–$112.53	—	79%
Occupational therapy evaluation, low complexity CPT 97165 Pace Ot Eval Low Complex; 30 Min	$75.09	$361.00	$97.29–$305.44	53% below	79%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Low Complex 30 Min	$86.53	$416.00	$97.29–$351.98	46% below	79%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Pace Ot Eval Low Complex; 30 Min	$75.09	$361.00	$97.29–$305.44	—	79%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Ot Eval Low Complex 30 Min	$86.53	$416.00	$97.29–$351.98	—	79%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval High Complex 45 Min	$100.67	$484.00	$94.80–$409.51	56% below	79%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pace Pt Eval High Complex; 45 Min	$112.11	$539.00	$94.80–$456.05	51% below	79%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Eval High Complex 45 Min	$100.67	$484.00	$94.80–$409.51	—	79%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pace Pt Eval High Complex; 45 Min	$112.11	$539.00	$94.80–$456.05	—	79%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Low Complex 20 Min	$71.76	$345.00	$94.80–$291.90	49% below	79%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pace Pt Eval Low Complex; 20 Min	$75.09	$361.00	$94.80–$305.44	47% below	79%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pt Eval Low Complex 20 Min	$71.76	$345.00	$94.80–$291.90	—	79%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pace Pt Eval Low Complex; 20 Min	$75.09	$361.00	$94.80–$305.44	—	79%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Mod Complex 30 Min	$86.53	$416.00	$94.80–$351.98	52% below	79%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pace Pt Eval Mod Complex; 30 Min	$106.50	$512.00	$94.80–$433.20	41% below	79%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Eval Mod Complex 30 Min	$86.53	$416.00	$94.80–$351.98	—	79%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pace Pt Eval Mod Complex; 30 Min	$106.50	$512.00	$94.80–$433.20	—	79%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy 1/> Regions Ea 15 Mins Ot	$26.00	$125.00	$26.73–$260.00	52% below	79%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy 1/> Regions Ea 15 Mins Pt	$26.00	$125.00	$26.73–$260.00	52% below	79%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Pace Manual Therapy 1> Regions Ea 15 Mins Ot	$33.70	$162.00	$26.73–$260.00	38% below	79%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pace Manual Therapy 1> Regions Ea 15 Mins Pt	$33.70	$162.00	$26.73–$260.00	38% below	79%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy 1/> Regions Ea 15 Mins Pt	$26.00	$125.00	$26.73–$260.00	—	79%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy 1/> Regions Ea 15 Mins Ot	$26.00	$125.00	$26.73–$260.00	—	79%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Pace Manual Therapy 1> Regions Ea 15 Mins Ot	$33.70	$162.00	$26.73–$260.00	—	79%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Pace Manual Therapy 1> Regions Ea 15 Mins Pt	$33.70	$162.00	$26.73–$260.00	—	79%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Pace Therapeutic Exercises 15 Min Ot	$33.70	$162.00	$28.03–$260.00	38% below	79%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Pace Therapeutic Exercises 15 Min Pt	$33.70	$162.00	$28.03–$260.00	38% below	79%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercises Ea 15 Min Ot	$35.78	$172.00	$28.03–$260.00	34% below	79%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercises Ea 15 Min Pt	$35.78	$172.00	$28.03–$260.00	34% below	79%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Pace Therapeutic Exercises 15 Min Pt	$33.70	$162.00	$28.03–$260.00	—	79%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Pace Therapeutic Exercises 15 Min Ot	$33.70	$162.00	$28.03–$260.00	—	79%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercises Ea 15 Min Pt	$35.78	$172.00	$28.03–$260.00	—	79%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercises Ea 15 Min Ot	$35.78	$172.00	$28.03–$260.00	—	79%
Psychiatric evaluation with medical services CPT 90792 Psych Diag Eval W/Med Srvcs	$146.22	$703.00	$159.12–$594.81	1% below	79%
Psychiatric evaluation with medical services inpatient CPT 90792 Psych Diag Eval W/Med Srvcs	$146.22	$703.00	$159.12–$594.81	—	79%
Psychotherapy session, 30 minutes CPT 90832 Pace Psytx Pt&/Family 30 Mins Typ 4	$75.92	$365.00	$159.12–$308.83	16% below	79%
Psychotherapy session, 30 minutes inpatient CPT 90832 Pace Psytx Pt&/Family 30 Mins Typ 4	$75.92	$365.00	$159.12–$308.83	—	79%
Psychotherapy session, 60 minutes CPT 90837 Psytx Pt 60 Mins	$123.55	$594.00	$159.12–$502.58	30% below	79%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psytx Pt 60 Mins	$123.55	$594.00	$159.12–$502.58	—	79%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Behav Chng Smoking Greater Than 3 Min Up to 10 Min	$17.06	$82.00	$39.64–$136.68	40% below	79%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Behav Chng Smoking Greater Than 3 Min Up to 10 Min	$17.06	$82.00	$39.64–$136.68	—	79%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Pace OP Visit E&M of Established Patient; Level 5	$79.04	$380.00	$120.15–$321.52	21% below	79%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP Visit E&M of Established Patient;Level 5	$106.50	$512.00	$140.86–$433.20	7% above	79%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP Visit E&M of Established Patient; Level 5	$109.20	$525.00	$140.86–$444.20	9% above	79%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Pace OP Visit E&M of Established Patient; Level 5	$79.04	$380.00	$120.15–$321.52	—	79%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP Visit E&M of Established Patient;Level 5	$106.50	$512.00	$140.86–$433.20	—	79%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP Visit E&M of Established Patient; Level 5	$109.20	$525.00	$140.86–$444.20	—	79%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Pace OP Visit E&M of Established Patient; Level 3	$48.88	$235.00	$55.10–$198.83	13% below	79%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP Visit E&M of Established Patient;Level 3	$66.35	$319.00	$140.86–$281.72	18% above	79%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP Visit E&M of Established Patient; Level 3	$66.35	$319.00	$140.86–$281.72	18% above	79%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Pace OP Visit E&M of Established Patient; Level 3	$48.88	$235.00	$55.10–$198.83	—	79%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP Visit E&M of Established Patient; Level 3	$66.35	$319.00	$140.86–$281.72	—	79%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP Visit E&M of Established Patient;Level 3	$66.35	$319.00	$140.86–$281.72	—	79%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Pace OP Visit E&M of Established Patient; Level 4	$58.03	$279.00	$80.95–$236.06	23% below	79%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP Visit E&M of Established Patient;Level 4	$89.02	$428.00	$140.86–$362.13	18% above	79%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP Visit E&M of Established Patient; Level 4	$89.02	$428.00	$140.86–$362.13	18% above	79%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Pace OP Visit E&M of Established Patient; Level 4	$58.03	$279.00	$80.95–$236.06	—	79%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP Visit E&M of Established Patient; Level 4	$89.02	$428.00	$140.86–$362.13	—	79%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP Visit E&M of Established Patient;Level 4	$89.02	$428.00	$140.86–$362.13	—	79%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Pace OP Visit E&M of Established Patient; Level 2	$39.73	$191.00	$29.62–$190.94	4% below	79%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP Visit E&M of Established Patient;Level 2	$66.35	$319.00	$140.86–$281.72	60% above	79%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP Visit E&M of Established Patient; Level 2	$86.11	$414.00	$140.86–$350.29	107% above	79%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Pace OP Visit E&M of Established Patient; Level 2	$39.73	$191.00	$29.62–$190.94	—	79%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP Visit E&M of Established Patient;Level 2	$66.35	$319.00	$140.86–$281.72	—	79%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP Visit E&M of Established Patient; Level 2	$86.11	$414.00	$140.86–$350.29	—	79%
Speech and language evaluation CPT 92523 Speech Sound Lang Comprehen	$178.26	$857.00	$186.46–$725.11	13% below	79%
Speech and language evaluation inpatient CPT 92523 Speech Sound Lang Comprehen	$178.26	$857.00	$186.46–$725.11	—	79%
Speech therapy session, individual CPT 92507 Speech/Hearing Therapy Indiv	$37.44	$180.00	$73.98–$223.75	62% below	79%
Speech therapy session, individual CPT 92507 Speech/Hearing Therapy, Individual	$154.75	$744.00	$73.98–$629.50	57% above	79%
Speech therapy session, individual inpatient CPT 92507 Speech/Hearing Therapy Indiv	$37.44	$180.00	$73.98–$223.75	—	79%
Speech therapy session, individual inpatient CPT 92507 Speech/Hearing Therapy, Individual	$154.75	$744.00	$73.98–$629.50	—	79%
Spirometry (breathing test) CPT 94010 Spirometry	$109.20	$525.00	$141.84–$787.79	55% below	79%
Spirometry (breathing test) inpatient CPT 94010 Spirometry	$109.20	$525.00	$141.84–$787.79	—	79%
Spirometry before and after a bronchodilator CPT 94060 Bronchospasm - Pre & Post Bd	$212.78	$1,023.00	$141.84–$1,361.43	61% below	79%
Spirometry before and after a bronchodilator inpatient CPT 94060 Bronchospasm - Pre & Post Bd	$212.78	$1,023.00	$141.84–$1,361.43	—	79%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Ea 15 Min Pt	$31.82	$153.00	$33.60–$260.00	45% below	79%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Ea 15 Min Ot	$31.82	$153.00	$33.60–$260.00	45% below	79%
Therapeutic activities (functional training), 15 minutes CPT 97530 Pace Therapeutic Activities Ot	$51.79	$249.00	$33.60–$260.00	10% below	79%
Therapeutic activities (functional training), 15 minutes CPT 97530 Pace Therapeutic Activities Pt	$51.79	$249.00	$33.60–$260.00	10% below	79%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Ea 15 Min Pt	$31.82	$153.00	$33.60–$260.00	—	79%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Ea 15 Min Ot	$31.82	$153.00	$33.60–$260.00	—	79%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Pace Therapeutic Activities Pt	$51.79	$249.00	$33.60–$260.00	—	79%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Pace Therapeutic Activities Ot	$51.79	$249.00	$33.60–$260.00	—	79%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic	$75.09	$361.00	$140.77–$491.59	63% below	79%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic 073	$77.79	$374.00	$140.77–$491.59	62% below	79%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic	$75.09	$361.00	$140.77–$491.59	—	79%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic 073	$77.79	$374.00	$140.77–$491.59	—	79%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$367.56	$1,767.10	$200.93–$1,495.14	2% below	79%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$367.56	$1,767.10	$200.93–$1,495.14	—	79%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$7.28	$35.00	$17.50–$46.44	82% below	79%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$7.28	$35.00	$17.50–$46.44	—	79%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SUSP	$116.86	$561.85	$150.30–$475.38	34% below	79%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SUSP	$116.86	$561.85	$150.30–$475.38	—	79%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$194.57	$935.45	$467.73–$791.48	16% below	79%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$194.57	$935.45	$467.73–$791.48	—	79%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$64.48	$310.00	$155.00–$1,298.99	89% below	79%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$64.48	$310.00	$155.00–$1,298.99	—	79%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$797.28	$3,833.10	$319.75–$3,243.19	2% below	79%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$797.28	$3,833.10	$319.75–$3,243.19	—	79%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$77.25	$371.40	$128.90–$314.24	24% below	79%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$77.25	$371.40	$128.90–$314.24	—	79%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$96.09	$461.95	$174.02–$390.86	22% below	79%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$96.09	$461.95	$174.02–$390.86	—	79%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$296.46	$1,425.30	$712.65–$1,205.95	9% below	79%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$296.46	$1,425.30	$712.65–$1,205.95	—	79%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin; 1 Vac	$8.94	$43.00	$21.50–$262.69	85% below	79%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin; 1 Vac	$8.94	$43.00	$21.50–$262.69	—	79%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin; Ea Add Vac	$6.03	$29.00	$14.50–$24.54	84% below	79%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin; Ea Add Vac	$6.03	$29.00	$14.50–$24.54	—	79%

Source file: https://images.franciscanhealth.org/pdfs/enterprise/price_transparency/350876394_franciscan-health-michigan-city_standardcharges.zip