Hospital Columbus, OH

Nationwide Children's Hospital

Nationwide Children's Hospital in Columbus, OH publishes cash prices for 410 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Ohio median for 210 of 405 procedures and below it for 191. By typical cash price it ranks #90 of 139 Ohio hospitals and #16 of 20 hospitals in the Columbus, OH area, cheapest first. Select a procedure to compare it with other hospitals nearby.

700 Children's Drive, Columbus, OH 43205 Collected Sep 22, 2026 Source price file Check a bill from this hospital (614) 722-2000

Children's hospital Nonprofit hospital Emergency department CCN 363305 · CMS hospital register NPI 1134152986

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Nationwide Children's Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

State law

This state limits hospital bills for lower-income patients

Ohio's Hospital Care Assurance Program (HCAP): Ohio residents who are not on Medicaid and whose income is at or below 100% of the federal poverty level get basic, medically necessary hospital services free at hospitals in the program; physician bills are not included. Ask the hospital's billing office for an HCAP application. Other states' laws.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Nationwide Children's Hospital in Columbus, OH:

Mar 1, 2023 Warning notice
Oct 6, 2023 Case closed
Apr 16, 2025 Met requirements

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems. Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Abdominal CT scan without and with contrast CPT 74170 ABDOMEN, W/O & W/ CONTRAST	$1,863.00	$2,070.00	$1,345.50–$2,028.60	40% above	10%
Abdominal CT scan without and with contrast inpatient CPT 74170 ABDOMEN, W/O & W/ CONTRAST	$1,863.00	$2,070.00	$1,345.50–$2,028.60	—	10%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN, 2 VWS	$333.00	$370.00	$240.50–$362.60	2% below	10%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN, 2 VWS	$333.00	$370.00	$240.50–$362.60	—	10%
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE, MIN 3 VW	$243.00	$270.00	$175.50–$264.60	24% below	10%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 ANKLE, MIN 3 VW, BILAT	$432.00	$480.00	$312.00–$470.40	—	10%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE, MIN 3 VW	$243.00	$270.00	$175.50–$264.60	—	10%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 EXTREMITY, UPPER, W/O CONTRAST	$1,089.00	$1,210.00	$786.50–$1,185.80	15% above	10%
Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 EXTREMITY, UPPER, W/O CONTRAST, BILAT	$1,908.00	$2,120.00	$1,378.00–$2,077.60	—	10%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 EXTREMITY, UPPER, W/O CONTRAST	$1,089.00	$1,210.00	$786.50–$1,185.80	—	10%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM, INC SCOUT CXR & DEL IMGS, SGL CONTRAST	$558.00	$620.00	$403.00–$607.60	26% above	10%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGRAM, INC SCOUT CXR & DEL IMGS, SGL CONTRAST	$558.00	$620.00	$403.00–$607.60	—	10%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE &/OR JOINT IMAGING; WHOLE BODY	$2,286.00	$2,540.00	$1,651.00–$2,489.20	49% above	10%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE &/OR JOINT IMAGING; WHOLE BODY	$2,286.00	$2,540.00	$1,651.00–$2,489.20	—	10%
Breast ultrasound, complete, one breast one side CPT 76641 BREAST, INC AXILLA WHEN PERF, UNILAT	$576.00	$640.00	$416.00–$627.20	21% above	10%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 BREAST, INC AXILLA WHEN PERF, BILAT	$1,017.00	$1,130.00	$734.50–$1,107.40	—	10%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 BREAST, INC AXILLA WHEN PERF, UNILAT	$576.00	$640.00	$416.00–$627.20	—	10%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 BREAST, LIMITED, UNILAT	$288.00	$320.00	$208.00–$313.60	30% below	10%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 BREAST, LIMITED, BILAT	$513.00	$570.00	$370.50–$558.60	—	10%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 BREAST, LIMITED, UNILAT	$288.00	$320.00	$208.00–$313.60	—	10%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 ANGIO, ABDOMEN & PELVIS, W/O &/OR W/ CONTRAST, IMG POST PROCESSI	$1,773.00	$1,970.00	$1,280.50–$1,930.60	17% below	10%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 ANGIO, ABDOMEN & PELVIS, W/O &/OR W/ CONTRAST, IMG POST PROCESSI	$1,773.00	$1,970.00	$1,280.50–$1,930.60	—	10%
CT angiography (CTA) of the head CPT 70496 ANGIO HEAD, W/O &/OR W/ CONTRAST, IMG POST PROCESSING	$1,764.00	$1,960.00	$1,274.00–$1,920.80	32% above	10%
CT angiography (CTA) of the head inpatient CPT 70496 ANGIO HEAD, W/O &/OR W/ CONTRAST, IMG POST PROCESSING	$1,764.00	$1,960.00	$1,274.00–$1,920.80	—	10%
CT angiography (CTA) of the neck CPT 70498 ANGIO NECK, W/O &/OR W/ CONTRAST, IMG POST PROCESSING	$1,764.00	$1,960.00	$1,274.00–$1,920.80	35% above	10%
CT angiography (CTA) of the neck inpatient CPT 70498 ANGIO NECK, W/O &/OR W/ CONTRAST, IMG POST PROCESSING	$1,764.00	$1,960.00	$1,274.00–$1,920.80	—	10%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 ANGIO CHEST, W/O &/OR W/ CONTRAST, IMG POST PROCESSING	$2,151.00	$2,390.00	$1,553.50–$2,342.20	52% above	10%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 ANGIO CHEST, W/O &/OR W/ CONTRAST, IMG POST PROCESSING	$2,151.00	$2,390.00	$1,553.50–$2,342.20	—	10%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 ANGIO HEART, EVAL CARD STRUC, MORPH & VENOUS STRUC, 3D INC, W/	$2,151.00	$2,390.00	$1,553.50–$2,342.20	34% above	10%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 ANGIO HEART, EVAL CARD STRUC, MORPH & VENOUS STRUC, 3D INC, W/	$2,151.00	$2,390.00	$1,553.50–$2,342.20	—	10%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CALCIUM SCORING, HEART W/O CONTRAST	$288.00	$320.00	$208.00–$313.60	3% above	10%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CALCIUM SCORING, HEART W/O CONTRAST	$288.00	$320.00	$208.00–$313.60	—	10%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 ABDOMEN & PELVIS, W/O CONTRAST	$2,133.00	$2,370.00	$1,540.50–$2,322.60	34% above	10%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 ABDOMEN & PELVIS, W/O CONTRAST	$2,133.00	$2,370.00	$1,540.50–$2,322.60	—	10%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 ABDOMEN & PELIVS, W/ CONTRAST	$2,421.00	$2,690.00	$1,748.50–$2,636.20	22% above	10%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 ABDOMEN & PELIVS, W/ CONTRAST	$2,421.00	$2,690.00	$1,748.50–$2,636.20	—	10%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 ABDOMEN & PELVIS, W/O & W/ CONTRAST	$5,886.00	$6,540.00	$4,251.00–$6,409.20	152% above	10%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 ABDOMEN & PELVIS, W/O & W/ CONTRAST	$5,886.00	$6,540.00	$4,251.00–$6,409.20	—	10%
CT scan of the abdomen with contrast CPT 74160 ABDOMEN, W/ CONTRAST	$1,494.00	$1,660.00	$1,079.00–$1,626.80	28% above	10%
CT scan of the abdomen with contrast inpatient CPT 74160 ABDOMEN, W/ CONTRAST	$1,494.00	$1,660.00	$1,079.00–$1,626.80	—	10%
CT scan of the abdomen without contrast CPT 74150 ABDOMEN, W/O CONTRAST	$1,251.00	$1,390.00	$903.50–$1,362.20	19% above	10%
CT scan of the abdomen without contrast inpatient CPT 74150 ABDOMEN, W/O CONTRAST	$1,251.00	$1,390.00	$903.50–$1,362.20	—	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 MAXILLOFACIAL, W/O CONTRAST	$1,035.00	$1,150.00	$747.50–$1,127.00	18% above	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 MAXILLOFACIAL, W/O CONTRAST	$1,035.00	$1,150.00	$747.50–$1,127.00	—	10%
CT scan of the head or brain, no contrast dye CPT 70450 HEAD/BRAIN W/O CONTRAST	$1,035.00	$1,150.00	$747.50–$1,127.00	24% above	10%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HEAD/BRAIN W/O CONTRAST	$1,035.00	$1,150.00	$747.50–$1,127.00	—	10%
CT scan of the head with contrast CPT 70460 HEAD/BRAIN W/ CONTRAST	$1,251.00	$1,390.00	$903.50–$1,362.20	24% above	10%
CT scan of the head with contrast inpatient CPT 70460 HEAD/BRAIN W/ CONTRAST	$1,251.00	$1,390.00	$903.50–$1,362.20	—	10%
CT scan of the head without and with contrast CPT 70470 HEAD/BRAIN W/O & W/ CONTRAST	$1,557.00	$1,730.00	$1,124.50–$1,695.40	31% above	10%
CT scan of the head without and with contrast inpatient CPT 70470 HEAD/BRAIN W/O & W/ CONTRAST	$1,557.00	$1,730.00	$1,124.50–$1,695.40	—	10%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 SPINE, LUMBAR, W/O CONTRAST	$1,296.00	$1,440.00	$936.00–$1,411.20	18% above	10%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 SPINE, LUMBAR, W/O CONTRAST	$1,296.00	$1,440.00	$936.00–$1,411.20	—	10%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 SPINE, CERVICAL, W/O CONTRAST	$1,296.00	$1,440.00	$936.00–$1,411.20	21% above	10%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 SPINE, CERVICAL, W/O CONTRAST	$1,296.00	$1,440.00	$936.00–$1,411.20	—	10%
CT scan of the pelvis, with contrast dye CPT 72193 PELVIS, W/ CONTRAST	$1,494.00	$1,660.00	$1,079.00–$1,626.80	22% above	10%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 PELVIS, W/ CONTRAST	$1,494.00	$1,660.00	$1,079.00–$1,626.80	—	10%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL ART, DUPLEX, COMP, BILAT	$1,557.00	$1,730.00	$1,124.50–$1,695.40	—	10%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 EXTRACRANIAL ART, DUPLEX, COMP, BILAT	$1,557.00	$1,730.00	$1,124.50–$1,695.40	—	10%
Chest CT scan without and with contrast CPT 71270 CHEST, W/O & W/ CONTRAST	$1,944.00	$2,160.00	$1,404.00–$2,116.80	29% above	10%
Chest CT scan without and with contrast inpatient CPT 71270 CHEST, W/O & W/ CONTRAST	$1,944.00	$2,160.00	$1,404.00–$2,116.80	—	10%
Chest X-ray, 2 views CPT 71046 CHEST, 2 VWS	$423.00	$470.00	$305.50–$460.60	60% above	10%
Chest X-ray, 2 views inpatient CPT 71046 CHEST, 2 VWS	$423.00	$470.00	$305.50–$460.60	—	10%
Chest X-ray, single view CPT 71045 CHEST, 1 VW	$387.00	$430.00	$279.50–$421.40	73% above	10%
Chest X-ray, single view inpatient CPT 71045 CHEST, 1 VW	$387.00	$430.00	$279.50–$421.40	—	10%
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE, COMP	$216.00	$240.00	$156.00–$235.20	20% below	10%
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 CLAVICLE , COMP, BILAT	$378.00	$420.00	$273.00–$411.60	—	10%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE, COMP	$216.00	$240.00	$156.00–$235.20	—	10%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RETROPERITONEAL, COMPLETE	$756.00	$840.00	$546.00–$823.20	7% above	10%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 RETROPERITONEAL, COMPLETE	$756.00	$840.00	$546.00–$823.20	—	10%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY STUDY, 1 OR MORE SITES, AXIAL	$828.00	$920.00	$598.00–$901.60	83% above	10%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY STUDY, 1 OR MORE SITES, AXIAL	$828.00	$920.00	$598.00–$901.60	—	10%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY, 1 OR MORE SITES, PERIPHERAL	$180.00	$200.00	$130.00–$196.00	30% below	10%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY, 1 OR MORE SITES, PERIPHERAL	$180.00	$200.00	$130.00–$196.00	—	10%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB DETAILED, TRANSABD, SNGL FETUS	$1,593.00	$1,770.00	$1,150.50–$1,734.60	87% above	10%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB DETAILED, TRANSABD, SNGL FETUS	$1,593.00	$1,770.00	$1,150.50–$1,734.60	—	10%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CHEST, W/O CONTRAST	$1,296.00	$1,440.00	$936.00–$1,411.20	38% above	10%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CHEST, W/O CONTRAST	$1,296.00	$1,440.00	$936.00–$1,411.20	—	10%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CHEST, W/ CONTRAST	$1,557.00	$1,730.00	$1,124.50–$1,695.40	28% above	10%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CHEST, W/ CONTRAST	$1,557.00	$1,730.00	$1,124.50–$1,695.40	—	10%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LOWER EXT ARTERY, DUPLEX, COMP, BILAT	$1,746.00	$1,940.00	$1,261.00–$1,901.20	—	10%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LOWER EXT ARTERY, DUPLEX, COMP, BILAT	$1,746.00	$1,940.00	$1,261.00–$1,901.20	—	10%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 EXTREMITY VEIN, DUPLEX, COMP, BILAT	$1,908.00	$2,120.00	$1,378.00–$2,077.60	—	10%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 EXTREMITY VEIN, DUPLEX, COMP, BILAT	$1,908.00	$2,120.00	$1,378.00–$2,077.60	—	10%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMPLETE W/ DOPPLER W/O CONTRAST	$3,645.00	$4,050.00	$2,632.50–$3,969.00	116% above	10%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO COMPLETE W/ DOPPLER W/O CONTRAST	$3,645.00	$4,050.00	$2,632.50–$3,969.00	—	10%
Elbow X-ray, 2 views CPT 73070 ELBOW, 2 VW	$216.00	$240.00	$156.00–$235.20	17% below	10%
Elbow X-ray, 2 views inpatient both sides CPT 73070 ELBOW, 2 VW, BILAT	$378.00	$420.00	$273.00–$411.60	—	10%
Elbow X-ray, 2 views inpatient CPT 73070 ELBOW, 2 VW	$216.00	$240.00	$156.00–$235.20	—	10%
Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW, COMP, MIN 3 VW	$252.00	$280.00	$182.00–$274.40	20% below	10%
Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 ELBOW, COMP, MIN 3 VW, BILAT	$450.00	$500.00	$325.00–$490.00	—	10%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 ELBOW, COMP, MIN 3 VW	$252.00	$280.00	$182.00–$274.40	—	10%
Eye socket (orbit) CT scan without contrast CPT 70480 ORBIT, SELLA, INNER EAR, W/O CONTRAST	$1,404.00	$1,560.00	$1,014.00–$1,528.80	63% above	10%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 ORBIT, SELLA, INNER EAR, W/O CONTRAST	$1,404.00	$1,560.00	$1,014.00–$1,528.80	—	10%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES, COMP, MIN 3 VW	$288.00	$320.00	$208.00–$313.60	24% below	10%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES, COMP, MIN 3 VW	$288.00	$320.00	$208.00–$313.60	—	10%
Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM, 2 VW	$216.00	$240.00	$156.00–$235.20	21% below	10%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 FOREARM, 2 VW, BILAT	$378.00	$420.00	$273.00–$411.60	—	10%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM, 2 VW	$216.00	$240.00	$156.00–$235.20	—	10%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY IMAGING, INC GB WHEN PRESENT	$1,548.00	$1,720.00	$1,118.00–$1,685.60	2% below	10%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY IMAGING, INC GB WHEN PRESENT	$1,548.00	$1,720.00	$1,118.00–$1,685.60	—	10%
Hand X-ray, 2 views CPT 73120 HAND, 2 VW	$234.00	$260.00	$169.00–$254.80	12% below	10%
Hand X-ray, 2 views inpatient both sides CPT 73120 HAND, 2 VW, BILAT	$405.00	$450.00	$292.50–$441.00	—	10%
Hand X-ray, 2 views inpatient CPT 73120 HAND, 2 VW	$234.00	$260.00	$169.00–$254.80	—	10%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 CALCANEUS, MIN 2 VW	$225.00	$250.00	$162.50–$245.00	17% below	10%
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 CALCANEUS, MIN 2 VW, BILAT	$396.00	$440.00	$286.00–$431.20	—	10%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 CALCANEUS, MIN 2 VW	$225.00	$250.00	$162.50–$245.00	—	10%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY, UNATTEND, SIMULT RECORD HR,02 SAT,RESP AIRFLOW & EF	$1,413.00	$1,570.00	$1,020.50–$1,538.60	101% above	10%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY, UNATTEND, SIMULT RECORD HR,02 SAT,RESP AIRFLOW & EF	$1,413.00	$1,570.00	$1,020.50–$1,538.60	—	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY, 6 YRS+, 4 OR MORE ADDL PARAM, W/PPD & TECH	$9,090.00	$10,100.00	$6,565.00–$9,898.00	121% above	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY, 6 YRS+, 4 OR MORE ADDL PARAM, W/PPD & TECH	$9,090.00	$10,100.00	$6,565.00–$9,898.00	—	10%
Knee X-ray, 3 views CPT 73562 KNEE, 3 VW	$252.00	$280.00	$182.00–$274.40	29% below	10%
Knee X-ray, 3 views inpatient both sides CPT 73562 KNEE, 3 VW, BILAT	$450.00	$500.00	$325.00–$490.00	—	10%
Knee X-ray, 3 views inpatient CPT 73562 KNEE, 3 VW	$252.00	$280.00	$182.00–$274.40	—	10%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE, COMP, 4 OR > VW	$288.00	$320.00	$208.00–$313.60	27% below	10%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 KNEE, COMP, 4 OR > VW, BILAT	$513.00	$570.00	$370.50–$558.60	—	10%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE, COMP, 4 OR > VW	$288.00	$320.00	$208.00–$313.60	—	10%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 EXTREMITY, LOWER, W/O CONTRAST	$1,089.00	$1,210.00	$786.50–$1,185.80	15% above	10%
Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 EXTREMITY, LOWER, W/O CONTRAST, BILAT	$1,908.00	$2,120.00	$1,378.00–$2,077.60	—	10%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 EXTREMITY, LOWER, W/O CONTRAST	$1,089.00	$1,210.00	$786.50–$1,185.80	—	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ABDOMEN, LIMITED	$504.00	$560.00	$364.00–$548.80	9% below	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ABDOMEN, LIMITED	$504.00	$560.00	$364.00–$548.80	—	10%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 EXTREMITY, JOINT/OTHER NON-VAS EXT STRUC, LIMITED, UNILAT	$540.00	$600.00	$390.00–$588.00	13% above	10%
Limited ultrasound of an arm or leg (non-vascular) inpatient both sides CPT 76882 EXTREMITY, JOINT/OTHER NON-VAS EXT STRUC, LIMITED, BILAT	$954.00	$1,060.00	$689.00–$1,038.80	—	10%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 EXTREMITY, JOINT/OTHER NON-VAS EXT STRUC, LIMITED, UNILAT	$540.00	$600.00	$390.00–$588.00	—	10%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIBIA/FIBULA, 2 VW	$216.00	$240.00	$156.00–$235.20	21% below	10%
Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 TIBIA/FIBULA, 2 VW, BILAT	$378.00	$420.00	$273.00–$411.60	—	10%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 TIBIA/FIBULA, 2 VW	$216.00	$240.00	$156.00–$235.20	—	10%
MR angiography (MRA) of the head without contrast CPT 70544 ANGIO BRAIN, W/O CONTRAST	$2,277.00	$2,530.00	$1,644.50–$2,479.40	57% above	10%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 ANGIO BRAIN, W/O CONTRAST	$2,277.00	$2,530.00	$1,644.50–$2,479.40	—	10%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 EXTREMITY, LOWER, JOINT, W/O CONTRAST	$2,367.00	$2,630.00	$1,709.50–$2,577.40	35% above	10%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 EXTREMITY, LOWER, JOINT, W/O CONTRAST	$2,367.00	$2,630.00	$1,709.50–$2,577.40	—	10%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 EXTREMITY, LOWER, JOINT, W/ & W/O CONTRAST	$3,672.00	$4,080.00	$2,652.00–$3,998.40	54% above	10%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 EXTREMITY, LOWER, JOINT, W/ & W/O CONTRAST	$3,672.00	$4,080.00	$2,652.00–$3,998.40	—	10%
MRI of the abdomen without contrast CPT 74181 ABDOMEN, NO CONTRAST	$2,385.00	$2,650.00	$1,722.50–$2,597.00	29% above	10%
MRI of the abdomen without contrast inpatient CPT 74181 ABDOMEN, NO CONTRAST	$2,385.00	$2,650.00	$1,722.50–$2,597.00	—	10%
MRI of the abdomen, without and then with contrast dye CPT 74183 ABDOMEN, W/ & W/O CONTRAST	$3,681.00	$4,090.00	$2,658.50–$4,008.20	61% above	10%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 ABDOMEN, W/ & W/O CONTRAST	$3,681.00	$4,090.00	$2,658.50–$4,008.20	—	10%
MRI of the brain, no contrast dye CPT 70551 BRAIN (INC BRAIN STEM), W/O CONTRAST	$2,286.00	$2,540.00	$1,651.00–$2,489.20	42% above	10%
MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN (INC BRAIN STEM), W/O CONTRAST	$2,286.00	$2,540.00	$1,651.00–$2,489.20	—	10%
MRI of the brain, with and without contrast dye CPT 70553 BRAIN (INCL BRAIN STEM), W/ & W/O CONTRAST	$3,483.00	$3,870.00	$2,515.50–$3,792.60	59% above	10%
MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN (INCL BRAIN STEM), W/ & W/O CONTRAST	$3,483.00	$3,870.00	$2,515.50–$3,792.60	—	10%
MRI of the lower back, no contrast dye CPT 72148 SPINE, LUMBAR, W/O CONTRAST	$2,430.00	$2,700.00	$1,755.00–$2,646.00	46% above	10%
MRI of the lower back, no contrast dye inpatient CPT 72148 SPINE, LUMBAR, W/O CONTRAST	$2,430.00	$2,700.00	$1,755.00–$2,646.00	—	10%
MRI of the lower back, without and then with contrast dye CPT 72158 SPINE, LUMBAR, W/ & W/O CONTRAST	$3,249.00	$3,610.00	$2,346.50–$3,537.80	39% above	10%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 SPINE, LUMBAR, W/ & W/O CONTRAST	$3,249.00	$3,610.00	$2,346.50–$3,537.80	—	10%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 SPINE, THORACIC, W/O CONTRAST	$2,430.00	$2,700.00	$1,755.00–$2,646.00	45% above	10%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 SPINE, THORACIC, W/O CONTRAST	$2,430.00	$2,700.00	$1,755.00–$2,646.00	—	10%
MRI of the neck (cervical spine) without and with contrast CPT 72156 SPINE, CERVICAL, W/ & W/O CONTRAST	$3,249.00	$3,610.00	$2,346.50–$3,537.80	44% above	10%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 SPINE, CERVICAL, W/ & W/O CONTRAST	$3,249.00	$3,610.00	$2,346.50–$3,537.80	—	10%
MRI of the neck (cervical spine), no contrast dye CPT 72141 SPINE, CERVICAL, W/O CONTRAST	$2,430.00	$2,700.00	$1,755.00–$2,646.00	47% above	10%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 SPINE, CERVICAL, W/O CONTRAST	$2,430.00	$2,700.00	$1,755.00–$2,646.00	—	10%
MRI of the pelvis without and with contrast CPT 72197 PELVIS, W/ & W/O CONTRAST	$3,681.00	$4,090.00	$2,658.50–$4,008.20	88% above	10%
MRI of the pelvis without and with contrast inpatient CPT 72197 PELVIS, W/ & W/O CONTRAST	$3,681.00	$4,090.00	$2,658.50–$4,008.20	—	10%
MRI of the pelvis, no contrast dye CPT 72195 PELVIS, W/O CONTRAST	$2,358.00	$2,620.00	$1,703.00–$2,567.60	55% above	10%
MRI of the pelvis, no contrast dye inpatient CPT 72195 PELVIS, W/O CONTRAST	$2,358.00	$2,620.00	$1,703.00–$2,567.60	—	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 EXTREMITY, UPPER, JOINT, W/O CONTRAST	$2,367.00	$2,630.00	$1,709.50–$2,577.40	57% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 EXTREMITY, UPPER, JOINT, W/O CONTRAST, BILAT	$4,140.00	$4,600.00	$2,990.00–$4,508.00	—	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 EXTREMITY, UPPER, JOINT, W/O CONTRAST	$2,367.00	$2,630.00	$1,709.50–$2,577.40	—	10%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE, CERVICAL, 4 OR 5 VW	$387.00	$430.00	$279.50–$421.40	14% below	10%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SPINE, CERVICAL, 4 OR 5 VW	$387.00	$430.00	$279.50–$421.40	—	10%
Neck soft tissue CT scan with contrast CPT 70491 SOFT TISSUE NECK, W/ CONTRAST	$1,296.00	$1,440.00	$936.00–$1,411.20	10% above	10%
Neck soft tissue CT scan with contrast inpatient CPT 70491 SOFT TISSUE NECK, W/ CONTRAST	$1,296.00	$1,440.00	$936.00–$1,411.20	—	10%
Neck soft tissue CT scan without contrast CPT 70490 SOFT TISSUE NECK, W/O CONTRAST	$1,080.00	$1,200.00	$780.00–$1,176.00	17% above	10%
Neck soft tissue CT scan without contrast inpatient CPT 70490 SOFT TISSUE NECK, W/O CONTRAST	$1,080.00	$1,200.00	$780.00–$1,176.00	—	10%
Neck soft tissue X-ray CPT 70360 NECK, SOFT TISSUE	$234.00	$260.00	$169.00–$254.80	10% below	10%
Neck soft tissue X-ray inpatient CPT 70360 NECK, SOFT TISSUE	$234.00	$260.00	$169.00–$254.80	—	10%
OCT scan of the retina (optical coherence tomography) both sides CPT 92134 RETINAL OCT W/ INTERP & REPORT, UNILAT OR BILAT (<NULL>)	$180.00	$200.00	$130.00–$196.00	—	10%
OCT scan of the retina (optical coherence tomography) inpatient both sides CPT 92134 RETINAL OCT W/ INTERP & REPORT, UNILAT OR BILAT (<NULL>)	$180.00	$200.00	$130.00–$196.00	—	10%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT, SKULL BASE TO MID-THIGH	$3,087.00	$3,430.00	$2,229.50–$3,361.40	36% below	10%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT, SKULL BASE TO MID-THIGH	$3,087.00	$3,430.00	$2,229.50–$3,361.40	—	10%
Pelvic CT scan without contrast CPT 72192 PELVIS, W/O CONTRAST	$1,296.00	$1,440.00	$936.00–$1,411.20	29% above	10%
Pelvic CT scan without contrast inpatient CPT 72192 PELVIS, W/O CONTRAST	$1,296.00	$1,440.00	$936.00–$1,411.20	—	10%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIC, NON-OB, LIMITED OR F/U	$486.00	$540.00	$351.00–$529.20	12% above	10%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIC, NON-OB, LIMITED OR F/U	$486.00	$540.00	$351.00–$529.20	—	10%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC, NON-OB, COMPLETE	$756.00	$840.00	$546.00–$823.20	50% above	10%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIC, NON-OB, COMPLETE	$756.00	$840.00	$546.00–$823.20	—	10%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB FETAL & MATRNL EVAL, POST 1ST TRI	$891.00	$990.00	$643.50–$970.20	48% above	10%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB FETAL & MATRNL EVAL, POST 1ST TRI	$891.00	$990.00	$643.50–$970.20	—	10%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB < 14 WKS, 1ST TRI, SNGL FETUS	$576.00	$640.00	$416.00–$627.20	5% above	10%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB < 14 WKS, 1ST TRI, SNGL FETUS	$576.00	$640.00	$416.00–$627.20	—	10%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB, 1 OR MORE FETUSES, LIMITED	$702.00	$780.00	$507.00–$764.40	47% above	10%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB, 1 OR MORE FETUSES, LIMITED	$702.00	$780.00	$507.00–$764.40	—	10%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS, UNILAT, 2 VW	$315.00	$350.00	$227.50–$343.00	4% above	10%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS, UNILAT, 2 VW	$315.00	$350.00	$227.50–$343.00	—	10%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS, UNILAT, INC PA CHEST, MIN 3 VW	$333.00	$370.00	$240.50–$362.60	13% below	10%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS, UNILAT, INC PA CHEST, MIN 3 VW	$333.00	$370.00	$240.50–$362.60	—	10%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER, COMP, MIN 2 VW	$270.00	$300.00	$195.00–$294.00	20% below	10%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 SHOULDER, COMP, MIN 2 VW, BILAT	$477.00	$530.00	$344.50–$519.40	—	10%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER, COMP, MIN 2 VW	$270.00	$300.00	$195.00–$294.00	—	10%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES, COMP, MIN 3 VW	$351.00	$390.00	$253.50–$382.20	3% below	10%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES, COMP, MIN 3 VW	$351.00	$390.00	$253.50–$382.20	—	10%
Skull X-ray, fewer than 4 views CPT 70250 SKULL, < 4 VW	$252.00	$280.00	$182.00–$274.40	13% below	10%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL, < 4 VW	$252.00	$280.00	$182.00–$274.40	—	10%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY, 6 YRS+, 4 OR MORE ADDL PARAM, W/ TECH	$9,090.00	$10,100.00	$6,565.00–$9,898.00	153% above	10%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY, 6 YRS+, 4 OR MORE ADDL PARAM, W/ TECH	$9,090.00	$10,100.00	$6,565.00–$9,898.00	—	10%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO W/ CONT ECG MONITORING AND SUPERVISION	$1,935.00	$2,150.00	$1,397.50–$2,107.00	6% below	10%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS ECHO W/ CONT ECG MONITORING AND SUPERVISION	$1,935.00	$2,150.00	$1,397.50–$2,107.00	—	10%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNCTION, W/ CINE OR VIDEO,INC SCOUT NECK & DEL IMGS,	$765.00	$850.00	$552.50–$833.00	51% above	10%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOWING FUNCTION, W/ CINE OR VIDEO,INC SCOUT NECK & DEL IMGS,	$765.00	$850.00	$552.50–$833.00	—	10%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 FEMUR, 2 VW	$270.00	$300.00	$195.00–$294.00	at median	10%
Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 FEMUR, 2 VW, BILAT	$477.00	$530.00	$344.50–$519.40	—	10%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 FEMUR, 2 VW	$270.00	$300.00	$195.00–$294.00	—	10%
Thoracic spine (mid back) CT scan without contrast CPT 72128 SPINE, THORACIC, W/O CONTRAST	$1,296.00	$1,440.00	$936.00–$1,411.20	43% above	10%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 SPINE, THORACIC, W/O CONTRAST	$1,296.00	$1,440.00	$936.00–$1,411.20	—	10%
Toe X-ray, 2 or more views CPT 73660 TOE(S), MIN 2 VW	$234.00	$260.00	$169.00–$254.80	6% below	10%
Toe X-ray, 2 or more views inpatient both sides CPT 73660 TOE(S), MIN 2 VW BILAT	$405.00	$450.00	$292.50–$441.00	—	10%
Toe X-ray, 2 or more views inpatient CPT 73660 TOE(S), MIN 2 VW	$234.00	$260.00	$169.00–$254.80	—	10%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL, NON-OB	$648.00	$720.00	$468.00–$705.60	15% above	10%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL, NON-OB	$648.00	$720.00	$468.00–$705.60	—	10%
Transvaginal ultrasound during pregnancy CPT 76817 OB PREG EVAL, TRANSVAGINAL	$720.00	$800.00	$520.00–$784.00	44% above	10%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 OB PREG EVAL, TRANSVAGINAL	$720.00	$800.00	$520.00–$784.00	—	10%
Ultrasound of the abdomen, complete CPT 76700 ABDOMEN, COMPLETE	$774.00	$860.00	$559.00–$842.80	23% above	10%
Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMEN, COMPLETE	$774.00	$860.00	$559.00–$842.80	—	10%
Ultrasound of the scrotum and testicles CPT 76870 SCROTUM	$666.00	$740.00	$481.00–$725.20	24% above	10%
Ultrasound of the scrotum and testicles inpatient CPT 76870 SCROTUM	$666.00	$740.00	$481.00–$725.20	—	10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 SOFT TISSUE HEAD OR NECK	$486.00	$540.00	$351.00–$529.20	15% below	10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 SOFT TISSUE HEAD OR NECK	$486.00	$540.00	$351.00–$529.20	—	10%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI, INC SCOUT ABD & DEL MGS, SGL CONTRAST	$495.00	$550.00	$357.50–$539.00	17% below	10%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI, INC SCOUT ABD & DEL MGS, SGL CONTRAST	$495.00	$550.00	$357.50–$539.00	—	10%
Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS, MIN 2 VW	$216.00	$240.00	$156.00–$235.20	21% below	10%
Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 HUMERUS, MIN 2 VW, BILAT	$378.00	$420.00	$273.00–$411.60	—	10%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS, MIN 2 VW	$216.00	$240.00	$156.00–$235.20	—	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY VEIN, DUPLEX, UNI OR LIMITED	$1,296.00	$1,440.00	$936.00–$1,411.20	76% above	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 EXTREMITY VEIN, DUPLEX, UNI OR LIMITED	$1,296.00	$1,440.00	$936.00–$1,411.20	—	10%
Wrist X-ray, 2 views CPT 73100 WRIST, 2VW	$225.00	$250.00	$162.50–$245.00	14% below	10%
Wrist X-ray, 2 views inpatient both sides CPT 73100 WRIST, 2 VW, BILAT	$396.00	$440.00	$286.00–$431.20	—	10%
Wrist X-ray, 2 views inpatient CPT 73100 WRIST, 2VW	$225.00	$250.00	$162.50–$245.00	—	10%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST, COMP, MIN 3 VW	$234.00	$260.00	$169.00–$254.80	30% below	10%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 WRIST, COMP, MIN 3VW, BILAT	$405.00	$450.00	$292.50–$441.00	—	10%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST, COMP, MIN 3 VW	$234.00	$260.00	$169.00–$254.80	—	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP, W/ PELVIS IF PERF, UNILAT, 2-3 VW	$360.00	$400.00	$260.00–$392.00	17% above	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP, W/ PELVIS IF PERF, UNILAT, 2-3 VW	$360.00	$400.00	$260.00–$392.00	—	10%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN, 1 VW	$297.00	$330.00	$214.50–$323.40	16% above	10%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN, 1 VW	$297.00	$330.00	$214.50–$323.40	—	10%
X-ray of the ankle, 2 views CPT 73600 ANKLE, 2 VW	$225.00	$250.00	$162.50–$245.00	10% below	10%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 ANKLE, 2 VW, BILAT	$396.00	$440.00	$286.00–$431.20	—	10%
X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE, 2 VW	$225.00	$250.00	$162.50–$245.00	—	10%
X-ray of the finger(s), 2 or more views CPT 73140 FINGERS, MIN 2 VW	$216.00	$240.00	$156.00–$235.20	16% below	10%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGERS, MIN 2 VW	$216.00	$240.00	$156.00–$235.20	—	10%
X-ray of the foot, 2 views CPT 73620 FOOT, 2 VW	$225.00	$250.00	$162.50–$245.00	3% below	10%
X-ray of the foot, 2 views inpatient both sides CPT 73620 FOOT, 2 VW, BILAT	$396.00	$440.00	$286.00–$431.20	—	10%
X-ray of the foot, 2 views inpatient CPT 73620 FOOT, 2 VW	$225.00	$250.00	$162.50–$245.00	—	10%
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT, MIN 3 VW	$243.00	$270.00	$175.50–$264.60	21% below	10%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 FOOT, MIN 3 VW, BILAT	$432.00	$480.00	$312.00–$470.40	—	10%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT, MIN 3 VW	$243.00	$270.00	$175.50–$264.60	—	10%
X-ray of the hand, 3 or more views CPT 73130 HAND, MIN 3 VW	$243.00	$270.00	$175.50–$264.60	26% below	10%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HAND, MIN 3 VW, BILAT	$432.00	$480.00	$312.00–$470.40	—	10%
X-ray of the hand, 3 or more views inpatient CPT 73130 HAND, MIN 3 VW	$243.00	$270.00	$175.50–$264.60	—	10%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE, 1 OR 2 VW	$216.00	$240.00	$156.00–$235.20	21% below	10%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 KNEE, 1 OR 2 VW, BILAT	$378.00	$420.00	$273.00–$411.60	—	10%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE, 1 OR 2 VW	$216.00	$240.00	$156.00–$235.20	—	10%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE, LUMBOSACRAL, 2 OR 3 VW	$297.00	$330.00	$214.50–$323.40	8% below	10%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE, LUMBOSACRAL, 2 OR 3 VW	$297.00	$330.00	$214.50–$323.40	—	10%
X-ray of the lower back, 4 or more views CPT 72110 SPINE, LUMBOSACRAL, MIN 4 VW	$432.00	$480.00	$312.00–$470.40	8% below	10%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE, LUMBOSACRAL, MIN 4 VW	$432.00	$480.00	$312.00–$470.40	—	10%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE, THORACIC, 2 VW	$288.00	$320.00	$208.00–$313.60	5% below	10%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE, THORACIC, 2 VW	$288.00	$320.00	$208.00–$313.60	—	10%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES, COMP, MIN 3 VW	$288.00	$320.00	$208.00–$313.60	1% below	10%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES, COMP, MIN 3 VW	$288.00	$320.00	$208.00–$313.60	—	10%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE, CERVICAL, 2 OR 3 VW	$360.00	$400.00	$260.00–$392.00	8% above	10%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE, CERVICAL, 2 OR 3 VW	$360.00	$400.00	$260.00–$392.00	—	10%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS, 1 OR 2 VW	$243.00	$270.00	$175.50–$264.60	3% below	10%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS, 1 OR 2 VW	$243.00	$270.00	$175.50–$264.60	—	10%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX, MIN 2 VW	$288.00	$320.00	$208.00–$313.60	3% below	10%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX, MIN 2 VW	$288.00	$320.00	$208.00–$313.60	—	10%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ACTH blood test CPT 82024 LAB ACTH	$94.05	$104.50	$49.12–$102.41	29% below	10%
ACTH blood test CPT 82024 ACTH - ASSAY OF ACTH	$122.40	$136.00	$63.92–$133.28	7% below	10%
ACTH blood test inpatient CPT 82024 LAB ACTH	$94.05	$104.50	$49.12–$102.41	—	10%
ACTH blood test inpatient CPT 82024 ACTH - ASSAY OF ACTH	$122.40	$136.00	$63.92–$133.28	—	10%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$57.60	$64.00	$30.08–$62.72	106% above	10%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT, FLUID	$72.90	$81.00	$38.07–$79.38	161% above	10%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$57.60	$64.00	$30.08–$62.72	—	10%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT, FLUID	$72.90	$81.00	$38.07–$79.38	—	10%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$57.60	$64.00	$30.08–$62.72	129% above	10%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$57.60	$64.00	$30.08–$62.72	—	10%
Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN	$10.80	$12.00	$5.64–$11.76	51% below	10%
Albumin blood test CPT 82040 ALBUMIN, SERUM	$55.80	$62.00	$29.14–$60.76	152% above	10%
Albumin blood test inpatient CPT 82040 ASSAY OF SERUM ALBUMIN	$10.80	$12.00	$5.64–$11.76	—	10%
Albumin blood test inpatient CPT 82040 ALBUMIN, SERUM	$55.80	$62.00	$29.14–$60.76	—	10%
Aldosterone blood test CPT 82088 LAB ALDOSTE-UR	$31.95	$35.50	$16.69–$34.79	77% below	10%
Aldosterone blood test CPT 82088 ALDOSTERONE	$38.70	$43.00	$20.21–$42.14	72% below	10%
Aldosterone blood test inpatient CPT 82088 LAB ALDOSTE-UR	$31.95	$35.50	$16.69–$34.79	—	10%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$38.70	$43.00	$20.21–$42.14	—	10%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS, TOTAL	$7.43	$8.25	$3.88–$8.09	69% below	10%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOSPHATASE	$55.80	$62.00	$29.14–$60.76	132% above	10%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOS, TOTAL	$7.43	$8.25	$3.88–$8.09	—	10%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOSPHATASE	$55.80	$62.00	$29.14–$60.76	—	10%
Allergy blood test, specific IgE, per allergen CPT 86003 BEE VENOM PROF ALLERGEN SPEC IGE	$5.85	$6.50	$3.06–$6.37	75% below	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE,QUANT	$12.60	$14.00	$6.58–$13.72	46% below	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE	$33.30	$37.00	$17.39–$36.26	42% above	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEE VENOM PROF ALLERGEN SPEC IGE	$5.85	$6.50	$3.06–$6.37	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE,QUANT	$12.60	$14.00	$6.58–$13.72	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE	$33.30	$37.00	$17.39–$36.26	—	10%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP ALPHA-FETOPROTEIN SERUM	$31.50	$35.00	$16.45–$34.30	48% below	10%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP ALPHA-FETOPROTEIN SERUM	$31.50	$35.00	$16.45–$34.30	—	10%
Ammonia blood test CPT 82140 XLITHS AMMONIA	$30.60	$34.00	$15.98–$33.32	44% below	10%
Ammonia blood test CPT 82140 AMMONIA	$62.10	$69.00	$32.43–$67.62	13% above	10%
Ammonia blood test inpatient CPT 82140 XLITHS AMMONIA	$30.60	$34.00	$15.98–$33.32	—	10%
Ammonia blood test inpatient CPT 82140 AMMONIA	$62.10	$69.00	$32.43–$67.62	—	10%
Amylase blood test CPT 82150 AMYLASE, ISOENZYMES	$16.20	$18.00	$8.46–$17.64	66% below	10%
Amylase blood test CPT 82150 XPAN ASSAY OF AMYLASE	$72.45	$80.50	$37.84–$78.89	51% above	10%
Amylase blood test CPT 82150 AMYLASE	$72.90	$81.00	$38.07–$79.38	52% above	10%
Amylase blood test inpatient CPT 82150 AMYLASE, ISOENZYMES	$16.20	$18.00	$8.46–$17.64	—	10%
Amylase blood test inpatient CPT 82150 XPAN ASSAY OF AMYLASE	$72.45	$80.50	$37.84–$78.89	—	10%
Amylase blood test inpatient CPT 82150 AMYLASE	$72.90	$81.00	$38.07–$79.38	—	10%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$56.70	$63.00	$29.61–$61.74	2% below	10%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY	$56.70	$63.00	$29.61–$61.74	—	10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$235.80	$262.00	$123.14–$256.76	327% above	10%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$235.80	$262.00	$123.14–$256.76	—	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$171.00	$190.00	$89.30–$186.20	14% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$180.90	$201.00	$94.47–$196.98	21% above	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$171.00	$190.00	$89.30–$186.20	—	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$180.90	$201.00	$94.47–$196.98	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 REF ISOL ID & SUSCEPT	$37.80	$42.00	$19.74–$41.16	43% below	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 THROAT/NP CULTURE	$81.00	$90.00	$42.30–$88.20	23% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BODY SCREEN CULTURE	$93.60	$104.00	$48.88–$101.92	42% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BODY FLUID CULTURE	$123.30	$137.00	$64.39–$134.26	87% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC	$126.00	$140.00	$65.80–$137.20	91% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 UROGENITAL CULTURE	$126.90	$141.00	$66.27–$138.18	92% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 TISSUE/ABSCESS CULTURE	$176.40	$196.00	$92.12–$192.08	167% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BODY FLD IN BLD CULT MEDIA	$190.80	$212.00	$99.64–$207.76	189% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 REF ISOL ID & SUSCEPT	$37.80	$42.00	$19.74–$41.16	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 THROAT/NP CULTURE	$81.00	$90.00	$42.30–$88.20	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BODY SCREEN CULTURE	$93.60	$104.00	$48.88–$101.92	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BODY FLUID CULTURE	$123.30	$137.00	$64.39–$134.26	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC	$126.00	$140.00	$65.80–$137.20	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 UROGENITAL CULTURE	$126.90	$141.00	$66.27–$138.18	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 TISSUE/ABSCESS CULTURE	$176.40	$196.00	$92.12–$192.08	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BODY FLD IN BLD CULT MEDIA	$190.80	$212.00	$99.64–$207.76	—	10%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$93.60	$104.00	$48.88–$101.92	43% above	10%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL CALCIUM TOTAL	$126.00	$140.00	$65.80–$137.20	92% above	10%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$93.60	$104.00	$48.88–$101.92	—	10%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL CALCIUM TOTAL	$126.00	$140.00	$65.80–$137.20	—	10%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$8.10	$9.00	$4.23–$8.82	66% below	10%
Bilirubin blood test, total CPT 82247 BILIRUBIN, TOTAL	$57.60	$64.00	$30.08–$62.72	140% above	10%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$8.10	$9.00	$4.23–$8.82	—	10%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN, TOTAL	$57.60	$64.00	$30.08–$62.72	—	10%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 GROSS AND MICRO LEVEL IV	$381.60	$424.00	$275.60–$415.52	88% above	10%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 GROSS AND MICRO LEVEL IV	$381.60	$424.00	$275.60–$415.52	—	10%
Blood culture for bacteria CPT 87040 RFIDB REFERRED TESTING ID BLOOD	$37.80	$42.00	$19.74–$41.16	60% below	10%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$190.80	$212.00	$99.64–$207.76	104% above	10%
Blood culture for bacteria inpatient CPT 87040 RFIDB REFERRED TESTING ID BLOOD	$37.80	$42.00	$19.74–$41.16	—	10%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$190.80	$212.00	$99.64–$207.76	—	10%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE	$15.30	$17.00	$7.99–$16.66	4% below	10%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE	$15.30	$17.00	$7.99–$16.66	—	10%
Blood glucose (sugar) test CPT 82947 GLUCOSE, BLOOD	$43.20	$48.00	$22.56–$47.04	83% above	10%
Blood glucose (sugar) test CPT 82947 GLUCOSE, QUANT BLOOD	$51.30	$57.00	$26.79–$55.86	118% above	10%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, BLOOD	$43.20	$48.00	$22.56–$47.04	—	10%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, QUANT BLOOD	$51.30	$57.00	$26.79–$55.86	—	10%
Blood lead test CPT 83655 LAB LEAD URINE	$14.63	$16.25	$7.64–$15.93	70% below	10%
Blood lead test CPT 83655 LEAD, BLOOD	$82.80	$92.00	$43.24–$90.16	70% above	10%
Blood lead test inpatient CPT 83655 LAB LEAD URINE	$14.63	$16.25	$7.64–$15.93	—	10%
Blood lead test inpatient CPT 83655 LEAD, BLOOD	$82.80	$92.00	$43.24–$90.16	—	10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG, SERUM QUALITATIVE	$72.90	$81.00	$38.07–$79.38	34% above	10%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG, SERUM QUALITATIVE	$72.90	$81.00	$38.07–$79.38	—	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$67.50	$75.00	$35.25–$73.50	14% above	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$67.50	$75.00	$35.25–$73.50	—	10%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN (BUN)	$51.30	$57.00	$26.79–$55.86	119% above	10%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN, FLUID	$72.90	$81.00	$38.07–$79.38	212% above	10%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN (BUN)	$51.30	$57.00	$26.79–$55.86	—	10%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN, FLUID	$72.90	$81.00	$38.07–$79.38	—	10%
C-peptide blood test CPT 84681 ASSAY OF C-PEPTIDE	$53.10	$59.00	$27.73–$57.82	33% below	10%
C-peptide blood test inpatient CPT 84681 ASSAY OF C-PEPTIDE	$53.10	$59.00	$27.73–$57.82	—	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 XIBD C-REACTIVE PROTEIN	$36.00	$40.00	$18.80–$39.20	28% below	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$72.90	$81.00	$38.07–$79.38	45% above	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 XIBD C-REACTIVE PROTEIN	$36.00	$40.00	$18.80–$39.20	—	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$72.90	$81.00	$38.07–$79.38	—	10%
C. difficile toxin gene test (stool PCR) CPT 87493 CLSTDM DFCL TX B GN PCR AMP PR	$213.30	$237.00	$111.39–$232.26	64% above	10%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLSTDM DFCL TX B GN PCR AMP PR	$213.30	$237.00	$111.39–$232.26	—	10%
CA 19-9 blood test (tumor marker) CPT 86301 CANCER ANTIGEN-GI	$34.88	$38.75	$18.21–$37.98	52% below	10%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CANCER ANTIGEN-GI	$34.88	$38.75	$18.21–$37.98	—	10%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$23.85	$26.50	$12.46–$25.97	75% below	10%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125	$23.85	$26.50	$12.46–$25.97	—	10%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 NCVQLT INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA) S	$112.50	$125.00	$58.75–$122.50	20% below	10%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 NCVQLT INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA) S	$112.50	$125.00	$58.75–$122.50	—	10%
Calcium blood test, total CPT 82310 CALCIUM, FLUID	$11.70	$13.00	$6.11–$12.74	63% below	10%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$51.30	$57.00	$26.79–$55.86	62% above	10%
Calcium blood test, total inpatient CPT 82310 CALCIUM, FLUID	$11.70	$13.00	$6.11–$12.74	—	10%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$51.30	$57.00	$26.79–$55.86	—	10%
Carcinoembryonic antigen (CEA) test CPT 82378 LAB CEA	$20.70	$23.00	$10.81–$22.54	76% below	10%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 LAB CEA	$20.70	$23.00	$10.81–$22.54	—	10%
Chickenpox (varicella) immunity blood test CPT 86787 VARICEL ANTIBOD TITR	$171.00	$190.00	$89.30–$186.20	196% above	10%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICEL ANTIBOD TITR	$171.00	$190.00	$89.30–$186.20	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AM PROBE	$50.40	$56.00	$26.32–$54.88	45% below	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS, AMP PRB	$100.80	$112.00	$52.64–$109.76	9% above	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH DNA AM PROBE	$50.40	$56.00	$26.32–$54.88	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS, AMP PRB	$100.80	$112.00	$52.64–$109.76	—	10%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$134.10	$149.00	$70.03–$146.02	153% above	10%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$134.10	$149.00	$70.03–$146.02	—	10%
Complete blood count (CBC) with differential CPT 85025 CBC W AUTO DIFF	$43.20	$48.00	$22.56–$47.04	19% above	10%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W AUTO DIFF	$43.20	$48.00	$22.56–$47.04	—	10%
Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFF	$27.90	$31.00	$14.57–$30.38	18% below	10%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITHOUT DIFF	$27.90	$31.00	$14.57–$30.38	—	10%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$143.10	$159.00	$74.73–$155.82	125% above	10%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$148.50	$165.00	$77.55–$161.70	134% above	10%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$143.10	$159.00	$74.73–$155.82	—	10%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$148.50	$165.00	$77.55–$161.70	—	10%
Cortisol blood test, total CPT 82533 TOTAL CORTISOL	$88.20	$98.00	$46.06–$96.04	22% above	10%
Cortisol blood test, total CPT 82533 CORTISOL, TOTAL	$183.60	$204.00	$95.88–$199.92	153% above	10%
Cortisol blood test, total inpatient CPT 82533 TOTAL CORTISOL	$88.20	$98.00	$46.06–$96.04	—	10%
Cortisol blood test, total inpatient CPT 82533 CORTISOL, TOTAL	$183.60	$204.00	$95.88–$199.92	—	10%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CK)	$57.60	$64.00	$30.08–$62.72	63% above	10%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE (CK)	$57.60	$64.00	$30.08–$62.72	—	10%
Creatinine blood test CPT 82565 CREATININE, BLOOD	$51.30	$57.00	$26.79–$55.86	108% above	10%
Creatinine blood test inpatient CPT 82565 CREATININE, BLOOD	$51.30	$57.00	$26.79–$55.86	—	10%
Cytomegalovirus (CMV) antibody test CPT 86644 XCMVG CMV ANTIBODY	$15.30	$17.00	$7.99–$16.66	78% below	10%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$125.10	$139.00	$65.33–$136.22	82% above	10%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 XCMVG CMV ANTIBODY	$15.30	$17.00	$7.99–$16.66	—	10%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY	$125.10	$139.00	$65.33–$136.22	—	10%
D-dimer blood test (blood clot marker) CPT 85379 QUANT D-DIMER FBRN DEGRDTN PRD	$65.70	$73.00	$34.31–$71.54	6% below	10%
D-dimer blood test (blood clot marker) inpatient CPT 85379 QUANT D-DIMER FBRN DEGRDTN PRD	$65.70	$73.00	$34.31–$71.54	—	10%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$225.00	$250.00	$117.50–$245.00	126% above	10%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$225.00	$250.00	$117.50–$245.00	—	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 XCOTU COTININE SCREEN	$48.60	$54.00	$25.38–$52.92	49% below	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMN/METHAMPHETAMN SCRN	$57.60	$64.00	$30.08–$62.72	40% below	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 XDOA10 DRUG TESTS, ANY NUMBER OF DRUG CLASSES	$180.00	$200.00	$94.00–$196.00	88% above	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZER	$251.10	$279.00	$131.13–$273.42	163% above	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUF SCR CLASS LIST A	$344.70	$383.00	$180.01–$375.34	261% above	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 XORD- DRUG TOXICOLOGY MONITORING	$413.10	$459.00	$215.73–$449.82	332% above	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 XCOTU COTININE SCREEN	$48.60	$54.00	$25.38–$52.92	—	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AMPHETAMN/METHAMPHETAMN SCRN	$57.60	$64.00	$30.08–$62.72	—	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 XDOA10 DRUG TESTS, ANY NUMBER OF DRUG CLASSES	$180.00	$200.00	$94.00–$196.00	—	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZER	$251.10	$279.00	$131.13–$273.42	—	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUF SCR CLASS LIST A	$344.70	$383.00	$180.01–$375.34	—	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 XORD- DRUG TOXICOLOGY MONITORING	$413.10	$459.00	$215.73–$449.82	—	10%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$57.60	$64.00	$30.08–$62.72	21% above	10%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$57.60	$64.00	$30.08–$62.72	—	10%
Epstein-Barr virus (EBV) antibody test CPT 86665 EB VIRUS VCA IGG	$122.40	$136.00	$63.92–$133.28	88% above	10%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EB VIRUS VCA IGG	$122.40	$136.00	$63.92–$133.28	—	10%
Estradiol blood test CPT 82670 LAB ESTRADIOL	$65.70	$73.00	$34.31–$71.54	41% below	10%
Estradiol blood test inpatient CPT 82670 LAB ESTRADIOL	$65.70	$73.00	$34.31–$71.54	—	10%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$29.48	$32.75	$15.39–$32.10	66% below	10%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN, FSH	$201.60	$224.00	$105.28–$219.52	135% above	10%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE	$29.48	$32.75	$15.39–$32.10	—	10%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN, FSH	$201.60	$224.00	$105.28–$219.52	—	10%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$201.60	$224.00	$105.28–$219.52	35% above	10%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$201.60	$224.00	$105.28–$219.52	—	10%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$190.80	$212.00	$99.64–$207.76	151% above	10%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$190.80	$212.00	$99.64–$207.76	—	10%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$134.10	$149.00	$70.03–$146.02	198% above	10%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$134.10	$149.00	$70.03–$146.02	—	10%
Folate (folic acid) blood test CPT 82746 BLOOD FOLIC ACID, SERUM	$63.00	$70.00	$32.90–$68.60	7% below	10%
Folate (folic acid) blood test inpatient CPT 82746 BLOOD FOLIC ACID, SERUM	$63.00	$70.00	$32.90–$68.60	—	10%
Free T3 thyroid hormone test CPT 84481 FREE ASAY (FT-3)	$63.90	$71.00	$33.37–$69.58	16% below	10%
Free T3 thyroid hormone test inpatient CPT 84481 FREE ASAY (FT-3)	$63.90	$71.00	$33.37–$69.58	—	10%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$13.50	$15.00	$7.05–$14.70	68% below	10%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE	$100.80	$112.00	$52.64–$109.76	137% above	10%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE	$13.50	$15.00	$7.05–$14.70	—	10%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE	$100.80	$112.00	$52.64–$109.76	—	10%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$57.60	$64.00	$30.08–$62.72	35% above	10%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$57.60	$64.00	$30.08–$62.72	—	10%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$297.90	$331.00	$155.57–$324.38	34% above	10%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$297.90	$331.00	$155.57–$324.38	—	10%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE, POST DOSE	$63.90	$71.00	$33.37–$69.58	66% above	10%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE, POST DOSE	$63.90	$71.00	$33.37–$69.58	—	10%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE, 3 SAMPLES	$168.30	$187.00	$87.89–$183.26	150% above	10%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE, 3 SAMPLES	$168.30	$187.00	$87.89–$183.26	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROBE	$50.40	$56.00	$26.32–$54.88	46% below	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHAEAE, AMP PROBE	$100.80	$112.00	$52.64–$109.76	8% above	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE DNA AMP PROBE	$50.40	$56.00	$26.32–$54.88	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHAEAE, AMP PROBE	$100.80	$112.00	$52.64–$109.76	—	10%
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN DETECTION	$201.60	$224.00	$105.28–$219.52	188% above	10%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ANTIGEN DETECTION	$201.60	$224.00	$105.28–$219.52	—	10%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 QUANT PCR REFLEX	$124.20	$138.00	$64.86–$135.24	65% below	10%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA ULTRASENS QUANT, PCR	$559.80	$622.00	$292.34–$609.56	56% above	10%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 QUANT PCR REFLEX	$124.20	$138.00	$64.86–$135.24	—	10%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA ULTRASENS QUANT, PCR	$559.80	$622.00	$292.34–$609.56	—	10%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 AND 2 SINGLE RESULT	$24.30	$27.00	$12.69–$26.46	61% below	10%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 ASSAY TEST - INTL	$29.70	$33.00	$15.51–$32.34	52% below	10%
HIV-1 and HIV-2 antibody test CPT 86703 HIV AB STAT SCREEN	$93.60	$104.00	$48.88–$101.92	52% above	10%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/ 2 ONE RESULT ANTIBODY	$114.30	$127.00	$59.69–$124.46	85% above	10%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 AND 2 SINGLE RESULT	$24.30	$27.00	$12.69–$26.46	—	10%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV-2 ASSAY TEST - INTL	$29.70	$33.00	$15.51–$32.34	—	10%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV AB STAT SCREEN	$93.60	$104.00	$48.88–$101.92	—	10%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1/ 2 ONE RESULT ANTIBODY	$114.30	$127.00	$59.69–$124.46	—	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$93.60	$104.00	$48.88–$101.92	26% above	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$93.60	$104.00	$48.88–$101.92	—	10%
HPV test for high-risk types, one combined (pooled) result CPT 87624 XHPVSC HPV HIGH RISK	$51.30	$57.00	$37.05–$55.86	57% below	10%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 XHPVSC HPV HIGH RISK	$51.30	$57.00	$37.05–$55.86	—	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$90.90	$101.00	$47.47–$98.98	99% above	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$90.90	$101.00	$47.47–$98.98	—	10%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$27.00	$30.00	$14.10–$29.40	67% above	10%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$27.00	$30.00	$14.10–$29.40	—	10%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY T - US	$99.90	$111.00	$52.17–$108.78	85% above	10%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY T - US	$99.90	$111.00	$52.17–$108.78	—	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 ANTIBODY TO HBSAG	$99.90	$111.00	$52.17–$108.78	107% above	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 ANTIBODY TO HBSAG	$99.90	$111.00	$52.17–$108.78	—	10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG EIA	$86.40	$96.00	$45.12–$94.08	83% above	10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$99.90	$111.00	$52.17–$108.78	111% above	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG EIA	$86.40	$96.00	$45.12–$94.08	—	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$99.90	$111.00	$52.17–$108.78	—	10%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C ANTIBODY TEST - INTL	$126.90	$141.00	$66.27–$138.18	98% above	10%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB TEST	$132.30	$147.00	$69.09–$144.06	107% above	10%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C ANTIBODY TEST - INTL	$126.90	$141.00	$66.27–$138.18	—	10%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB TEST	$132.30	$147.00	$69.09–$144.06	—	10%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV VIRUS QUANTITATION	$238.50	$265.00	$124.55–$259.70	24% above	10%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV VIRUS QUANTITATION	$238.50	$265.00	$124.55–$259.70	—	10%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$18.90	$21.00	$9.87–$20.58	68% below	10%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE I	$48.60	$54.00	$25.38–$52.92	18% below	10%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX, AB ID TYPE 1	$78.75	$87.50	$41.13–$85.75	33% above	10%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$18.90	$21.00	$9.87–$20.58	—	10%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE I	$48.60	$54.00	$25.38–$52.92	—	10%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX, AB ID TYPE 1	$78.75	$87.50	$41.13–$85.75	—	10%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$27.90	$31.00	$14.57–$30.38	58% below	10%
Herpes blood test, HSV-2 antibody CPT 86696 AB; HSV II	$48.60	$54.00	$25.38–$52.92	27% below	10%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX, AB ID TYPE 2	$78.75	$87.50	$41.13–$85.75	19% above	10%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$27.90	$31.00	$14.57–$30.38	—	10%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 AB; HSV II	$48.60	$54.00	$25.38–$52.92	—	10%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX, AB ID TYPE 2	$78.75	$87.50	$41.13–$85.75	—	10%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$28.80	$32.00	$15.04–$31.36	57% below	10%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP	$87.30	$97.00	$45.59–$95.06	29% above	10%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HS	$28.80	$32.00	$15.04–$31.36	—	10%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HIGH SENSITIVITY CRP	$87.30	$97.00	$45.59–$95.06	—	10%
Homocysteine blood test CPT 83090 HOMOCYSTINE	$112.50	$125.00	$58.75–$122.50	40% above	10%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE	$112.50	$125.00	$58.75–$122.50	—	10%
Insulin blood test CPT 83525 INSULIN, TOTAL	$134.10	$149.00	$70.03–$146.02	161% above	10%
Insulin blood test inpatient CPT 83525 INSULIN, TOTAL	$134.10	$149.00	$70.03–$146.02	—	10%
Iron blood test (serum iron) CPT 83540 IRON, SERUM	$57.60	$64.00	$30.08–$62.72	51% above	10%
Iron blood test (serum iron) inpatient CPT 83540 IRON, SERUM	$57.60	$64.00	$30.08–$62.72	—	10%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$68.40	$76.00	$35.72–$74.48	75% above	10%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$68.40	$76.00	$35.72–$74.48	—	10%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$117.00	$130.00	$61.10–$127.40	63% above	10%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$117.00	$130.00	$61.10–$127.40	—	10%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$32.63	$36.25	$17.04–$35.53	66% below	10%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE LH	$201.60	$224.00	$105.28–$219.52	111% above	10%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$32.63	$36.25	$17.04–$35.53	—	10%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE LH	$201.60	$224.00	$105.28–$219.52	—	10%
Lactate (lactic acid) blood test CPT 83605 XDLAC ASSAY OF LACTIC ACID	$92.70	$103.00	$48.41–$100.94	78% above	10%
Lactate (lactic acid) blood test CPT 83605 LACTATE	$122.40	$136.00	$63.92–$133.28	135% above	10%
Lactate (lactic acid) blood test inpatient CPT 83605 XDLAC ASSAY OF LACTIC ACID	$92.70	$103.00	$48.41–$100.94	—	10%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE	$122.40	$136.00	$63.92–$133.28	—	10%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$57.60	$64.00	$30.08–$62.72	111% above	10%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE, FLUID	$72.90	$81.00	$38.07–$79.38	167% above	10%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$57.60	$64.00	$30.08–$62.72	—	10%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE, FLUID	$72.90	$81.00	$38.07–$79.38	—	10%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$72.90	$81.00	$38.07–$79.38	25% above	10%
Lipase blood test (pancreas enzyme) CPT 83690 XPAN ASSAY OF LIPASE	$76.50	$85.00	$39.95–$83.30	31% above	10%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$72.90	$81.00	$38.07–$79.38	—	10%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 XPAN ASSAY OF LIPASE	$76.50	$85.00	$39.95–$83.30	—	10%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$358.20	$398.00	$187.06–$390.04	492% above	10%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$358.20	$398.00	$187.06–$390.04	—	10%
Lyme disease antibody test CPT 86618 LAB LYME SEROL	$168.30	$187.00	$87.89–$183.26	119% above	10%
Lyme disease antibody test inpatient CPT 86618 LAB LYME SEROL	$168.30	$187.00	$87.89–$183.26	—	10%
Magnesium blood test CPT 83735 XLITHS MAGNESIUM	$14.40	$16.00	$7.52–$15.68	57% below	10%
Magnesium blood test CPT 83735 MAGNESIUM	$72.90	$81.00	$38.07–$79.38	116% above	10%
Magnesium blood test CPT 83735 XMAGR ASSAY OF MAGNESIUM	$190.80	$212.00	$99.64–$207.76	465% above	10%
Magnesium blood test inpatient CPT 83735 XLITHS MAGNESIUM	$14.40	$16.00	$7.52–$15.68	—	10%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$72.90	$81.00	$38.07–$79.38	—	10%
Magnesium blood test inpatient CPT 83735 XMAGR ASSAY OF MAGNESIUM	$190.80	$212.00	$99.64–$207.76	—	10%
Measles (rubeola) antibody test CPT 86765 XMEAM, ANTIBODY, RUBEOLA	$18.90	$21.00	$9.87–$20.58	67% below	10%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$122.40	$136.00	$63.92–$133.28	114% above	10%
Measles (rubeola) antibody test inpatient CPT 86765 XMEAM, ANTIBODY, RUBEOLA	$18.90	$21.00	$9.87–$20.58	—	10%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$122.40	$136.00	$63.92–$133.28	—	10%
Mono test (heterophile antibody, Monospot) CPT 86308 INFECTIOUS MONO SCREEN	$65.70	$73.00	$34.31–$71.54	23% above	10%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 INFECTIOUS MONO SCREEN	$65.70	$73.00	$34.31–$71.54	—	10%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY IGM	$17.55	$19.50	$9.17–$19.11	70% below	10%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$120.60	$134.00	$62.98–$131.32	106% above	10%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY IGM	$17.55	$19.50	$9.17–$19.11	—	10%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY	$120.60	$134.00	$62.98–$131.32	—	10%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA	$19.80	$22.00	$10.34–$21.56	75% below	10%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA	$19.80	$22.00	$10.34–$21.56	—	10%
Pap test (liquid-based, automated screening with review) CPT 88175 XCYA, CYTOPATHOLOGY, CERVICAL OR VAGINAL	$59.40	$66.00	$42.90–$64.68	39% below	10%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 XCYA, CYTOPATHOLOGY, CERVICAL OR VAGINAL	$59.40	$66.00	$42.90–$64.68	—	10%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER	$67.50	$75.00	$48.75–$73.50	26% below	10%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN LAYER PAP TEST	$180.90	$201.00	$130.65–$196.98	99% above	10%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH C/V THIN LAYER	$67.50	$75.00	$48.75–$73.50	—	10%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN LAYER PAP TEST	$180.90	$201.00	$130.65–$196.98	—	10%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE (N)	$91.58	$101.75	$47.82–$99.72	35% below	10%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$145.80	$162.00	$76.14–$158.76	3% above	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE (N)	$91.58	$101.75	$47.82–$99.72	—	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$145.80	$162.00	$76.14–$158.76	—	10%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$84.60	$94.00	$44.18–$92.12	125% above	10%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$84.60	$94.00	$44.18–$92.12	—	10%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS, INORGANIC	$11.70	$13.00	$6.11–$12.74	67% below	10%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS INORGANIC, FLUID	$72.90	$81.00	$38.07–$79.38	104% above	10%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS, INORGANIC	$11.70	$13.00	$6.11–$12.74	—	10%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS INORGANIC, FLUID	$72.90	$81.00	$38.07–$79.38	—	10%
Potassium blood test CPT 84132 POTASSIUM, FLUID	$11.70	$13.00	$6.11–$12.74	50% below	10%
Potassium blood test CPT 84132 POTASSIUM SERUM PLASMA OR WHOLE BLOOD	$18.00	$20.00	$9.40–$19.60	23% below	10%
Potassium blood test CPT 84132 WHOLE BLOOD POTASSIUM	$51.30	$57.00	$26.79–$55.86	120% above	10%
Potassium blood test inpatient CPT 84132 POTASSIUM, FLUID	$11.70	$13.00	$6.11–$12.74	—	10%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM PLASMA OR WHOLE BLOOD	$18.00	$20.00	$9.40–$19.60	—	10%
Potassium blood test inpatient CPT 84132 WHOLE BLOOD POTASSIUM	$51.30	$57.00	$26.79–$55.86	—	10%
Progesterone blood test CPT 84144 PROGESTERONE	$63.90	$71.00	$33.37–$69.58	21% below	10%
Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE	$65.70	$73.00	$34.31–$71.54	19% below	10%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$63.90	$71.00	$33.37–$69.58	—	10%
Progesterone blood test inpatient CPT 84144 ASSAY OF PROGESTERONE	$65.70	$73.00	$34.31–$71.54	—	10%
Prolactin blood test CPT 84146 PROLACTIN	$213.30	$237.00	$111.39–$232.26	145% above	10%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$213.30	$237.00	$111.39–$232.26	—	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR	$70.20	$78.00	$36.66–$76.44	192% above	10%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR	$70.20	$78.00	$36.66–$76.44	—	10%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 FENTANYL DRUG SCREEN	$15.30	$17.00	$7.99–$16.66	74% below	10%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DOAP DRUG SCREEN, SINGLE	$108.90	$121.00	$56.87–$118.58	88% above	10%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DOA WITH FENTANYL	$123.30	$137.00	$64.39–$134.26	113% above	10%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DOAWBP DRUG SCR NON TLC DEVICE	$190.80	$212.00	$99.64–$207.76	230% above	10%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 FENTANYL DRUG SCREEN	$15.30	$17.00	$7.99–$16.66	—	10%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DOAP DRUG SCREEN, SINGLE	$108.90	$121.00	$56.87–$118.58	—	10%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DOA WITH FENTANYL	$123.30	$137.00	$64.39–$134.26	—	10%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DOAWBP DRUG SCR NON TLC DEVICE	$190.80	$212.00	$99.64–$207.76	—	10%
Rapid flu test (influenza antigen) CPT 87804 RAPID FLU A&B	$56.70	$63.00	$29.61–$61.74	14% below	10%
Rapid flu test (influenza antigen) inpatient CPT 87804 RAPID FLU A&B	$56.70	$63.00	$29.61–$61.74	—	10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A AG DETECTION	$77.40	$86.00	$40.42–$84.28	35% above	10%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A AG DETECTION	$77.40	$86.00	$40.42–$84.28	—	10%
Renin blood test CPT 84244 LAB RENIN	$61.20	$68.00	$31.96–$66.64	28% below	10%
Renin blood test CPT 84244 RENIN ACTIVITY PLASMA	$77.40	$86.00	$40.42–$84.28	9% below	10%
Renin blood test inpatient CPT 84244 LAB RENIN	$61.20	$68.00	$31.96–$66.64	—	10%
Renin blood test inpatient CPT 84244 RENIN ACTIVITY PLASMA	$77.40	$86.00	$40.42–$84.28	—	10%
Rh blood typing CPT 86901 BLOOD TYPING RH D	$72.90	$81.00	$38.07–$79.38	95% above	10%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH D	$72.90	$81.00	$38.07–$79.38	—	10%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR, QUAL	$72.90	$81.00	$38.07–$79.38	120% above	10%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR, QUAL	$72.90	$81.00	$38.07–$79.38	—	10%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ELISA	$122.40	$136.00	$63.92–$133.28	149% above	10%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ELISA	$122.40	$136.00	$63.92–$133.28	—	10%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED	$50.40	$56.00	$26.32–$54.88	33% above	10%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE AUTOMATED	$50.40	$56.00	$26.32–$54.88	—	10%
Sodium blood test CPT 84295 SODIUM, SERUM	$11.70	$13.00	$6.11–$12.74	57% below	10%
Sodium blood test CPT 84295 WHOLE BLOOD SODIUM	$51.30	$57.00	$26.79–$55.86	89% above	10%
Sodium blood test inpatient CPT 84295 SODIUM, SERUM	$11.70	$13.00	$6.11–$12.74	—	10%
Sodium blood test inpatient CPT 84295 WHOLE BLOOD SODIUM	$51.30	$57.00	$26.79–$55.86	—	10%
Stool ova and parasites exam CPT 87177 OVA & PARASITES	$90.00	$100.00	$47.00–$98.00	127% above	10%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES	$90.00	$100.00	$47.00–$98.00	—	10%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA	$20.25	$22.50	$10.58–$22.05	65% below	10%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB BY TP PA	$32.85	$36.50	$17.16–$35.77	43% below	10%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA SENDOUT	$47.70	$53.00	$24.91–$51.94	18% below	10%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS NON TREP QUAL.	$122.40	$136.00	$63.92–$133.28	111% above	10%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA	$20.25	$22.50	$10.58–$22.05	—	10%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB BY TP PA	$32.85	$36.50	$17.16–$35.77	—	10%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA SENDOUT	$47.70	$53.00	$24.91–$51.94	—	10%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS NON TREP QUAL.	$122.40	$136.00	$63.92–$133.28	—	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR VDRL	$65.70	$73.00	$34.31–$71.54	175% above	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR VDRL	$65.70	$73.00	$34.31–$71.54	—	10%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$176.40	$196.00	$92.12–$192.08	51% above	10%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD	$176.40	$196.00	$92.12–$192.08	—	10%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$68.40	$76.00	$35.72–$74.48	26% below	10%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$68.40	$76.00	$35.72–$74.48	—	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$21.60	$24.00	$11.28–$23.52	67% below	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER/KIDNEY MICROSOMAL AB	$39.38	$43.75	$20.56–$42.88	39% below	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY	$190.80	$212.00	$99.64–$207.76	194% above	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH	$21.60	$24.00	$11.28–$23.52	—	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER/KIDNEY MICROSOMAL AB	$39.38	$43.75	$20.56–$42.88	—	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY	$190.80	$212.00	$99.64–$207.76	—	10%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$27.00	$30.00	$14.10–$29.40	64% below	10%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$111.60	$124.00	$58.28–$121.52	48% above	10%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE	$27.00	$30.00	$14.10–$29.40	—	10%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$111.60	$124.00	$58.28–$121.52	—	10%
Total IgE blood test CPT 82785 GAMMAGLOBULIN, IGE	$180.90	$201.00	$94.47–$196.98	192% above	10%
Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN, IGE	$180.90	$201.00	$94.47–$196.98	—	10%
Total cholesterol blood test CPT 82465 CHOLESTEROL, TOTAL	$45.90	$51.00	$23.97–$49.98	25% above	10%
Total cholesterol blood test CPT 82465 CHOLESTEROL, FLUID	$70.20	$78.00	$36.66–$76.44	92% above	10%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL, TOTAL	$45.90	$51.00	$23.97–$49.98	—	10%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL, FLUID	$70.20	$78.00	$36.66–$76.44	—	10%
Total thyroxine (T4) blood test CPT 84436 THYROXINE, TOTAL	$80.10	$89.00	$41.83–$87.22	91% above	10%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE, TOTAL	$80.10	$89.00	$41.83–$87.22	—	10%
Total triiodothyronine (T3) blood test CPT 84480 ASSAY TRIIODOTHYRONIE (T3)	$20.70	$23.00	$10.81–$22.54	66% below	10%
Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE, TOTAL	$156.60	$174.00	$81.78–$170.52	160% above	10%
Total triiodothyronine (T3) blood test inpatient CPT 84480 ASSAY TRIIODOTHYRONIE (T3)	$20.70	$23.00	$10.81–$22.54	—	10%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE, TOTAL	$156.60	$174.00	$81.78–$170.52	—	10%
Transferrin blood test CPT 84466 TRANSFERRIN	$191.70	$213.00	$100.11–$208.74	159% above	10%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$191.70	$213.00	$100.11–$208.74	—	10%
Trichomonas test (NAAT) CPT 87661 TVAGP DETECT, DNA AMP	$190.80	$212.00	$99.64–$207.76	121% above	10%
Trichomonas test (NAAT) inpatient CPT 87661 TVAGP DETECT, DNA AMP	$190.80	$212.00	$99.64–$207.76	—	10%
Triglycerides blood test CPT 84478 VAP CHOL, TRIGLYCERIDES	$26.78	$29.75	$13.98–$29.16	22% below	10%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$48.60	$54.00	$25.38–$52.92	41% above	10%
Triglycerides blood test CPT 84478 TRIGLYCERIDES, FLUID	$70.20	$78.00	$36.66–$76.44	104% above	10%
Triglycerides blood test inpatient CPT 84478 VAP CHOL, TRIGLYCERIDES	$26.78	$29.75	$13.98–$29.16	—	10%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$48.60	$54.00	$25.38–$52.92	—	10%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES, FLUID	$70.20	$78.00	$36.66–$76.44	—	10%
Troponin test, quantitative CPT 84484 TROPONIN I	$156.60	$174.00	$81.78–$170.52	86% above	10%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$156.60	$174.00	$81.78–$170.52	—	10%
Uric acid blood test CPT 84550 URIC ACID; BLOOD	$57.60	$64.00	$30.08–$62.72	64% above	10%
Uric acid blood test inpatient CPT 84550 URIC ACID; BLOOD	$57.60	$64.00	$30.08–$62.72	—	10%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS, AUTO WITH SCOPE	$36.00	$40.00	$18.80–$39.20	33% above	10%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS, AUTO WITH SCOPE	$36.00	$40.00	$18.80–$39.20	—	10%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS, NON-AUTO WITH SCOPE	$22.50	$25.00	$11.75–$24.50	24% above	10%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS, NON-AUTO WITH SCOPE	$22.50	$25.00	$11.75–$24.50	—	10%
Urinalysis without microscope exam, automated CPT 81003 URINE ANALYSIS DIPSTICK AUTOMATED	$23.40	$26.00	$12.22–$25.48	at median	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE ANALYSIS DIPSTICK AUTOMATED	$23.40	$26.00	$12.22–$25.48	—	10%
Urinalysis without microscope exam, manual CPT 81002 URINE, NON-AUTO, NO MICRO	$23.40	$26.00	$12.22–$25.48	44% above	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE, NON-AUTO, NO MICRO	$23.40	$26.00	$12.22–$25.48	—	10%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE, QUANTITATIVE	$81.00	$90.00	$42.30–$88.20	42% above	10%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE, QUANTITATIVE	$81.00	$90.00	$42.30–$88.20	—	10%
Urine microalbumin (albumin) test CPT 82043 URINE MICROALBUMIN	$89.10	$99.00	$46.53–$97.02	75% above	10%
Urine microalbumin (albumin) test inpatient CPT 82043 URINE MICROALBUMIN	$89.10	$99.00	$46.53–$97.02	—	10%
Urine pregnancy test, read by color change CPT 81025 HCG, URINE QUALITATIVE	$70.20	$78.00	$36.66–$76.44	44% above	10%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG, URINE QUALITATIVE	$70.20	$78.00	$36.66–$76.44	—	10%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$64.80	$72.00	$33.84–$70.56	13% below	10%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$64.80	$72.00	$33.84–$70.56	—	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$79.20	$88.00	$41.36–$86.24	16% below	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25 HYDROXY	$192.60	$214.00	$100.58–$209.72	104% above	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$79.20	$88.00	$41.36–$86.24	—	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25 HYDROXY	$192.60	$214.00	$100.58–$209.72	—	10%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 LAB VIT D 1,25	$81.23	$90.25	$42.42–$88.45	47% below	10%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D (1 25 DIHYDROXY)	$87.30	$97.00	$45.59–$95.06	43% below	10%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 LAB VIT D 1,25	$81.23	$90.25	$42.42–$88.45	—	10%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D (1 25 DIHYDROXY)	$87.30	$97.00	$45.59–$95.06	—	10%
Zinc blood test CPT 84630 ASSAY OF ZINC	$46.80	$52.00	$24.44–$50.96	9% below	10%
Zinc blood test inpatient CPT 84630 ASSAY OF ZINC	$46.80	$52.00	$24.44–$50.96	—	10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 LAB CHORION GO	$25.88	$28.75	$13.51–$28.18	62% below	10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 QUANTITATIVE HCG (QHCG)	$101.70	$113.00	$53.11–$110.74	50% above	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 LAB CHORION GO	$25.88	$28.75	$13.51–$28.18	—	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 QUANTITATIVE HCG (QHCG)	$101.70	$113.00	$53.11–$110.74	—	10%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Botox injections for chronic migraine both sides CPT 64615 CHEMODENERVATION, MUSC INNERVATED, BILATERAL	$315.00	$350.00	$164.50–$343.00	—	10%
Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION, MUSC INNERVATED, BILATERAL	$315.00	$350.00	$164.50–$343.00	—	10%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX, DIST FIB FRACTURE, W/O MANIP	$1,035.00	$1,150.00	$540.50–$1,127.00	174% above	10%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TX, DIST FIB FRACTURE, W/O MANIP	$1,035.00	$1,150.00	$540.50–$1,127.00	—	10%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX, FX METATARSAL, W/O MANIP, EACH	$711.00	$790.00	$371.30–$774.20	95% above	10%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX, FX METATARSAL, W/O MANIP, EACH	$711.00	$790.00	$371.30–$774.20	—	10%
Cardiac catheterization with coronary angiogram CPT 93458 CORONARY ANGIOGRAPHY W/LHC (INCLUDES LV ANGIO)	$9,054.00	$10,060.00	$6,539.00–$9,858.80	25% below	10%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 CORONARY ANGIOGRAPHY W/LHC (INCLUDES LV ANGIO)	$9,054.00	$10,060.00	$6,539.00–$9,858.80	—	10%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION, ELECTIVE, EXTERNAL	$3,231.00	$3,590.00	$2,333.50–$3,518.20	57% above	10%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION, ELECTIVE, EXTERNAL	$3,231.00	$3,590.00	$2,333.50–$3,518.20	—	10%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX, SINGLE OR MULT, W OR W/O FULGURATION	$576.00	$640.00	$300.80–$627.20	67% below	10%
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX, SINGLE OR MULT, W OR W/O FULGURATION	$576.00	$640.00	$300.80–$627.20	—	10%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION W/ SUTURES, > 28 DAYS OF AGE	$558.00	$620.00	$403.00–$607.60	91% below	10%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION W/ SUTURES, > 28 DAYS OF AGE	$558.00	$620.00	$403.00–$607.60	—	10%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/ CLAMP W/ BLOCK	$675.00	$750.00	$487.50–$735.00	62% below	10%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/ CLAMP W/ BLOCK	$675.00	$750.00	$487.50–$735.00	—	10%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION W/ SUTURES, 28 DAYS OF AGE OR LESS	$558.00	$620.00	$403.00–$607.60	72% below	10%
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION W/ SUTURES, 28 DAYS OF AGE OR LESS	$558.00	$620.00	$403.00–$607.60	—	10%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TX, DIST RADIAL FX (COLLES OR SMITH TYPE), W/O MANIP	$1,071.00	$1,190.00	$559.30–$1,166.20	162% above	10%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TX, DIST RADIAL FX (COLLES OR SMITH TYPE), W/O MANIP	$1,071.00	$1,190.00	$559.30–$1,166.20	—	10%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY W/BIOPSY	$324.00	$360.00	$169.20–$352.80	64% below	10%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY W/BIOPSY	$324.00	$360.00	$169.20–$352.80	—	10%
Coronary stent placement, one artery CPT 92928 PERC TRANSCATH INTRACORONARY STENT(S) W/ ANGIOPLASTY IF PERF	$17,694.00	$19,660.00	$12,779.00–$19,266.80	37% above	10%
Coronary stent placement, one artery inpatient CPT 92928 PERC TRANSCATH INTRACORONARY STENT(S) W/ ANGIOPLASTY IF PERF	$17,694.00	$19,660.00	$12,779.00–$19,266.80	—	10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESIONS, FIRST LESION	$102.60	$114.00	$53.58–$111.72	49% below	10%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGNANT LESIONS, FIRST LESION	$102.60	$114.00	$53.58–$111.72	—	10%
Ear tube placement (tympanostomy) with local anesthesia, one ear one side CPT 69433 TYMPANOSTOMY W/ LOCAL OR TOPICAL ANESTHESIA, UNILAT	$423.00	$470.00	$220.90–$460.60	68% below	10%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient both sides CPT 69433 TYMPANOSTOMY W/ LOCAL OR TOPICAL ANESTHESIA, BILAT	$729.00	$810.00	$380.70–$793.80	—	10%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient one side CPT 69433 TYMPANOSTOMY W/ LOCAL OR TOPICAL ANESTHESIA, UNILAT	$423.00	$470.00	$220.90–$460.60	—	10%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRATION/LAVAGE, UNILAT	$74.70	$83.00	$39.01–$81.34	52% below	10%
Earwax removal by irrigation (rinsing), one ear inpatient both sides CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, BILAT	$153.00	$170.00	$79.90–$166.60	—	10%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRATION/LAVAGE, UNILAT	$74.70	$83.00	$39.01–$81.34	—	10%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY	$297.00	$330.00	$155.10–$323.40	23% below	10%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BIOPSY	$297.00	$330.00	$155.10–$323.40	—	10%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECTION; DIAG/THER AGENT;FACET JOINT/MBB;LUMBAR OR SACRAL, SIN	$954.00	$1,060.00	$498.20–$1,038.80	56% below	10%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJECTION; DIAG/THER AGENT;FACET JOINT/MBB;LUMBAR OR SACRAL, SIN	$954.00	$1,060.00	$498.20–$1,038.80	—	10%
IUD insertion (the device itself billed separately) CPT 58300 IUD INSERTION	$261.00	$290.00	$136.30–$284.20	48% below	10%
IUD insertion (the device itself billed separately) inpatient CPT 58300 IUD INSERTION	$261.00	$290.00	$136.30–$284.20	—	10%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D OF ABSCESS - SIMPLE	$198.00	$220.00	$103.40–$215.60	49% below	10%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D OF ABSCESS - SIMPLE	$198.00	$220.00	$103.40–$215.60	—	10%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION,TENDON SHEATH, SINGLE	$252.00	$280.00	$131.60–$274.40	26% below	10%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION,TENDON SHEATH, SINGLE	$252.00	$280.00	$131.60–$274.40	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP &/OR INJ, MAJOR JOINT, W/O US GUIDANCE	$441.00	$490.00	$230.30–$480.20	37% below	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP &/OR INJ, MAJOR JOINT, W/O US GUIDANCE	$441.00	$490.00	$230.30–$480.20	—	10%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT, DRUG DELIVERY IMPLANT (BIORESORBABLE, NON & BIODEGRADABL	$333.00	$370.00	$173.90–$362.60	12% below	10%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT, DRUG DELIVERY IMPLANT (BIORESORBABLE, NON & BIODEGRADABL	$333.00	$370.00	$173.90–$362.60	—	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP &/OR INJ, INTERMED JOINT, W/O US GUIDANCE	$270.00	$300.00	$141.00–$294.00	56% below	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP &/OR INJ, INTERMED JOINT, W/O US GUIDANCE	$270.00	$300.00	$141.00–$294.00	—	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASP &/OR INJ, SM JOINT, W/O US GUIDANCE	$288.00	$320.00	$150.40–$313.60	42% below	10%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASP &/OR INJ, SM JOINT, W/O US GUIDANCE	$288.00	$320.00	$150.40–$313.60	—	10%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 POST CATARACT LASER SURGERY (YAG)	$675.00	$750.00	$352.50–$735.00	52% below	10%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 POST CATARACT LASER SURGERY (YAG)	$675.00	$750.00	$352.50–$735.00	—	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMED WOUNDS SCALP/AXILLAE/TRUNK &/OR EXT, 2.5CM OR LE	$198.00	$220.00	$103.40–$215.60	63% below	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMED WOUNDS SCALP/AXILLAE/TRUNK &/OR EXT, 2.5CM OR LE	$198.00	$220.00	$103.40–$215.60	—	10%
Left heart catheterization, diagnostic one side CPT 93452 LHC, INC LEFT VENTRICULOGRAPHY WHEN PERF	$7,272.00	$8,080.00	$5,252.00–$7,918.40	22% below	10%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LHC, INC LEFT VENTRICULOGRAPHY WHEN PERF	$7,272.00	$8,080.00	$5,252.00–$7,918.40	—	10%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION, NON-NEUROLYTIC, INTERL EPID/SUBARACH, LUMBAR OR SACRA	$1,827.00	$2,030.00	$1,319.50–$1,989.40	10% below	10%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECTION, NON-NEUROLYTIC, INTERL EPID/SUBARACH, LUMBAR OR SACRA	$1,827.00	$2,030.00	$1,319.50–$1,989.40	—	10%
Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION, INTERLAMINAR LUMBAR/SACRAL W/O IMAGE	$1,467.00	$1,630.00	$766.10–$1,597.40	10% below	10%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION, INTERLAMINAR LUMBAR/SACRAL W/O IMAGE	$1,467.00	$1,630.00	$766.10–$1,597.40	—	10%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION; ANESTHETIC AGENT;TRANSFORAMINAL;LUMBAR OR SACRAL, SIN	$954.00	$1,060.00	$689.00–$1,038.80	54% below	10%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJECTION; ANESTHETIC AGENT;TRANSFORAMINAL;LUMBAR OR SACRAL, SIN	$954.00	$1,060.00	$689.00–$1,038.80	—	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 BENIGN EXCISN (EXCEPT SKIN TAG) TRUNK/ARMS OR LEGS <0.6CM	$270.00	$300.00	$141.00–$294.00	80% below	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 BENIGN EXCISN (EXCEPT SKIN TAG) TRUNK/ARMS OR LEGS <0.6CM	$270.00	$300.00	$141.00–$294.00	—	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 BENIGN EXCISN,FACE/EARS/EYELIDS/NOSE/LIPS/MUC MEMB, <0.6CM	$333.00	$370.00	$173.90–$362.60	76% below	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 BENIGN EXCISN,FACE/EARS/EYELIDS/NOSE/LIPS/MUC MEMB, <0.6CM	$333.00	$370.00	$173.90–$362.60	—	10%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE, PART OR COMP, SIMPLE, SINGLE	$234.00	$260.00	$122.20–$254.80	27% below	10%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE, PART OR COMP, SIMPLE, SINGLE	$234.00	$260.00	$122.20–$254.80	—	10%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION(S), ANESTHETIC AGENT(S), GREATER OCCIPITAL NERVE	$234.00	$260.00	$122.20–$254.80	70% below	10%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION(S), ANESTHETIC AGENT(S), GREATER OCCIPITAL NERVE	$234.00	$260.00	$122.20–$254.80	—	10%
Pacemaker implant (dual chamber) CPT 33208 INSERT NEW/REPLACE PERM PM W/ATRIAL & VENTRIC LEADS	$13,761.00	$15,290.00	$9,938.50–$14,984.20	12% below	10%
Pacemaker implant (dual chamber) inpatient CPT 33208 INSERT NEW/REPLACE PERM PM W/ATRIAL & VENTRIC LEADS	$13,761.00	$15,290.00	$9,938.50–$14,984.20	—	10%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS ABD (DX OR THERAP), W/ IMAGE GUIDANCE	$3,231.00	$3,590.00	$2,333.50–$3,518.20	86% above	10%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS ABD (DX OR THERAP), W/ IMAGE GUIDANCE	$3,231.00	$3,590.00	$2,333.50–$3,518.20	—	10%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC OF NAIL&MATRIX, PARTIAL/COMP, PERM REMOVAL	$603.00	$670.00	$314.90–$656.60	22% below	10%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC OF NAIL&MATRIX, PARTIAL/COMP, PERM REMOVAL	$603.00	$670.00	$314.90–$656.60	—	10%
Removal of a breast lump, open surgery CPT 19120 OPEN EXCISION OF BREAST MASS, MALE OR FEMALE, 1 OR MORE LESIONS	$2,574.00	$2,860.00	$1,344.20–$2,802.80	42% below	10%
Removal of a breast lump, open surgery inpatient CPT 19120 OPEN EXCISION OF BREAST MASS, MALE OR FEMALE, 1 OR MORE LESIONS	$2,574.00	$2,860.00	$1,344.20–$2,802.80	—	10%
Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOV FOREIGN BODY SUBCUTANEOUS;SIMPLE	$261.00	$290.00	$136.30–$284.20	61% below	10%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOV FOREIGN BODY SUBCUTANEOUS;SIMPLE	$261.00	$290.00	$136.30–$284.20	—	10%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF SHORT ARM CAST (ELBOW TO FINGER)	$396.00	$440.00	$206.80–$431.20	32% above	10%
Short arm cast (elbow to hand) inpatient both sides CPT 29075 APPLICATION OF SHORT ARM CAST (ELBOW TO FINGER) - BILAT	$684.00	$760.00	$494.00–$744.80	—	10%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF SHORT ARM CAST (ELBOW TO FINGER)	$396.00	$440.00	$206.80–$431.20	—	10%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT (FOREARM TO HAND), STATIC	$360.00	$400.00	$260.00–$392.00	24% above	10%
Short arm splint (forearm and hand) inpatient both sides CPT 29125 DORSAL HAND SPLINT- BILAT	$639.00	$710.00	$461.50–$695.80	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT (FOREARM TO HAND), STATIC	$360.00	$400.00	$260.00–$392.00	—	10%
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES)	$639.00	$710.00	$333.70–$695.80	68% above	10%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES)	$639.00	$710.00	$333.70–$695.80	—	10%
Short leg splint (calf to foot) CPT 29515 APPLIC OF SHORT LEG SPLINT (CALF TO FOOT)	$378.00	$420.00	$197.40–$411.60	28% above	10%
Short leg splint (calf to foot) inpatient both sides CPT 29515 APPLIC OF SHORT LEG SPLINT (CALF TO FOOT) - BILAT	$657.00	$730.00	$474.50–$715.40	—	10%
Short leg splint (calf to foot) inpatient CPT 29515 APPLIC OF SHORT LEG SPLINT (CALF TO FOOT)	$378.00	$420.00	$197.40–$411.60	—	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$162.00	$180.00	$84.60–$176.40	51% below	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$162.00	$180.00	$84.60–$176.40	—	10%
Skin biopsy, punch, one lesion CPT 11104 BIOPSY OF SKIN, PUNCH, SINGLE LESION	$279.00	$310.00	$145.70–$303.80	37% below	10%
Skin biopsy, punch, one lesion inpatient CPT 11104 BIOPSY OF SKIN, PUNCH, SINGLE LESION	$279.00	$310.00	$145.70–$303.80	—	10%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 MALIGNANT EXCISION,TRUNK, ARMS OR LEGS, < 0.6	$270.00	$300.00	$141.00–$294.00	80% below	10%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 MALIGNANT EXCISION,TRUNK, ARMS OR LEGS, < 0.6	$270.00	$300.00	$141.00–$294.00	—	10%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS, UP TO 15	$180.00	$200.00	$94.00–$196.00	38% below	10%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS, UP TO 15	$180.00	$200.00	$94.00–$196.00	—	10%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC	$1,071.00	$1,190.00	$773.50–$1,166.20	at median	10%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC	$1,071.00	$1,190.00	$773.50–$1,166.20	—	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$135.00	$150.00	$70.50–$147.00	62% below	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$135.00	$150.00	$70.50–$147.00	—	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REP SUPERF WOUNDS FACE/EARS/EYELIDS/NOSE/LIPS/MUC MEMB, 2	$121.50	$135.00	$63.45–$132.30	62% below	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REP SUPERF WOUNDS FACE/EARS/EYELIDS/NOSE/LIPS/MUC MEMB, 2	$121.50	$135.00	$63.45–$132.30	—	10%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF SKIN, TANGENTIAL, SINGLE LESION	$279.00	$310.00	$145.70–$303.80	8% below	10%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BIOPSY OF SKIN, TANGENTIAL, SINGLE LESION	$279.00	$310.00	$145.70–$303.80	—	10%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS, ASP PLEURAL SPACE, NEEDLE OR CATH, IMG GUIDANCE	$3,663.00	$4,070.00	$2,645.50–$3,988.60	111% above	10%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS, ASP PLEURAL SPACE, NEEDLE OR CATH, IMG GUIDANCE	$3,663.00	$4,070.00	$2,645.50–$3,988.60	—	10%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SGL/MULT TRGR PTS 1-2 MUSC	$225.00	$250.00	$117.50–$245.00	68% below	10%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SGL/MULT TRGR PTS 1-2 MUSC	$225.00	$250.00	$117.50–$245.00	—	10%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS OTHER THAN SKIN TAGS, UP TO 14 LESION	$153.00	$170.00	$79.90–$166.60	51% below	10%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS OTHER THAN SKIN TAGS, UP TO 14 LESION	$153.00	$170.00	$79.90–$166.60	—	10%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT, MUSCLE &/OR FACIA; FIRST 20 SQ CM OR LESS	$171.00	$190.00	$89.30–$186.20	78% below	10%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT, MUSCLE &/OR FACIA; FIRST 20 SQ CM OR LESS	$171.00	$190.00	$89.30–$186.20	—	10%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENTS	$558.00	$620.00	$403.00–$607.60	50% below	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENTS	$558.00	$620.00	$403.00–$607.60	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL	$85.50	$95.00	$61.75–$93.10	51% below	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL	$85.50	$95.00	$61.75–$93.10	—	10%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO AGENT INFUSION, 1ST HOUR	$1,404.00	$1,560.00	$1,014.00–$1,528.80	83% above	10%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO AGENT INFUSION, 1ST HOUR	$1,404.00	$1,560.00	$1,014.00–$1,528.80	—	10%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HEARING EVALUATION	$423.00	$470.00	$305.50–$460.60	61% above	10%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HEARING EVALUATION	$423.00	$470.00	$305.50–$460.60	—	10%
Critical care, first 30 to 74 minutes CPT 99291 99291-TEAM CRIT CARE FIRST 30-74 MINS	$4,095.00	$4,550.00	$2,957.50–$4,459.00	39% above	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291-TEAM CRIT CARE FIRST 30-74 MINS	$4,095.00	$4,550.00	$2,957.50–$4,459.00	—	10%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$1,134.00	$1,260.00	$819.00–$1,234.80	19% above	10%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY	$1,134.00	$1,260.00	$819.00–$1,234.80	—	10%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG	$252.00	$280.00	$182.00–$274.40	at median	10%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ECG	$252.00	$280.00	$182.00–$274.40	—	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG, ROUTINE, MIN 12 LEADS, TRACING ONLY	$252.00	$280.00	$182.00–$274.40	36% above	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG, ROUTINE, MIN 12 LEADS, TRACING ONLY	$252.00	$280.00	$182.00–$274.40	—	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281-LEVEL 1	$234.00	$260.00	$169.00–$254.80	25% below	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281-LEVEL 1	$234.00	$260.00	$169.00–$254.80	—	10%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282-LEVEL 2	$468.00	$520.00	$338.00–$509.60	8% below	10%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282-LEVEL 2	$468.00	$520.00	$338.00–$509.60	—	10%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283-LEVEL 3	$837.00	$930.00	$604.50–$911.40	1% below	10%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283-LEVEL 3	$837.00	$930.00	$604.50–$911.40	—	10%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284-LEVEL 4	$1,215.00	$1,350.00	$877.50–$1,323.00	9% below	10%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284-LEVEL 4	$1,215.00	$1,350.00	$877.50–$1,323.00	—	10%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285-LEVEL 5	$2,430.00	$2,700.00	$1,755.00–$2,646.00	40% above	10%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285-LEVEL 5	$2,430.00	$2,700.00	$1,755.00–$2,646.00	—	10%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS TEST	$1,080.00	$1,200.00	$780.00–$1,176.00	20% above	10%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS TEST	$1,080.00	$1,200.00	$780.00–$1,176.00	—	10%
Eye exam, returning patient, intermediate CPT 92012 OPHTHALM SVCS, MEDICAL E&M, W/INITI OR CONT DX & TX PGRM, INTERM	$270.00	$300.00	$141.00–$294.00	11% below	10%
Eye exam, returning patient, intermediate inpatient CPT 92012 OPHTHALM SVCS, MEDICAL E&M, W/INITI OR CONT DX & TX PGRM, INTERM	$270.00	$300.00	$141.00–$294.00	—	10%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY W/PATIENT, 26+ MIN (90847)	$256.50	$285.00	$185.25–$279.30	14% below	10%
Family therapy with the patient, 50 minutes CPT 90847 FAM THRPY W/PATIENT PER VISIT, 26+ MIN	$279.00	$310.00	$201.50–$303.80	6% below	10%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY W/PATIENT, 26+ MIN (90847)	$256.50	$285.00	$185.25–$279.30	—	10%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAM THRPY W/PATIENT PER VISIT, 26+ MIN	$279.00	$310.00	$201.50–$303.80	—	10%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY THERAPY W/O PATIENT, 26+ MIN (90846)	$256.50	$285.00	$185.25–$279.30	17% below	10%
Family therapy without the patient, 50 minutes CPT 90846 FAM THPY W/O PATIENT PER VISIT, 26+ MIN	$378.00	$420.00	$273.00–$411.60	22% above	10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY THERAPY W/O PATIENT, 26+ MIN (90846)	$256.50	$285.00	$185.25–$279.30	—	10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAM THPY W/O PATIENT PER VISIT, 26+ MIN	$378.00	$420.00	$273.00–$411.60	—	10%
Group psychotherapy session CPT 90853 GROUP THERAPY (PATIENT GROUPS) (90853)	$107.10	$119.00	$77.35–$116.62	37% below	10%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY, NOT MULTI FAMILY	$162.00	$180.00	$117.00–$176.40	5% below	10%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY (PATIENT GROUPS) (90853)	$107.10	$119.00	$77.35–$116.62	—	10%
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY, NOT MULTI FAMILY	$162.00	$180.00	$117.00–$176.40	—	10%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 CARD HOLTER MONITOR	$1,476.00	$1,640.00	$1,066.00–$1,607.20	164% above	10%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 CARD HOLTER MONITOR	$1,476.00	$1,640.00	$1,066.00–$1,607.20	—	10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION, INITIAL, 31 MIN TO 1 HR	$189.00	$210.00	$136.50–$205.80	55% below	10%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION, INITIAL, 31 MIN TO 1 HR	$189.00	$210.00	$136.50–$205.80	—	10%
IV infusion of a medicine, first hour CPT 96365 THER IV INFUSION, INITIAL 1ST HR	$468.00	$520.00	$338.00–$509.60	8% above	10%
IV infusion of a medicine, first hour inpatient CPT 96365 THER IV INFUSION, INITIAL 1ST HR	$468.00	$520.00	$338.00–$509.60	—	10%
IV push of a medicine, first drug CPT 96374 THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG	$189.00	$210.00	$136.50–$205.80	26% below	10%
IV push of a medicine, first drug inpatient CPT 96374 THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG	$189.00	$210.00	$136.50–$205.80	—	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$46.80	$52.00	$33.80–$50.96	67% below	10%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$46.80	$52.00	$33.80–$50.96	—	10%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 DIAGNOSTIC ASSESSMENT (90791)	$325.80	$362.00	$235.30–$354.76	4% above	10%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL	$396.00	$440.00	$286.00–$431.20	26% above	10%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 DIAGNOSTIC ASSESSMENT (90791)	$325.80	$362.00	$235.30–$354.76	—	10%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL	$396.00	$440.00	$286.00–$431.20	—	10%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES	$2,133.00	$2,370.00	$1,540.50–$2,322.60	55% above	10%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES	$2,133.00	$2,370.00	$1,540.50–$2,322.60	—	10%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION, EA 15 MIN	$83.70	$93.00	$60.45–$91.14	24% below	10%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION, EA 15 MIN	$83.70	$93.00	$60.45–$91.14	—	10%
New patient office visit, about 30 minutes CPT 99203 99203-OFF VISIT NEW LVL 3	$266.40	$296.00	$192.40–$290.08	143% above	10%
New patient office visit, about 30 minutes inpatient CPT 99203 99203-OFF VISIT NEW LVL 3	$266.40	$296.00	$192.40–$290.08	—	10%
New patient office visit, about 45 minutes CPT 99204 99204-OFF VISIT NEW LVL 4	$343.80	$382.00	$248.30–$374.36	184% above	10%
New patient office visit, about 45 minutes inpatient CPT 99204 99204-OFF VISIT NEW LVL 4	$343.80	$382.00	$248.30–$374.36	—	10%
New patient office visit, about 60 minutes CPT 99205 99205-OFF VISIT NEW LVL 5	$443.70	$493.00	$320.45–$483.14	157% above	10%
New patient office visit, about 60 minutes inpatient CPT 99205 99205-OFF VISIT NEW LVL 5	$443.70	$493.00	$320.45–$483.14	—	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202-OFF VISIT NEW LVL 2	$177.30	$197.00	$128.05–$193.06	75% above	10%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202-OFF VISIT NEW LVL 2	$177.30	$197.00	$128.05–$193.06	—	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRITION TX, INITIAL ASSESS/INTERV, FACE TO FACE, EA 15 MIN	$37.80	$42.00	$27.30–$41.16	42% below	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTRITION TX, INITIAL ASSESS/INTERV, FACE TO FACE, EA 15 MIN	$37.80	$42.00	$27.30–$41.16	—	10%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL, LOW COMPLEXITY	$261.00	$290.00	$188.50–$284.20	at median	10%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL, LOW COMPLEXITY	$261.00	$290.00	$188.50–$284.20	—	10%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL, HIGH COMPLEXITY	$495.00	$550.00	$357.50–$539.00	64% above	10%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL, HIGH COMPLEXITY	$495.00	$550.00	$357.50–$539.00	—	10%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL, LOW COMPLEXITY	$261.00	$290.00	$188.50–$284.20	at median	10%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL, LOW COMPLEXITY	$261.00	$290.00	$188.50–$284.20	—	10%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL, MOD COMPLEXITY	$405.00	$450.00	$292.50–$441.00	46% above	10%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL, MOD COMPLEXITY	$405.00	$450.00	$292.50–$441.00	—	10%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY TECHNIQUES, 1 OR > REGIONS, EA 15 MIN	$83.70	$93.00	$60.45–$91.14	25% below	10%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY TECHNIQUES, 1 OR > REGIONS, EA 15 MIN	$83.70	$93.00	$60.45–$91.14	—	10%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE(S), EA 15 MIN	$83.70	$93.00	$60.45–$91.14	29% below	10%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE(S), EA 15 MIN	$83.70	$93.00	$60.45–$91.14	—	10%
Preventive checkup, new patient aged 18–39 CPT 99385 99385-PREV VISIT NEW 18-39YR	$180.00	$200.00	$94.00–$196.00	51% above	10%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385-PREV VISIT NEW 18-39YR	$180.00	$200.00	$94.00–$196.00	—	10%
Preventive checkup, new patient aged 40–64 CPT 99386 99386-PREV VISIT NEW 40-64YR	$180.00	$200.00	$94.00–$196.00	24% above	10%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386-PREV VISIT NEW 40-64YR	$180.00	$200.00	$94.00–$196.00	—	10%
Preventive checkup, new patient aged 65 or older CPT 99387 99387-PREV VISIT NEW 65 & OVER	$180.00	$200.00	$94.00–$196.00	15% above	10%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 99387-PREV VISIT NEW 65 & OVER	$180.00	$200.00	$94.00–$196.00	—	10%
Preventive checkup, returning patient aged 18–39 CPT 99395 99395-PREV VISIT EST 18-39YR	$180.00	$200.00	$94.00–$196.00	44% above	10%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 99395-PREV VISIT EST 18-39YR	$180.00	$200.00	$94.00–$196.00	—	10%
Preventive checkup, returning patient aged 40–64 CPT 99396 99396-PREV VISIT EST 40-64YR	$180.00	$200.00	$94.00–$196.00	43% above	10%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 99396-PREV VISIT EST 40-64YR	$180.00	$200.00	$94.00–$196.00	—	10%
Preventive checkup, returning patient aged 65 or older CPT 99397 99397-PREV VISIT EST 65 & OVER	$180.00	$200.00	$94.00–$196.00	40% above	10%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 99397-PREV VISIT EST 65 & OVER	$180.00	$200.00	$94.00–$196.00	—	10%
Psychiatric evaluation with medical services CPT 90792 90792-PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES (28)	$456.30	$507.00	$329.55–$496.86	29% above	10%
Psychiatric evaluation with medical services inpatient CPT 90792 90792-PSYCHIATRIC DIAGNOSTIC EVALUATION W/MEDICAL SERVICES (28)	$456.30	$507.00	$329.55–$496.86	—	10%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCH TESTING, PSYCHOLOGIST/QHP, FIRST HOUR	$315.90	$351.00	$228.15–$343.98	25% below	10%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCH TESTING, QHP, FIRST HOUR	$450.00	$500.00	$325.00–$490.00	6% above	10%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCH TESTING, PSYCHOLOGIST/QHP, FIRST HOUR	$315.90	$351.00	$228.15–$343.98	—	10%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCH TESTING, QHP, FIRST HOUR	$450.00	$500.00	$325.00–$490.00	—	10%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS, FIRST 60 MIN (90839)	$261.00	$290.00	$188.50–$284.20	17% below	10%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS, 60 MIN	$459.00	$510.00	$331.50–$499.80	47% above	10%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS, FIRST 60 MIN (90839)	$261.00	$290.00	$188.50–$284.20	—	10%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS, 60 MIN	$459.00	$510.00	$331.50–$499.80	—	10%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 16-37 MIN W/PATIENT (90832)	$107.10	$119.00	$77.35–$116.62	43% below	10%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 16-37 MIN W/ PATIENT	$180.00	$200.00	$130.00–$196.00	5% below	10%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 16-37 MIN W/PATIENT (90832)	$107.10	$119.00	$77.35–$116.62	—	10%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 16-37 MIN W/ PATIENT	$180.00	$200.00	$130.00–$196.00	—	10%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 38-52 MIN, W/PATIENT (90834)	$153.90	$171.00	$111.15–$167.58	42% below	10%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 38-52 MIN W/ PATIENT	$333.00	$370.00	$240.50–$362.60	25% above	10%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 38-52 MIN, W/PATIENT (90834)	$153.90	$171.00	$111.15–$167.58	—	10%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 38-52 MIN W/ PATIENT	$333.00	$370.00	$240.50–$362.60	—	10%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 53+ MIN, W/PATIENT (90837)	$200.70	$223.00	$144.95–$218.54	36% below	10%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY, 53+ MIN W/ PATIENT	$459.00	$510.00	$331.50–$499.80	47% above	10%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 53+ MIN, W/PATIENT (90837)	$200.70	$223.00	$144.95–$218.54	—	10%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 53+ MIN W/ PATIENT	$459.00	$510.00	$331.50–$499.80	—	10%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING/TOBACCO CESSATION COUNSEL 3-10 MIN	$27.90	$31.00	$14.57–$30.38	36% below	10%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING/TOBACCO CESSATION COUNSEL 3-10 MIN	$27.90	$31.00	$14.57–$30.38	—	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215-OFF VISIT EST LVL 5	$297.90	$331.00	$215.15–$324.38	77% above	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 BM DONOR PHYSICAL EXAM - US	$4,014.00	$4,460.00	$2,899.00–$4,370.80	2284% above	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PBSC DONOR PHYSICAL EXAM - US	$4,023.00	$4,470.00	$2,905.50–$4,380.60	2289% above	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 BONE MARROW WORKUP CANCEL-US	$4,086.00	$4,540.00	$2,951.00–$4,449.20	2327% above	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PBSC WORKUP CANCEL - US	$4,221.00	$4,690.00	$3,048.50–$4,596.20	2407% above	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215-OFF VISIT EST LVL 5	$297.90	$331.00	$215.15–$324.38	—	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 BM DONOR PHYSICAL EXAM - US	$4,014.00	$4,460.00	$2,899.00–$4,370.80	—	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PBSC DONOR PHYSICAL EXAM - US	$4,023.00	$4,470.00	$2,905.50–$4,380.60	—	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 BONE MARROW WORKUP CANCEL-US	$4,086.00	$4,540.00	$2,951.00–$4,449.20	—	10%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PBSC WORKUP CANCEL - US	$4,221.00	$4,690.00	$3,048.50–$4,596.20	—	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213-OFF VISIT EST LVL 3	$188.10	$209.00	$135.85–$204.82	62% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PBSC DONOR INFO. SESSION - US	$1,170.00	$1,300.00	$611.00–$1,274.00	907% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 BM DONOR INFO. SESSION - US	$1,206.00	$1,340.00	$871.00–$1,313.20	938% above	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213-OFF VISIT EST LVL 3	$188.10	$209.00	$135.85–$204.82	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PBSC DONOR INFO. SESSION - US	$1,170.00	$1,300.00	$611.00–$1,274.00	—	10%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 BM DONOR INFO. SESSION - US	$1,206.00	$1,340.00	$871.00–$1,313.20	—	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214-OFF VISIT EST LVL 4	$243.90	$271.00	$176.15–$265.58	78% above	10%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214-OFF VISIT EST LVL 4	$243.90	$271.00	$176.15–$265.58	—	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212-OFF VISIT EST LVL 2	$132.30	$147.00	$95.55–$144.06	31% above	10%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212-OFF VISIT EST LVL 2	$132.30	$147.00	$95.55–$144.06	—	10%
Speech and language evaluation CPT 92523 EVAL OF SPEECH SOUND PROD WITH LANGUAGE COMPREHENSION	$630.00	$700.00	$455.00–$686.00	85% above	10%
Speech and language evaluation inpatient CPT 92523 EVAL OF SPEECH SOUND PROD WITH LANGUAGE COMPREHENSION	$630.00	$700.00	$455.00–$686.00	—	10%
Speech therapy session, individual CPT 92507 INDIVIDUAL SPEECH/HEARING THERAPY	$243.00	$270.00	$175.50–$264.60	11% above	10%
Speech therapy session, individual inpatient CPT 92507 INDIVIDUAL SPEECH/HEARING THERAPY	$243.00	$270.00	$175.50–$264.60	—	10%
Spirometry (breathing test) CPT 94010 SPIROMETRY, INC RECORD, VITAL CAP, EXP RATE, W/ OR W/O MAX VOL V	$85.50	$95.00	$61.75–$93.10	72% below	10%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY, INC RECORD, VITAL CAP, EXP RATE, W/ OR W/O MAX VOL V	$85.50	$95.00	$61.75–$93.10	—	10%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY, PRE/POST BRONCH	$85.50	$95.00	$61.75–$93.10	85% below	10%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY, PRE/POST BRONCH	$85.50	$95.00	$61.75–$93.10	—	10%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES, DIRECT, EA 15 MIN	$83.70	$93.00	$60.45–$91.14	32% below	10%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES, DIRECT, EA 15 MIN	$83.70	$93.00	$60.45–$91.14	—	10%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$37.80	$42.00	$19.74–$41.16	84% below	10%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$37.80	$42.00	$19.74–$41.16	—	10%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 DRUG CHALLENGE	$1,206.00	$1,340.00	$871.00–$1,313.20	54% above	10%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 DRUG CHALLENGE	$1,206.00	$1,340.00	$871.00–$1,313.20	—	10%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML IM SYRG	$148.50	$165.00	$107.25–$161.70	55% below	10%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML IM SYRG	$148.50	$165.00	$15.35	55% below	10%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML IM SYRG	$148.50	$165.00	$107.25–$161.70	—	10%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML IM SYRG	$148.50	$165.00	$107.25–$161.70	—	10%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR	$612.82	$680.91	$25.88	65% above	10%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR	$612.82	$680.91	$442.59–$667.29	65% above	10%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR	$612.82	$680.91	$442.59–$667.29	—	10%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR	$612.82	$680.91	$442.59–$667.29	—	10%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRG	$201.41	$223.79	$105.18–$219.31	56% above	10%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRG	$201.41	$223.79	$15.35	56% above	10%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRG	$201.41	$223.79	$105.18–$219.31	—	10%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRG	$201.41	$223.79	$105.18–$219.31	—	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE < 7YRS IM, ODH	$9.00	$10.00	$4.70–$9.80	86% below	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX (DTAP) (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG	$98.42	$109.36	$51.40–$107.17	52% above	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX (DTAP) (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG	$98.42	$109.36	$15.35	52% above	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP VACCINE < 7YRS IM, ODH	$9.00	$10.00	$4.70–$9.80	—	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX (DTAP) (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG	$98.42	$109.36	$51.40–$107.17	—	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX (DTAP) (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG	$98.42	$109.36	$51.40–$107.17	—	10%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG	$336.41	$373.79	$242.96–$366.31	72% above	10%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG	$336.41	$373.79	$15.35	72% above	10%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG	$336.41	$373.79	$242.96–$366.31	—	10%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG	$336.41	$373.79	$242.96–$366.31	—	10%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG	$348.96	$387.73	$15.35	2% above	10%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG	$348.96	$387.73	$182.23–$379.98	2% above	10%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG	$348.96	$387.73	$182.23–$379.98	—	10%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG	$348.96	$387.73	$182.23–$379.98	—	10%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TRIVALENT (PF) 0.5 ML IM, ODH	$9.00	$10.00	$4.70–$9.80	80% below	10%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$36.00	$40.00	$26.00–$39.20	21% below	10%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLULAVAL 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$36.00	$40.00	$18.80–$39.20	21% below	10%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUARIX 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$36.00	$40.00	$26.00–$39.20	21% below	10%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUARIX 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$36.00	$40.00	$15.35	21% below	10%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$36.00	$40.00	$15.35	21% below	10%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLULAVAL 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$36.00	$40.00	$15.35	21% below	10%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TRIVALENT (PF) 0.5 ML IM, ODH	$9.00	$10.00	$4.70–$9.80	—	10%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$36.00	$40.00	$26.00–$39.20	—	10%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLULAVAL 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$36.00	$40.00	$18.80–$39.20	—	10%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLULAVAL 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$36.00	$40.00	$18.80–$39.20	—	10%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$36.00	$40.00	$26.00–$39.20	—	10%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUARIX 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$36.00	$40.00	$26.00–$39.20	—	10%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUARIX 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$36.00	$40.00	$26.00–$39.20	—	10%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML IM SYRG	$1,012.34	$1,124.82	$528.67–$1,102.32	95% above	10%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML IM SYRG	$1,012.34	$1,124.82	$25.88	95% above	10%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML IM SYRG	$1,012.34	$1,124.82	$528.67–$1,102.32	—	10%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML IM SYRG	$1,012.34	$1,124.82	$528.67–$1,102.32	—	10%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TWINREX VACCINE PER DOSE	$639.00	$710.00	$333.70–$695.80	108% above	10%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TWINREX VACCINE PER DOSE	$639.00	$710.00	$333.70–$695.80	—	10%
Hepatitis A vaccine, adult dose CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML IM SYRG	$275.68	$306.31	$199.10–$300.18	42% above	10%
Hepatitis A vaccine, adult dose CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML IM SYRG	$275.68	$306.31	$15.35	42% above	10%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML IM SYRG	$275.68	$306.31	$199.10–$300.18	—	10%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML IM SYRG	$275.68	$306.31	$199.10–$300.18	—	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 EL UNIT/0.5 ML IM SUSP, ODH	$9.00	$10.00	$4.70–$9.80	90% below	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML IM SYRG	$124.09	$137.88	$15.35	38% above	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML IM SYRG	$124.09	$137.88	$64.80–$135.12	38% above	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 EL UNIT/0.5 ML IM SUSP, ODH	$9.00	$10.00	$4.70–$9.80	—	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML IM SYRG	$124.09	$137.88	$64.80–$135.12	—	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML IM SYRG	$124.09	$137.88	$64.80–$135.12	—	10%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (PF) 20 MCG/ML IM SYRG	$231.19	$256.88	$15.35	48% above	10%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (PF) 20 MCG/ML IM SYRG	$231.19	$256.88	$166.97–$251.74	48% above	10%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (PF) 20 MCG/ML IM SYRG	$231.19	$256.88	$166.97–$251.74	—	10%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (PF) 20 MCG/ML IM SYRG	$231.19	$256.88	$166.97–$251.74	—	10%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML IM SYRG	$428.31	$475.90	$309.34–$466.38	96% above	10%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML IM SYRG	$428.31	$475.90	$15.35	96% above	10%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML IM SYRG	$428.31	$475.90	$309.34–$466.38	—	10%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML IM SYRG	$428.31	$475.90	$309.34–$466.38	—	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE PED/ADOL IM SUSP, ODH	$9.00	$10.00	$4.70–$9.80	85% below	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML IM SYRG	$98.11	$109.01	$15.35	64% above	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML IM SYRG	$98.11	$109.01	$70.86–$106.83	64% above	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE PED/ADOL IM SUSP, ODH	$9.00	$10.00	$4.70–$9.80	—	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML IM SYRG	$98.11	$109.01	$70.86–$106.83	—	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML IM SYRG	$98.11	$109.01	$70.86–$106.83	—	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM, ODH	$9.00	$10.00	$4.70–$9.80	71% below	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML IM SOLR	$40.53	$45.03	$29.27–$44.13	33% above	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML IM SOLR	$40.53	$45.03	$15.35	33% above	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM, ODH	$9.00	$10.00	$4.70–$9.80	—	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML IM SOLR	$40.53	$45.03	$29.27–$44.13	—	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML IM SOLR	$40.53	$45.03	$29.27–$44.13	—	10%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE 2025-26 (PF) 180 MCG/0.5 ML IM SYRG	$36.00	$40.00	$15.35	65% below	10%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE 2025-26 (PF) 180 MCG/0.5 ML IM SYRG	$36.00	$40.00	$26.00–$39.20	65% below	10%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE 2025-26 (PF) 180 MCG/0.5 ML IM SYRG	$36.00	$40.00	$26.00–$39.20	—	10%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE 2025-26 (PF) 180 MCG/0.5 ML IM SYRG	$36.00	$40.00	$26.00–$39.20	—	10%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 IXIARO (PF) 6 MCG/0.5 ML IM SYRG	$990.59	$1,100.65	$715.42–$1,078.64	28% below	10%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 IXIARO (PF) 6 MCG/0.5 ML IM SYRG	$990.59	$1,100.65	$25.88	28% below	10%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 IXIARO (PF) 6 MCG/0.5 ML IM SYRG	$990.59	$1,100.65	$715.42–$1,078.64	—	10%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 IXIARO (PF) 6 MCG/0.5 ML IM SYRG	$990.59	$1,100.65	$715.42–$1,078.64	—	10%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLR	$290.11	$322.34	$15.35	39% above	10%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLR	$290.11	$322.34	$151.50–$315.89	39% above	10%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLR	$290.11	$322.34	$151.50–$315.89	—	10%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLR	$290.11	$322.34	$151.50–$315.89	—	10%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PROQUAD (PF) 10EXP3-4.3-3- 3.99 TCID50/0.5 SUBCUTANEOUS SUSR	$903.49	$1,003.88	$652.52–$983.80	77% above	10%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PROQUAD (PF) 10EXP3-4.3-3- 3.99 TCID50/0.5 SUBCUTANEOUS SUSR	$903.49	$1,003.88	$15.35	77% above	10%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PROQUAD (PF) 10EXP3-4.3-3- 3.99 TCID50/0.5 SUBCUTANEOUS SUSR	$903.49	$1,003.88	$652.52–$983.80	—	10%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PROQUAD (PF) 10EXP3-4.3-3- 3.99 TCID50/0.5 SUBCUTANEOUS SUSR	$903.49	$1,003.88	$652.52–$983.80	—	10%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10-5 MCG/0.5 ML IM KIT	$513.05	$570.05	$370.53–$558.65	62% above	10%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10-5 MCG/0.5 ML IM KIT	$513.05	$570.05	$25.88	62% above	10%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10-5 MCG/0.5 ML IM KIT	$513.05	$570.05	$370.53–$558.65	—	10%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10-5 MCG/0.5 ML IM KIT	$513.05	$570.05	$370.53–$558.65	—	10%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML IM SOLUTION	$376.63	$418.48	$196.69–$410.11	6% below	10%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML IM SOLUTION	$376.63	$418.48	$25.88	6% below	10%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML IM SOLUTION	$376.63	$418.48	$196.69–$410.11	—	10%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML IM SOLUTION	$376.63	$418.48	$196.69–$410.11	—	10%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO 50-50-50-25 MCG/0.5 ML IM SYRG	$700.13	$777.92	$25.88	27% above	10%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO 50-50-50-25 MCG/0.5 ML IM SYRG	$700.13	$777.92	$365.62–$762.36	27% above	10%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO 50-50-50-25 MCG/0.5 ML IM SYRG	$700.13	$777.92	$365.62–$762.36	—	10%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO 50-50-50-25 MCG/0.5 ML IM SYRG	$700.13	$777.92	$365.62–$762.36	—	10%
Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST TRIVALENT NASAL, ODH	$9.00	$10.00	$4.70–$9.80	77% below	10%
Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL NSSY	$36.00	$40.00	$15.35	9% below	10%
Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL NSSY	$36.00	$40.00	$18.80–$39.20	9% below	10%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST TRIVALENT NASAL, ODH	$9.00	$10.00	$4.70–$9.80	—	10%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL NSSY	$36.00	$40.00	$18.80–$39.20	—	10%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL NSSY	$36.00	$40.00	$18.80–$39.20	—	10%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (PF) 0.5 ML IM SYRG	$884.57	$982.86	$25.88	34% above	10%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (PF) 0.5 ML IM SYRG	$884.57	$982.86	$461.94–$963.20	34% above	10%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (PF) 0.5 ML IM SYRG	$884.57	$982.86	$461.94–$963.20	—	10%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (PF) 0.5 ML IM SYRG	$884.57	$982.86	$461.94–$963.20	—	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRG	$352.82	$392.02	$15.35	28% above	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRG	$352.82	$392.02	$254.81–$384.18	28% above	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRG	$352.82	$392.02	$254.81–$384.18	—	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRG	$352.82	$392.02	$254.81–$384.18	—	10%
Polio vaccine, inactivated (IPV) CPT 90713 IPOL 40-8-32 UNIT/0.5 ML INJECTION SUSP	$97.20	$108.00	$15.35	53% above	10%
Polio vaccine, inactivated (IPV) CPT 90713 IPOL 40-8-32 UNIT/0.5 ML INJECTION SUSP	$97.20	$108.00	$50.76–$105.84	53% above	10%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL 40-8-32 UNIT/0.5 ML INJECTION SUSP	$97.20	$108.00	$50.76–$105.84	—	10%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL 40-8-32 UNIT/0.5 ML INJECTION SUSP	$97.20	$108.00	$50.76–$105.84	—	10%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 BEYFORTUS 100 MG/ML IM SYRG	$1,400.35	$1,555.94	$731.29–$1,524.82	35% above	10%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 BEYFORTUS 100 MG/ML IM SYRG	$1,400.35	$1,555.94	$2,152.38	35% above	10%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 BEYFORTUS 100 MG/ML IM SYRG	$1,400.35	$1,555.94	$731.29–$1,524.82	—	10%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 BEYFORTUS 100 MG/ML IM SYRG	$1,400.35	$1,555.94	$731.29–$1,524.82	—	10%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 50 MG/0.5 ML IM SYRG	$1,400.35	$1,555.94	$731.29–$1,524.82	4% above	10%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 50 MG/0.5 ML IM SYRG	$1,400.35	$1,555.94	$2,152.38	4% above	10%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS 50 MG/0.5 ML IM SYRG	$1,400.35	$1,555.94	$731.29–$1,524.82	—	10%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS 50 MG/0.5 ML IM SYRG	$1,400.35	$1,555.94	$731.29–$1,524.82	—	10%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML IM SOLR	$914.99	$1,016.65	$15.35	27% above	10%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML IM SOLR	$914.99	$1,016.65	$660.82–$996.32	27% above	10%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML IM SOLR	$914.99	$1,016.65	$660.82–$996.32	—	10%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML IM SOLR	$914.99	$1,016.65	$660.82–$996.32	—	10%
Rabies vaccine, one dose CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSR	$1,406.83	$1,563.14	$1,016.04–$1,531.88	48% above	10%
Rabies vaccine, one dose CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSR	$1,406.83	$1,563.14	$25.88	48% above	10%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSR	$1,406.83	$1,563.14	$1,016.04–$1,531.88	—	10%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSR	$1,406.83	$1,563.14	$1,016.04–$1,531.88	—	10%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTARIX 10EXP6 CCID50 /1.5 ML ORAL SUSP	$479.37	$532.63	$250.34–$521.98	83% above	10%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTARIX 10EXP6 CCID50 /1.5 ML ORAL SUSP	$479.37	$532.63	$15.35	83% above	10%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTARIX 10EXP6 CCID50 /1.5 ML ORAL SUSP	$479.37	$532.63	$250.34–$521.98	—	10%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTARIX 10EXP6 CCID50 /1.5 ML ORAL SUSP	$479.37	$532.63	$250.34–$521.98	—	10%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML IM SUSR	$668.83	$743.14	$25.88	33% above	10%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML IM SUSR	$668.83	$743.14	$483.04–$728.28	33% above	10%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML IM SUSR	$668.83	$743.14	$483.04–$728.28	—	10%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML IM SUSR	$668.83	$743.14	$483.04–$728.28	—	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOXOID IM SUSP, ODH	$9.00	$10.00	$4.70–$9.80	90% below	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5-2 LF UNIT/0.5 ML IM SYRG	$103.33	$114.81	$74.63–$112.51	15% above	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5-2 LF UNIT/0.5 ML IM SYRG	$103.33	$114.81	$15.35	15% above	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOXOID IM SUSP, ODH	$9.00	$10.00	$4.70–$9.80	—	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5-2 LF UNIT/0.5 ML IM SYRG	$103.33	$114.81	$74.63–$112.51	—	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5-2 LF UNIT/0.5 ML IM SYRG	$103.33	$114.81	$74.63–$112.51	—	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL(TDAP ADOLESN/ADULT)(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYRG	$129.15	$143.50	$15.35	17% above	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL(TDAP ADOLESN/ADULT)(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYRG	$129.15	$143.50	$67.45–$140.63	17% above	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL(TDAP ADOLESN/ADULT)(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYRG	$129.15	$143.50	$67.45–$140.63	—	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL(TDAP ADOLESN/ADULT)(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYRG	$129.15	$143.50	$67.45–$140.63	—	10%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML IM SYRG	$382.87	$425.41	$276.52–$416.90	34% above	10%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML IM SYRG	$382.87	$425.41	$15.35	34% above	10%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML IM SYRG	$382.87	$425.41	$276.52–$416.90	—	10%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML IM SYRG	$382.87	$425.41	$276.52–$416.90	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN, ONE VACCINE	$19.13	$21.25	$13.81–$20.83	53% below	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ ADMIN, ONE VACCINE	$19.13	$21.25	$13.81–$20.83	—	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN, EA ADDL	$12.15	$13.50	$8.78–$13.23	65% below	10%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZ ADMIN, EA ADDL	$12.15	$13.50	$8.78–$13.23	—	10%
Yellow fever vaccine, live CPT 90717 YF-VAX (PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSR	$472.20	$524.67	$25.88	12% above	10%
Yellow fever vaccine, live CPT 90717 YF-VAX (PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSR	$472.20	$524.67	$341.04–$514.18	12% above	10%
Yellow fever vaccine, live inpatient CPT 90717 YF-VAX (PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSR	$472.20	$524.67	$341.04–$514.18	—	10%
Yellow fever vaccine, live inpatient CPT 90717 YF-VAX (PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSR	$472.20	$524.67	$341.04–$514.18	—	10%

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

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

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

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

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

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

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

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

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

Source file: https://nationwidechildrens.pt.panaceainc.com/MRFDownload/nationwidechildrens/nationwidechildrens