Northern Light Maine Coast Hospital
Listed in its price file as “Maine Coast Regional Health Facilities”.
Northern Light Maine Coast Hospital in Ellsworth, ME publishes cash prices for 369 common procedures listed here, from its own machine-readable price file updated Mar 30, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Maine median for 301 of 367 procedures and above it for 55. By typical cash price it ranks #4 of 28 Maine hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
50 Union St, Ellsworth, Maine 04605 Collected Sep 22, 2026 Source price file Check a bill from this hospital (207) 667-5311
Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 200050 · CMS hospital register NPI 1740249739
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Northern Light Maine Coast 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.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Renal w & w/o Contrast | $551.75 | $2,207.00 | $1,105.71–$1,774.43 | 61% below | 75% |
| Abdominal CT scan without and with contrast CPT 74170 CT Exam DTA | $551.75 | $2,207.00 | $1,105.71–$1,774.43 | 61% below | 75% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Exam DTA | $551.75 | $2,207.00 | $1,434.55–$1,646.42 | — | 75% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Renal w & w/o Contrast | $551.75 | $2,207.00 | $1,434.55–$1,646.42 | — | 75% |
| Abdominal X-ray, 2 views CPT 74019 XRBMC Abdomen 2 Views | $113.50 | $454.00 | $227.45–$365.02 | 53% below | 75% |
| Abdominal X-ray, 2 views CPT 74019 Rad Exam DTA | $113.50 | $454.00 | $227.45–$365.02 | 53% below | 75% |
| Abdominal X-ray, 2 views inpatient CPT 74019 Rad Exam DTA | $113.50 | $454.00 | $295.10–$338.68 | — | 75% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XRBMC Abdomen 2 Views | $113.50 | $454.00 | $295.10–$338.68 | — | 75% |
| Ankle X-ray, complete, 3 or more views CPT 73610 X-Ray Exam Ankle Read Only In Office 73610 | $110.50 | $442.00 | $221.44–$355.37 | 48% below | 75% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-Ray Exam Ankle Read Only In Office 73610 | $110.50 | $442.00 | $287.30–$329.73 | — | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Ankle Brachial Index | $70.00 | $280.00 | $140.28–$225.12 | 52% below | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Vasc Upper/Lower Extrem Art 1-2 Lvl Bil Ltd (In Office) 93922 | $81.25 | $325.00 | $162.82–$261.30 | 44% below | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Ankle Brachial Index | $70.00 | $280.00 | $182.00–$208.88 | — | 75% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Vasc Upper/Lower Extrem Art 1-2 Lvl Bil Ltd (In Office) 93922 | $81.25 | $325.00 | $211.25–$242.45 | — | 75% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Fluoro Exam DTA | $195.50 | $782.00 | $391.78–$628.73 | 45% below | 75% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Fluoro Exam DTA | $195.50 | $782.00 | $508.30–$583.37 | — | 75% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Exam DTA | $438.25 | $1,753.00 | $878.25–$1,409.41 | 63% below | 75% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Exam DTA | $438.25 | $1,753.00 | $1,139.45–$1,307.74 | — | 75% |
| Breast ultrasound, complete, one breast one side CPT 76641 USBMC Breast Sonogram Complete Left | $117.00 | $468.00 | $234.47–$376.27 | 42% below | 75% |
| Breast ultrasound, complete, one breast one side CPT 76641 USBMC Breast Sonogram Complete Right | $117.00 | $468.00 | $234.47–$376.27 | 42% below | 75% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 USBMC Breast Sonogram Complete Left | $117.00 | $468.00 | $304.20–$349.13 | — | 75% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 USBMC Breast Sonogram Complete Right | $117.00 | $468.00 | $304.20–$349.13 | — | 75% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 USBMC Breast Sonogram Limited Bilateral | $209.00 | $836.00 | $418.84–$672.14 | — | 75% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 USBMC Breast Sonogram Limited Right | $104.50 | $418.00 | $209.42–$336.07 | 56% below | 75% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 USBMC Breast Sonogram Limited Left | $104.50 | $418.00 | $209.42–$336.07 | 56% below | 75% |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 USBMC Breast Sonogram Limited Bilateral | $209.00 | $836.00 | $543.40–$623.66 | — | 75% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 USBMC Breast Sonogram Limited Left | $104.50 | $418.00 | $271.70–$311.83 | — | 75% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 USBMC Breast Sonogram Limited Right | $104.50 | $418.00 | $271.70–$311.83 | — | 75% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTBMC CTA Abdomen/Pelvis | $1,210.50 | $4,842.00 | $2,425.84–$3,892.97 | 21% below | 75% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTBMC CTA Abdomen/Pelvis | $1,210.50 | $4,842.00 | $3,147.30–$3,612.13 | — | 75% |
| CT angiography (CTA) of the head CPT 70496 CTBMC CTA Head w & w/o Contrast | $566.25 | $2,265.00 | $1,134.77–$1,821.06 | 64% below | 75% |
| CT angiography (CTA) of the head CPT 70496 CT Exam DTA | $566.25 | $2,265.00 | $1,134.77–$1,821.06 | 64% below | 75% |
| CT angiography (CTA) of the head CPT 70496 CT CTA Head | $566.25 | $2,265.00 | $1,134.77–$1,821.06 | 64% below | 75% |
| CT angiography (CTA) of the head CPT 70496 CT Venogram Head | $566.25 | $2,265.00 | $1,134.77–$1,821.06 | 64% below | 75% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Venogram Head | $566.25 | $2,265.00 | $1,472.25–$1,689.69 | — | 75% |
| CT angiography (CTA) of the head inpatient CPT 70496 CTBMC CTA Head w & w/o Contrast | $566.25 | $2,265.00 | $1,472.25–$1,689.69 | — | 75% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Exam DTA | $566.25 | $2,265.00 | $1,472.25–$1,689.69 | — | 75% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT CTA Head | $566.25 | $2,265.00 | $1,472.25–$1,689.69 | — | 75% |
| CT angiography (CTA) of the neck CPT 70498 CT CTA Neck | $581.00 | $2,324.00 | $1,164.32–$1,868.50 | 63% below | 75% |
| CT angiography (CTA) of the neck CPT 70498 CT Exam DTA | $581.00 | $2,324.00 | $1,164.32–$1,868.50 | 63% below | 75% |
| CT angiography (CTA) of the neck CPT 70498 CTBMC CTA Neck w & w/o Contrast | $581.00 | $2,324.00 | $1,164.32–$1,868.50 | 63% below | 75% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Exam DTA | $581.00 | $2,324.00 | $1,510.60–$1,733.70 | — | 75% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CTBMC CTA Neck w & w/o Contrast | $581.00 | $2,324.00 | $1,510.60–$1,733.70 | — | 75% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT CTA Neck | $581.00 | $2,324.00 | $1,510.60–$1,733.70 | — | 75% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTBMC CTA Chest | $720.75 | $2,883.00 | $1,444.38–$2,317.93 | 61% below | 75% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTBMC CTA Chest | $720.75 | $2,883.00 | $1,873.95–$2,150.72 | — | 75% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT CTA Heart Coronary Arteries | $357.25 | $1,429.00 | $715.93–$1,148.92 | 32% below | 75% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT CTA Heart Coronary Arteries w/Cont | $357.25 | $1,429.00 | $715.93–$1,148.92 | 32% below | 75% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT CTA Heart Coronary Arteries | $357.25 | $1,429.00 | $928.85–$1,066.03 | — | 75% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT CTA Heart Coronary Arteries w/Cont | $357.25 | $1,429.00 | $928.85–$1,066.03 | — | 75% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Coronary Calcium Scoring | $88.00 | $352.00 | $176.35–$283.01 | 33% below | 75% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Coronary Calcium Scoring | $88.00 | $352.00 | $228.80–$262.59 | — | 75% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Renal Stone Abd/Pelvis w/o Contrast | $812.25 | $3,249.00 | $1,627.75–$2,612.20 | 42% below | 75% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast | $812.25 | $3,249.00 | $1,627.75–$2,612.20 | 42% below | 75% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast | $812.25 | $3,249.00 | $2,111.85–$2,423.75 | — | 75% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Renal Stone Abd/Pelvis w/o Contrast | $812.25 | $3,249.00 | $2,111.85–$2,423.75 | — | 75% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography | $974.25 | $3,897.00 | $1,952.40–$3,133.19 | 51% below | 75% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd/Pelvis Pancreas Protocol w/Cont | $974.25 | $3,897.00 | $1,952.40–$3,133.19 | 51% below | 75% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd/Pelvis Liver Protocol w/Cont | $974.25 | $3,897.00 | $1,952.40–$3,133.19 | 51% below | 75% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd & Pelvis with Contrast Exam DTA | $974.25 | $3,897.00 | $1,952.40–$3,133.19 | 51% below | 75% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT IV Contrast Only Abdomen & Pelvis | $974.25 | $3,897.00 | $1,952.40–$3,133.19 | 51% below | 75% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography | $974.25 | $3,897.00 | $2,533.05–$2,907.16 | — | 75% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd/Pelvis Liver Protocol w/Cont | $974.25 | $3,897.00 | $2,533.05–$2,907.16 | — | 75% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd & Pelvis with Contrast Exam DTA | $974.25 | $3,897.00 | $2,533.05–$2,907.16 | — | 75% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd/Pelvis Pancreas Protocol w/Cont | $974.25 | $3,897.00 | $2,533.05–$2,907.16 | — | 75% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT IV Contrast Only Abdomen & Pelvis | $974.25 | $3,897.00 | $2,533.05–$2,907.16 | — | 75% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd/Pelvis Liver Protocol w&wo Cont | $1,100.50 | $4,402.00 | $2,205.40–$3,539.21 | 50% below | 75% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd & Pelvis w & w/o Cont Exam DTA | $1,100.50 | $4,402.00 | $2,205.40–$3,539.21 | 50% below | 75% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Hematuria w & w/o Contrast | $1,100.50 | $4,402.00 | $2,205.40–$3,539.21 | 50% below | 75% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Hematuria w & w/o Contrast | $1,100.50 | $4,402.00 | $2,861.30–$3,283.89 | — | 75% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd/Pelvis Liver Protocol w&wo Cont | $1,100.50 | $4,402.00 | $2,861.30–$3,283.89 | — | 75% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd & Pelvis w & w/o Cont Exam DTA | $1,100.50 | $4,402.00 | $2,861.30–$3,283.89 | — | 75% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen with Pancreatic Protocol | $416.00 | $1,664.00 | $833.66–$1,337.86 | 63% below | 75% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen with Liver Protocol | $416.00 | $1,664.00 | $833.66–$1,337.86 | 63% below | 75% |
| CT scan of the abdomen with contrast CPT 74160 CT Exam DTA | $416.00 | $1,664.00 | $833.66–$1,337.86 | 63% below | 75% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen with Liver Protocol | $416.00 | $1,664.00 | $1,081.60–$1,241.34 | — | 75% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Exam DTA | $416.00 | $1,664.00 | $1,081.60–$1,241.34 | — | 75% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen with Pancreatic Protocol | $416.00 | $1,664.00 | $1,081.60–$1,241.34 | — | 75% |
| CT scan of the abdomen without contrast CPT 74150 CT Exam DTA | $321.25 | $1,285.00 | $643.78–$1,033.14 | 62% below | 75% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Exam DTA | $321.25 | $1,285.00 | $835.25–$958.61 | — | 75% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillo/Facial w/o Contrast w/3D | $301.50 | $1,206.00 | $604.21–$969.62 | 66% below | 75% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 MCO CT Maxillo/Facial w/o Contrast | $301.50 | $1,206.00 | $604.21–$969.62 | 66% below | 75% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Exam DTA | $301.50 | $1,206.00 | $604.21–$969.62 | 66% below | 75% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Exam DTA | $301.50 | $1,206.00 | $783.90–$899.68 | — | 75% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillo/Facial w/o Contrast w/3D | $301.50 | $1,206.00 | $783.90–$899.68 | — | 75% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 MCO CT Maxillo/Facial w/o Contrast | $301.50 | $1,206.00 | $783.90–$899.68 | — | 75% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain Stroke Protocol | $401.75 | $1,607.00 | $805.11–$1,292.03 | 59% below | 75% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Exam DTA | $401.75 | $1,607.00 | $805.11–$1,292.03 | 59% below | 75% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain Stroke Protocol | $401.75 | $1,607.00 | $1,044.55–$1,198.82 | — | 75% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Exam DTA | $401.75 | $1,607.00 | $1,044.55–$1,198.82 | — | 75% |
| CT scan of the head with contrast CPT 70460 CT Exam DTA | $461.75 | $1,847.00 | $925.35–$1,484.99 | 57% below | 75% |
| CT scan of the head with contrast inpatient CPT 70460 CT Exam DTA | $461.75 | $1,847.00 | $1,200.55–$1,377.86 | — | 75% |
| CT scan of the head without and with contrast CPT 70470 CT Exam DTA | $515.75 | $2,063.00 | $1,033.56–$1,658.65 | 65% below | 75% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Exam DTA | $515.75 | $2,063.00 | $1,340.95–$1,539.00 | — | 75% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Exam DTA | $313.00 | $1,252.00 | $627.25–$1,006.61 | 68% below | 75% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Exam DTA | $313.00 | $1,252.00 | $813.80–$933.99 | — | 75% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Exam DTA | $331.75 | $1,327.00 | $664.83–$1,066.91 | 66% below | 75% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Exam DTA | $331.75 | $1,327.00 | $862.55–$989.94 | — | 75% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Exam DTA | $544.25 | $2,177.00 | $1,090.68–$1,750.31 | 46% below | 75% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Exam DTA | $544.25 | $2,177.00 | $1,415.05–$1,624.04 | — | 75% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US Exam DTA | $337.50 | $1,350.00 | $676.35–$1,085.40 | 49% below | 75% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US Exam DTA | $337.50 | $1,350.00 | $877.50–$1,007.10 | — | 75% |
| Chest CT scan without and with contrast CPT 71270 CT Exam DTA | $655.25 | $2,621.00 | $1,313.12–$2,107.28 | 62% below | 75% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Exam DTA | $655.25 | $2,621.00 | $1,703.65–$1,955.27 | — | 75% |
| Chest X-ray, 2 views CPT 71046 Rad Exam DTA | $118.00 | $472.00 | $236.47–$379.49 | 44% below | 75% |
| Chest X-ray, 2 views CPT 71046 XRBMC Chest Two Views | $118.00 | $472.00 | $236.47–$379.49 | 44% below | 75% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views B Reader | $118.00 | $472.00 | $236.47–$379.49 | 44% below | 75% |
| Chest X-ray, 2 views inpatient CPT 71046 Rad Exam DTA | $118.00 | $472.00 | $306.80–$352.11 | — | 75% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views B Reader | $118.00 | $472.00 | $306.80–$352.11 | — | 75% |
| Chest X-ray, 2 views inpatient CPT 71046 XRBMC Chest Two Views | $118.00 | $472.00 | $306.80–$352.11 | — | 75% |
| Chest X-ray, single view CPT 71045 Rad Exam DTA | $97.25 | $389.00 | $194.89–$312.76 | 52% below | 75% |
| Chest X-ray, single view CPT 71045 XRBMC Chest 1 View | $97.25 | $389.00 | $194.89–$312.76 | 52% below | 75% |
| Chest X-ray, single view inpatient CPT 71045 Rad Exam DTA | $97.25 | $389.00 | $252.85–$290.19 | — | 75% |
| Chest X-ray, single view inpatient CPT 71045 XRBMC Chest 1 View | $97.25 | $389.00 | $252.85–$290.19 | — | 75% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Exam DTA | $179.75 | $719.00 | $360.22–$578.08 | 60% below | 75% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Exam DTA | $179.75 | $719.00 | $467.35–$536.37 | — | 75% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 WC Bone Densitometry Dexa | $132.25 | $529.00 | $265.03–$425.32 | 47% below | 75% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 WC Bone Densitometry Dexa | $132.25 | $529.00 | $343.85–$394.63 | — | 75% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Exam DTA | $208.25 | $833.00 | $417.33–$669.73 | 50% below | 75% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Exam DTA | $208.25 | $833.00 | $541.45–$621.42 | — | 75% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Lung Screening Follow Up | $347.00 | $1,388.00 | $695.39–$1,115.95 | 63% below | 75% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Exam DTA | $347.00 | $1,388.00 | $695.39–$1,115.95 | 63% below | 75% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Lung Screening Follow Up | $347.00 | $1,388.00 | $902.20–$1,035.45 | — | 75% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Exam DTA | $347.00 | $1,388.00 | $902.20–$1,035.45 | — | 75% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Exam DTA | $526.25 | $2,105.00 | $1,054.60–$1,692.42 | 59% below | 75% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Exam DTA | $526.25 | $2,105.00 | $1,368.25–$1,570.33 | — | 75% |
| Diagnostic mammogram, both breasts CPT 77066 MMX Exam DTA | $158.00 | $632.00 | $316.63–$508.13 | 20% below | 75% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MMX Exam DTA | $158.00 | $632.00 | $410.80–$471.47 | — | 75% |
| Diagnostic mammogram, one breast CPT 77065 MMX Exam DTA | $123.50 | $494.00 | $247.49–$397.18 | 22% below | 75% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MMX Exam DTA | $123.50 | $494.00 | $321.10–$368.52 | — | 75% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 US Exam DTA | $202.50 | $810.00 | $405.81–$651.24 | 46% below | 75% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US Exam DTA | $202.50 | $810.00 | $526.50–$604.26 | — | 75% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Venous Duplex Bilat | $260.50 | $1,042.00 | $522.04–$837.77 | — | 75% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Venous Insuff Duplex Bilat Exam DTA | $260.50 | $1,042.00 | $522.04–$837.77 | — | 75% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Dup scan/extremity vein/bilat/comp (In Office) 93970 | $290.75 | $1,163.00 | $582.66–$935.05 | — | 75% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US Exam DTA | $260.50 | $1,042.00 | $522.04–$837.77 | 49% below | 75% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Venous Insuff Duplex Bilat Exam DTA | $260.50 | $1,042.00 | $677.30–$777.33 | — | 75% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Venous Duplex Bilat | $260.50 | $1,042.00 | $677.30–$777.33 | — | 75% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Dup scan/extremity vein/bilat/comp (In Office) 93970 | $290.75 | $1,163.00 | $755.95–$867.60 | — | 75% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Exam DTA | $260.50 | $1,042.00 | $677.30–$777.33 | — | 75% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECBMC 2D Echo With Color or Doppler | $587.50 | $2,350.00 | $1,177.35–$1,889.40 | 46% below | 75% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECBMC 2D Echo With Color or Doppler | $587.50 | $2,350.00 | $1,527.50–$1,753.10 | — | 75% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Exam DTA | $329.75 | $1,319.00 | $660.82–$1,060.48 | 66% below | 75% |
| Eye socket (orbit) CT scan without contrast CPT 70480 MCO CT Orbit/Ear/Sella w/o Contrast | $329.75 | $1,319.00 | $660.82–$1,060.48 | 66% below | 75% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Exam DTA | $329.75 | $1,319.00 | $857.35–$983.97 | — | 75% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 MCO CT Orbit/Ear/Sella w/o Contrast | $329.75 | $1,319.00 | $857.35–$983.97 | — | 75% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 Rad Exam DTA | $97.75 | $391.00 | $195.89–$314.36 | 57% below | 75% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Rad Exam DTA | $97.75 | $391.00 | $254.15–$291.69 | — | 75% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Exam DTA | $438.25 | $1,753.00 | $878.25–$1,409.41 | 56% below | 75% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Exam DTA | $438.25 | $1,753.00 | $1,139.45–$1,307.74 | — | 75% |
| Hand X-ray, 2 views CPT 73120 Rad Exam DTA | $90.25 | $361.00 | $180.86–$290.24 | 57% below | 75% |
| Hand X-ray, 2 views inpatient CPT 73120 Rad Exam DTA | $90.25 | $361.00 | $234.65–$269.31 | — | 75% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 *Sleep Study Charges -> Home Sleep Study Unattended 95806 | $198.25 | $793.00 | $397.29–$637.57 | 29% below | 75% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 *Sleep Study Charges -> Home Sleep Study Unattended 95806 | $198.25 | $793.00 | $515.45–$591.58 | — | 75% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 *Sleep Study Charges -> Polysomnography 4+ parameters w/PAP 95811 | $1,162.50 | $4,650.00 | $2,329.65–$3,738.60 | 33% below | 75% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 *Sleep Study Charges -> Polysomnography 4+ parameters w/PAP 95811 | $1,162.50 | $4,650.00 | $3,022.50–$3,468.90 | — | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Exam DTA | $171.25 | $685.00 | $343.18–$550.74 | 30% below | 75% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Exam DTA | $171.25 | $685.00 | $445.25–$511.01 | — | 75% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Screening Low Dose Exam DTA | $206.75 | $827.00 | $414.33–$664.91 | 9% below | 75% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Screening Low Dose Exam DTA | $206.75 | $827.00 | $537.55–$616.94 | — | 75% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRI Exam DTA | $486.75 | $1,947.00 | $975.45–$1,565.39 | 72% below | 75% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRI Venogram Head w/o Contrast | $486.75 | $1,947.00 | $975.45–$1,565.39 | 72% below | 75% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRI Venogram Head w/o Contrast | $486.75 | $1,947.00 | $1,265.55–$1,452.46 | — | 75% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRI Exam DTA | $486.75 | $1,947.00 | $1,265.55–$1,452.46 | — | 75% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast w & w/o Contrast BILAT | $357.25 | $1,429.00 | $715.93–$1,148.92 | — | 75% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast w/Contrast BILAT | $357.25 | $1,429.00 | $715.93–$1,148.92 | — | 75% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI Breast w/Contrast BILAT | $357.25 | $1,429.00 | $928.85–$1,066.03 | — | 75% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI Breast w & w/o Contrast BILAT | $357.25 | $1,429.00 | $928.85–$1,066.03 | — | 75% |
| MRI of the abdomen without contrast CPT 74181 MRI Exam DTA | $452.75 | $1,811.00 | $907.31–$1,456.04 | 74% below | 75% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen Iron Quant w/o Contrast | $452.75 | $1,811.00 | $907.31–$1,456.04 | 74% below | 75% |
| MRI of the abdomen without contrast CPT 74181 MRI MRCP w/o Contrast | $452.75 | $1,811.00 | $907.31–$1,456.04 | 74% below | 75% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen Iron Quant w/o Contrast | $452.75 | $1,811.00 | $1,177.15–$1,351.01 | — | 75% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Exam DTA | $452.75 | $1,811.00 | $1,177.15–$1,351.01 | — | 75% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP w/o Contrast | $452.75 | $1,811.00 | $1,177.15–$1,351.01 | — | 75% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Exam DTA | $837.75 | $3,351.00 | $1,678.85–$2,694.20 | 62% below | 75% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen Iron Quant w/wo Contrast | $837.75 | $3,351.00 | $1,678.85–$2,694.20 | 62% below | 75% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI MRCP w & w/o Contrast | $837.75 | $3,351.00 | $1,678.85–$2,694.20 | 62% below | 75% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Liver w & w/o Eovist Contrast | $837.75 | $3,351.00 | $1,678.85–$2,694.20 | 62% below | 75% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Liver w & w/o Eovist Contrast | $837.75 | $3,351.00 | $2,178.15–$2,499.85 | — | 75% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Exam DTA | $837.75 | $3,351.00 | $2,178.15–$2,499.85 | — | 75% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI MRCP w & w/o Contrast | $837.75 | $3,351.00 | $2,178.15–$2,499.85 | — | 75% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen Iron Quant w/wo Contrast | $837.75 | $3,351.00 | $2,178.15–$2,499.85 | — | 75% |
| MRI of the brain, no contrast dye CPT 70551 MRI IAC w/o contrast | $449.50 | $1,798.00 | $900.80–$1,445.59 | 69% below | 75% |
| MRI of the brain, no contrast dye CPT 70551 MRI Exam DTA | $449.50 | $1,798.00 | $900.80–$1,445.59 | 69% below | 75% |
| MRI of the brain, no contrast dye CPT 70551 MRI Pituitary w/o contrast | $449.50 | $1,798.00 | $900.80–$1,445.59 | 69% below | 75% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Pituitary w/o contrast | $449.50 | $1,798.00 | $1,168.70–$1,341.31 | — | 75% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Exam DTA | $449.50 | $1,798.00 | $1,168.70–$1,341.31 | — | 75% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI IAC w/o contrast | $449.50 | $1,798.00 | $1,168.70–$1,341.31 | — | 75% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Pituitary w & w/o Contrast | $588.00 | $2,352.00 | $1,178.35–$1,891.01 | 73% below | 75% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Exam DTA | $588.00 | $2,352.00 | $1,178.35–$1,891.01 | 73% below | 75% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI IAC w & w/o Contrast | $588.00 | $2,352.00 | $1,178.35–$1,891.01 | 73% below | 75% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Exam DTA | $588.00 | $2,352.00 | $1,528.80–$1,754.59 | — | 75% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Pituitary w & w/o Contrast | $588.00 | $2,352.00 | $1,528.80–$1,754.59 | — | 75% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC w & w/o Contrast | $588.00 | $2,352.00 | $1,528.80–$1,754.59 | — | 75% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Exam DTA | $449.50 | $1,798.00 | $900.80–$1,445.59 | 68% below | 75% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Exam DTA | $449.50 | $1,798.00 | $1,168.70–$1,341.31 | — | 75% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Exam DTA | $586.50 | $2,346.00 | $1,175.35–$1,886.18 | 75% below | 75% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Exam DTA | $586.50 | $2,346.00 | $1,524.90–$1,750.12 | — | 75% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Exam DTA | $449.50 | $1,798.00 | $900.80–$1,445.59 | 68% below | 75% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Exam DTA | $449.50 | $1,798.00 | $1,168.70–$1,341.31 | — | 75% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Exam DTA | $586.75 | $2,347.00 | $1,175.85–$1,886.99 | 71% below | 75% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Exam DTA | $586.75 | $2,347.00 | $1,525.55–$1,750.86 | — | 75% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Exam DTA | $449.50 | $1,798.00 | $900.80–$1,445.59 | 68% below | 75% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Exam DTA | $449.50 | $1,798.00 | $1,168.70–$1,341.31 | — | 75% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Lumbosacral Plexus w & w/o Contrast | $613.75 | $2,455.00 | $1,229.96–$1,973.82 | 74% below | 75% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Prostate w & w/o contrast | $613.75 | $2,455.00 | $1,229.96–$1,973.82 | 74% below | 75% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Exam DTA | $613.75 | $2,455.00 | $1,229.96–$1,973.82 | 74% below | 75% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Exam DTA | $613.75 | $2,455.00 | $1,595.75–$1,831.43 | — | 75% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Prostate w & w/o contrast | $613.75 | $2,455.00 | $1,595.75–$1,831.43 | — | 75% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Lumbosacral Plexus w & w/o Contrast | $613.75 | $2,455.00 | $1,595.75–$1,831.43 | — | 75% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Exam DTA | $455.75 | $1,823.00 | $913.32–$1,465.69 | 71% below | 75% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Prostate w/o contrast | $455.75 | $1,823.00 | $913.32–$1,465.69 | 71% below | 75% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Lumbosacral Plexus w/o Contrast | $455.75 | $1,823.00 | $913.32–$1,465.69 | 71% below | 75% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Exam DTA | $455.75 | $1,823.00 | $1,184.95–$1,359.96 | — | 75% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Prostate w/o contrast | $455.75 | $1,823.00 | $1,184.95–$1,359.96 | — | 75% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Lumbosacral Plexus w/o Contrast | $455.75 | $1,823.00 | $1,184.95–$1,359.96 | — | 75% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 FBO XR Cervical Spine Minimum 4 Views | $117.00 | $468.00 | $234.47–$376.27 | 60% below | 75% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Rad Exam DTA | $117.00 | $468.00 | $234.47–$376.27 | 60% below | 75% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 FBO XR Cervical Spine Minimum 4 Views | $117.00 | $468.00 | $304.20–$349.13 | — | 75% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Rad Exam DTA | $117.00 | $468.00 | $304.20–$349.13 | — | 75% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Exam DTA | $408.25 | $1,633.00 | $818.13–$1,312.93 | 68% below | 75% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Exam DTA | $408.25 | $1,633.00 | $1,061.45–$1,218.22 | — | 75% |
| Neck soft tissue CT scan without contrast CPT 70490 CT Exam DTA | $387.50 | $1,550.00 | $776.55–$1,246.20 | 61% below | 75% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Exam DTA | $387.50 | $1,550.00 | $1,007.50–$1,156.30 | — | 75% |
| Neck soft tissue X-ray CPT 70360 Rad Exam DTA | $96.75 | $387.00 | $193.89–$311.15 | 54% below | 75% |
| Neck soft tissue X-ray inpatient CPT 70360 Rad Exam DTA | $96.75 | $387.00 | $251.55–$288.70 | — | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NCBMC Treadmill Stress Test | $1,269.50 | $5,078.00 | $2,544.08–$4,082.71 | 38% below | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NCBMC Lexiscan Stress Test | $1,269.50 | $5,078.00 | $2,544.08–$4,082.71 | 38% below | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NCBMC Lexiscan Stress Test | $1,269.50 | $5,078.00 | $3,300.70–$3,788.19 | — | 75% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NCBMC Treadmill Stress Test | $1,269.50 | $5,078.00 | $3,300.70–$3,788.19 | — | 75% |
| Pelvic CT scan without contrast CPT 72192 CT Cystogram | $448.25 | $1,793.00 | $898.29–$1,441.57 | 53% below | 75% |
| Pelvic CT scan without contrast CPT 72192 CT Exam DTA | $448.25 | $1,793.00 | $898.29–$1,441.57 | 53% below | 75% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Exam DTA | $448.25 | $1,793.00 | $1,165.45–$1,337.58 | — | 75% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Cystogram | $448.25 | $1,793.00 | $1,165.45–$1,337.58 | — | 75% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Exam DTA | $117.00 | $468.00 | $234.47–$376.27 | 33% below | 75% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Ultrasound Simple Pelvic (In Office) 76857 | $136.75 | $547.00 | $274.05–$439.79 | 22% below | 75% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Exam DTA | $117.00 | $468.00 | $304.20–$349.13 | — | 75% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Ultrasound Simple Pelvic (In Office) 76857 | $136.75 | $547.00 | $355.55–$408.06 | — | 75% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Exam DTA | $207.00 | $828.00 | $414.83–$665.71 | 47% below | 75% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Exam DTA | $207.00 | $828.00 | $538.20–$617.69 | — | 75% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Exam DTA | $158.50 | $634.00 | $317.63–$509.74 | 64% below | 75% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Exam DTA | $158.50 | $634.00 | $412.10–$472.96 | — | 75% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Exam DTA | $123.25 | $493.00 | $246.99–$396.37 | 60% below | 75% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 Wks, Single Fetus (In Office) 76801 | $167.00 | $668.00 | $334.67–$537.07 | 46% below | 75% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Exam DTA | $123.25 | $493.00 | $320.45–$367.78 | — | 75% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 Wks, Single Fetus (In Office) 76801 | $167.00 | $668.00 | $434.20–$498.33 | — | 75% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Exam DTA | $117.00 | $468.00 | $234.47–$376.27 | 39% below | 75% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US Limited Fetus(s) (In Office) 76815 | $117.00 | $468.00 | $234.47–$376.27 | 39% below | 75% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US Limited Fetus(s) (In Office) 76815 | $117.00 | $468.00 | $304.20–$349.13 | — | 75% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Exam DTA | $117.00 | $468.00 | $304.20–$349.13 | — | 75% |
| Screening mammogram, both breasts CPT 77067 MMX Exam DTA | $130.50 | $522.00 | $261.52–$419.69 | 23% below | 75% |
| Screening mammogram, both breasts inpatient CPT 77067 MMX Exam DTA | $130.50 | $522.00 | $339.30–$389.41 | — | 75% |
| Sinus X-ray, complete, 3 or more views CPT 70220 Rad Exam DTA | $96.75 | $387.00 | $193.89–$311.15 | 57% below | 75% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Rad Exam DTA | $96.75 | $387.00 | $251.55–$288.70 | — | 75% |
| Skull X-ray, fewer than 4 views CPT 70250 Rad Exam DTA | $113.25 | $453.00 | $226.95–$364.21 | 48% below | 75% |
| Skull X-ray, fewer than 4 views CPT 70250 XRBMC Skull 1-3 Views | $113.25 | $453.00 | $226.95–$364.21 | 48% below | 75% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XRBMC Skull 1-3 Views | $113.25 | $453.00 | $294.45–$337.94 | — | 75% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 Rad Exam DTA | $113.25 | $453.00 | $294.45–$337.94 | — | 75% |
| Sleep study in a lab (polysomnography) CPT 95810 *Sleep Study Charges -> Polysomnography 4+ parameters 95810 | $1,110.75 | $4,443.00 | $2,225.94–$3,572.17 | 32% below | 75% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 *Sleep Study Charges -> Polysomnography 4+ parameters 95810 | $1,110.75 | $4,443.00 | $2,887.95–$3,314.48 | — | 75% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECBMC Stress TTE Complete | $586.25 | $2,345.00 | $1,174.84–$1,885.38 | 48% below | 75% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 ECBMC Stress TTE Complete | $586.25 | $2,345.00 | $1,524.25–$1,749.37 | — | 75% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Fluoro Exam DTA | $127.25 | $509.00 | $255.01–$409.24 | 71% below | 75% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Fluoro Exam DTA | $127.25 | $509.00 | $330.85–$379.71 | — | 75% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Exam DTA | $333.00 | $1,332.00 | $667.33–$1,070.93 | 69% below | 75% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Exam DTA | $333.00 | $1,332.00 | $865.80–$993.67 | — | 75% |
| Toe X-ray, 2 or more views CPT 73660 X-Ray Exam Toe(s) Read Only In Office 73660 | $98.25 | $393.00 | $196.89–$315.97 | 45% below | 75% |
| Toe X-ray, 2 or more views inpatient CPT 73660 X-Ray Exam Toe(s) Read Only In Office 73660 | $98.25 | $393.00 | $255.45–$293.18 | — | 75% |
| Transvaginal pelvic ultrasound CPT 76830 US Exam DTA | $155.75 | $623.00 | $312.12–$500.89 | 58% below | 75% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal (In Office) 76830 | $209.50 | $838.00 | $419.84–$673.75 | 44% below | 75% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Exam DTA | $155.75 | $623.00 | $404.95–$464.76 | — | 75% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal (In Office) 76830 | $209.50 | $838.00 | $544.70–$625.15 | — | 75% |
| Transvaginal ultrasound during pregnancy CPT 76817 Transvaginal Us Obstetric (In Office) 76817 | $128.75 | $515.00 | $258.02–$414.06 | 58% below | 75% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Exam DTA | $128.75 | $515.00 | $258.02–$414.06 | 58% below | 75% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Exam DTA | $128.75 | $515.00 | $334.75–$384.19 | — | 75% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 Transvaginal Us Obstetric (In Office) 76817 | $128.75 | $515.00 | $334.75–$384.19 | — | 75% |
| Ultrasound of the abdomen, complete CPT 76700 US Exam DTA | $175.25 | $701.00 | $351.20–$563.60 | 63% below | 75% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Exam DTA | $175.25 | $701.00 | $455.65–$522.95 | — | 75% |
| Ultrasound of the scrotum and testicles CPT 76870 US Exam DTA | $147.00 | $588.00 | $294.59–$472.75 | 68% below | 75% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Exam DTA | $147.00 | $588.00 | $382.20–$438.65 | — | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid | $179.75 | $719.00 | $360.22–$578.08 | 56% below | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Exam DTA | $179.75 | $719.00 | $360.22–$578.08 | 56% below | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid | $179.75 | $719.00 | $467.35–$536.37 | — | 75% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Exam DTA | $179.75 | $719.00 | $467.35–$536.37 | — | 75% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XRBMC GI Series w/Small Bowel | $195.50 | $782.00 | $391.78–$628.73 | 55% below | 75% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XRBMC GI Series | $195.50 | $782.00 | $391.78–$628.73 | 55% below | 75% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XRBMC GI Series | $195.50 | $782.00 | $508.30–$583.37 | — | 75% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XRBMC GI Series w/Small Bowel | $195.50 | $782.00 | $508.30–$583.37 | — | 75% |
| X-ray of the abdomen, 1 view CPT 74018 XR Sitz Motility Study | $94.00 | $376.00 | $188.38–$302.30 | 56% below | 75% |
| X-ray of the abdomen, 1 view CPT 74018 Rad Exam DTA | $94.00 | $376.00 | $188.38–$302.30 | 56% below | 75% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Sitz Motility Study | $94.00 | $376.00 | $244.40–$280.50 | — | 75% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Rad Exam DTA | $94.00 | $376.00 | $244.40–$280.50 | — | 75% |
| X-ray of the foot, 2 views CPT 73620 X-Ray Exam Foot 2 Views Read Only In Office 73620 | $96.75 | $387.00 | $193.89–$311.15 | 52% below | 75% |
| X-ray of the foot, 2 views inpatient CPT 73620 X-Ray Exam Foot 2 Views Read Only In Office 73620 | $96.75 | $387.00 | $251.55–$288.70 | — | 75% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-Ray Exam Foot Min 3 Views Read Only In Office 73630 | $119.50 | $478.00 | $239.48–$384.31 | 44% below | 75% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-Ray Exam Foot Min 3 Views Read Only In Office 73630 | $119.50 | $478.00 | $310.70–$356.59 | — | 75% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 FBO XR Lumbar Spine 2 Views | $123.75 | $495.00 | $248.00–$397.98 | 50% below | 75% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Rad Exam DTA | $123.75 | $495.00 | $248.00–$397.98 | 50% below | 75% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 FBO XR Lumbar Spine 2 Views | $123.75 | $495.00 | $321.75–$369.27 | — | 75% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Rad Exam DTA | $123.75 | $495.00 | $321.75–$369.27 | — | 75% |
| X-ray of the lower back, 4 or more views CPT 72110 Rad Exam DTA | $148.75 | $595.00 | $298.10–$478.38 | 54% below | 75% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Rad Exam DTA | $148.75 | $595.00 | $386.75–$443.87 | — | 75% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Rad Exam DTA | $79.00 | $316.00 | $158.32–$254.06 | 65% below | 75% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 FBO XR Thoracic Spine 2 Views | $79.00 | $316.00 | $158.32–$254.06 | 65% below | 75% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 FBO XR Thoracic Spine 2 Views | $79.00 | $316.00 | $205.40–$235.74 | — | 75% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Rad Exam DTA | $79.00 | $316.00 | $205.40–$235.74 | — | 75% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Rad Exam DTA | $96.75 | $387.00 | $193.89–$311.15 | 57% below | 75% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Rad Exam DTA | $96.75 | $387.00 | $251.55–$288.70 | — | 75% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Rad Exam DTA | $96.75 | $387.00 | $193.89–$311.15 | 54% below | 75% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 FBO XR Cervical Spine 2-3 Views | $96.75 | $387.00 | $193.89–$311.15 | 54% below | 75% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 FBO XR Cervical Spine 2-3 Views | $96.75 | $387.00 | $251.55–$288.70 | — | 75% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Rad Exam DTA | $96.75 | $387.00 | $251.55–$288.70 | — | 75% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Rad Exam DTA | $114.75 | $459.00 | $229.96–$369.04 | 46% below | 75% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 FBO XR Pelvis 1-2 Views | $114.75 | $459.00 | $229.96–$369.04 | 46% below | 75% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 FBO XR Pelvis 1-2 Views | $114.75 | $459.00 | $298.35–$342.41 | — | 75% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Rad Exam DTA | $114.75 | $459.00 | $298.35–$342.41 | — | 75% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 FBO XR Sacrum/Coccyx | $96.75 | $387.00 | $193.89–$311.15 | 57% below | 75% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Rad Exam DTA | $96.75 | $387.00 | $193.89–$311.15 | 57% below | 75% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 FBO XR Sacrum/Coccyx | $96.75 | $387.00 | $251.55–$288.70 | — | 75% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Rad Exam DTA | $96.75 | $387.00 | $251.55–$288.70 | — | 75% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 Adrenocorticotropic Hormone | $67.75 | $271.00 | $135.77–$217.88 | 58% below | 75% |
| ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone | $67.75 | $271.00 | $176.15–$202.17 | — | 75% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 FM ALT CHG | $13.50 | $54.00 | $27.05–$43.42 | 60% below | 75% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase [ALT]-Q | $13.50 | $54.00 | $27.05–$43.42 | 60% below | 75% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase | $13.50 | $54.00 | $27.05–$43.42 | 60% below | 75% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 FS ALT CHG | $13.50 | $54.00 | $27.05–$43.42 | 60% below | 75% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase [ALT]-Q | $13.50 | $54.00 | $35.10–$40.28 | — | 75% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 FS ALT CHG | $13.50 | $54.00 | $35.10–$40.28 | — | 75% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase | $13.50 | $54.00 | $35.10–$40.28 | — | 75% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 FM ALT CHG | $13.50 | $54.00 | $35.10–$40.28 | — | 75% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase [AST]-Q | $11.25 | $45.00 | $22.54–$36.18 | 63% below | 75% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 FS AST CHG | $11.25 | $45.00 | $22.54–$36.18 | 63% below | 75% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 FM AST CHG | $11.25 | $45.00 | $22.54–$36.18 | 63% below | 75% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase | $11.25 | $45.00 | $22.54–$36.18 | 63% below | 75% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 FS AST CHG | $11.25 | $45.00 | $29.25–$33.57 | — | 75% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase [AST]-Q | $11.25 | $45.00 | $29.25–$33.57 | — | 75% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 FM AST CHG | $11.25 | $45.00 | $29.25–$33.57 | — | 75% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase | $11.25 | $45.00 | $29.25–$33.57 | — | 75% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEP 1 | $45.75 | $183.00 | $91.68–$147.13 | 71% below | 75% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEP 1 | $45.75 | $183.00 | $118.95–$136.52 | — | 75% |
| Albumin blood test CPT 82040 Albumin Level-Q | $7.75 | $31.00 | $15.53–$24.92 | 66% below | 75% |
| Albumin blood test CPT 82040 Albumin Level | $7.75 | $31.00 | $15.53–$24.92 | 66% below | 75% |
| Albumin blood test CPT 82040 Albumin | $7.75 | $31.00 | $15.53–$24.92 | 66% below | 75% |
| Albumin blood test CPT 82040 ALB CHARGE | $7.75 | $31.00 | $15.53–$24.92 | 66% below | 75% |
| Albumin blood test inpatient CPT 82040 Albumin | $7.75 | $31.00 | $20.15–$23.13 | — | 75% |
| Albumin blood test inpatient CPT 82040 ALB CHARGE | $7.75 | $31.00 | $20.15–$23.13 | — | 75% |
| Albumin blood test inpatient CPT 82040 Albumin Level | $7.75 | $31.00 | $20.15–$23.13 | — | 75% |
| Albumin blood test inpatient CPT 82040 Albumin Level-Q | $7.75 | $31.00 | $20.15–$23.13 | — | 75% |
| Aldosterone blood test CPT 82088 Aldosterone | $72.50 | $290.00 | $145.29–$233.16 | 54% below | 75% |
| Aldosterone blood test CPT 82088 Aldosterone/Renin Activity Ratio | $72.50 | $290.00 | $145.29–$233.16 | 54% below | 75% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone/Renin Activity Ratio | $72.50 | $290.00 | $188.50–$216.34 | — | 75% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone | $72.50 | $290.00 | $188.50–$216.34 | — | 75% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase-Q | $9.50 | $38.00 | $19.04–$30.55 | 65% below | 75% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $9.50 | $38.00 | $19.04–$30.55 | 65% below | 75% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase Isoenzymes | $9.50 | $38.00 | $19.04–$30.55 | 65% below | 75% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Bone Specific Alkaline Phosphatase | $9.50 | $38.00 | $19.04–$30.55 | 65% below | 75% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase | $9.50 | $38.00 | $24.70–$28.35 | — | 75% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase Isoenzymes | $9.50 | $38.00 | $24.70–$28.35 | — | 75% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Bone Specific Alkaline Phosphatase | $9.50 | $38.00 | $24.70–$28.35 | — | 75% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase-Q | $9.50 | $38.00 | $24.70–$28.35 | — | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Fungi/Mold E. floccosum | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Cinnamon | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Baker's/Brewer's Yeast | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Rice | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Weed Goldenrod | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pecan IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Hazelnut (Filbert) IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Yolk IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Wheat IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Walnut IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tomato IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Timothy Grass IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Soybean IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Common Ragweed IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Peanut IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Oak IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Milk IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Inhalants Foods Profile A | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Latex IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen June Grass IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen House Dust Greer IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Aspergillus Fumigat IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg White IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dog Dander IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen D farinea IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Corn IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cockroach IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Chocolate IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cat Epi. & Dander IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cashew IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALAT | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergy, Common Adult Food | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHG | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD PAN | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Hormodendrum | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lambs Quarters | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Seafood Profile | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Codfish | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Crab | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lobster | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Shrimp | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tuna | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Shell Fish Profile | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mussel | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Oyster | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Scallop | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Clam | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, English Plantain | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pistachio | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Horse Hair/Dander | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Chestnut | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Macadamia Nut | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Coconut | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Almond | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Salmon | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Sesame | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Egg Whole | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Gluten | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMACKEREL | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Trout | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Mugwort | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Russian Thistle | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Perennial Rye Grass | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Elm Tree | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Meadow Fescue | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Giant Ragweed | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Walnut Tree | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Birch Tree | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Mites, D. pteronyssinus | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Box Elder/Maple Tree | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Orchard Grass | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Bermuda | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, P. notatum | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Mixed Nuts | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Feather Mix | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Bee Venom Profile | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Nut Mix Profile | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Brazil Nut | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Peanut Components | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Venom, Honey Bee IgE | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Venom, Yellow Jacket Venom | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Venom, White-Faced Hornet | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Venom, Yellow-Faced Hornet | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Venom, Paper Wasp | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Chicken | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Cow Hair/Dander | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Halibut | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Haddock | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Pine (Pinon) Nut | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Tilapia | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Sole | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Perch | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Bass Black | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Pollack White | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Gulf Flounder | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Swordfish | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Strawberry | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Oat | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Apple | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Barley | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Beef | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Coffee | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Weed Dandelion | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Garlic | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Pork | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Rye | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grape | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cabbage | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lettuce | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Orange | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Fungi Trichophyton mentagrophytes | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Fungi/Mold Candida albicans | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Carrot | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Mountain Cedar (Juniper) | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Poplar White | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree White Pine Tree | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food Onion | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Fungi/Mold Muco racemosus | $6.50 | $26.00 | $13.03–$20.90 | 72% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMPPRO 18 | $7.75 | $31.00 | $15.53–$24.92 | 66% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergy, Food Comprehensive Profile 1 | $7.75 | $31.00 | $15.53–$24.92 | 66% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 zzAllergy, Food, Profile 13 | $7.75 | $31.00 | $15.53–$24.92 | 66% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 zzAllergen, Food, Fish Profile IgE | $7.75 | $31.00 | $15.53–$24.92 | 66% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 zzAllergen, Food, Profile 9 | $7.75 | $31.00 | $15.53–$24.92 | 66% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PED MARCH | $7.75 | $31.00 | $15.53–$24.92 | 66% below | 75% |
| Allergy blood test, specific IgE, per allergen CPT 86003 zzAllergen, Food, Alpha-Gal | $13.50 | $54.00 | $27.05–$43.42 | 41% below | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Mugwort | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Trout | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen House Dust Greer IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Rye | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grape | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cabbage | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lettuce | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Perennial Rye Grass | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Russian Thistle | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Latex IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen June Grass IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Oat | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Aspergillus Fumigat IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Egg White IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Feather Mix | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Bee Venom Profile | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Nut Mix Profile | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Brazil Nut | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Peanut Components | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Venom, Honey Bee IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Venom, Yellow Jacket Venom | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Venom, White-Faced Hornet | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Venom, Yellow-Faced Hornet | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Venom, Paper Wasp | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Onion | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Chicken | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Cow Hair/Dander | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Halibut | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Haddock | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Pine (Pinon) Nut | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Tilapia | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Sole | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Perch | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Bass Black | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Pollack White | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dog Dander IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen D farinea IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Corn IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cockroach IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Chocolate IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cat Epi. & Dander IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cashew IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALAT | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Gulf Flounder | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Swordfish | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Strawberry | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Weed Goldenrod | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Mountain Cedar (Juniper) | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Carrot | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Fungi/Mold Candida albicans | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMACKEREL | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Gluten | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Egg Whole | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Sesame | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Fungi Trichophyton mentagrophytes | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Pork | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Garlic | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Weed Dandelion | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Coffee | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Beef | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Barley | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Salmon | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Almond | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Coconut | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Macadamia Nut | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Chestnut | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Horse Hair/Dander | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pistachio | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, English Plantain | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Clam | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Scallop | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Apple | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Oyster | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mussel | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Shell Fish Profile | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tuna | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Shrimp | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lobster | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Crab | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Codfish | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Seafood Profile | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lambs Quarters | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Hormodendrum | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOLD PAN | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHG | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy, Common Adult Food | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pecan IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Hazelnut (Filbert) IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Yolk IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Wheat IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Rice | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Baker's/Brewer's Yeast | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Orange | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Poplar White | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Elm Tree | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Meadow Fescue | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Giant Ragweed | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Walnut Tree | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Birch Tree | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Mites, D. pteronyssinus | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Box Elder/Maple Tree | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Orchard Grass | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree White Pine Tree | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Bermuda | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, P. notatum | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Mixed Nuts | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Walnut IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tomato IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food Cinnamon | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Fungi/Mold E. floccosum | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Timothy Grass IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Soybean IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Common Ragweed IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Peanut IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Oak IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Milk IgE | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Fungi/Mold Muco racemosus | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy Inhalants Foods Profile A | $6.50 | $26.00 | $16.90–$19.40 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMPPRO 18 | $7.75 | $31.00 | $20.15–$23.13 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy, Food Comprehensive Profile 1 | $7.75 | $31.00 | $20.15–$23.13 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PED MARCH | $7.75 | $31.00 | $20.15–$23.13 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 zzAllergen, Food, Fish Profile IgE | $7.75 | $31.00 | $20.15–$23.13 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 zzAllergen, Food, Profile 9 | $7.75 | $31.00 | $20.15–$23.13 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 zzAllergy, Food, Profile 13 | $7.75 | $31.00 | $20.15–$23.13 | — | 75% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 zzAllergen, Food, Alpha-Gal | $13.50 | $54.00 | $35.10–$40.28 | — | 75% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Maternal Screening Alpha Fetoprotein | $18.75 | $75.00 | $37.58–$60.30 | 72% below | 75% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Tumor Marker | $18.75 | $75.00 | $37.58–$60.30 | 72% below | 75% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Maternal Screening Alpha Fetoprotein | $18.75 | $75.00 | $48.75–$55.95 | — | 75% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein Tumor Marker | $18.75 | $75.00 | $48.75–$55.95 | — | 75% |
| Ammonia blood test CPT 82140 Ammonia Level | $28.50 | $114.00 | $57.11–$91.66 | 69% below | 75% |
| Ammonia blood test CPT 82140 Ammonia, 24 Hour Urine | $28.50 | $114.00 | $57.11–$91.66 | 69% below | 75% |
| Ammonia blood test inpatient CPT 82140 Ammonia, 24 Hour Urine | $28.50 | $114.00 | $74.10–$85.04 | — | 75% |
| Ammonia blood test inpatient CPT 82140 Ammonia Level | $28.50 | $114.00 | $74.10–$85.04 | — | 75% |
| Amylase blood test CPT 82150 Amylase Pleural Fluid-Q | $21.75 | $87.00 | $43.59–$69.95 | 48% below | 75% |
| Amylase blood test CPT 82150 Amylase Peritoneal Fluid-Q | $21.75 | $87.00 | $43.59–$69.95 | 48% below | 75% |
| Amylase blood test CPT 82150 Amylase Level-Q | $21.75 | $87.00 | $43.59–$69.95 | 48% below | 75% |
| Amylase blood test CPT 82150 Amylase Level Random Urine-Q | $21.75 | $87.00 | $43.59–$69.95 | 48% below | 75% |
| Amylase blood test CPT 82150 Amylase Urine Random Collection | $21.75 | $87.00 | $43.59–$69.95 | 48% below | 75% |
| Amylase blood test CPT 82150 UR AMY | $21.75 | $87.00 | $43.59–$69.95 | 48% below | 75% |
| Amylase blood test CPT 82150 BF AMY | $21.75 | $87.00 | $43.59–$69.95 | 48% below | 75% |
| Amylase blood test CPT 82150 Amylase | $21.75 | $87.00 | $43.59–$69.95 | 48% below | 75% |
| Amylase blood test inpatient CPT 82150 Amylase | $21.75 | $87.00 | $56.55–$64.90 | — | 75% |
| Amylase blood test inpatient CPT 82150 BF AMY | $21.75 | $87.00 | $56.55–$64.90 | — | 75% |
| Amylase blood test inpatient CPT 82150 Amylase Pleural Fluid-Q | $21.75 | $87.00 | $56.55–$64.90 | — | 75% |
| Amylase blood test inpatient CPT 82150 Amylase Peritoneal Fluid-Q | $21.75 | $87.00 | $56.55–$64.90 | — | 75% |
| Amylase blood test inpatient CPT 82150 Amylase Level-Q | $21.75 | $87.00 | $56.55–$64.90 | — | 75% |
| Amylase blood test inpatient CPT 82150 Amylase Level Random Urine-Q | $21.75 | $87.00 | $56.55–$64.90 | — | 75% |
| Amylase blood test inpatient CPT 82150 Amylase Urine Random Collection | $21.75 | $87.00 | $56.55–$64.90 | — | 75% |
| Amylase blood test inpatient CPT 82150 UR AMY | $21.75 | $87.00 | $56.55–$64.90 | — | 75% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab IgG | $40.75 | $163.00 | $81.66–$131.05 | 43% below | 75% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab IgG | $40.75 | $163.00 | $105.95–$121.60 | — | 75% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Screen with Reflex to Titer (Quest) | $24.50 | $98.00 | $49.10–$78.79 | 55% below | 75% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Titer | $24.50 | $98.00 | $49.10–$78.79 | 55% below | 75% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Extractable Nuclear Antigen Antibodies | $24.50 | $98.00 | $49.10–$78.79 | 55% below | 75% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 zzAnti-Nuclear Ab (ANA) Reflexive Panel | $33.25 | $133.00 | $66.63–$106.93 | 40% below | 75% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 zzAnti-Nuclear Antibody | $33.25 | $133.00 | $66.63–$106.93 | 40% below | 75% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Titer | $24.50 | $98.00 | $63.70–$73.11 | — | 75% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Extractable Nuclear Antigen Antibodies | $24.50 | $98.00 | $63.70–$73.11 | — | 75% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Screen with Reflex to Titer (Quest) | $24.50 | $98.00 | $63.70–$73.11 | — | 75% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 zzAnti-Nuclear Antibody | $33.25 | $133.00 | $86.45–$99.22 | — | 75% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 zzAnti-Nuclear Ab (ANA) Reflexive Panel | $33.25 | $133.00 | $86.45–$99.22 | — | 75% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PROBNP | $89.25 | $357.00 | $178.86–$287.03 | 43% below | 75% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PROBNP | $89.25 | $357.00 | $232.05–$266.32 | — | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Veterinary Culture | $18.00 | $72.00 | $36.07–$57.89 | 67% below | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hospital Sterility | $18.00 | $72.00 | $36.07–$57.89 | 67% below | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cystic Fibrosis Culture | $18.00 | $72.00 | $36.07–$57.89 | 67% below | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Catheter Tip Culture | $18.00 | $72.00 | $36.07–$57.89 | 67% below | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bacterial Culture With Gram Stain | $18.00 | $72.00 | $36.07–$57.89 | 67% below | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bacterial Culture Sputum | $18.00 | $72.00 | $36.07–$57.89 | 67% below | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bacterial Culture Respiratory | $18.00 | $72.00 | $36.07–$57.89 | 67% below | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Legionella Culture | $18.00 | $72.00 | $36.07–$57.89 | 67% below | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Vaginitis Screen Prepubertal and Postmenopausal | $18.00 | $72.00 | $36.07–$57.89 | 67% below | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Vaginitis Screen Prepubertal and Postmenopausal | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bacterial Culture Respiratory | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hospital Sterility | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cystic Fibrosis Culture | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Catheter Tip Culture | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Veterinary Culture | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bacterial Culture Sputum | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bacterial Culture With Gram Stain | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Legionella Culture | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel-Q | $46.00 | $184.00 | $92.18–$147.94 | 41% below | 75% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $46.00 | $184.00 | $92.18–$147.94 | 41% below | 75% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel-Q | $46.00 | $184.00 | $119.60–$137.26 | — | 75% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $46.00 | $184.00 | $119.60–$137.26 | — | 75% |
| Bilirubin blood test, total CPT 82247 T BILI CREDIT | $15.50 | $62.00 | $31.06–$49.85 | 50% below | 75% |
| Bilirubin blood test, total CPT 82247 Total Bilirubin | $15.50 | $62.00 | $31.06–$49.85 | 50% below | 75% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total-Q | $15.50 | $62.00 | $31.06–$49.85 | 50% below | 75% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $15.50 | $62.00 | $31.06–$49.85 | 50% below | 75% |
| Bilirubin blood test, total CPT 82247 BF TBILI | $15.50 | $62.00 | $31.06–$49.85 | 50% below | 75% |
| Bilirubin blood test, total inpatient CPT 82247 T BILI CREDIT | $15.50 | $62.00 | $40.30–$46.25 | — | 75% |
| Bilirubin blood test, total inpatient CPT 82247 Total Bilirubin | $15.50 | $62.00 | $40.30–$46.25 | — | 75% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total | $15.50 | $62.00 | $40.30–$46.25 | — | 75% |
| Bilirubin blood test, total inpatient CPT 82247 BF TBILI | $15.50 | $62.00 | $40.30–$46.25 | — | 75% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total-Q | $15.50 | $62.00 | $40.30–$46.25 | — | 75% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Pathology Level 4 | $102.25 | $409.00 | $204.91–$328.84 | 26% below | 75% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 RB88305 Renal Biopsy Level IV | $102.25 | $409.00 | $204.91–$328.84 | 26% below | 75% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surgical Pathology Level 4 | $102.25 | $409.00 | $265.85–$305.11 | — | 75% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 RB88305 Renal Biopsy Level IV | $102.25 | $409.00 | $265.85–$305.11 | — | 75% |
| Blood culture for bacteria CPT 87040 Bacterial Culture Blood | $68.75 | $275.00 | $137.78–$221.10 | 19% below | 75% |
| Blood culture for bacteria inpatient CPT 87040 Bacterial Culture Blood | $68.75 | $275.00 | $178.75–$205.15 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture | $8.75 | $35.00 | $17.54–$28.14 | 38% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 BCE VENIPUNCTURE 36415 | $8.75 | $35.00 | $17.54–$28.14 | 38% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection Of Venous Blood By Venipuncture 36415 | $8.75 | $35.00 | $17.54–$28.14 | 38% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Legal Blood Draw | $8.75 | $35.00 | $17.54–$28.14 | 38% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 - VENIPUNCTURE | $8.75 | $35.00 | $17.54–$28.14 | 38% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection of venous blood by venipuncture 36415 | $8.75 | $35.00 | $17.54–$28.14 | 38% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Charge Offsite | $8.75 | $35.00 | $17.54–$28.14 | 38% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $8.75 | $35.00 | $17.54–$28.14 | 38% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Charge | $8.75 | $35.00 | $17.54–$28.14 | 38% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Nursing Home Draw Charge | $8.75 | $35.00 | $17.54–$28.14 | 38% below | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture Charge Offsite | $8.75 | $35.00 | $22.75–$26.11 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture Charge | $8.75 | $35.00 | $22.75–$26.11 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture | $8.75 | $35.00 | $22.75–$26.11 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BCE VENIPUNCTURE 36415 | $8.75 | $35.00 | $22.75–$26.11 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection Of Venous Blood By Venipuncture 36415 | $8.75 | $35.00 | $22.75–$26.11 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Legal Blood Draw | $8.75 | $35.00 | $22.75–$26.11 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415 - VENIPUNCTURE | $8.75 | $35.00 | $22.75–$26.11 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection of venous blood by venipuncture 36415 | $8.75 | $35.00 | $22.75–$26.11 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw | $8.75 | $35.00 | $22.75–$26.11 | — | 75% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Nursing Home Draw Charge | $8.75 | $35.00 | $22.75–$26.11 | — | 75% |
| Blood glucose (sugar) test CPT 82947 Glucose (Prenatal Profile Only) | $11.75 | $47.00 | $23.55–$37.79 | 49% below | 75% |
| Blood glucose (sugar) test CPT 82947 Glucose Level-Q | $11.75 | $47.00 | $23.55–$37.79 | 49% below | 75% |
| Blood glucose (sugar) test CPT 82947 Glucose Verification | $11.75 | $47.00 | $23.55–$37.79 | 49% below | 75% |
| Blood glucose (sugar) test CPT 82947 FS GLU CHG | $11.75 | $47.00 | $23.55–$37.79 | 49% below | 75% |
| Blood glucose (sugar) test CPT 82947 Glucose Screen 2HR Postprandial | $11.75 | $47.00 | $23.55–$37.79 | 49% below | 75% |
| Blood glucose (sugar) test CPT 82947 Glucose Screen 1 Hr Postprandial | $11.75 | $47.00 | $23.55–$37.79 | 49% below | 75% |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $11.75 | $47.00 | $23.55–$37.79 | 49% below | 75% |
| Blood glucose (sugar) test CPT 82947 Glucose Fasting | $11.75 | $47.00 | $23.55–$37.79 | 49% below | 75% |
| Blood glucose (sugar) test CPT 82947 ISTAT Glucose | $11.75 | $47.00 | $23.55–$37.79 | 49% below | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Screen 2HR Postprandial | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 ISTAT Glucose | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Level | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Level-Q | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Verification | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 FS GLU CHG | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose (Prenatal Profile Only) | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Screen 1 Hr Postprandial | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Blood lead test CPT 83655 Lead, Whole Blood | $20.25 | $81.00 | $40.58–$65.12 | 55% below | 75% |
| Blood lead test CPT 83655 Lead, Urine - Ug/Day | $20.25 | $81.00 | $40.58–$65.12 | 55% below | 75% |
| Blood lead test CPT 83655 LEAD | $20.25 | $81.00 | $40.58–$65.12 | 55% below | 75% |
| Blood lead test CPT 83655 Lead Whole Blood | $20.25 | $81.00 | $40.58–$65.12 | 55% below | 75% |
| Blood lead test CPT 83655 Whole Blood Lead Level POC 83655 | $20.25 | $81.00 | $40.58–$65.12 | 55% below | 75% |
| Blood lead test CPT 83655 Lead Random Urine | $20.25 | $81.00 | $40.58–$65.12 | 55% below | 75% |
| Blood lead test CPT 83655 HETL Lead Capillary | $20.25 | $81.00 | $40.58–$65.12 | 55% below | 75% |
| Blood lead test CPT 83655 HETL Lead Venous | $20.25 | $81.00 | $40.58–$65.12 | 55% below | 75% |
| Blood lead test CPT 83655 Lead, Blood (Venous) | $20.25 | $81.00 | $40.58–$65.12 | 55% below | 75% |
| Blood lead test inpatient CPT 83655 HETL Lead Capillary | $20.25 | $81.00 | $52.65–$60.43 | — | 75% |
| Blood lead test inpatient CPT 83655 Lead, Urine - Ug/Day | $20.25 | $81.00 | $52.65–$60.43 | — | 75% |
| Blood lead test inpatient CPT 83655 LEAD | $20.25 | $81.00 | $52.65–$60.43 | — | 75% |
| Blood lead test inpatient CPT 83655 Lead, Blood (Venous) | $20.25 | $81.00 | $52.65–$60.43 | — | 75% |
| Blood lead test inpatient CPT 83655 Lead Whole Blood | $20.25 | $81.00 | $52.65–$60.43 | — | 75% |
| Blood lead test inpatient CPT 83655 Lead, Whole Blood | $20.25 | $81.00 | $52.65–$60.43 | — | 75% |
| Blood lead test inpatient CPT 83655 Whole Blood Lead Level POC 83655 | $20.25 | $81.00 | $52.65–$60.43 | — | 75% |
| Blood lead test inpatient CPT 83655 Lead Random Urine | $20.25 | $81.00 | $52.65–$60.43 | — | 75% |
| Blood lead test inpatient CPT 83655 HETL Lead Venous | $20.25 | $81.00 | $52.65–$60.43 | — | 75% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta hCG Qualitative-Q | $16.25 | $65.00 | $32.56–$52.26 | 62% below | 75% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Serum HCG Qualitative | $16.25 | $65.00 | $32.56–$52.26 | 62% below | 75% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Beta hCG Qualitative-Q | $16.25 | $65.00 | $42.25–$48.49 | — | 75% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Serum HCG Qualitative | $16.25 | $65.00 | $42.25–$48.49 | — | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Group and Rh Type (Quest) | $64.75 | $259.00 | $129.76–$208.24 | 31% above | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABORh NB Interp | $64.75 | $259.00 | $129.76–$208.24 | 31% above | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABORh Interp | $64.75 | $259.00 | $129.76–$208.24 | 31% above | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 AMB Type and Screen. | $64.75 | $259.00 | $129.76–$208.24 | 31% above | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABORh - Adult | $64.75 | $259.00 | $129.76–$208.24 | 31% above | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Group and Rh Type (Quest) | $64.75 | $259.00 | $168.35–$193.21 | — | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 AMB Type and Screen. | $64.75 | $259.00 | $168.35–$193.21 | — | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABORh Interp | $64.75 | $259.00 | $168.35–$193.21 | — | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABORh NB Interp | $64.75 | $259.00 | $168.35–$193.21 | — | 75% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABORh - Adult | $64.75 | $259.00 | $168.35–$193.21 | — | 75% |
| Blood urea nitrogen (BUN) test CPT 84520 BF UREA | $9.50 | $38.00 | $19.04–$30.55 | 62% below | 75% |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Reduction Ratio | $9.50 | $38.00 | $19.04–$30.55 | 62% below | 75% |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen | $9.50 | $38.00 | $19.04–$30.55 | 62% below | 75% |
| Blood urea nitrogen (BUN) test CPT 84520 ISTAT Urea Nitrogen | $9.50 | $38.00 | $19.04–$30.55 | 62% below | 75% |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen (BUN)-Q | $9.50 | $38.00 | $19.04–$30.55 | 62% below | 75% |
| Blood urea nitrogen (BUN) test CPT 84520 FM BUN CHG | $9.50 | $38.00 | $19.04–$30.55 | 62% below | 75% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen | $9.50 | $38.00 | $24.70–$28.35 | — | 75% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen (BUN)-Q | $9.50 | $38.00 | $24.70–$28.35 | — | 75% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 FM BUN CHG | $9.50 | $38.00 | $24.70–$28.35 | — | 75% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Reduction Ratio | $9.50 | $38.00 | $24.70–$28.35 | — | 75% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BF UREA | $9.50 | $38.00 | $24.70–$28.35 | — | 75% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 ISTAT Urea Nitrogen | $9.50 | $38.00 | $24.70–$28.35 | — | 75% |
| C-peptide blood test CPT 84681 C-Peptide | $27.00 | $108.00 | $54.11–$86.83 | 62% below | 75% |
| C-peptide blood test CPT 84681 CARDIO IG CHG | $27.00 | $108.00 | $54.11–$86.83 | 62% below | 75% |
| C-peptide blood test inpatient CPT 84681 C-Peptide | $27.00 | $108.00 | $70.20–$80.57 | — | 75% |
| C-peptide blood test inpatient CPT 84681 CARDIO IG CHG | $27.00 | $108.00 | $70.20–$80.57 | — | 75% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP | $19.00 | $76.00 | $38.08–$61.10 | 49% below | 75% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein mg/L | $19.00 | $76.00 | $38.08–$61.10 | 49% below | 75% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein mg/L | $19.00 | $76.00 | $49.40–$56.70 | — | 75% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP | $19.00 | $76.00 | $49.40–$56.70 | — | 75% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile Testing Molecular | $33.25 | $133.00 | $66.63–$106.93 | 68% below | 75% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile Testing Molecular | $33.25 | $133.00 | $86.45–$99.22 | — | 75% |
| CA 19-9 blood test (tumor marker) CPT 86301 Cancer Antigen GI (CA19-9) | $22.25 | $89.00 | $44.59–$71.56 | 66% below | 75% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Cancer Antigen GI (CA19-9) | $22.25 | $89.00 | $57.85–$66.39 | — | 75% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 | $45.50 | $182.00 | $91.18–$146.33 | 47% below | 75% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen 125 | $45.50 | $182.00 | $118.30–$135.77 | — | 75% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 zzAdministrative Test for COVID 19 | $32.25 | $129.00 | $64.63–$103.72 | 63% below | 75% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID 19 | $32.25 | $129.00 | $64.63–$103.72 | 63% below | 75% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID 19 | $32.25 | $129.00 | $83.85–$96.23 | — | 75% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 zzAdministrative Test for COVID 19 | $32.25 | $129.00 | $83.85–$96.23 | — | 75% |
| Calcium blood test, total CPT 82310 CALPTH CREDIT | $12.75 | $51.00 | $25.55–$41.00 | 55% below | 75% |
| Calcium blood test, total CPT 82310 Calcium for PTH | $12.75 | $51.00 | $25.55–$41.00 | 55% below | 75% |
| Calcium blood test, total CPT 82310 Calcium Level | $12.75 | $51.00 | $25.55–$41.00 | 55% below | 75% |
| Calcium blood test, total CPT 82310 Calcium | $12.75 | $51.00 | $25.55–$41.00 | 55% below | 75% |
| Calcium blood test, total CPT 82310 Calcium Level Total-Q | $12.75 | $51.00 | $25.55–$41.00 | 55% below | 75% |
| Calcium blood test, total inpatient CPT 82310 CALPTH CREDIT | $12.75 | $51.00 | $33.15–$38.05 | — | 75% |
| Calcium blood test, total inpatient CPT 82310 Calcium Level | $12.75 | $51.00 | $33.15–$38.05 | — | 75% |
| Calcium blood test, total inpatient CPT 82310 Calcium | $12.75 | $51.00 | $33.15–$38.05 | — | 75% |
| Calcium blood test, total inpatient CPT 82310 Calcium Level Total-Q | $12.75 | $51.00 | $33.15–$38.05 | — | 75% |
| Calcium blood test, total inpatient CPT 82310 Calcium for PTH | $12.75 | $51.00 | $33.15–$38.05 | — | 75% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA Peritoneal Fluid | $35.00 | $140.00 | $70.14–$112.56 | 60% below | 75% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA Pericardial Fluid | $35.00 | $140.00 | $70.14–$112.56 | 60% below | 75% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA CSF | $35.00 | $140.00 | $70.14–$112.56 | 60% below | 75% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA Pleural Fluid | $35.00 | $140.00 | $70.14–$112.56 | 60% below | 75% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen | $35.00 | $140.00 | $70.14–$112.56 | 60% below | 75% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen, Fluid | $46.75 | $187.00 | $93.69–$150.35 | 47% below | 75% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA Pericardial Fluid | $35.00 | $140.00 | $91.00–$104.44 | — | 75% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen | $35.00 | $140.00 | $91.00–$104.44 | — | 75% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA Pleural Fluid | $35.00 | $140.00 | $91.00–$104.44 | — | 75% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA CSF | $35.00 | $140.00 | $91.00–$104.44 | — | 75% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA Peritoneal Fluid | $35.00 | $140.00 | $91.00–$104.44 | — | 75% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen, Fluid | $46.75 | $187.00 | $121.55–$139.50 | — | 75% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Virus Antibody IgG (Immune Status) | $28.00 | $112.00 | $56.11–$90.05 | 42% below | 75% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Virus Antibody, IgM | $28.00 | $112.00 | $56.11–$90.05 | 42% below | 75% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Virus Antibody IgG (Immune Status) | $28.00 | $112.00 | $72.80–$83.55 | — | 75% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Virus Antibody, IgM | $28.00 | $112.00 | $72.80–$83.55 | — | 75% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis Molecular Test | $38.00 | $152.00 | $76.15–$122.21 | 47% below | 75% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMCHG | $38.00 | $152.00 | $76.15–$122.21 | 47% below | 75% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. trachomatis & N. gonorrhoeae by TMA | $48.50 | $194.00 | $97.19–$155.98 | 33% below | 75% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLMCHG | $38.00 | $152.00 | $98.80–$113.39 | — | 75% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis Molecular Test | $38.00 | $152.00 | $98.80–$113.39 | — | 75% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. trachomatis & N. gonorrhoeae by TMA | $48.50 | $194.00 | $126.10–$144.72 | — | 75% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HDL 2 Profile | $31.50 | $126.00 | $63.13–$101.30 | 57% below | 75% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile (Non-Reflexive) | $31.50 | $126.00 | $63.13–$101.30 | 57% below | 75% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Advanced Lipid Panel w/Inflammation | $31.50 | $126.00 | $63.13–$101.30 | 57% below | 75% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Profile (Non-Reflexive) | $31.50 | $126.00 | $81.90–$94.00 | — | 75% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Advanced Lipid Panel w/Inflammation | $31.50 | $126.00 | $81.90–$94.00 | — | 75% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HDL 2 Profile | $31.50 | $126.00 | $81.90–$94.00 | — | 75% |
| Complete blood count (CBC) with differential CPT 85025 CBC | $25.25 | $101.00 | $50.60–$81.20 | 46% below | 75% |
| Complete blood count (CBC) with differential CPT 85025 CBC with DIFF | $25.25 | $101.00 | $50.60–$81.20 | 46% below | 75% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC with DIFF | $25.25 | $101.00 | $65.65–$75.35 | — | 75% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC | $25.25 | $101.00 | $65.65–$75.35 | — | 75% |
| Complete blood count (CBC), no differential CPT 85027 HM | $20.75 | $83.00 | $41.58–$66.73 | 33% below | 75% |
| Complete blood count (CBC), no differential CPT 85027 CBC without Differential-Q | $20.75 | $83.00 | $41.58–$66.73 | 33% below | 75% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HM | $20.75 | $83.00 | $53.95–$61.92 | — | 75% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC without Differential-Q | $20.75 | $83.00 | $53.95–$61.92 | — | 75% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $47.25 | $189.00 | $94.69–$151.96 | 55% below | 75% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP Add On Panel | $47.25 | $189.00 | $94.69–$151.96 | 55% below | 75% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel-Q | $47.25 | $189.00 | $94.69–$151.96 | 55% below | 75% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel-Q | $47.25 | $189.00 | $122.85–$140.99 | — | 75% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP Add On Panel | $47.25 | $189.00 | $122.85–$140.99 | — | 75% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $47.25 | $189.00 | $122.85–$140.99 | — | 75% |
| Cortisol blood test, total CPT 82533 60 Minute Cortisol | $31.75 | $127.00 | $63.63–$102.11 | 55% below | 75% |
| Cortisol blood test, total CPT 82533 30 Minute Cortisol | $31.75 | $127.00 | $63.63–$102.11 | 55% below | 75% |
| Cortisol blood test, total CPT 82533 Baseline Cortisol | $31.75 | $127.00 | $63.63–$102.11 | 55% below | 75% |
| Cortisol blood test, total CPT 82533 Cortisol | $31.75 | $127.00 | $63.63–$102.11 | 55% below | 75% |
| Cortisol blood test, total CPT 82533 Cortisol Post Dexamethasone | $31.75 | $127.00 | $63.63–$102.11 | 55% below | 75% |
| Cortisol blood test, total CPT 82533 Cortisol, Saliva | $31.75 | $127.00 | $63.63–$102.11 | 55% below | 75% |
| Cortisol blood test, total CPT 82533 ACTH Stimulation, 2 Specimens | $31.75 | $127.00 | $63.63–$102.11 | 55% below | 75% |
| Cortisol blood test, total CPT 82533 ACTH Stimulation, 3 Specimens | $31.75 | $127.00 | $63.63–$102.11 | 55% below | 75% |
| Cortisol blood test, total CPT 82533 ACTH CHG | $31.75 | $127.00 | $63.63–$102.11 | 55% below | 75% |
| Cortisol blood test, total CPT 82533 Cortisol, 3 Specimens | $31.75 | $127.00 | $63.63–$102.11 | 55% below | 75% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol Post Dexamethasone | $31.75 | $127.00 | $82.55–$94.74 | — | 75% |
| Cortisol blood test, total inpatient CPT 82533 ACTH Stimulation, 2 Specimens | $31.75 | $127.00 | $82.55–$94.74 | — | 75% |
| Cortisol blood test, total inpatient CPT 82533 60 Minute Cortisol | $31.75 | $127.00 | $82.55–$94.74 | — | 75% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol | $31.75 | $127.00 | $82.55–$94.74 | — | 75% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol, Saliva | $31.75 | $127.00 | $82.55–$94.74 | — | 75% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol, 3 Specimens | $31.75 | $127.00 | $82.55–$94.74 | — | 75% |
| Cortisol blood test, total inpatient CPT 82533 ACTH CHG | $31.75 | $127.00 | $82.55–$94.74 | — | 75% |
| Cortisol blood test, total inpatient CPT 82533 ACTH Stimulation, 3 Specimens | $31.75 | $127.00 | $82.55–$94.74 | — | 75% |
| Cortisol blood test, total inpatient CPT 82533 Baseline Cortisol | $31.75 | $127.00 | $82.55–$94.74 | — | 75% |
| Cortisol blood test, total inpatient CPT 82533 30 Minute Cortisol | $31.75 | $127.00 | $82.55–$94.74 | — | 75% |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase (CPK Total) | $15.00 | $60.00 | $30.06–$48.24 | 67% below | 75% |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase-Q | $15.00 | $60.00 | $30.06–$48.24 | 67% below | 75% |
| Creatine kinase (CK) blood test, total CPT 82550 CK CHARGE | $15.00 | $60.00 | $30.06–$48.24 | 67% below | 75% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase-Q | $15.00 | $60.00 | $39.00–$44.76 | — | 75% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CK CHARGE | $15.00 | $60.00 | $39.00–$44.76 | — | 75% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase (CPK Total) | $15.00 | $60.00 | $39.00–$44.76 | — | 75% |
| Creatinine blood test CPT 82565 ISTAT Creatinine | $11.00 | $44.00 | $22.04–$35.38 | 62% below | 75% |
| Creatinine blood test CPT 82565 Creatinine Serum | $11.00 | $44.00 | $22.04–$35.38 | 62% below | 75% |
| Creatinine blood test CPT 82565 Creatinine Serum-Q | $11.00 | $44.00 | $22.04–$35.38 | 62% below | 75% |
| Creatinine blood test CPT 82565 Creatinine | $11.00 | $44.00 | $22.04–$35.38 | 62% below | 75% |
| Creatinine blood test inpatient CPT 82565 Creatinine | $11.00 | $44.00 | $28.60–$32.82 | — | 75% |
| Creatinine blood test inpatient CPT 82565 ISTAT Creatinine | $11.00 | $44.00 | $28.60–$32.82 | — | 75% |
| Creatinine blood test inpatient CPT 82565 Creatinine Serum-Q | $11.00 | $44.00 | $28.60–$32.82 | — | 75% |
| Creatinine blood test inpatient CPT 82565 Creatinine Serum | $11.00 | $44.00 | $28.60–$32.82 | — | 75% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Ab IgG | $27.75 | $111.00 | $55.61–$89.24 | 56% below | 75% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV Ab, IgG | $27.75 | $111.00 | $55.61–$89.24 | 56% below | 75% |
| Cytomegalovirus (CMV) antibody test CPT 86644 ARC Donor CMV Test Charge | $27.75 | $111.00 | $55.61–$89.24 | 56% below | 75% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV Ab, IgG | $27.75 | $111.00 | $72.15–$82.81 | — | 75% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ARC Donor CMV Test Charge | $27.75 | $111.00 | $72.15–$82.81 | — | 75% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Ab IgG | $27.75 | $111.00 | $72.15–$82.81 | — | 75% |
| D-dimer blood test (blood clot marker) CPT 85379 DD QUANT | $24.00 | $96.00 | $48.10–$77.18 | 67% below | 75% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 DD QUANT | $24.00 | $96.00 | $62.40–$71.62 | — | 75% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate | $25.75 | $103.00 | $51.60–$82.81 | 72% below | 75% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate | $25.75 | $103.00 | $66.95–$76.84 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 UDRMCH | $10.25 | $41.00 | $20.54–$32.96 | 89% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 URUDR | $10.25 | $41.00 | $20.54–$32.96 | 89% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Tricyclic Antidepressants, Quant, Urine | $17.75 | $71.00 | $35.57–$57.08 | 82% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Ethanol Level Urine-Q | $29.50 | $118.00 | $59.12–$94.87 | 70% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 UDSV | $60.50 | $242.00 | $121.24–$194.57 | 38% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Ethyl Glucuronide Screen with Reflex, Urine | $60.50 | $242.00 | $121.24–$194.57 | 38% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS | $60.50 | $242.00 | $121.24–$194.57 | 38% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Detection Panel Meconium Qualitative | $60.50 | $242.00 | $121.24–$194.57 | 38% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 9 Panel (Send Out) w/Reflex | $60.50 | $242.00 | $121.24–$194.57 | 38% below | 75% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 MEC 9 CHG | $60.50 | $242.00 | $121.24–$194.57 | 38% below | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDRMCH | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URUDR | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Tricyclic Antidepressants, Quant, Urine | $17.75 | $71.00 | $46.15–$52.97 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ethanol Level Urine-Q | $29.50 | $118.00 | $76.70–$88.03 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 9 Panel (Send Out) w/Reflex | $60.50 | $242.00 | $157.30–$180.53 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Detection Panel Meconium Qualitative | $60.50 | $242.00 | $157.30–$180.53 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS | $60.50 | $242.00 | $157.30–$180.53 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ethyl Glucuronide Screen with Reflex, Urine | $60.50 | $242.00 | $157.30–$180.53 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDSV | $60.50 | $242.00 | $157.30–$180.53 | — | 75% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MEC 9 CHG | $60.50 | $242.00 | $157.30–$180.53 | — | 75% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 LYTES-Q | $17.50 | $70.00 | $35.07–$56.28 | 65% below | 75% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel | $17.50 | $70.00 | $35.07–$56.28 | 65% below | 75% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 LYTES-Q | $17.50 | $70.00 | $45.50–$52.22 | — | 75% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel | $17.50 | $70.00 | $45.50–$52.22 | — | 75% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV M | $28.25 | $113.00 | $56.61–$90.85 | 54% below | 75% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV G | $28.25 | $113.00 | $56.61–$90.85 | 54% below | 75% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Viral Capsid, IgM | $28.25 | $113.00 | $56.61–$90.85 | 54% below | 75% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Viral Capsid, IgG | $28.25 | $113.00 | $56.61–$90.85 | 54% below | 75% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV M | $28.25 | $113.00 | $73.45–$84.30 | — | 75% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV G | $28.25 | $113.00 | $73.45–$84.30 | — | 75% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Viral Capsid, IgG | $28.25 | $113.00 | $73.45–$84.30 | — | 75% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Viral Capsid, IgM | $28.25 | $113.00 | $73.45–$84.30 | — | 75% |
| Estradiol blood test CPT 82670 Estradiol Level | $50.00 | $200.00 | $100.20–$160.80 | 51% below | 75% |
| Estradiol blood test inpatient CPT 82670 Estradiol Level | $50.00 | $200.00 | $130.00–$149.20 | — | 75% |
| FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone | $36.75 | $147.00 | $73.65–$118.19 | 54% below | 75% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone | $36.75 | $147.00 | $95.55–$109.66 | — | 75% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal by Immunoassay | $60.75 | $243.00 | $121.74–$195.37 | 60% below | 75% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Fecal by Immunoassay | $60.75 | $243.00 | $157.95–$181.28 | — | 75% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $32.25 | $129.00 | $64.63–$103.72 | 57% below | 75% |
| Ferritin blood test (iron stores) CPT 82728 Liver Fibrosis, Non-Alcoholic Fatty Liver Disease, (Echosens) | $32.25 | $129.00 | $64.63–$103.72 | 57% below | 75% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $32.25 | $129.00 | $83.85–$96.23 | — | 75% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Liver Fibrosis, Non-Alcoholic Fatty Liver Disease, (Echosens) | $32.25 | $129.00 | $83.85–$96.23 | — | 75% |
| Fibrinogen blood test CPT 85384 Fibrinogen | $22.25 | $89.00 | $44.59–$71.56 | 63% below | 75% |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen | $22.25 | $89.00 | $57.85–$66.39 | — | 75% |
| Folate (folic acid) blood test CPT 82746 Folate Level | $20.50 | $82.00 | $41.08–$65.93 | 73% below | 75% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level | $20.50 | $82.00 | $53.30–$61.17 | — | 75% |
| Free T3 thyroid hormone test CPT 84481 Free T3 (Triiodothyronine) | $40.00 | $160.00 | $80.16–$128.64 | 54% below | 75% |
| Free T3 thyroid hormone test inpatient CPT 84481 Free T3 (Triiodothyronine) | $40.00 | $160.00 | $104.00–$119.36 | — | 75% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, Free, Direct Dialysis | $21.25 | $85.00 | $42.58–$68.34 | 64% below | 75% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FT4 | $21.25 | $85.00 | $42.58–$68.34 | 64% below | 75% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FT4 | $21.25 | $85.00 | $55.25–$63.41 | — | 75% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4, Free, Direct Dialysis | $21.25 | $85.00 | $55.25–$63.41 | — | 75% |
| Free testosterone test CPT 84402 Testosterone Bioavailable Panel | $38.00 | $152.00 | $76.15–$122.21 | 63% below | 75% |
| Free testosterone test CPT 84402 Testosterone Bioavailable Woman or Child | $38.00 | $152.00 | $76.15–$122.21 | 63% below | 75% |
| Free testosterone test CPT 84402 FTEST CHG | $38.00 | $152.00 | $76.15–$122.21 | 63% below | 75% |
| Free testosterone test CPT 84402 Testosterone, Free | $50.75 | $203.00 | $101.70–$163.21 | 50% below | 75% |
| Free testosterone test CPT 84402 zzTestosterone Free (Male Only) | $50.75 | $203.00 | $101.70–$163.21 | 50% below | 75% |
| Free testosterone test inpatient CPT 84402 Testosterone Bioavailable Panel | $38.00 | $152.00 | $98.80–$113.39 | — | 75% |
| Free testosterone test inpatient CPT 84402 FTEST CHG | $38.00 | $152.00 | $98.80–$113.39 | — | 75% |
| Free testosterone test inpatient CPT 84402 Testosterone Bioavailable Woman or Child | $38.00 | $152.00 | $98.80–$113.39 | — | 75% |
| Free testosterone test inpatient CPT 84402 Testosterone, Free | $50.75 | $203.00 | $131.95–$151.44 | — | 75% |
| Free testosterone test inpatient CPT 84402 zzTestosterone Free (Male Only) | $50.75 | $203.00 | $131.95–$151.44 | — | 75% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase | $14.50 | $58.00 | $29.06–$46.63 | 67% below | 75% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 FM GGT CHG | $14.50 | $58.00 | $29.06–$46.63 | 67% below | 75% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase-Q | $14.50 | $58.00 | $29.06–$46.63 | 67% below | 75% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase-Q | $14.50 | $58.00 | $37.70–$43.27 | — | 75% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 FM GGT CHG | $14.50 | $58.00 | $37.70–$43.27 | — | 75% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase | $14.50 | $58.00 | $37.70–$43.27 | — | 75% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 80050 General Health Panel | $94.25 | $377.00 | $188.88–$303.11 | 78% below | 75% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 80050 General Health Panel | $94.25 | $377.00 | $245.05–$281.24 | — | 75% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 120 Minute Glucose | $19.25 | $77.00 | $38.58–$61.91 | 48% below | 75% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 HR Pregnancy Screen | $19.25 | $77.00 | $38.58–$61.91 | 48% below | 75% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 60 Minute Glucose | $19.25 | $77.00 | $38.58–$61.91 | 48% below | 75% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 60 Minute Glucose | $19.25 | $77.00 | $50.05–$57.44 | — | 75% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1 HR Pregnancy Screen | $19.25 | $77.00 | $50.05–$57.44 | — | 75% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 120 Minute Glucose | $19.25 | $77.00 | $50.05–$57.44 | — | 75% |
| Glucose tolerance test, 3 samples CPT 82951 AMB Glucose Diabetes.(Quest) | $28.50 | $114.00 | $57.11–$91.66 | 55% below | 75% |
| Glucose tolerance test, 3 samples CPT 82951 Lactose Tolerance Test-Q | $28.50 | $114.00 | $57.11–$91.66 | 55% below | 75% |
| Glucose tolerance test, 3 samples CPT 82951 30 Minute Glucose | $28.50 | $114.00 | $57.11–$91.66 | 55% below | 75% |
| Glucose tolerance test, 3 samples CPT 82951 60 Minute Glucose | $28.50 | $114.00 | $57.11–$91.66 | 55% below | 75% |
| Glucose tolerance test, 3 samples CPT 82951 120 Minute Glucose | $28.50 | $114.00 | $57.11–$91.66 | 55% below | 75% |
| Glucose tolerance test, 3 samples CPT 82951 AMB Glucose Tolerance Gestational. (Quest) | $28.50 | $114.00 | $57.11–$91.66 | 55% below | 75% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Lactose Tolerance Test-Q | $28.50 | $114.00 | $74.10–$85.04 | — | 75% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 AMB Glucose Tolerance Gestational. (Quest) | $28.50 | $114.00 | $74.10–$85.04 | — | 75% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 AMB Glucose Diabetes.(Quest) | $28.50 | $114.00 | $74.10–$85.04 | — | 75% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 120 Minute Glucose | $28.50 | $114.00 | $74.10–$85.04 | — | 75% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 60 Minute Glucose | $28.50 | $114.00 | $74.10–$85.04 | — | 75% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 30 Minute Glucose | $28.50 | $114.00 | $74.10–$85.04 | — | 75% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NG CHG | $34.00 | $136.00 | $68.14–$109.34 | 48% below | 75% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. gonorrhoeae Molecular Test | $34.00 | $136.00 | $68.14–$109.34 | 48% below | 75% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CT, GC & Trich Molecular STD Panel Urogenital | $34.00 | $136.00 | $68.14–$109.34 | 48% below | 75% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CT & GC Molecular - STD Panel Urogenital | $34.00 | $136.00 | $68.14–$109.34 | 48% below | 75% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. gonorrhoeae Molecular Test | $34.00 | $136.00 | $88.40–$101.46 | — | 75% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CT, GC & Trich Molecular STD Panel Urogenital | $34.00 | $136.00 | $88.40–$101.46 | — | 75% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CT & GC Molecular - STD Panel Urogenital | $34.00 | $136.00 | $88.40–$101.46 | — | 75% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NG CHG | $34.00 | $136.00 | $88.40–$101.46 | — | 75% |
| H. pylori stool antigen test CPT 87338 Helicobacter pylori Ag, Fecal by EIA | $31.75 | $127.00 | $63.63–$102.11 | 72% below | 75% |
| H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Ag, Fecal by EIA | $31.75 | $127.00 | $82.55–$94.74 | — | 75% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA PCR Quantitative | $108.00 | $432.00 | $216.43–$347.33 | 53% below | 75% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 RNA PCR Quantitative | $108.00 | $432.00 | $280.80–$322.27 | — | 75% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1,2 Combo Ag/Ab EIA, Reflexive Panel | $27.50 | $110.00 | $55.11–$88.44 | 42% below | 75% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1,2 Combo Ag/Ab EIA, Reflexive Panel | $27.50 | $110.00 | $71.50–$82.06 | — | 75% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA Assay | $32.25 | $129.00 | $64.63–$103.72 | 55% below | 75% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA Assay | $32.25 | $129.00 | $83.85–$96.23 | — | 75% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGBAG | $21.50 | $86.00 | $43.09–$69.14 | 59% below | 75% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGBAG | $21.50 | $86.00 | $55.90–$64.16 | — | 75% |
| Hemoglobin blood test CPT 85018 Hemoglobin | $7.25 | $29.00 | $14.53–$23.32 | 52% below | 75% |
| Hemoglobin blood test CPT 85018 Hemoglobin-Q | $7.25 | $29.00 | $14.53–$23.32 | 52% below | 75% |
| Hemoglobin blood test CPT 85018 Hemoglobin POC Form | $7.25 | $29.00 | $14.53–$23.32 | 52% below | 75% |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin | $7.25 | $29.00 | $18.85–$21.63 | — | 75% |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin-Q | $7.25 | $29.00 | $18.85–$21.63 | — | 75% |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin POC Form | $7.25 | $29.00 | $18.85–$21.63 | — | 75% |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core - IgG & IgM | $27.50 | $110.00 | $55.11–$88.44 | 55% below | 75% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core - IgG & IgM | $27.50 | $110.00 | $71.50–$82.06 | — | 75% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody | $19.75 | $79.00 | $39.58–$63.52 | 61% below | 75% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody | $19.75 | $79.00 | $51.35–$58.93 | — | 75% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen | $19.75 | $79.00 | $39.58–$63.52 | 59% below | 75% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG | $19.75 | $79.00 | $39.58–$63.52 | 59% below | 75% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAG | $19.75 | $79.00 | $51.35–$58.93 | — | 75% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen | $19.75 | $79.00 | $51.35–$58.93 | — | 75% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Antibody | $24.00 | $96.00 | $48.10–$77.18 | 67% below | 75% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Antibody | $24.00 | $96.00 | $62.40–$71.62 | — | 75% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCVQ R | $73.00 | $292.00 | $146.29–$234.77 | 58% below | 75% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCVQ | $73.00 | $292.00 | $146.29–$234.77 | 58% below | 75% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus by Quant NAAT | $75.00 | $300.00 | $150.30–$241.20 | 56% below | 75% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCVQ R | $73.00 | $292.00 | $189.80–$217.83 | — | 75% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCVQ | $73.00 | $292.00 | $189.80–$217.83 | — | 75% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus by Quant NAAT | $75.00 | $300.00 | $195.00–$223.80 | — | 75% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV Type 1 IgG | $41.00 | $164.00 | $82.16–$131.86 | 22% below | 75% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV Type 1 IgG | $41.00 | $164.00 | $106.60–$122.34 | — | 75% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV Type 2 IgG | $41.00 | $164.00 | $82.16–$131.86 | 42% below | 75% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV Type 2 IgG | $41.00 | $164.00 | $106.60–$122.34 | — | 75% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein High Sensitivity-Q | $25.75 | $103.00 | $51.60–$82.81 | 50% below | 75% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HS Charge | $25.75 | $103.00 | $51.60–$82.81 | 50% below | 75% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-High Sensitivity | $25.75 | $103.00 | $51.60–$82.81 | 50% below | 75% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HS Charge | $25.75 | $103.00 | $66.95–$76.84 | — | 75% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP-High Sensitivity | $25.75 | $103.00 | $66.95–$76.84 | — | 75% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein High Sensitivity-Q | $25.75 | $103.00 | $66.95–$76.84 | — | 75% |
| Homocysteine blood test CPT 83090 HOMOCY-QNT | $39.75 | $159.00 | $79.66–$127.84 | 45% below | 75% |
| Homocysteine blood test inpatient CPT 83090 HOMOCY-QNT | $39.75 | $159.00 | $103.35–$118.61 | — | 75% |
| Insulin blood test CPT 83525 Insulin Response to Glucose, 6 Specimens | $25.50 | $102.00 | $51.10–$82.01 | 61% below | 75% |
| Insulin blood test CPT 83525 INSULI CHG | $25.50 | $102.00 | $51.10–$82.01 | 61% below | 75% |
| Insulin blood test CPT 83525 Insulin Response to Glucose, 3 Specimens | $25.50 | $102.00 | $51.10–$82.01 | 61% below | 75% |
| Insulin blood test CPT 83525 Insulin Response to Glucose, 2 Specimens | $25.50 | $102.00 | $51.10–$82.01 | 61% below | 75% |
| Insulin blood test CPT 83525 Insulin Response to Glucose, 5 Specimens | $25.50 | $102.00 | $51.10–$82.01 | 61% below | 75% |
| Insulin blood test CPT 83525 Cardio IQ Insulin Resistance Panel | $25.50 | $102.00 | $51.10–$82.01 | 61% below | 75% |
| Insulin blood test CPT 83525 Insulin Free | $25.50 | $102.00 | $51.10–$82.01 | 61% below | 75% |
| Insulin blood test CPT 83525 Insulin 90 Minutes | $25.50 | $102.00 | $51.10–$82.01 | 61% below | 75% |
| Insulin blood test CPT 83525 Insulin Level, Fasting | $25.50 | $102.00 | $51.10–$82.01 | 61% below | 75% |
| Insulin blood test inpatient CPT 83525 Cardio IQ Insulin Resistance Panel | $25.50 | $102.00 | $66.30–$76.09 | — | 75% |
| Insulin blood test inpatient CPT 83525 Insulin Response to Glucose, 2 Specimens | $25.50 | $102.00 | $66.30–$76.09 | — | 75% |
| Insulin blood test inpatient CPT 83525 Insulin Response to Glucose, 3 Specimens | $25.50 | $102.00 | $66.30–$76.09 | — | 75% |
| Insulin blood test inpatient CPT 83525 Insulin Response to Glucose, 6 Specimens | $25.50 | $102.00 | $66.30–$76.09 | — | 75% |
| Insulin blood test inpatient CPT 83525 INSULI CHG | $25.50 | $102.00 | $66.30–$76.09 | — | 75% |
| Insulin blood test inpatient CPT 83525 Insulin Response to Glucose, 5 Specimens | $25.50 | $102.00 | $66.30–$76.09 | — | 75% |
| Insulin blood test inpatient CPT 83525 Insulin Level, Fasting | $25.50 | $102.00 | $66.30–$76.09 | — | 75% |
| Insulin blood test inpatient CPT 83525 Insulin 90 Minutes | $25.50 | $102.00 | $66.30–$76.09 | — | 75% |
| Insulin blood test inpatient CPT 83525 Insulin Free | $25.50 | $102.00 | $66.30–$76.09 | — | 75% |
| Iron blood test (serum iron) CPT 83540 83540 Iron, Liver Tissue | $16.50 | $66.00 | $33.07–$53.06 | 56% below | 75% |
| Iron blood test (serum iron) CPT 83540 Iron | $16.50 | $66.00 | $33.07–$53.06 | 56% below | 75% |
| Iron blood test (serum iron) inpatient CPT 83540 83540 Iron, Liver Tissue | $16.50 | $66.00 | $42.90–$49.24 | — | 75% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron | $16.50 | $66.00 | $42.90–$49.24 | — | 75% |
| Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity | $16.25 | $65.00 | $32.56–$52.26 | 60% below | 75% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity | $16.25 | $65.00 | $42.25–$48.49 | — | 75% |
| Kidney function blood test panel CPT 80069 Renal Function Panel-Q | $19.25 | $77.00 | $38.58–$61.91 | 71% below | 75% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $19.25 | $77.00 | $38.58–$61.91 | 71% below | 75% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $19.25 | $77.00 | $50.05–$57.44 | — | 75% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel-Q | $19.25 | $77.00 | $50.05–$57.44 | — | 75% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone | $54.25 | $217.00 | $108.72–$174.47 | 36% below | 75% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone | $54.25 | $217.00 | $141.05–$161.88 | — | 75% |
| Lactate (lactic acid) blood test CPT 83605 Lactate | $40.50 | $162.00 | $81.16–$130.25 | 30% below | 75% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid Cerebrospinal Fluid | $40.50 | $162.00 | $81.16–$130.25 | 30% below | 75% |
| Lactate (lactic acid) blood test CPT 83605 Lactate w/Reflex greater than 2 | $40.50 | $162.00 | $81.16–$130.25 | 30% below | 75% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid Cerebrospinal Fluid | $40.50 | $162.00 | $105.30–$120.85 | — | 75% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactate w/Reflex greater than 2 | $40.50 | $162.00 | $105.30–$120.85 | — | 75% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactate | $40.50 | $162.00 | $105.30–$120.85 | — | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LD CHARGE | $12.00 | $48.00 | $24.05–$38.59 | 67% below | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LD Pleural Fluid-Q | $12.00 | $48.00 | $24.05–$38.59 | 67% below | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LD Synovial Fluid-Q | $12.00 | $48.00 | $24.05–$38.59 | 67% below | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LD Peritoneal Fluid-Q | $12.00 | $48.00 | $24.05–$38.59 | 67% below | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LD Pericardial Fluid-Q | $12.00 | $48.00 | $24.05–$38.59 | 67% below | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LD Body Fluid-Q | $12.00 | $48.00 | $24.05–$38.59 | 67% below | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase (LDH)-Q | $12.00 | $48.00 | $24.05–$38.59 | 67% below | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase | $12.00 | $48.00 | $24.05–$38.59 | 67% below | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 BF LDH | $12.00 | $48.00 | $24.05–$38.59 | 67% below | 75% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 CSF LDH | $12.00 | $48.00 | $24.05–$38.59 | 67% below | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 CSF LDH | $12.00 | $48.00 | $31.20–$35.81 | — | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD Pleural Fluid-Q | $12.00 | $48.00 | $31.20–$35.81 | — | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD Peritoneal Fluid-Q | $12.00 | $48.00 | $31.20–$35.81 | — | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD Pericardial Fluid-Q | $12.00 | $48.00 | $31.20–$35.81 | — | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD Synovial Fluid-Q | $12.00 | $48.00 | $31.20–$35.81 | — | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD Body Fluid-Q | $12.00 | $48.00 | $31.20–$35.81 | — | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase (LDH)-Q | $12.00 | $48.00 | $31.20–$35.81 | — | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase | $12.00 | $48.00 | $31.20–$35.81 | — | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 BF LDH | $12.00 | $48.00 | $31.20–$35.81 | — | 75% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD CHARGE | $12.00 | $48.00 | $31.20–$35.81 | — | 75% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase | $19.00 | $76.00 | $38.08–$61.10 | 59% below | 75% |
| Lipase blood test (pancreas enzyme) CPT 83690 BF LIPA | $19.00 | $76.00 | $38.08–$61.10 | 59% below | 75% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level-Q | $19.00 | $76.00 | $38.08–$61.10 | 59% below | 75% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase | $19.00 | $76.00 | $49.40–$56.70 | — | 75% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level-Q | $19.00 | $76.00 | $49.40–$56.70 | — | 75% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 BF LIPA | $19.00 | $76.00 | $49.40–$56.70 | — | 75% |
| Liver function blood test panel CPT 80076 HEPATIC | $24.75 | $99.00 | $49.60–$79.60 | 70% below | 75% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel-Q | $24.75 | $99.00 | $49.60–$79.60 | 70% below | 75% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC | $24.75 | $99.00 | $64.35–$73.85 | — | 75% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel-Q | $24.75 | $99.00 | $64.35–$73.85 | — | 75% |
| Lyme disease antibody test CPT 86618 CSF LYME | $36.75 | $147.00 | $73.65–$118.19 | 53% below | 75% |
| Lyme disease antibody test CPT 86618 Lyme Antibody | $36.75 | $147.00 | $73.65–$118.19 | 53% below | 75% |
| Lyme disease antibody test CPT 86618 Borrelia burgdorferi (LYME) Abs with Reflex | $36.75 | $147.00 | $73.65–$118.19 | 53% below | 75% |
| Lyme disease antibody test inpatient CPT 86618 CSF LYME | $36.75 | $147.00 | $95.55–$109.66 | — | 75% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Antibody | $36.75 | $147.00 | $95.55–$109.66 | — | 75% |
| Lyme disease antibody test inpatient CPT 86618 Borrelia burgdorferi (LYME) Abs with Reflex | $36.75 | $147.00 | $95.55–$109.66 | — | 75% |
| Magnesium blood test CPT 83735 Magnesium Level | $21.50 | $86.00 | $43.09–$69.14 | 46% below | 75% |
| Magnesium blood test CPT 83735 Magnesium Urine Timed Collection-Q | $21.50 | $86.00 | $43.09–$69.14 | 46% below | 75% |
| Magnesium blood test CPT 83735 Magnesium Level Urine Timed Collection | $21.50 | $86.00 | $43.09–$69.14 | 46% below | 75% |
| Magnesium blood test CPT 83735 Magnesium, RBC | $21.50 | $86.00 | $43.09–$69.14 | 46% below | 75% |
| Magnesium blood test CPT 83735 Magnesium Urine Random Collection | $21.50 | $86.00 | $43.09–$69.14 | 46% below | 75% |
| Magnesium blood test CPT 83735 Magnesium, 24 Hour Urine | $21.50 | $86.00 | $43.09–$69.14 | 46% below | 75% |
| Magnesium blood test CPT 83735 Magnesium Level-Q | $21.50 | $86.00 | $43.09–$69.14 | 46% below | 75% |
| Magnesium blood test CPT 83735 Magnesium Urine Random Collection-Q | $21.50 | $86.00 | $43.09–$69.14 | 46% below | 75% |
| Magnesium blood test inpatient CPT 83735 Magnesium, 24 Hour Urine | $21.50 | $86.00 | $55.90–$64.16 | — | 75% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level | $21.50 | $86.00 | $55.90–$64.16 | — | 75% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level Urine Timed Collection | $21.50 | $86.00 | $55.90–$64.16 | — | 75% |
| Magnesium blood test inpatient CPT 83735 Magnesium, RBC | $21.50 | $86.00 | $55.90–$64.16 | — | 75% |
| Magnesium blood test inpatient CPT 83735 Magnesium Urine Random Collection-Q | $21.50 | $86.00 | $55.90–$64.16 | — | 75% |
| Magnesium blood test inpatient CPT 83735 Magnesium Urine Timed Collection-Q | $21.50 | $86.00 | $55.90–$64.16 | — | 75% |
| Magnesium blood test inpatient CPT 83735 Magnesium Urine Random Collection | $21.50 | $86.00 | $55.90–$64.16 | — | 75% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level-Q | $21.50 | $86.00 | $55.90–$64.16 | — | 75% |
| Measles (rubeola) antibody test CPT 86765 Measles (Rubeola), IgM | $22.75 | $91.00 | $45.59–$73.16 | 35% below | 75% |
| Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Antibody IgG (Immune Status) | $22.75 | $91.00 | $45.59–$73.16 | 35% below | 75% |
| Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Antibody Immune Status IgG | $30.25 | $121.00 | $60.62–$97.28 | 14% below | 75% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola), IgM | $22.75 | $91.00 | $59.15–$67.89 | — | 75% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Antibody IgG (Immune Status) | $22.75 | $91.00 | $59.15–$67.89 | — | 75% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Antibody Immune Status IgG | $30.25 | $121.00 | $78.65–$90.27 | — | 75% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mono Spot | $15.75 | $63.00 | $31.56–$50.65 | 56% below | 75% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Monospot: Whole Blood POC | $15.75 | $63.00 | $31.56–$50.65 | 56% below | 75% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Monospot: Whole Blood POC | $15.75 | $63.00 | $40.95–$47.00 | — | 75% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Spot | $15.75 | $63.00 | $40.95–$47.00 | — | 75% |
| Mumps immunity blood test CPT 86735 Mumps Virus Antibody, IgM | $23.00 | $92.00 | $46.09–$73.97 | 38% below | 75% |
| Mumps immunity blood test CPT 86735 Mumps Virus Antibody IgG (Immune Status) | $23.00 | $92.00 | $46.09–$73.97 | 38% below | 75% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Virus Antibody, IgM | $23.00 | $92.00 | $59.80–$68.63 | — | 75% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Virus Antibody IgG (Immune Status) | $23.00 | $92.00 | $59.80–$68.63 | — | 75% |
| Obstetric blood test panel CPT 80055 AMB Prenatal Profile. | $95.50 | $382.00 | $191.38–$307.13 | 33% below | 75% |
| Obstetric blood test panel inpatient CPT 80055 AMB Prenatal Profile. | $95.50 | $382.00 | $248.30–$284.97 | — | 75% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, Free | $31.50 | $126.00 | $63.13–$101.30 | 66% below | 75% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, Free | $31.50 | $126.00 | $81.90–$94.00 | — | 75% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA | $23.00 | $92.00 | $46.09–$73.97 | 68% below | 75% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Reflex | $23.00 | $92.00 | $46.09–$73.97 | 68% below | 75% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Reflex | $23.00 | $92.00 | $59.80–$68.63 | — | 75% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA | $23.00 | $92.00 | $59.80–$68.63 | — | 75% |
| Pap test (liquid-based, automated screening with review) CPT 88175 88175 Thin PrepTest Imagin | $26.50 | $106.00 | $53.11–$85.22 | 59% below | 75% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 Thin PrepTest Imagin | $26.50 | $106.00 | $68.90–$79.08 | — | 75% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact With Calcium | $48.00 | $192.00 | $96.19–$154.37 | 51% below | 75% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact W/O Calcium | $48.00 | $192.00 | $96.19–$154.37 | 51% below | 75% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact W/O Calcium | $48.00 | $192.00 | $124.80–$143.23 | — | 75% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact With Calcium | $48.00 | $192.00 | $124.80–$143.23 | — | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 MIX CHG | $18.00 | $72.00 | $36.07–$57.89 | 59% below | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT LA w/Reflex | $18.00 | $72.00 | $36.07–$57.89 | 59% below | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT HEPZYME CHG | $18.00 | $72.00 | $36.07–$57.89 | 59% below | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT HEP REFLEX | $18.00 | $72.00 | $36.07–$57.89 | 59% below | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $18.00 | $72.00 | $36.07–$57.89 | 59% below | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT HEPZYME CHG | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT LA w/Reflex | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 MIX CHG | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT HEP REFLEX | $18.00 | $72.00 | $46.80–$53.71 | — | 75% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Serum | $9.25 | $37.00 | $18.54–$29.75 | 67% below | 75% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level-Q | $9.25 | $37.00 | $18.54–$29.75 | 67% below | 75% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level-Q | $9.25 | $37.00 | $24.05–$27.60 | — | 75% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Serum | $9.25 | $37.00 | $24.05–$27.60 | — | 75% |
| Potassium blood test CPT 84132 Potassium Level | $11.00 | $44.00 | $22.04–$35.38 | 55% below | 75% |
| Potassium blood test CPT 84132 Potassium [K+] Level-Q | $11.00 | $44.00 | $22.04–$35.38 | 55% below | 75% |
| Potassium blood test CPT 84132 Potassium | $11.00 | $44.00 | $22.04–$35.38 | 55% below | 75% |
| Potassium blood test CPT 84132 ISTAT Potassium | $11.00 | $44.00 | $22.04–$35.38 | 55% below | 75% |
| Potassium blood test inpatient CPT 84132 ISTAT Potassium | $11.00 | $44.00 | $28.60–$32.82 | — | 75% |
| Potassium blood test inpatient CPT 84132 Potassium [K+] Level-Q | $11.00 | $44.00 | $28.60–$32.82 | — | 75% |
| Potassium blood test inpatient CPT 84132 Potassium Level | $11.00 | $44.00 | $28.60–$32.82 | — | 75% |
| Potassium blood test inpatient CPT 84132 Potassium | $11.00 | $44.00 | $28.60–$32.82 | — | 75% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 zzFetal Aneuploidy Screening | $805.50 | $3,222.00 | $1,614.22–$2,590.49 | 23% below | 75% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 zzFetal Aneuploidy Screening | $805.50 | $3,222.00 | $2,094.30–$2,403.61 | — | 75% |
| Progesterone blood test CPT 84144 PROG | $38.25 | $153.00 | $76.65–$123.01 | 57% below | 75% |
| Progesterone blood test inpatient CPT 84144 PROG | $38.25 | $153.00 | $99.45–$114.14 | — | 75% |
| Prolactin blood test CPT 84146 PROL CHG | $36.25 | $145.00 | $72.64–$116.58 | 52% below | 75% |
| Prolactin blood test CPT 84146 Prolactin Level | $36.25 | $145.00 | $72.64–$116.58 | 52% below | 75% |
| Prolactin blood test CPT 84146 Prolactin, Total and Monomeric | $36.25 | $145.00 | $72.64–$116.58 | 52% below | 75% |
| Prolactin blood test CPT 84146 Prolactin, Dilution Study | $36.25 | $145.00 | $72.64–$116.58 | 52% below | 75% |
| Prolactin blood test inpatient CPT 84146 PROL CHG | $36.25 | $145.00 | $94.25–$108.17 | — | 75% |
| Prolactin blood test inpatient CPT 84146 Prolactin Level | $36.25 | $145.00 | $94.25–$108.17 | — | 75% |
| Prolactin blood test inpatient CPT 84146 Prolactin, Total and Monomeric | $36.25 | $145.00 | $94.25–$108.17 | — | 75% |
| Prolactin blood test inpatient CPT 84146 Prolactin, Dilution Study | $36.25 | $145.00 | $94.25–$108.17 | — | 75% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin and INR POC Form | $11.75 | $47.00 | $23.55–$37.79 | 60% below | 75% |
| Prothrombin time (PT/INR) clotting test CPT 85610 International Normal Ratio | $11.75 | $47.00 | $23.55–$37.79 | 60% below | 75% |
| Prothrombin time (PT/INR) clotting test CPT 85610 ISTAT INR | $11.75 | $47.00 | $23.55–$37.79 | 60% below | 75% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin and INR POC Form | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 International Normal Ratio | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 ISTAT INR | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drugs of Abuse Profile 5 POC | $10.25 | $41.00 | $20.54–$32.96 | 60% below | 75% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drugs of Abuse Profile 5 POC | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep POC | $17.25 | $69.00 | $34.57–$55.48 | 56% below | 75% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep POC | $17.25 | $69.00 | $44.85–$51.47 | — | 75% |
| Renin blood test CPT 84244 Renin Activity | $39.50 | $158.00 | $79.16–$127.03 | 46% below | 75% |
| Renin blood test CPT 84244 RENIN CHG | $39.50 | $158.00 | $79.16–$127.03 | 46% below | 75% |
| Renin blood test inpatient CPT 84244 RENIN CHG | $39.50 | $158.00 | $102.70–$117.87 | — | 75% |
| Renin blood test inpatient CPT 84244 Renin Activity | $39.50 | $158.00 | $102.70–$117.87 | — | 75% |
| Rh blood typing CPT 86901 Rh Type | $42.75 | $171.00 | $85.67–$137.48 | 17% above | 75% |
| Rh blood typing CPT 86901 Anti-D | $42.75 | $171.00 | $85.67–$137.48 | 17% above | 75% |
| Rh blood typing inpatient CPT 86901 Anti-D | $42.75 | $171.00 | $111.15–$127.57 | — | 75% |
| Rh blood typing inpatient CPT 86901 Rh Type | $42.75 | $171.00 | $111.15–$127.57 | — | 75% |
| Rheumatoid factor (RF) test CPT 86431 RHEUM FAC CHG | $6.00 | $24.00 | $12.02–$19.30 | 82% below | 75% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor | $6.00 | $24.00 | $12.02–$19.30 | 82% below | 75% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUM FAC CHG | $6.00 | $24.00 | $15.60–$17.90 | — | 75% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor | $6.00 | $24.00 | $15.60–$17.90 | — | 75% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Ab, IgG | $25.25 | $101.00 | $50.60–$81.20 | 50% below | 75% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IgG (Immune Status) | $25.25 | $101.00 | $50.60–$81.20 | 50% below | 75% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IgG (Immune Status) | $25.25 | $101.00 | $65.65–$75.35 | — | 75% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab, IgG | $25.25 | $101.00 | $65.65–$75.35 | — | 75% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate | $8.50 | $34.00 | $17.03–$27.34 | 71% below | 75% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate | $8.50 | $34.00 | $22.10–$25.36 | — | 75% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 89320 Sperm Morphology | $28.75 | $115.00 | $57.62–$92.46 | 65% below | 75% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 89320 Sperm Morphology | $28.75 | $115.00 | $74.75–$85.79 | — | 75% |
| Sodium blood test CPT 84295 Sodium Level-Q | $10.75 | $43.00 | $21.54–$34.57 | 55% below | 75% |
| Sodium blood test CPT 84295 Sodium Level | $10.75 | $43.00 | $21.54–$34.57 | 55% below | 75% |
| Sodium blood test CPT 84295 Sodium | $10.75 | $43.00 | $21.54–$34.57 | 55% below | 75% |
| Sodium blood test CPT 84295 ISTAT Sodium | $10.75 | $43.00 | $21.54–$34.57 | 55% below | 75% |
| Sodium blood test inpatient CPT 84295 Sodium | $10.75 | $43.00 | $27.95–$32.08 | — | 75% |
| Sodium blood test inpatient CPT 84295 Sodium Level | $10.75 | $43.00 | $27.95–$32.08 | — | 75% |
| Sodium blood test inpatient CPT 84295 Sodium Level-Q | $10.75 | $43.00 | $27.95–$32.08 | — | 75% |
| Sodium blood test inpatient CPT 84295 ISTAT Sodium | $10.75 | $43.00 | $27.95–$32.08 | — | 75% |
| Stool ova and parasites exam CPT 87177 zzOva and Parasites Comprehensive | $15.00 | $60.00 | $30.06–$48.24 | 59% below | 75% |
| Stool ova and parasites exam CPT 87177 Ova and Parasites, Comprehensive | $15.00 | $60.00 | $30.06–$48.24 | 59% below | 75% |
| Stool ova and parasites exam inpatient CPT 87177 zzOva and Parasites Comprehensive | $15.00 | $60.00 | $39.00–$44.76 | — | 75% |
| Stool ova and parasites exam inpatient CPT 87177 Ova and Parasites, Comprehensive | $15.00 | $60.00 | $39.00–$44.76 | — | 75% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Fecal Occult Blood Home POC | $4.25 | $17.00 | $8.52–$13.67 | 79% below | 75% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Hemoccult POC Form | $4.25 | $17.00 | $8.52–$13.67 | 79% below | 75% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool Immunochemical #1 - Medicare Screen | $4.25 | $17.00 | $8.52–$13.67 | 79% below | 75% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool #1 - Medicare Screen | $4.25 | $17.00 | $8.52–$13.67 | 79% below | 75% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool Immunochemical #1 - Medicare Screen | $4.25 | $17.00 | $11.05–$12.68 | — | 75% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Hemoccult POC Form | $4.25 | $17.00 | $11.05–$12.68 | — | 75% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Fecal Occult Blood Home POC | $4.25 | $17.00 | $11.05–$12.68 | — | 75% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool #1 - Medicare Screen | $4.25 | $17.00 | $11.05–$12.68 | — | 75% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Occult Blood POC Form Screening | $21.25 | $85.00 | $42.58–$68.34 | 48% below | 75% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood Stool Immunochemical | $21.25 | $85.00 | $42.58–$68.34 | 48% below | 75% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood Stool Immunochemical | $21.25 | $85.00 | $55.25–$63.41 | — | 75% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Fecal Occult Blood POC Form Screening | $21.25 | $85.00 | $55.25–$63.41 | — | 75% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Fluorescent Treponemal Antibody-Absorption | $29.50 | $118.00 | $59.12–$94.87 | 45% below | 75% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum Ab by TP-PA | $29.50 | $118.00 | $59.12–$94.87 | 45% below | 75% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum Ab by TP-PA | $29.50 | $118.00 | $76.70–$88.03 | — | 75% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Fluorescent Treponemal Antibody-Absorption | $29.50 | $118.00 | $76.70–$88.03 | — | 75% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR w/Reflex Titer and FTA | $17.00 | $68.00 | $34.07–$54.67 | 46% below | 75% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL Reflex to Titer Serum | $17.00 | $68.00 | $34.07–$54.67 | 46% below | 75% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL with Reflex to Titer, CSF | $17.00 | $68.00 | $34.07–$54.67 | 46% below | 75% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Test | $17.00 | $68.00 | $34.07–$54.67 | 46% below | 75% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL with Reflex to Titer, CSF | $17.00 | $68.00 | $44.20–$50.73 | — | 75% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Test | $17.00 | $68.00 | $44.20–$50.73 | — | 75% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL Reflex to Titer Serum | $17.00 | $68.00 | $44.20–$50.73 | — | 75% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR w/Reflex Titer and FTA | $17.00 | $68.00 | $44.20–$50.73 | — | 75% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QFT-1 36970 | $26.50 | $106.00 | $53.11–$85.22 | 77% below | 75% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon-TB Gold Plus 4-Tube | $26.50 | $106.00 | $53.11–$85.22 | 77% below | 75% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon-TB Gold Plus 4-Tube | $26.50 | $106.00 | $68.90–$79.08 | — | 75% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QFT-1 36970 | $26.50 | $106.00 | $68.90–$79.08 | — | 75% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total | $11.75 | $47.00 | $23.55–$37.79 | 87% below | 75% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total (MS), Women or Children | $14.75 | $59.00 | $29.56–$47.44 | 84% below | 75% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Free (Quest) | $14.75 | $59.00 | $29.56–$47.44 | 84% below | 75% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total | $14.75 | $59.00 | $29.56–$47.44 | 84% below | 75% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Free and Total, Women or Children | $14.75 | $59.00 | $29.56–$47.44 | 84% below | 75% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TEST CHG | $14.75 | $59.00 | $29.56–$47.44 | 84% below | 75% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TEST CHG | $14.75 | $59.00 | $38.35–$44.01 | — | 75% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total | $14.75 | $59.00 | $38.35–$44.01 | — | 75% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total (MS), Women or Children | $14.75 | $59.00 | $38.35–$44.01 | — | 75% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Free and Total, Women or Children | $14.75 | $59.00 | $38.35–$44.01 | — | 75% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Free (Quest) | $14.75 | $59.00 | $38.35–$44.01 | — | 75% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibody | $35.25 | $141.00 | $70.64–$113.36 | 59% below | 75% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsome-1 Antibody, IgG | $35.25 | $141.00 | $70.64–$113.36 | 59% below | 75% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 AMICR | $35.25 | $141.00 | $70.64–$113.36 | 59% below | 75% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Antibody | $35.25 | $141.00 | $91.65–$105.19 | — | 75% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 AMICR | $35.25 | $141.00 | $91.65–$105.19 | — | 75% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsome-1 Antibody, IgG | $35.25 | $141.00 | $91.65–$105.19 | — | 75% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyrotropin-TSH-Reflex | $38.75 | $155.00 | $77.66–$124.62 | 50% below | 75% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $38.75 | $155.00 | $77.66–$124.62 | 50% below | 75% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyrotropin-TSH-Reflex | $38.75 | $155.00 | $100.75–$115.63 | — | 75% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $38.75 | $155.00 | $100.75–$115.63 | — | 75% |
| Total IgE blood test CPT 82785 IGE CREDIT | $29.50 | $118.00 | $59.12–$94.87 | 54% below | 75% |
| Total IgE blood test CPT 82785 Immunoglobulin E | $29.50 | $118.00 | $59.12–$94.87 | 54% below | 75% |
| Total IgE blood test CPT 82785 IGE CHG | $29.50 | $118.00 | $59.12–$94.87 | 54% below | 75% |
| Total IgE blood test CPT 82785 REG1PAN 10643 | $29.50 | $118.00 | $59.12–$94.87 | 54% below | 75% |
| Total IgE blood test inpatient CPT 82785 IGE CREDIT | $29.50 | $118.00 | $76.70–$88.03 | — | 75% |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E | $29.50 | $118.00 | $76.70–$88.03 | — | 75% |
| Total IgE blood test inpatient CPT 82785 REG1PAN 10643 | $29.50 | $118.00 | $76.70–$88.03 | — | 75% |
| Total IgE blood test inpatient CPT 82785 IGE CHG | $29.50 | $118.00 | $76.70–$88.03 | — | 75% |
| Total cholesterol blood test CPT 82465 Cholesterol | $12.50 | $50.00 | $25.05–$40.20 | 49% below | 75% |
| Total cholesterol blood test CPT 82465 TCHOL CHG | $12.50 | $50.00 | $25.05–$40.20 | 49% below | 75% |
| Total cholesterol blood test CPT 82465 BF CHOL | $16.50 | $66.00 | $33.07–$53.06 | 32% below | 75% |
| Total cholesterol blood test inpatient CPT 82465 TCHOL CHG | $12.50 | $50.00 | $32.50–$37.30 | — | 75% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol | $12.50 | $50.00 | $32.50–$37.30 | — | 75% |
| Total cholesterol blood test inpatient CPT 82465 BF CHOL | $16.50 | $66.00 | $42.90–$49.24 | — | 75% |
| Total thyroxine (T4) blood test CPT 84436 Total Thyroxine (T4) | $17.75 | $71.00 | $35.57–$57.08 | 63% below | 75% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Total Thyroxine (T4) | $17.75 | $71.00 | $46.15–$52.97 | — | 75% |
| Total triiodothyronine (T3) blood test CPT 84480 Total Triiodothyronine | $31.00 | $124.00 | $62.12–$99.70 | 63% below | 75% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Total Triiodothyronine | $31.00 | $124.00 | $80.60–$92.50 | — | 75% |
| Transferrin blood test CPT 84466 Transferrin | $24.25 | $97.00 | $48.60–$77.99 | 58% below | 75% |
| Transferrin blood test inpatient CPT 84466 Transferrin | $24.25 | $97.00 | $63.05–$72.36 | — | 75% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis Molecular Test | $37.00 | $148.00 | $74.15–$118.99 | 59% below | 75% |
| Trichomonas test (NAAT) CPT 87661 TRICHCHG | $37.00 | $148.00 | $74.15–$118.99 | 59% below | 75% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHCHG | $37.00 | $148.00 | $96.20–$110.41 | — | 75% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis Molecular Test | $37.00 | $148.00 | $96.20–$110.41 | — | 75% |
| Triglycerides blood test CPT 84478 Triglycerides Pleural Fluid | $21.25 | $85.00 | $42.58–$68.34 | 52% below | 75% |
| Triglycerides blood test CPT 84478 Triglyceride | $21.25 | $85.00 | $42.58–$68.34 | 52% below | 75% |
| Triglycerides blood test CPT 84478 Triglycerides Peritoneal Fluid | $21.25 | $85.00 | $42.58–$68.34 | 52% below | 75% |
| Triglycerides blood test CPT 84478 zzTriglyceride Body Fluid | $28.25 | $113.00 | $56.61–$90.85 | 37% below | 75% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides Peritoneal Fluid | $21.25 | $85.00 | $55.25–$63.41 | — | 75% |
| Triglycerides blood test inpatient CPT 84478 Triglyceride | $21.25 | $85.00 | $55.25–$63.41 | — | 75% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides Pleural Fluid | $21.25 | $85.00 | $55.25–$63.41 | — | 75% |
| Triglycerides blood test inpatient CPT 84478 zzTriglyceride Body Fluid | $28.25 | $113.00 | $73.45–$84.30 | — | 75% |
| Troponin test, quantitative CPT 84484 Troponin I Highly Sensitive Random | $63.00 | $252.00 | $126.25–$202.61 | 21% below | 75% |
| Troponin test, quantitative CPT 84484 Troponin I | $63.00 | $252.00 | $126.25–$202.61 | 21% below | 75% |
| Troponin test, quantitative CPT 84484 Troponin I Protocol 3 | $63.00 | $252.00 | $126.25–$202.61 | 21% below | 75% |
| Troponin test, quantitative CPT 84484 Troponin I Protocol 2 | $63.00 | $252.00 | $126.25–$202.61 | 21% below | 75% |
| Troponin test, quantitative CPT 84484 Troponin I Protocol 1 | $63.00 | $252.00 | $126.25–$202.61 | 21% below | 75% |
| Troponin test, quantitative CPT 84484 ISTAT Troponin | $63.00 | $252.00 | $126.25–$202.61 | 21% below | 75% |
| Troponin test, quantitative CPT 84484 Troponin I Highly Sensitive Random-Q | $63.00 | $252.00 | $126.25–$202.61 | 21% below | 75% |
| Troponin test, quantitative CPT 84484 Troponin I Highly Sensitive Protocol 2 | $63.00 | $252.00 | $126.25–$202.61 | 21% below | 75% |
| Troponin test, quantitative CPT 84484 Troponin I Highly Sensitive Protocol 1 | $63.00 | $252.00 | $126.25–$202.61 | 21% below | 75% |
| Troponin test, quantitative CPT 84484 Troponin I Highly Sensitive Protocol 3 | $63.00 | $252.00 | $126.25–$202.61 | 21% below | 75% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I Protocol 1 | $63.00 | $252.00 | $163.80–$187.99 | — | 75% |
| Troponin test, quantitative inpatient CPT 84484 ISTAT Troponin | $63.00 | $252.00 | $163.80–$187.99 | — | 75% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I Protocol 2 | $63.00 | $252.00 | $163.80–$187.99 | — | 75% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I Protocol 3 | $63.00 | $252.00 | $163.80–$187.99 | — | 75% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I Highly Sensitive Protocol 2 | $63.00 | $252.00 | $163.80–$187.99 | — | 75% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I Highly Sensitive Protocol 3 | $63.00 | $252.00 | $163.80–$187.99 | — | 75% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I Highly Sensitive Protocol 1 | $63.00 | $252.00 | $163.80–$187.99 | — | 75% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I Highly Sensitive Random | $63.00 | $252.00 | $163.80–$187.99 | — | 75% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I | $63.00 | $252.00 | $163.80–$187.99 | — | 75% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I Highly Sensitive Random-Q | $63.00 | $252.00 | $163.80–$187.99 | — | 75% |
| Uric acid blood test CPT 84550 Uric Acid | $14.50 | $58.00 | $29.06–$46.63 | 53% below | 75% |
| Uric acid blood test CPT 84550 Uric Acid-Q | $14.50 | $58.00 | $29.06–$46.63 | 53% below | 75% |
| Uric acid blood test inpatient CPT 84550 Uric Acid-Q | $14.50 | $58.00 | $37.70–$43.27 | — | 75% |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $14.50 | $58.00 | $37.70–$43.27 | — | 75% |
| Urinalysis with microscope exam, automated CPT 81001 81001 Charge Transformation Order | $14.50 | $58.00 | $29.06–$46.63 | 58% below | 75% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis, Complete, Reflex to Culture | $14.50 | $58.00 | $29.06–$46.63 | 58% below | 75% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis, Complete, Reflex to Culture | $14.50 | $58.00 | $37.70–$43.27 | — | 75% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 81001 Charge Transformation Order | $14.50 | $58.00 | $37.70–$43.27 | — | 75% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis Non-Auto w/o Scope POC | $5.50 | $22.00 | $11.02–$17.69 | 78% below | 75% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Non-Auto w/o Scope POC | $5.50 | $22.00 | $14.30–$16.41 | — | 75% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Auto w/o Scope POC | $10.25 | $41.00 | $20.54–$32.96 | 53% below | 75% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis w/Microscopic if Indicated | $10.25 | $41.00 | $20.54–$32.96 | 53% below | 75% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Macroscopic-Q | $10.25 | $41.00 | $20.54–$32.96 | 53% below | 75% |
| Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine-Q | $10.25 | $41.00 | $20.54–$32.96 | 53% below | 75% |
| Urinalysis without microscope exam, automated CPT 81003 pH Urine-Q | $10.25 | $41.00 | $20.54–$32.96 | 53% below | 75% |
| Urinalysis without microscope exam, automated CPT 81003 UA DIP for Beva/Avastin treatment | $10.25 | $41.00 | $20.54–$32.96 | 53% below | 75% |
| Urinalysis without microscope exam, automated CPT 81003 UA-REFLEX | $10.25 | $41.00 | $20.54–$32.96 | 53% below | 75% |
| Urinalysis without microscope exam, automated CPT 81003 UA DIP | $10.25 | $41.00 | $20.54–$32.96 | 53% below | 75% |
| Urinalysis without microscope exam, automated CPT 81003 UA | $10.25 | $41.00 | $20.54–$32.96 | 53% below | 75% |
| Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine | $10.25 | $41.00 | $20.54–$32.96 | 53% below | 75% |
| Urinalysis without microscope exam, automated CPT 81003 pH Urine | $10.25 | $41.00 | $20.54–$32.96 | 53% below | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine-Q | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Macroscopic-Q | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA-REFLEX | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 pH Urine-Q | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 pH Urine | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA DIP | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA DIP for Beva/Avastin treatment | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Auto w/o Scope POC | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis w/Microscopic if Indicated | $10.25 | $41.00 | $26.65–$30.59 | — | 75% |
| Urinalysis without microscope exam, manual CPT 81002 Reducing Substance Urine | $4.50 | $18.00 | $9.02–$14.47 | 71% below | 75% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Dipstick POC | $4.50 | $18.00 | $9.02–$14.47 | 71% below | 75% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Reducing Substance Urine | $4.50 | $18.00 | $11.70–$13.43 | — | 75% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Dipstick POC | $4.50 | $18.00 | $11.70–$13.43 | — | 75% |
| Urine culture for bacteria, with colony count CPT 87086 Bacterial Culture Urine | $21.50 | $86.00 | $43.09–$69.14 | 67% below | 75% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Bacterial Culture Urine | $21.50 | $86.00 | $55.90–$64.16 | — | 75% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine Timed Collection-Q | $14.25 | $57.00 | $28.56–$45.83 | 72% below | 75% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine Random Collection-Q | $14.25 | $57.00 | $28.56–$45.83 | 72% below | 75% |
| Urine microalbumin (albumin) test CPT 82043 UMALB RANDOM | $14.25 | $57.00 | $28.56–$45.83 | 72% below | 75% |
| Urine microalbumin (albumin) test CPT 82043 UR MALB | $14.25 | $57.00 | $28.56–$45.83 | 72% below | 75% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine Random Collection-Q | $14.25 | $57.00 | $37.05–$42.52 | — | 75% |
| Urine microalbumin (albumin) test inpatient CPT 82043 UMALB RANDOM | $14.25 | $57.00 | $37.05–$42.52 | — | 75% |
| Urine microalbumin (albumin) test inpatient CPT 82043 UR MALB | $14.25 | $57.00 | $37.05–$42.52 | — | 75% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine Timed Collection-Q | $14.25 | $57.00 | $37.05–$42.52 | — | 75% |
| Urine pregnancy test, read by color change CPT 81025 U PREG | $15.25 | $61.00 | $30.56–$49.04 | 46% below | 75% |
| Urine pregnancy test, read by color change CPT 81025 Beta hCG Qualitative Urine-Q | $15.25 | $61.00 | $30.56–$49.04 | 46% below | 75% |
| Urine pregnancy test, read by color change CPT 81025 HCG, Urine POC | $15.25 | $61.00 | $30.56–$49.04 | 46% below | 75% |
| Urine pregnancy test, read by color change inpatient CPT 81025 U PREG | $15.25 | $61.00 | $39.65–$45.51 | — | 75% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG, Urine POC | $15.25 | $61.00 | $39.65–$45.51 | — | 75% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Beta hCG Qualitative Urine-Q | $15.25 | $61.00 | $39.65–$45.51 | — | 75% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level Reflex | $21.00 | $84.00 | $42.08–$67.54 | 76% below | 75% |
| Vitamin B12 (cobalamin) blood test CPT 82607 B12 | $21.00 | $84.00 | $42.08–$67.54 | 76% below | 75% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level Reflex | $21.00 | $84.00 | $54.60–$62.66 | — | 75% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B12 | $21.00 | $84.00 | $54.60–$62.66 | — | 75% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level | $37.75 | $151.00 | $75.65–$121.40 | 67% below | 75% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D2 and D3, 25-Hydroxy | $37.75 | $151.00 | $75.65–$121.40 | 67% below | 75% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Under 3 Years | $37.75 | $151.00 | $75.65–$121.40 | 67% below | 75% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy Under 3 Years | $37.75 | $151.00 | $98.15–$112.65 | — | 75% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D2 and D3, 25-Hydroxy | $37.75 | $151.00 | $98.15–$112.65 | — | 75% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy Level | $37.75 | $151.00 | $98.15–$112.65 | — | 75% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D 1-25 Dihydroxy Level | $51.75 | $207.00 | $103.71–$166.43 | 61% below | 75% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D 1-25 Dihydroxy Level | $51.75 | $207.00 | $134.55–$154.42 | — | 75% |
| Zinc blood test CPT 84630 Zinc Level-Serum | $12.25 | $49.00 | $24.55–$39.40 | 71% below | 75% |
| Zinc blood test CPT 84630 Zinc, Red Blood Cells | $12.25 | $49.00 | $24.55–$39.40 | 71% below | 75% |
| Zinc blood test CPT 84630 Zinc Charge | $12.25 | $49.00 | $24.55–$39.40 | 71% below | 75% |
| Zinc blood test inpatient CPT 84630 Zinc, Red Blood Cells | $12.25 | $49.00 | $31.85–$36.55 | — | 75% |
| Zinc blood test inpatient CPT 84630 Zinc Level-Serum | $12.25 | $49.00 | $31.85–$36.55 | — | 75% |
| Zinc blood test inpatient CPT 84630 Zinc Charge | $12.25 | $49.00 | $31.85–$36.55 | — | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG CHG | $37.50 | $150.00 | $75.15–$120.60 | 54% below | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG | $37.50 | $150.00 | $75.15–$120.60 | 54% below | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta-HCG (Tumor Marker) | $37.50 | $150.00 | $75.15–$120.60 | 54% below | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Pregnancy Test Quantitative Serum-Q | $37.50 | $150.00 | $75.15–$120.60 | 54% below | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG CHG | $37.50 | $150.00 | $97.50–$111.90 | — | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG | $37.50 | $150.00 | $97.50–$111.90 | — | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta-HCG (Tumor Marker) | $37.50 | $150.00 | $97.50–$111.90 | — | 75% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Pregnancy Test Quantitative Serum-Q | $37.50 | $150.00 | $97.50–$111.90 | — | 75% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786 - CLOSED TRMNT DIST FIB FX W/O MANIP | $276.00 | $1,104.00 | $553.10–$887.62 | at median | 75% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Closed treatment of distal fibular fracture (lateral malleolus); without manipulation 27786 | $412.50 | $1,650.00 | $826.65–$1,326.60 | 49% above | 75% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786 - CLOSED TRMNT DIST FIB FX W/O MANIP | $276.00 | $1,104.00 | $717.60–$823.58 | — | 75% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Closed treatment of distal fibular fracture (lateral malleolus); without manipulation 27786 | $412.50 | $1,650.00 | $1,072.50–$1,230.90 | — | 75% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470 - CLSD TRMNT METATARSAL FX EA W/O MANIP | $247.25 | $989.00 | $495.49–$795.16 | 2% above | 75% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed treatment of metatarsal fracture; without manipulation, each 28470 | $324.50 | $1,298.00 | $650.30–$1,043.59 | 34% above | 75% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 28470 - CLSD TRMNT METATARSAL FX EA W/O MANIP | $247.25 | $989.00 | $642.85–$737.79 | — | 75% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed treatment of metatarsal fracture; without manipulation, each 28470 | $324.50 | $1,298.00 | $843.70–$968.31 | — | 75% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 BCE 92960 CARDIOVERSION ELECTIVE EXTERNAL | $487.25 | $1,949.00 | $976.45–$1,567.00 | at median | 75% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 BCE HC CARDIOVERSION ELECTIVE EXTERNAL 92960 | $487.25 | $1,949.00 | $976.45–$1,567.00 | at median | 75% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 - Cardioversion Elective External | $487.25 | $1,949.00 | $976.45–$1,567.00 | at median | 75% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion OR | $487.25 | $1,949.00 | $976.45–$1,567.00 | at median | 75% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 BCE HC CARDIOVERSION ELECTIVE EXTERNAL 92960 | $487.25 | $1,949.00 | $1,266.85–$1,453.95 | — | 75% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 BCE 92960 CARDIOVERSION ELECTIVE EXTERNAL | $487.25 | $1,949.00 | $1,266.85–$1,453.95 | — | 75% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 - Cardioversion Elective External | $487.25 | $1,949.00 | $1,266.85–$1,453.95 | — | 75% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion OR | $487.25 | $1,949.00 | $1,266.85–$1,453.95 | — | 75% |
| Cervical biopsy CPT 57500 Biopsy/cervix/single/multiple 57500 | $588.75 | $2,355.00 | $1,179.86–$1,893.42 | 62% above | 75% |
| Cervical biopsy inpatient CPT 57500 Biopsy/cervix/single/multiple 57500 | $588.75 | $2,355.00 | $1,530.75–$1,756.83 | — | 75% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circumcision Age >28 Days 54161 | $986.25 | $3,945.00 | $1,976.44–$3,171.78 | 63% above | 75% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 Circumcision Age >28 Days 54161 | $986.25 | $3,945.00 | $2,564.25–$2,942.97 | — | 75% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 WC$ Newborn Circumcision Charge -> Done | $862.25 | $3,449.00 | $1,727.95–$2,773.00 | 177% above | 75% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision 54150 | $941.75 | $3,767.00 | $1,887.27–$3,028.67 | 203% above | 75% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 WC$ Newborn Circumcision Charge -> Done | $862.25 | $3,449.00 | $2,241.85–$2,572.95 | — | 75% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision 54150 | $941.75 | $3,767.00 | $2,448.55–$2,810.18 | — | 75% |
| Circumcision, surgical, older than a newborn CPT 54160 Neonate Circumcision Inpt 54160 | $803.75 | $3,215.00 | $1,610.72–$2,584.86 | 399% above | 75% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 Neonate Circumcision Inpt 54160 | $803.75 | $3,215.00 | $2,089.75–$2,398.39 | — | 75% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600 - CLSD TRMNT DIST RADIAL FX W/O MANIP | $301.00 | $1,204.00 | $603.20–$968.02 | 2% above | 75% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed tx of distal radial fx/epiphyseal separation w/ or w/o fx of ulnar styloid; w/o manip 25600 | $437.25 | $1,749.00 | $876.25–$1,406.20 | 48% above | 75% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 25600 - CLSD TRMNT DIST RADIAL FX W/O MANIP | $301.00 | $1,204.00 | $782.60–$898.18 | — | 75% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Closed tx of distal radial fx/epiphyseal separation w/ or w/o fx of ulnar styloid; w/o manip 25600 | $437.25 | $1,749.00 | $1,136.85–$1,304.75 | — | 75% |
| Colonoscopy with endoscopic ultrasound CPT 45391 HC COLONOSCOPY FLEXIBLE W/ENDOSCOPIC US | $1,469.75 | $5,879.00 | $2,945.38–$4,726.72 | — | 75% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 HC COLONOSCOPY FLEXIBLE W/ENDOSCOPIC US | $1,469.75 | $5,879.00 | $3,821.35–$4,385.73 | — | 75% |
| Colonoscopy with polyp removal CPT 45385 HC COLONOSCOPY FLEX W/RMVL TUMOR/POLYP/LES SNARE | $1,450.50 | $5,802.00 | $2,906.80–$4,664.81 | 16% below | 75% |
| Colonoscopy with polyp removal inpatient CPT 45385 HC COLONOSCOPY FLEX W/RMVL TUMOR/POLYP/LES SNARE | $1,450.50 | $5,802.00 | $3,771.30–$4,328.29 | — | 75% |
| Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY FLEX W/BX SNGL/MULT | $1,146.25 | $4,585.00 | $2,297.08–$3,686.34 | 26% below | 75% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY FLEX W/BX SNGL/MULT | $1,146.25 | $4,585.00 | $2,980.25–$3,420.41 | — | 75% |
| Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY FLEX DX BRUSH/WASH HIGH RISK | $1,055.50 | $4,222.00 | $2,115.22–$3,394.49 | 16% below | 75% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY FLEX DX BRUSH/WASH HIGH RISK | $1,055.50 | $4,222.00 | $2,744.30–$3,149.61 | — | 75% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 Colposcopy Cervx Loop Bx 57460 | $1,487.25 | $5,949.00 | $2,980.45–$4,783.00 | 77% above | 75% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 Colposcopy Cervx Loop Bx 57460 | $1,487.25 | $5,949.00 | $3,866.85–$4,437.95 | — | 75% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colposcopy/cervix/biopsy/curettage 57454 | $323.50 | $1,294.00 | $648.29–$1,040.38 | 55% above | 75% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Colposcopy/cervix/biopsy/curettage 57454 | $323.50 | $1,294.00 | $841.10–$965.32 | — | 75% |
| Cystoscopy with ureteral stent placement CPT 52332 HC CYSTO W/INDWELLING URETERAL STNT | $1,755.25 | $7,021.00 | $3,517.52–$5,644.88 | 57% below | 75% |
| Cystoscopy with ureteral stent placement CPT 52332 52332 - CYSTO W/INDWELLING URETERAL STNT | $1,755.25 | $7,021.00 | $3,517.52–$5,644.88 | 57% below | 75% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 52332 - CYSTO W/INDWELLING URETERAL STNT | $1,755.25 | $7,021.00 | $4,563.65–$5,237.67 | — | 75% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 HC CYSTO W/INDWELLING URETERAL STNT | $1,755.25 | $7,021.00 | $4,563.65–$5,237.67 | — | 75% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY | $369.50 | $1,478.00 | $740.48–$1,188.31 | 33% below | 75% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystourethroscopy 52000 | $435.50 | $1,742.00 | $872.74–$1,400.57 | 21% below | 75% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY | $369.50 | $1,478.00 | $960.70–$1,102.59 | — | 75% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystourethroscopy 52000 | $435.50 | $1,742.00 | $1,132.30–$1,299.53 | — | 75% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 Dilation & Curettage 58120 | $1,574.00 | $6,296.00 | $3,154.30–$5,061.98 | at median | 75% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 Dilation & Curettage 58120 | $1,574.00 | $6,296.00 | $4,092.40–$4,696.82 | — | 75% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destroy premlg lesion 17000 | $144.50 | $578.00 | $289.58–$464.71 | 57% above | 75% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destroy premlg lesion 17000 | $144.50 | $578.00 | $375.70–$431.19 | — | 75% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Create Eardrum Opening 69433 | $481.75 | $1,927.00 | $965.43–$1,549.31 | 40% above | 75% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 Create Eardrum Opening 69433 | $481.75 | $1,927.00 | $1,252.55–$1,437.54 | — | 75% |
| Earwax removal by irrigation (rinsing), one ear both sides CPT 69209 BCE 69209 BILAT - RMVL IMPACTED CERUMEN USING IRR/LAVAGE | $80.50 | $322.00 | $161.32–$258.89 | — | 75% |
| Earwax removal by irrigation (rinsing), one ear both sides CPT 69209 Ear Lavage Laterality -> Bilateral | $80.50 | $322.00 | $161.32–$258.89 | — | 75% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 69209 - RMVL IMP CERUMEN USE IRR/LAV UNI | $48.25 | $193.00 | $96.69–$155.17 | 4% below | 75% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 BCE 69209 UNILAT - RMVL IMPACTED CERUMEN USING IRR/LAVAGE | $40.25 | $161.00 | $80.66–$129.44 | 20% below | 75% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Ear Lavage Laterality -> Left | $40.25 | $161.00 | $80.66–$129.44 | 20% below | 75% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Ear Lavage Laterality -> right | $40.25 | $161.00 | $80.66–$129.44 | 20% below | 75% |
| Earwax removal by irrigation (rinsing), one ear inpatient both sides CPT 69209 Ear Lavage Laterality -> Bilateral | $80.50 | $322.00 | $209.30–$240.21 | — | 75% |
| Earwax removal by irrigation (rinsing), one ear inpatient both sides CPT 69209 BCE 69209 BILAT - RMVL IMPACTED CERUMEN USING IRR/LAVAGE | $80.50 | $322.00 | $209.30–$240.21 | — | 75% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209 - RMVL IMP CERUMEN USE IRR/LAV UNI | $48.25 | $193.00 | $125.45–$143.98 | — | 75% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Ear Lavage Laterality -> right | $40.25 | $161.00 | $104.65–$120.11 | — | 75% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 BCE 69209 UNILAT - RMVL IMPACTED CERUMEN USING IRR/LAVAGE | $40.25 | $161.00 | $104.65–$120.11 | — | 75% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Ear Lavage Laterality -> Left | $40.25 | $161.00 | $104.65–$120.11 | — | 75% |
| Earwax removal with instruments, one ear both sides CPT 69210 Remove impacted cerumen requiring instrumentation, uni/bilat 69210 | $61.75 | $247.00 | $123.75–$198.59 | — | 75% |
| Earwax removal with instruments, one ear CPT 69210 69210 - RMVL IMPACTED CERUMEN REQUIRING INSTR UNI | $41.75 | $167.00 | $83.67–$134.27 | 28% below | 75% |
| Earwax removal with instruments, one ear inpatient both sides CPT 69210 Remove impacted cerumen requiring instrumentation, uni/bilat 69210 | $61.75 | $247.00 | $160.55–$184.26 | — | 75% |
| Earwax removal with instruments, one ear inpatient CPT 69210 69210 - RMVL IMPACTED CERUMEN REQUIRING INSTR UNI | $41.75 | $167.00 | $108.55–$124.58 | — | 75% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial Biopsy 58100 | $221.50 | $886.00 | $443.89–$712.34 | 11% above | 75% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Endometrial Biopsy 58100 | $221.50 | $886.00 | $575.90–$660.96 | — | 75% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ DX/THER PARAVERTB JNT W/IMG L/S SNGL LVL | $861.50 | $3,446.00 | $1,726.45–$2,770.58 | 13% below | 75% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ DX/THER PARAVERTB JNT W/IMG L/S SNGL LVL | $861.50 | $3,446.00 | $2,239.90–$2,570.72 | — | 75% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC FLEX SIG DX W/COL BRUSH/WSH | $681.25 | $2,725.00 | $1,365.22–$2,190.90 | 22% above | 75% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC FLEX SIG DX W/COL BRUSH/WSH | $681.25 | $2,725.00 | $1,771.25–$2,032.85 | — | 75% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 Hemorrhoidectomy, internal, by rubber band ligation 46221 | $750.25 | $3,001.00 | $1,503.50–$2,412.80 | 1% below | 75% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC HEMORRHAIDECTOMY INTRNL BY RUBBER BAND LIG(S) | $784.75 | $3,139.00 | $1,572.64–$2,523.76 | 4% above | 75% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 Hemorrhoidectomy, internal, by rubber band ligation 46221 | $750.25 | $3,001.00 | $1,950.65–$2,238.75 | — | 75% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC HEMORRHAIDECTOMY INTRNL BY RUBBER BAND LIG(S) | $784.75 | $3,139.00 | $2,040.35–$2,341.69 | — | 75% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 USBMC Injection/Cath Intro HSG | $105.50 | $422.00 | $211.42–$339.29 | 69% below | 75% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 XRBMC Injection/Cath Intro HSG | $105.50 | $422.00 | $211.42–$339.29 | 69% below | 75% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Catheter For Hysterography 58340 | $155.25 | $621.00 | $311.12–$499.28 | 54% below | 75% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 XRBMC Injection/Cath Intro HSG | $105.50 | $422.00 | $274.30–$314.81 | — | 75% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 USBMC Injection/Cath Intro HSG | $105.50 | $422.00 | $274.30–$314.81 | — | 75% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Catheter For Hysterography 58340 | $155.25 | $621.00 | $403.65–$463.27 | — | 75% |
| IUD insertion (the device itself billed separately) CPT 58300 Insertion/intrauterine device 58300 | $77.00 | $308.00 | $154.31–$247.63 | 54% below | 75% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 Insertion/intrauterine device 58300 | $77.00 | $308.00 | $200.20–$229.77 | — | 75% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060 - I & D simple | $178.25 | $713.00 | $357.21–$573.25 | 11% above | 75% |
| Incision and drainage of a simple or single skin abscess CPT 10060 IP Incision/Drainage of skin abscess simple/single 10060 | $186.00 | $744.00 | $372.74–$598.18 | 16% above | 75% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Incision/Drainage of skin abscess simple/single 10060 | $215.75 | $863.00 | $432.36–$693.85 | 35% above | 75% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 - I & D simple | $178.25 | $713.00 | $463.45–$531.90 | — | 75% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 IP Incision/Drainage of skin abscess simple/single 10060 | $186.00 | $744.00 | $483.60–$555.02 | — | 75% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision/Drainage of skin abscess simple/single 10060 | $215.75 | $863.00 | $560.95–$643.80 | — | 75% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection 1 Tendon Sheath/Ligament Aponeurosis 20550 | $246.75 | $987.00 | $494.49–$793.55 | 31% above | 75% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection 1 Tendon Sheath/Ligament Aponeurosis 20550 | $246.75 | $987.00 | $641.55–$736.30 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 Arthrocentesis; Aspiration &/ Injection Major Joint/Bursa W/O US, Bilateral 20610 | $309.00 | $1,236.00 | $619.24–$993.74 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 XRBMC Injection Major Joint BILAT | $548.50 | $2,194.00 | $1,099.19–$1,763.98 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 XRBMC Inject/Aspiration Major Jt | $274.25 | $1,097.00 | $549.60–$881.99 | 4% above | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 USBMC Intro/Remove Major Joint/Bursa | $274.25 | $1,097.00 | $549.60–$881.99 | 4% above | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 - ARTHROCENTESIS ASP/INJ MJR JNT/BURSA | $329.00 | $1,316.00 | $659.32–$1,058.06 | 24% above | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XRBMC Injection Major Joint RT | $274.25 | $1,097.00 | $549.60–$881.99 | 4% above | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XRBMC Injection Major Joint LT | $274.25 | $1,097.00 | $549.60–$881.99 | 4% above | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Arthrocnts Asp&/ Inj Mjr Jt/Brsa W/O US Right (In Office) 20610 | $309.00 | $1,236.00 | $619.24–$993.74 | 17% above | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Arthrocnts Asp&/ Inj Mjr Jt/Brsa W/O US Left 20610 | $309.00 | $1,236.00 | $619.24–$993.74 | 17% above | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Arthrocnts Asp&/ Inj Mjr Jt/Brsa W/O US Left (In Office) 20610 | $309.00 | $1,236.00 | $619.24–$993.74 | 17% above | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 Arthrocentesis; Aspiration &/ Injection Major Joint/Bursa W/O US, Bilateral 20610 | $309.00 | $1,236.00 | $803.40–$922.06 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 XRBMC Injection Major Joint BILAT | $548.50 | $2,194.00 | $1,426.10–$1,636.72 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 USBMC Intro/Remove Major Joint/Bursa | $274.25 | $1,097.00 | $713.05–$818.36 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 XRBMC Inject/Aspiration Major Jt | $274.25 | $1,097.00 | $713.05–$818.36 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 - ARTHROCENTESIS ASP/INJ MJR JNT/BURSA | $329.00 | $1,316.00 | $855.40–$981.74 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XRBMC Injection Major Joint LT | $274.25 | $1,097.00 | $713.05–$818.36 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XRBMC Injection Major Joint RT | $274.25 | $1,097.00 | $713.05–$818.36 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Arthrocnts Asp&/ Inj Mjr Jt/Brsa W/O US Right (In Office) 20610 | $309.00 | $1,236.00 | $803.40–$922.06 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Arthrocnts Asp&/ Inj Mjr Jt/Brsa W/O US Left (In Office) 20610 | $309.00 | $1,236.00 | $803.40–$922.06 | — | 75% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Arthrocnts Asp&/ Inj Mjr Jt/Brsa W/O US Left 20610 | $309.00 | $1,236.00 | $803.40–$922.06 | — | 75% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Admin Implant Insertion -> 11981 - Insertion of Drug Delivery Implant | $70.00 | $280.00 | $140.28–$225.12 | 39% below | 75% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG IMPLANT 11981 | $142.25 | $569.00 | $285.07–$457.48 | 24% above | 75% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Admin Implant Insertion -> 11981 - Insertion of Drug Delivery Implant | $70.00 | $280.00 | $182.00–$208.88 | — | 75% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG IMPLANT 11981 | $142.25 | $569.00 | $369.85–$424.47 | — | 75% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 XRBMC Inject/Aspiration Intermediate Jt | $221.75 | $887.00 | $444.39–$713.15 | 22% above | 75% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis/injection/intermed joint 20605 | $251.50 | $1,006.00 | $504.01–$808.82 | 39% above | 75% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Joint Aspiration and/or injection intermediate joint without Ultrasound Guidance 20605 | $251.50 | $1,006.00 | $504.01–$808.82 | 39% above | 75% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 - ARTHROCENTESIS ASP/INJ INTERM JNT/BURSA W/O US | $266.00 | $1,064.00 | $533.06–$855.46 | 47% above | 75% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 XRBMC Inject/Aspiration Intermediate Jt | $221.75 | $887.00 | $576.55–$661.70 | — | 75% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis/injection/intermed joint 20605 | $251.50 | $1,006.00 | $653.90–$750.48 | — | 75% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Joint Aspiration and/or injection intermediate joint without Ultrasound Guidance 20605 | $251.50 | $1,006.00 | $653.90–$750.48 | — | 75% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 - ARTHROCENTESIS ASP/INJ INTERM JNT/BURSA W/O US | $266.00 | $1,064.00 | $691.60–$793.74 | — | 75% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Joint Aspiration and/or injection small joint without Ultrasound Guidance 20600 | $250.75 | $1,003.00 | $502.50–$806.41 | 25% above | 75% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Aspiration/Injection; Joint/Bursa; Small 20600 | $250.75 | $1,003.00 | $502.50–$806.41 | 25% above | 75% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 - ARTHROCENTESIS ASP/INJ SML JNT/BURSA W/O US | $259.00 | $1,036.00 | $519.04–$832.94 | 29% above | 75% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Joint Aspiration and/or injection small joint without Ultrasound Guidance 20600 | $250.75 | $1,003.00 | $651.95–$748.24 | — | 75% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Aspiration/Injection; Joint/Bursa; Small 20600 | $250.75 | $1,003.00 | $651.95–$748.24 | — | 75% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 - ARTHROCENTESIS ASP/INJ SML JNT/BURSA W/O US | $259.00 | $1,036.00 | $673.40–$772.86 | — | 75% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 - RPR INTM WND SCALP AXILLAE TRUNK 2.5CM/< | $332.50 | $1,330.00 | $666.33–$1,069.32 | 15% above | 75% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Repair intermediate wound; <2.5 cm scalp,axillae,trunk,ext 12031 | $425.25 | $1,701.00 | $852.20–$1,367.60 | 48% above | 75% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031 - RPR INTM WND SCALP AXILLAE TRUNK 2.5CM/< | $332.50 | $1,330.00 | $864.50–$992.18 | — | 75% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Repair intermediate wound; <2.5 cm scalp,axillae,trunk,ext 12031 | $425.25 | $1,701.00 | $1,105.65–$1,268.95 | — | 75% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection Therapeutic Agent Lumbar Spine with Navigation | $713.50 | $2,854.00 | $1,429.85–$2,294.62 | 23% below | 75% |
| Lower-back epidural injection, with imaging guidance CPT 62323 BCE INJ DX/TH INTLAM LSACRL IMG GD 62323 | $713.50 | $2,854.00 | $1,429.85–$2,294.62 | 23% below | 75% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ DX/THER INTLAM L/SACRL IMG GDE 62323 | $804.50 | $3,218.00 | $1,612.22–$2,587.27 | 13% below | 75% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Injection Therapeutic Agent Lumbar Spine with Navigation | $713.50 | $2,854.00 | $1,855.10–$2,129.08 | — | 75% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 BCE INJ DX/TH INTLAM LSACRL IMG GD 62323 | $713.50 | $2,854.00 | $1,855.10–$2,129.08 | — | 75% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ DX/THER INTLAM L/SACRL IMG GDE 62323 | $804.50 | $3,218.00 | $2,091.70–$2,400.63 | — | 75% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Inj Dx/Ther Interlaminar L/Sacral W/O Img 62322 | $723.75 | $2,895.00 | $1,450.40–$2,327.58 | 20% below | 75% |
| Lower-back epidural injection, without imaging guidance CPT 62322 WC$ OB Epidural / Intrathecal -> Lumbar/Sacral | $802.25 | $3,209.00 | $1,607.71–$2,580.04 | 11% below | 75% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Inj Dx/Ther Interlaminar L/Sacral W/O Img 62322 | $723.75 | $2,895.00 | $1,881.75–$2,159.67 | — | 75% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 WC$ OB Epidural / Intrathecal -> Lumbar/Sacral | $802.25 | $3,209.00 | $2,085.85–$2,393.91 | — | 75% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ ANES/STRD EPID W/IMG GUIDE L/S SNGL LVL | $623.25 | $2,493.00 | $1,248.99–$2,004.37 | 35% below | 75% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ ANES/STRD EPID W/IMG GUIDE L/S SNGL LVL | $623.25 | $2,493.00 | $1,620.45–$1,859.78 | — | 75% |
| Miscarriage treatment with D&C, first trimester CPT 59820 Tx Missed Abortion First Trimester Surgical 59820 | $1,640.00 | $6,560.00 | $3,286.56–$5,274.24 | at median | 75% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Tx Missed Abortion First Trimester Surgical 59820 | $1,640.00 | $6,560.00 | $4,264.00–$4,893.76 | — | 75% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Excision Benign Lesion; Trunk/Arms/Legs, <0.5 cm 11400 | $324.25 | $1,297.00 | $649.80–$1,042.79 | 90% above | 75% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Excision benign lesion; <0.5 cm trunk/ext 11400 | $324.25 | $1,297.00 | $649.80–$1,042.79 | 90% above | 75% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Excision Benign Lesion; Trunk/Arms/Legs, <0.5 cm 11400 | $324.25 | $1,297.00 | $843.05–$967.56 | — | 75% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Excision benign lesion; <0.5 cm trunk/ext 11400 | $324.25 | $1,297.00 | $843.05–$967.56 | — | 75% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Excision benign lesion; < 0.5 cm face,ear,eyelid,nose,lips 11440 | $432.00 | $1,728.00 | $865.73–$1,389.31 | 60% above | 75% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Excision benign lesion; < 0.5 cm face,ear,eyelid,nose,lips 11440 | $432.00 | $1,728.00 | $1,123.20–$1,289.09 | — | 75% |
| Nail removal (partial or complete), one nail CPT 11730 11730 - AVULSION NAIL PLT PRTL/CMPL SMPL SNGL | $130.25 | $521.00 | $261.02–$418.88 | at median | 75% |
| Nail removal (partial or complete), one nail CPT 11730 Removal of nail plate; single 11730 | $169.25 | $677.00 | $339.18–$544.31 | 30% above | 75% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 11730 - AVULSION NAIL PLT PRTL/CMPL SMPL SNGL | $130.25 | $521.00 | $338.65–$388.67 | — | 75% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Removal of nail plate; single 11730 | $169.25 | $677.00 | $440.05–$505.04 | — | 75% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJ ANES AGENT GREATER OCCIPITAL NRV | $225.75 | $903.00 | $452.40–$726.01 | 24% below | 75% |
| Occipital nerve block (injection for headaches) CPT 64405 Injection; Anesthetic; Greater occipital nerve 64405 | $266.00 | $1,064.00 | $533.06–$855.46 | 11% below | 75% |
| Occipital nerve block (injection for headaches) CPT 64405 64405 - INJ ANES AGENT GREATER OCCIPITAL NRV | $271.00 | $1,084.00 | $543.08–$871.54 | 9% below | 75% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJ ANES AGENT GREATER OCCIPITAL NRV | $225.75 | $903.00 | $586.95–$673.64 | — | 75% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 Injection; Anesthetic; Greater occipital nerve 64405 | $266.00 | $1,064.00 | $691.60–$793.74 | — | 75% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 64405 - INJ ANES AGENT GREATER OCCIPITAL NRV | $271.00 | $1,084.00 | $704.60–$808.66 | — | 75% |
| Paracentesis with imaging guidance CPT 49083 US Paracentesis Exam DTA | $963.00 | $3,852.00 | $1,929.85–$3,097.01 | 18% above | 75% |
| Paracentesis with imaging guidance CPT 49083 USBMC Paracentesis Radiologist Performed | $963.00 | $3,852.00 | $1,929.85–$3,097.01 | 18% above | 75% |
| Paracentesis with imaging guidance CPT 49083 Paracentesis (Abdomen) with imaging guidance 49083 | $1,032.50 | $4,130.00 | $2,069.13–$3,320.52 | 27% above | 75% |
| Paracentesis with imaging guidance CPT 49083 Abdom Paracentesis Dx/Ther W/Imaging guidance (In Office) 49083 | $1,032.50 | $4,130.00 | $2,069.13–$3,320.52 | 27% above | 75% |
| Paracentesis with imaging guidance CPT 49083 49083 - ABD PARACENTESIS W/IMG GUIDE | $1,155.50 | $4,622.00 | $2,315.62–$3,716.09 | 42% above | 75% |
| Paracentesis with imaging guidance inpatient CPT 49083 USBMC Paracentesis Radiologist Performed | $963.00 | $3,852.00 | $2,503.80–$2,873.59 | — | 75% |
| Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis Exam DTA | $963.00 | $3,852.00 | $2,503.80–$2,873.59 | — | 75% |
| Paracentesis with imaging guidance inpatient CPT 49083 Paracentesis (Abdomen) with imaging guidance 49083 | $1,032.50 | $4,130.00 | $2,684.50–$3,080.98 | — | 75% |
| Paracentesis with imaging guidance inpatient CPT 49083 Abdom Paracentesis Dx/Ther W/Imaging guidance (In Office) 49083 | $1,032.50 | $4,130.00 | $2,684.50–$3,080.98 | — | 75% |
| Paracentesis with imaging guidance inpatient CPT 49083 49083 - ABD PARACENTESIS W/IMG GUIDE | $1,155.50 | $4,622.00 | $3,004.30–$3,448.01 | — | 75% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 - EXC NAIL & NAIL MATRIX FOR PERMANENT RMVL | $342.25 | $1,369.00 | $685.87–$1,100.68 | 4% above | 75% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Exc nail/nail matrix, permanent removal 11750 | $382.50 | $1,530.00 | $766.53–$1,230.12 | 17% above | 75% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 - EXC NAIL & NAIL MATRIX FOR PERMANENT RMVL | $342.25 | $1,369.00 | $889.85–$1,021.27 | — | 75% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Exc nail/nail matrix, permanent removal 11750 | $382.50 | $1,530.00 | $994.50–$1,141.38 | — | 75% |
| Prostate biopsy CPT 55700 Bx/prostate/needle/punch/sng/mul 55700 | $1,041.75 | $4,167.00 | $2,087.67–$3,350.27 | 137% above | 75% |
| Prostate biopsy inpatient CPT 55700 Bx/prostate/needle/punch/sng/mul 55700 | $1,041.75 | $4,167.00 | $2,708.55–$3,108.58 | — | 75% |
| Removal of a breast lump, open surgery CPT 19120 Removal Of Breast Lesion 19120 | $1,979.75 | $7,919.00 | $3,967.42–$6,366.88 | 39% above | 75% |
| Removal of a breast lump, open surgery inpatient CPT 19120 Removal Of Breast Lesion 19120 | $1,979.75 | $7,919.00 | $5,147.35–$5,907.57 | — | 75% |
| Removal of a foreign object under the skin, simple CPT 10120 10120 - INC & RMVL FB SC TISS SMPL | $386.75 | $1,547.00 | $775.05–$1,243.79 | 69% above | 75% |
| Removal of a foreign object under the skin, simple CPT 10120 Incision and removal foreign body, subcutaneous; simple 10120 | $403.50 | $1,614.00 | $808.61–$1,297.66 | 76% above | 75% |
| Removal of a foreign object under the skin, simple CPT 10120 INC & RMVL FB SC TISS SMPL 10120 | $403.50 | $1,614.00 | $808.61–$1,297.66 | 76% above | 75% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 10120 - INC & RMVL FB SC TISS SMPL | $386.75 | $1,547.00 | $1,005.55–$1,154.06 | — | 75% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision and removal foreign body, subcutaneous; simple 10120 | $403.50 | $1,614.00 | $1,049.10–$1,204.04 | — | 75% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INC & RMVL FB SC TISS SMPL 10120 | $403.50 | $1,614.00 | $1,049.10–$1,204.04 | — | 75% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC COLORECTAL CANCER SCRN NOT HIGH RISK | $1,057.25 | $4,229.00 | $2,118.73–$3,400.12 | 5% above | 75% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC COLORECTAL CANCER SCRN COLONOSCOPY NO HIGH RISK | $1,057.25 | $4,229.00 | $2,118.73–$3,400.12 | 5% above | 75% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC COLORECTAL CANCER SCRN COLONOSCOPY NO HIGH RISK | $1,057.25 | $4,229.00 | $2,748.85–$3,154.83 | — | 75% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC COLORECTAL CANCER SCRN NOT HIGH RISK | $1,057.25 | $4,229.00 | $2,748.85–$3,154.83 | — | 75% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC COLORECTAL CANCER SCRN COLONOSCOPY HIGH RISK | $1,055.50 | $4,222.00 | $2,115.22–$3,394.49 | 3% above | 75% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC COLORECTAL CANCER SCRNÂ HIGH RISK | $1,055.50 | $4,222.00 | $2,115.22–$3,394.49 | 3% above | 75% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC COLORECTAL CANCER SCRN COLONOSCOPY HIGH RISK | $1,055.50 | $4,222.00 | $2,744.30–$3,149.61 | — | 75% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC COLORECTAL CANCER SCRNÂ HIGH RISK | $1,055.50 | $4,222.00 | $2,744.30–$3,149.61 | — | 75% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC Lithotripsy Extracorporeal Shock | $1,808.75 | $7,235.00 | $3,624.74–$5,816.94 | 30% below | 75% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy Extracorporeal | $2,170.50 | $8,682.00 | $4,349.68–$6,980.33 | 16% below | 75% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 HC Lithotripsy Extracorporeal Shock | $1,808.75 | $7,235.00 | $4,702.75–$5,397.31 | — | 75% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Lithotripsy Extracorporeal | $2,170.50 | $8,682.00 | $5,643.30–$6,476.77 | — | 75% |
| Short arm cast (elbow to hand) CPT 29075 OT Short Arm Cast Units | $199.00 | $796.00 | $398.80–$639.98 | 13% above | 75% |
| Short arm cast (elbow to hand) CPT 29075 29075 - CAST APPL SHRT ARM ELBOW-FINGER | $238.75 | $955.00 | $478.46–$767.82 | 36% above | 75% |
| Short arm cast (elbow to hand) CPT 29075 Cast Application; Short arm (elbow to finger) 29075 | $254.25 | $1,017.00 | $509.52–$817.67 | 45% above | 75% |
| Short arm cast (elbow to hand) inpatient CPT 29075 OT Short Arm Cast Units | $199.00 | $796.00 | $517.40–$593.82 | — | 75% |
| Short arm cast (elbow to hand) inpatient CPT 29075 29075 - CAST APPL SHRT ARM ELBOW-FINGER | $238.75 | $955.00 | $620.75–$712.43 | — | 75% |
| Short arm cast (elbow to hand) inpatient CPT 29075 Cast Application; Short arm (elbow to finger) 29075 | $254.25 | $1,017.00 | $661.05–$758.68 | — | 75% |
| Short arm splint (forearm and hand) CPT 29125 PT Short Arm Cast Assist Units | $110.00 | $440.00 | $220.44–$353.76 | 5% below | 75% |
| Short arm splint (forearm and hand) CPT 29125 OT Short Arm Splint Units | $110.00 | $440.00 | $220.44–$353.76 | 5% below | 75% |
| Short arm splint (forearm and hand) CPT 29125 PT Short Arm Cast Units | $110.00 | $440.00 | $220.44–$353.76 | 5% below | 75% |
| Short arm splint (forearm and hand) CPT 29125 29125 - SPLINT APPL SHRT ARM FOREARM-HND ST | $132.00 | $528.00 | $264.53–$424.51 | 14% above | 75% |
| Short arm splint (forearm and hand) CPT 29125 Splint Application; Short arm splint (forearm to hand); Static 29125 | $169.00 | $676.00 | $338.68–$543.50 | 47% above | 75% |
| Short arm splint (forearm and hand) inpatient CPT 29125 PT Short Arm Cast Assist Units | $110.00 | $440.00 | $286.00–$328.24 | — | 75% |
| Short arm splint (forearm and hand) inpatient CPT 29125 PT Short Arm Cast Units | $110.00 | $440.00 | $286.00–$328.24 | — | 75% |
| Short arm splint (forearm and hand) inpatient CPT 29125 OT Short Arm Splint Units | $110.00 | $440.00 | $286.00–$328.24 | — | 75% |
| Short arm splint (forearm and hand) inpatient CPT 29125 29125 - SPLINT APPL SHRT ARM FOREARM-HND ST | $132.00 | $528.00 | $343.20–$393.89 | — | 75% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Splint Application; Short arm splint (forearm to hand); Static 29125 | $169.00 | $676.00 | $439.40–$504.30 | — | 75% |
| Short leg cast (below the knee) CPT 29405 PT Short Leg Cast App Assistant Units | $199.00 | $796.00 | $398.80–$639.98 | 24% above | 75% |
| Short leg cast (below the knee) CPT 29405 Cast Application; Short leg cast (below knee to toes) 29405 | $242.00 | $968.00 | $484.97–$778.27 | 51% above | 75% |
| Short leg cast (below the knee) inpatient CPT 29405 PT Short Leg Cast App Assistant Units | $199.00 | $796.00 | $517.40–$593.82 | — | 75% |
| Short leg cast (below the knee) inpatient CPT 29405 Cast Application; Short leg cast (below knee to toes) 29405 | $242.00 | $968.00 | $629.20–$722.13 | — | 75% |
| Short leg splint (calf to foot) CPT 29515 PT Short Leg Splint App Assist Units | $136.25 | $545.00 | $273.04–$438.18 | 8% above | 75% |
| Short leg splint (calf to foot) CPT 29515 PT Short Leg Splint App Units | $136.25 | $545.00 | $273.04–$438.18 | 8% above | 75% |
| Short leg splint (calf to foot) CPT 29515 29515 - SPLINT APPL SHRT LEG CALF-FOOT | $163.50 | $654.00 | $327.65–$525.82 | 29% above | 75% |
| Short leg splint (calf to foot) CPT 29515 Splint Application; Short leg splint (calf to foot) 29515 | $179.50 | $718.00 | $359.72–$577.27 | 42% above | 75% |
| Short leg splint (calf to foot) inpatient CPT 29515 PT Short Leg Splint App Assist Units | $136.25 | $545.00 | $354.25–$406.57 | — | 75% |
| Short leg splint (calf to foot) inpatient CPT 29515 PT Short Leg Splint App Units | $136.25 | $545.00 | $354.25–$406.57 | — | 75% |
| Short leg splint (calf to foot) inpatient CPT 29515 29515 - SPLINT APPL SHRT LEG CALF-FOOT | $163.50 | $654.00 | $425.10–$487.88 | — | 75% |
| Short leg splint (calf to foot) inpatient CPT 29515 Splint Application; Short leg splint (calf to foot) 29515 | $179.50 | $718.00 | $466.70–$535.63 | — | 75% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 - RPR SF WND SCALP HND FOOT GENIT 2.5CM/LESS | $130.25 | $521.00 | $261.02–$418.88 | 12% below | 75% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair simple wound; <2.5 cm scalp,neck,axillae,genitalia,trunk,ext 12001 | $204.25 | $817.00 | $409.32–$656.87 | 37% above | 75% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Repair; Scalp/Neck/Axillae/Ext Genitalia/Trunk/Extrem 2.5 Cm or Less 12001 | $204.25 | $817.00 | $409.32–$656.87 | 37% above | 75% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 - RPR SF WND SCALP HND FOOT GENIT 2.5CM/LESS | $130.25 | $521.00 | $338.65–$388.67 | — | 75% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple Repair; Scalp/Neck/Axillae/Ext Genitalia/Trunk/Extrem 2.5 Cm or Less 12001 | $204.25 | $817.00 | $531.05–$609.48 | — | 75% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Repair simple wound; <2.5 cm scalp,neck,axillae,genitalia,trunk,ext 12001 | $204.25 | $817.00 | $531.05–$609.48 | — | 75% |
| Skin biopsy, punch, one lesion CPT 11104 11104 - PUNCH BX SKIN SNGL LESION | $260.75 | $1,043.00 | $522.54–$838.57 | 2% above | 75% |
| Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy of Skin W/Simple Closure; Single Lesion 11104 | $284.75 | $1,139.00 | $570.64–$915.76 | 11% above | 75% |
| Skin biopsy, punch, one lesion CPT 11104 Punch biopsy of skin (including simple closure); single lesion 11104 | $284.75 | $1,139.00 | $570.64–$915.76 | 11% above | 75% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 11104 - PUNCH BX SKIN SNGL LESION | $260.75 | $1,043.00 | $677.95–$778.08 | — | 75% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy of Skin W/Simple Closure; Single Lesion 11104 | $284.75 | $1,139.00 | $740.35–$849.69 | — | 75% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Punch biopsy of skin (including simple closure); single lesion 11104 | $284.75 | $1,139.00 | $740.35–$849.69 | — | 75% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Excision malignant lesion; < 0.5 cm trunk/ext 11600 | $363.75 | $1,455.00 | $728.96–$1,169.82 | 12% above | 75% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Excision malignant lesion; < 0.5 cm trunk/ext 11600 | $363.75 | $1,455.00 | $945.75–$1,085.43 | — | 75% |
| Skin tag removal, up to 15 tags CPT 11200 11200 - RMVL SKIN TAGS UP-15 LES | $130.25 | $521.00 | $261.02–$418.88 | 1% below | 75% |
| Skin tag removal, up to 15 tags CPT 11200 Removal of skin tags; up to 15 lesions 11200 | $165.25 | $661.00 | $331.16–$531.44 | 26% above | 75% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 11200 - RMVL SKIN TAGS UP-15 LES | $130.25 | $521.00 | $338.65–$388.67 | — | 75% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of skin tags; up to 15 lesions 11200 | $165.25 | $661.00 | $429.65–$493.11 | — | 75% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture | $523.25 | $2,093.00 | $1,048.59–$1,682.77 | 7% above | 75% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 BCE SPINAL PNCTR L DX 62270 | $523.25 | $2,093.00 | $1,048.59–$1,682.77 | 7% above | 75% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Diagnostic Lumbar Spinal Puncture 62270 | $594.50 | $2,378.00 | $1,191.38–$1,911.91 | 22% above | 75% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture 62270 | $594.50 | $2,378.00 | $1,191.38–$1,911.91 | 22% above | 75% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 - SPINAL PNCTR L DX | $628.00 | $2,512.00 | $1,258.51–$2,019.65 | 29% above | 75% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 BCE SPINAL PNCTR L DX 62270 | $523.25 | $2,093.00 | $1,360.45–$1,561.38 | — | 75% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture | $523.25 | $2,093.00 | $1,360.45–$1,561.38 | — | 75% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture 62270 | $594.50 | $2,378.00 | $1,545.70–$1,773.99 | — | 75% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Diagnostic Lumbar Spinal Puncture 62270 | $594.50 | $2,378.00 | $1,545.70–$1,773.99 | — | 75% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270 - SPINAL PNCTR L DX | $628.00 | $2,512.00 | $1,632.80–$1,873.95 | — | 75% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 - RPR SF WND SCALP HND FOOT GENIT 2.6CM-7.5CM | $169.75 | $679.00 | $340.18–$545.92 | 9% below | 75% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Repair simple wound; 2.6-7.5 cm scalp,neck,axillae,genitalia,trunk,ext 12002 | $262.00 | $1,048.00 | $525.05–$842.59 | 41% above | 75% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 - RPR SF WND SCALP HND FOOT GENIT 2.6CM-7.5CM | $169.75 | $679.00 | $441.35–$506.53 | — | 75% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Repair simple wound; 2.6-7.5 cm scalp,neck,axillae,genitalia,trunk,ext 12002 | $262.00 | $1,048.00 | $681.20–$781.81 | — | 75% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 - RPR SF WND FACE EAR EYE NOSE LIP 2.5CM/LESS | $133.75 | $535.00 | $268.04–$430.14 | 19% below | 75% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Repair simple wound; <2.5 cm face,ear, eyelid,nose,lips 12011 | $204.25 | $817.00 | $409.32–$656.87 | 24% above | 75% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011 - RPR SF WND FACE EAR EYE NOSE LIP 2.5CM/LESS | $133.75 | $535.00 | $347.75–$399.11 | — | 75% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Repair simple wound; <2.5 cm face,ear, eyelid,nose,lips 12011 | $204.25 | $817.00 | $531.05–$609.48 | — | 75% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion 11102 | $203.75 | $815.00 | $408.32–$655.26 | 4% above | 75% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion 11102 | $203.75 | $815.00 | $529.75–$607.99 | — | 75% |
| Thoracentesis with imaging guidance CPT 32555 US Thoracentesis w/Aspiration Exam DTA | $602.25 | $2,409.00 | $1,206.91–$1,936.84 | 10% below | 75% |
| Thoracentesis with imaging guidance CPT 32555 32555 - THORACENTES ASP PLRL SPACE W/IMG | $722.75 | $2,891.00 | $1,448.39–$2,324.36 | 8% above | 75% |
| Thoracentesis with imaging guidance CPT 32555 Thoracentesis ASP Pleural Space w/ img 32555 | $740.00 | $2,960.00 | $1,482.96–$2,379.84 | 10% above | 75% |
| Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis w/Aspiration Exam DTA | $602.25 | $2,409.00 | $1,565.85–$1,797.11 | — | 75% |
| Thoracentesis with imaging guidance inpatient CPT 32555 32555 - THORACENTES ASP PLRL SPACE W/IMG | $722.75 | $2,891.00 | $1,879.15–$2,156.69 | — | 75% |
| Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis ASP Pleural Space w/ img 32555 | $740.00 | $2,960.00 | $1,924.00–$2,208.16 | — | 75% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552 - INJ(S) SNGL/MULT TRIGGER POINT(S) 1/2 MSCL(S) | $191.75 | $767.00 | $384.27–$616.67 | at median | 75% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Injection Trigger Point; 1 - 2 Muscles 20552 | $193.50 | $774.00 | $387.77–$622.30 | 1% above | 75% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 - INJ(S) SNGL/MULT TRIGGER POINT(S) 1/2 MSCL(S) | $191.75 | $767.00 | $498.55–$572.18 | — | 75% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Injection Trigger Point; 1 - 2 Muscles 20552 | $193.50 | $774.00 | $503.10–$577.40 | — | 75% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 USBMC Breast Bx 1st Lesion | $715.25 | $2,861.00 | $1,433.36–$2,300.24 | 48% below | 75% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Biopsy/breast/1st lesion/US guide (In Office) 19083 | $986.00 | $3,944.00 | $1,975.94–$3,170.98 | 29% below | 75% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/Localization Perc RT | $715.25 | $2,861.00 | $1,433.36–$2,300.24 | 48% below | 75% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/Localization Perc LT | $715.25 | $2,861.00 | $1,433.36–$2,300.24 | 48% below | 75% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 USBMC Breast Bx 1st Lesion | $715.25 | $2,861.00 | $1,859.65–$2,134.31 | — | 75% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Biopsy/breast/1st lesion/US guide (In Office) 19083 | $986.00 | $3,944.00 | $2,563.60–$2,942.22 | — | 75% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/Localization Perc LT | $715.25 | $2,861.00 | $1,859.65–$2,134.31 | — | 75% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/Localization Perc RT | $715.25 | $2,861.00 | $1,859.65–$2,134.31 | — | 75% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC EGD FLEX TRNSRL W/TRANSENDOSC BLLN DIL ESOPH | $1,070.75 | $4,283.00 | $2,145.78–$3,443.53 | 12% below | 75% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC EGD FLEX TRNSRL W/TRANSENDOSC BLLN DIL ESOPH | $1,070.75 | $4,283.00 | $2,783.95–$3,195.12 | — | 75% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD FLEX TRANSORAL W/BX SNGL/MULT | $1,155.50 | $4,622.00 | $2,315.62–$3,716.09 | 2% below | 75% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD FLEX TRANSORAL W/BX SNGL/MULT | $1,155.50 | $4,622.00 | $3,004.30–$3,448.01 | — | 75% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 HC EGD FLEX TRNSRL W/DIR SUBMCSL INJ(S) ANY SUBST | $967.25 | $3,869.00 | $1,938.37–$3,110.68 | 47% above | 75% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC EGD FLEX TRNSRL W/DIR SUBMCSL INJ(S) ANY SUBST | $967.25 | $3,869.00 | $2,514.85–$2,886.27 | — | 75% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC EGD FLEX W/RMVL TUMOR/POLYP/OTH LES SNARE | $1,363.25 | $5,453.00 | $2,731.95–$4,384.21 | 31% above | 75% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC EGD FLEX W/RMVL TUMOR/POLYP/OTH LES SNARE | $1,363.25 | $5,453.00 | $3,544.45–$4,067.94 | — | 75% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC EGD FLEX W/INS GUIDEWIRE PASSAGE DIL THRU ESO | $1,158.00 | $4,632.00 | $2,320.63–$3,724.13 | 48% above | 75% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC EGD FLEX W/INS GUIDEWIRE PASSAGE DIL THRU ESO | $1,158.00 | $4,632.00 | $3,010.80–$3,455.47 | — | 75% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC EGD FLEX TRNSRL DIAG W/COLLECT SPEC BRUSH/WASH | $856.25 | $3,425.00 | $1,715.92–$2,753.70 | 16% below | 75% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC EGD FLEX TRNSRL DIAG W/COLLECT SPEC BRUSH/WASH | $856.25 | $3,425.00 | $2,226.25–$2,555.05 | — | 75% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Vasectomy w/ post-op semen exam 55250 | $1,320.25 | $5,281.00 | $2,645.78–$4,245.92 | 160% above | 75% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 Vasectomy w/ post-op semen exam 55250 | $1,320.25 | $5,281.00 | $3,432.65–$3,939.63 | — | 75% |
| Wart removal, up to 14 warts CPT 17110 Destruction other benign lesions; up to 14 lesions 17110 | $169.50 | $678.00 | $339.68–$545.11 | at median | 75% |
| Wart removal, up to 14 warts inpatient CPT 17110 Destruction other benign lesions; up to 14 lesions 17110 | $169.50 | $678.00 | $440.70–$505.79 | — | 75% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Subcutan Each Add 20 sq cm | $423.75 | $1,695.00 | $849.20–$1,362.78 | 128% above | 75% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride subcu tissue; first 20 sq cm or less 11042 | $492.75 | $1,971.00 | $987.47–$1,584.68 | 165% above | 75% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 - DEBRID SC TISS FIRST 20 SQCM/LESS | $508.50 | $2,034.00 | $1,019.03–$1,635.34 | 173% above | 75% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Subcutan Each Add 20 sq cm | $423.75 | $1,695.00 | $1,101.75–$1,264.47 | — | 75% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride subcu tissue; first 20 sq cm or less 11042 | $492.75 | $1,971.00 | $1,281.15–$1,470.37 | — | 75% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 - DEBRID SC TISS FIRST 20 SQCM/LESS | $508.50 | $2,034.00 | $1,322.10–$1,517.36 | — | 75% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 36430 - TRANSFUSION BLD/BLD CPNT(S) | $461.25 | $1,845.00 | $924.34–$1,483.38 | 6% below | 75% |
| Blood transfusion (giving blood or blood components) CPT 36430 BP CHARGE Blood Transfusion -> Yes | $461.25 | $1,845.00 | $924.34–$1,483.38 | 6% below | 75% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion, Blood Or Blood Components 36430 | $461.25 | $1,845.00 | $924.34–$1,483.38 | 6% below | 75% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 - TRANSFUSION BLD/BLD CPNT(S) | $461.25 | $1,845.00 | $1,199.25–$1,376.37 | — | 75% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BP CHARGE Blood Transfusion -> Yes | $461.25 | $1,845.00 | $1,199.25–$1,376.37 | — | 75% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion, Blood Or Blood Components 36430 | $461.25 | $1,845.00 | $1,199.25–$1,376.37 | — | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE Inhalation TRMNT -> Neb/MDI/DPI | $226.75 | $907.00 | $454.41–$729.23 | 24% above | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 -INH TRMNT PRESSURE/NONPRESSURE | $272.00 | $1,088.00 | $545.09–$874.75 | 48% above | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE Inhalation TRMNT -> Neb/MDI/DPI | $226.75 | $907.00 | $589.55–$676.62 | — | 75% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 -INH TRMNT PRESSURE/NONPRESSURE | $272.00 | $1,088.00 | $707.20–$811.65 | — | 75% |
| Chemotherapy IV infusion, first hour CPT 96413 Chemo IV Infusion 1 HR 96413 | $232.50 | $930.00 | $465.93–$747.72 | 41% below | 75% |
| Chemotherapy IV infusion, first hour CPT 96413 Chemotherapy Inf up to 1 Hour Single or Initial Drug 96413 | $232.50 | $930.00 | $465.93–$747.72 | 41% below | 75% |
| Chemotherapy IV infusion, first hour CPT 96413 96413 - CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG | $232.50 | $930.00 | $465.93–$747.72 | 41% below | 75% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo IV Infusion 1 HR 96413 | $232.50 | $930.00 | $604.50–$693.78 | — | 75% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 96413 - CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG | $232.50 | $930.00 | $604.50–$693.78 | — | 75% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemotherapy Inf up to 1 Hour Single or Initial Drug 96413 | $232.50 | $930.00 | $604.50–$693.78 | — | 75% |
| Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care Ill/Injured Patient Init 30-74 Min | $852.50 | $3,410.00 | $1,708.41–$2,741.64 | 17% below | 75% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care Ill/Injured Patient Init 30-74 Min | $852.50 | $3,410.00 | $2,216.50–$2,543.86 | — | 75% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CV ECG Acquisition | $70.75 | $283.00 | $141.78–$227.53 | 37% below | 75% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CV ECG Acquisition | $70.75 | $283.00 | $183.95–$211.12 | — | 75% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1 | $81.25 | $325.00 | $162.82–$261.30 | 21% below | 75% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1 | $81.25 | $325.00 | $211.25–$242.45 | — | 75% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2 | $135.00 | $540.00 | $270.54–$434.16 | 35% below | 75% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2 | $135.00 | $540.00 | $351.00–$402.84 | — | 75% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3 | $263.00 | $1,052.00 | $527.05–$845.81 | 22% below | 75% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3 | $263.00 | $1,052.00 | $683.80–$784.79 | — | 75% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4 | $444.25 | $1,777.00 | $890.28–$1,428.71 | 27% below | 75% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4 | $444.25 | $1,777.00 | $1,155.05–$1,325.64 | — | 75% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5 | $646.75 | $2,587.00 | $1,296.09–$2,079.95 | 34% below | 75% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5 | $646.75 | $2,587.00 | $1,681.55–$1,929.90 | — | 75% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 ECBMC Contrast Stress Echo | $333.50 | $1,334.00 | $668.33–$1,072.54 | 42% below | 75% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 NCBMC CV Stress Test | $333.50 | $1,334.00 | $668.33–$1,072.54 | 42% below | 75% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 NC CV Stress Test Exam DTA | $333.50 | $1,334.00 | $668.33–$1,072.54 | 42% below | 75% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NCBMC CV Stress Test | $333.50 | $1,334.00 | $867.10–$995.16 | — | 75% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 ECBMC Contrast Stress Echo | $333.50 | $1,334.00 | $867.10–$995.16 | — | 75% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NC CV Stress Test Exam DTA | $333.50 | $1,334.00 | $867.10–$995.16 | — | 75% |
| Family therapy with the patient, 50 minutes CPT 90847 Family Psychotherapy with Patient 90847 | $144.75 | $579.00 | $290.08–$465.52 | 19% below | 75% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Psychotherapy with Patient 90847 | $144.75 | $579.00 | $376.35–$431.93 | — | 75% |
| Family therapy without the patient, 50 minutes CPT 90846 Family Psychotherapy w/o Patient 90846 | $138.00 | $552.00 | $276.55–$443.81 | 1% above | 75% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psychotherapy w/o Patient 90846 | $138.00 | $552.00 | $358.80–$411.79 | — | 75% |
| Group psychotherapy session CPT 90853 Group Therapy 90853 | $62.50 | $250.00 | $125.25–$201.00 | 3% above | 75% |
| Group psychotherapy session inpatient CPT 90853 Group Therapy 90853 | $62.50 | $250.00 | $162.50–$186.50 | — | 75% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Infusion Hydration Initial 31 Min-1 Hour 96360 | $228.00 | $912.00 | $456.91–$733.25 | 8% above | 75% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR | $228.00 | $912.00 | $456.91–$733.25 | 8% above | 75% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion for Hydration Initial 31 to 60 Minutes 96360 | $228.00 | $912.00 | $456.91–$733.25 | 8% above | 75% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour | $273.50 | $1,094.00 | $548.09–$879.58 | 30% above | 75% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR | $228.00 | $912.00 | $592.80–$680.35 | — | 75% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Infusion for Hydration Initial 31 to 60 Minutes 96360 | $228.00 | $912.00 | $592.80–$680.35 | — | 75% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Infusion Hydration Initial 31 Min-1 Hour 96360 | $228.00 | $912.00 | $592.80–$680.35 | — | 75% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour | $273.50 | $1,094.00 | $711.10–$816.12 | — | 75% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion Therapy/Prophylaxis /Dx 1St To 1 Hr 96365 | $228.00 | $912.00 | $456.91–$733.25 | 30% below | 75% |
| IV infusion of a medicine, first hour CPT 96365 96365 - IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST >1 HOUR | $228.00 | $912.00 | $456.91–$733.25 | 30% below | 75% |
| IV infusion of a medicine, first hour CPT 96365 Inf for Therapy, Prophylaxis, Dx Initial up to 1 Hour 96365 | $228.00 | $912.00 | $456.91–$733.25 | 30% below | 75% |
| IV infusion of a medicine, first hour CPT 96365 96365 - IV tx, first hour | $273.50 | $1,094.00 | $548.09–$879.58 | 16% below | 75% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 - IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST >1 HOUR | $228.00 | $912.00 | $592.80–$680.35 | — | 75% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Inf for Therapy, Prophylaxis, Dx Initial up to 1 Hour 96365 | $228.00 | $912.00 | $592.80–$680.35 | — | 75% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Therapy/Prophylaxis /Dx 1St To 1 Hr 96365 | $228.00 | $912.00 | $592.80–$680.35 | — | 75% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 - IV tx, first hour | $273.50 | $1,094.00 | $711.10–$816.12 | — | 75% |
| IV push of a medicine, first drug CPT 96374 Admin Therapeutic IV Push -> 96374 - Initial IV Push | $228.00 | $912.00 | $456.91–$733.25 | 16% above | 75% |
| IV push of a medicine, first drug CPT 96374 Admin Injection/Therapeutic IV -> 96374 - Initial IV Push | $228.00 | $912.00 | $456.91–$733.25 | 16% above | 75% |
| IV push of a medicine, first drug CPT 96374 Therapeutic Proph/Dx Njx IV Push Single/1St Sbst/Drug 96374 | $228.00 | $912.00 | $456.91–$733.25 | 16% above | 75% |
| IV push of a medicine, first drug CPT 96374 Tx Prophylactic or Diag IVP Single or Initial Drug 96374 | $228.00 | $912.00 | $456.91–$733.25 | 16% above | 75% |
| IV push of a medicine, first drug CPT 96374 96374 - IV Injection, single/initial | $273.50 | $1,094.00 | $548.09–$879.58 | 39% above | 75% |
| IV push of a medicine, first drug inpatient CPT 96374 Tx Prophylactic or Diag IVP Single or Initial Drug 96374 | $228.00 | $912.00 | $592.80–$680.35 | — | 75% |
| IV push of a medicine, first drug inpatient CPT 96374 Admin Therapeutic IV Push -> 96374 - Initial IV Push | $228.00 | $912.00 | $592.80–$680.35 | — | 75% |
| IV push of a medicine, first drug inpatient CPT 96374 Admin Injection/Therapeutic IV -> 96374 - Initial IV Push | $228.00 | $912.00 | $592.80–$680.35 | — | 75% |
| IV push of a medicine, first drug inpatient CPT 96374 Therapeutic Proph/Dx Njx IV Push Single/1St Sbst/Drug 96374 | $228.00 | $912.00 | $592.80–$680.35 | — | 75% |
| IV push of a medicine, first drug inpatient CPT 96374 96374 - IV Injection, single/initial | $273.50 | $1,094.00 | $711.10–$816.12 | — | 75% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Admin Injection/Therapeutic IV -> 96372 - Injection Administration | $75.00 | $300.00 | $150.30–$241.20 | 9% above | 75% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Therapy, Prophylactic, Diagnostic Injection SQ or IM 96372 | $75.00 | $300.00 | $150.30–$241.20 | 9% above | 75% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 BCE 96372 - Ther/Prophylactic/Dx Inj Sc/Im | $75.00 | $300.00 | $150.30–$241.20 | 9% above | 75% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection Fee 96372 | $75.00 | $300.00 | $150.30–$241.20 | 9% above | 75% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Admin Injection SC/IM -> 96372 - Injection Administration | $75.00 | $300.00 | $150.30–$241.20 | 9% above | 75% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 - Subq/IM Injection | $90.00 | $360.00 | $180.36–$289.44 | 30% above | 75% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 BCE 96372 - Ther/Prophylactic/Dx Inj Sc/Im | $75.00 | $300.00 | $195.00–$223.80 | — | 75% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Admin Injection/Therapeutic IV -> 96372 - Injection Administration | $75.00 | $300.00 | $195.00–$223.80 | — | 75% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection Fee 96372 | $75.00 | $300.00 | $195.00–$223.80 | — | 75% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Admin Injection SC/IM -> 96372 - Injection Administration | $75.00 | $300.00 | $195.00–$223.80 | — | 75% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Therapy, Prophylactic, Diagnostic Injection SQ or IM 96372 | $75.00 | $300.00 | $195.00–$223.80 | — | 75% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 - Subq/IM Injection | $90.00 | $360.00 | $234.00–$268.56 | — | 75% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psych Diagnostic Eval W/O Med Mgmt 90791 | $205.50 | $822.00 | $411.82–$660.89 | 5% below | 75% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psych Diagnostic Eval W/O Med Mgmt 90791 | $205.50 | $822.00 | $534.30–$613.21 | — | 75% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve conduction study/7-8 study 95910 | $320.50 | $1,282.00 | $642.28–$1,030.73 | 49% above | 75% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Nerve conduction study/7-8 study 95910 | $320.50 | $1,282.00 | $833.30–$956.37 | — | 75% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Assistant Units | $26.25 | $105.00 | $52.60–$84.42 | 74% below | 75% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Units | $26.25 | $105.00 | $52.60–$84.42 | 74% below | 75% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units | $26.25 | $105.00 | $52.60–$84.42 | 74% below | 75% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Assistant Units | $26.25 | $105.00 | $52.60–$84.42 | 74% below | 75% |
| Neuromuscular re-education, 15 minutes CPT 97112 SLP Neuromuscular Re-Education Units | $34.00 | $136.00 | $68.14–$109.34 | 66% below | 75% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Assistant Units | $26.25 | $105.00 | $68.25–$78.33 | — | 75% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Assistant Units | $26.25 | $105.00 | $68.25–$78.33 | — | 75% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Units | $26.25 | $105.00 | $68.25–$78.33 | — | 75% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units | $26.25 | $105.00 | $68.25–$78.33 | — | 75% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 SLP Neuromuscular Re-Education Units | $34.00 | $136.00 | $88.40–$101.46 | — | 75% |
| New patient office visit, about 30 minutes CPT 99203 Office Visit Level 3 New (30+min) 99203 | $104.50 | $418.00 | $209.42–$336.07 | 27% below | 75% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office Visit Level 3 New (30+min) 99203 | $104.50 | $418.00 | $271.70–$311.83 | — | 75% |
| New patient office visit, about 45 minutes CPT 99204 Office Visit Level 4 New (45+min) 99204 | $151.00 | $604.00 | $302.60–$485.62 | 28% below | 75% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office Visit Level 4 New (45+min) 99204 | $151.00 | $604.00 | $392.60–$450.58 | — | 75% |
| New patient office visit, about 60 minutes CPT 99205 Office Visit Level 5 New (60+min) 99205 | $225.50 | $902.00 | $451.90–$725.21 | 32% below | 75% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office Visit Level 5 New (60+min) 99205 | $225.50 | $902.00 | $586.30–$672.89 | — | 75% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office Visit Level 2 New (15+min) 99202 | $76.25 | $305.00 | $152.80–$245.22 | 14% below | 75% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office Visit Level 2 New (15+min) 99202 | $76.25 | $305.00 | $198.25–$227.53 | — | 75% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT initial/ind pt/15 min 97802 | $20.00 | $80.00 | $40.08–$64.32 | 56% below | 75% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT initial/ind pt/15 min 97802 | $20.00 | $80.00 | $52.00–$59.68 | — | 75% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Units, Low Complexity | $71.00 | $284.00 | $142.28–$228.34 | 68% below | 75% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Evaluation Units, Low Complexity | $71.00 | $284.00 | $184.60–$211.86 | — | 75% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Evaluation Units, High Complexity | $80.75 | $323.00 | $161.82–$259.69 | 71% below | 75% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Evaluation Units, High Complexity | $80.75 | $323.00 | $209.95–$240.96 | — | 75% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Units, Low Complexity | $73.25 | $293.00 | $146.79–$235.57 | 67% below | 75% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Evaluation Units, Low Complexity | $73.25 | $293.00 | $190.45–$218.58 | — | 75% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Units, Moderate Complexity | $75.00 | $300.00 | $150.30–$241.20 | 72% below | 75% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Evaluation Units, Moderate Complexity | $75.00 | $300.00 | $195.00–$223.80 | — | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units | $30.25 | $121.00 | $60.62–$97.28 | 69% below | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Assistant Units | $30.25 | $121.00 | $60.62–$97.28 | 69% below | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units | $30.25 | $121.00 | $60.62–$97.28 | 69% below | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Assistant Units | $30.25 | $121.00 | $60.62–$97.28 | 69% below | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units | $30.25 | $121.00 | $78.65–$90.27 | — | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Assistant Units | $30.25 | $121.00 | $78.65–$90.27 | — | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units | $30.25 | $121.00 | $78.65–$90.27 | — | 75% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Assistant Units | $30.25 | $121.00 | $78.65–$90.27 | — | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Units | $31.00 | $124.00 | $62.12–$99.70 | 54% below | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units | $31.00 | $124.00 | $62.12–$99.70 | 54% below | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Units | $31.00 | $124.00 | $62.12–$99.70 | 54% below | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units | $31.00 | $124.00 | $62.12–$99.70 | 54% below | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 SLP Therapeutic Exericse Units | $32.50 | $130.00 | $65.13–$104.52 | 52% below | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Units | $31.00 | $124.00 | $80.60–$92.50 | — | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Units | $31.00 | $124.00 | $80.60–$92.50 | — | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units | $31.00 | $124.00 | $80.60–$92.50 | — | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units | $31.00 | $124.00 | $80.60–$92.50 | — | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 SLP Therapeutic Exericse Units | $32.50 | $130.00 | $84.50–$96.98 | — | 75% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial Comp Preventive Med 18 to 39 years New 99385 | $145.00 | $580.00 | $290.58–$466.32 | at median | 75% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Initial Comp Preventive Med 18 to 39 years New 99385 | $145.00 | $580.00 | $377.00–$432.68 | — | 75% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial Comp Preventive Med 40 to 64 years New 99386 | $175.50 | $702.00 | $351.70–$564.41 | at median | 75% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Initial Comp Preventive Med 40 to 64 years New 99386 | $175.50 | $702.00 | $456.30–$523.69 | — | 75% |
| Preventive checkup, new patient aged 65 or older CPT 99387 Initial Comp Preventive Med 65+ yrs New 99387 | $189.00 | $756.00 | $378.76–$607.82 | 57% above | 75% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Initial Comp Preventive Med 65+ yrs New 99387 | $189.00 | $756.00 | $491.40–$563.98 | — | 75% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 Periodic Comp Preventive Med 18 to 39 years Est 99395 | $117.00 | $468.00 | $234.47–$376.27 | at median | 75% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Periodic Comp Preventive Med 18 to 39 years Est 99395 | $117.00 | $468.00 | $304.20–$349.13 | — | 75% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 Periodic Comp Preventive Med 40 to 64 years Est 99396 | $104.50 | $418.00 | $209.42–$336.07 | 7% below | 75% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Periodic Comp Preventive Med 40 to 64 years Est 99396 | $104.50 | $418.00 | $271.70–$311.83 | — | 75% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 Periodic Comp Preventive Med 65+ years Est 99397 | $120.25 | $481.00 | $240.98–$386.72 | 21% below | 75% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Periodic Comp Preventive Med 65+ years Est 99397 | $120.25 | $481.00 | $312.65–$358.83 | — | 75% |
| Psychiatric evaluation with medical services CPT 90792 Psych Diagnostic Eval With Med Mgmt 90792 | $221.25 | $885.00 | $443.38–$711.54 | 2% below | 75% |
| Psychiatric evaluation with medical services inpatient CPT 90792 Psych Diagnostic Eval With Med Mgmt 90792 | $221.25 | $885.00 | $575.25–$660.21 | — | 75% |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 Minutes 90832 | $134.50 | $538.00 | $269.54–$432.55 | at median | 75% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy, 30 Minutes 90832 | $134.50 | $538.00 | $349.70–$401.35 | — | 75% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 Minutes 90834 | $194.75 | $779.00 | $390.28–$626.32 | 12% above | 75% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy, 45 Minutes 90834 | $194.75 | $779.00 | $506.35–$581.13 | — | 75% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 Minutes 90837 | $216.50 | $866.00 | $433.87–$696.26 | 28% above | 75% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy, 60 Minutes 90837 | $216.50 | $866.00 | $562.90–$646.04 | — | 75% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 RT CHARGE Tobacco Cessation -> 3-10 minutes | $20.25 | $81.00 | $40.58–$65.12 | 19% below | 75% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco Use Cessation Intermediate 3-10 Minutes 99406 | $41.50 | $166.00 | $83.17–$133.46 | 67% above | 75% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 RT CHARGE Tobacco Cessation -> 3-10 minutes | $20.25 | $81.00 | $52.65–$60.43 | — | 75% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco Use Cessation Intermediate 3-10 Minutes 99406 | $41.50 | $166.00 | $107.90–$123.84 | — | 75% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC$ OB Level Charges -> Level 5 | $81.75 | $327.00 | $163.83–$262.91 | 44% below | 75% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office Visit Level 5 Est 99215 (40+ min) | $167.00 | $668.00 | $334.67–$537.07 | 15% above | 75% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC$ OB Level Charges -> Level 5 | $81.75 | $327.00 | $212.55–$243.94 | — | 75% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office Visit Level 5 Est 99215 (40+ min) | $167.00 | $668.00 | $434.20–$498.33 | — | 75% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC$ OB Level Charges -> Level 3 | $41.00 | $164.00 | $82.16–$131.86 | 44% below | 75% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office Visit Level 3 Est 99213 (20+min) | $84.25 | $337.00 | $168.84–$270.95 | 15% above | 75% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC$ OB Level Charges -> Level 3 | $41.00 | $164.00 | $106.60–$122.34 | — | 75% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office Visit Level 3 Est 99213 (20+min) | $84.25 | $337.00 | $219.05–$251.40 | — | 75% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC$ OB Level Charges -> Level 4 | $53.75 | $215.00 | $107.72–$172.86 | 49% below | 75% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office Visit Level 4 Est (30+min) 99214 | $114.75 | $459.00 | $229.96–$369.04 | 9% above | 75% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC$ OB Level Charges -> Level 4 | $53.75 | $215.00 | $139.75–$160.39 | — | 75% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office Visit Level 4 Est (30+min) 99214 | $114.75 | $459.00 | $298.35–$342.41 | — | 75% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC$ OB Level Charges -> Level 2 | $31.75 | $127.00 | $63.63–$102.11 | 44% below | 75% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office Visit Level 2 Est 99212 (10+ min) | $57.25 | $229.00 | $114.73–$184.12 | 2% above | 75% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC$ OB Level Charges -> Level 2 | $31.75 | $127.00 | $82.55–$94.74 | — | 75% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office Visit Level 2 Est 99212 (10+ min) | $57.25 | $229.00 | $148.85–$170.83 | — | 75% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Office/OP Consult Level 3 New 99243 | $137.50 | $550.00 | $275.55–$442.20 | 204% above | 75% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Office/OP Consult Level 3 Est 99243 | $137.50 | $550.00 | $275.55–$442.20 | 204% above | 75% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office/OP Consult Level 3 New 99243 | $137.50 | $550.00 | $357.50–$410.30 | — | 75% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office/OP Consult Level 3 Est 99243 | $137.50 | $550.00 | $357.50–$410.30 | — | 75% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office/OP Consult Level 4 Est 99244 | $183.25 | $733.00 | $367.23–$589.33 | 186% above | 75% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office/OP Consult Level 4 New 99244 | $183.25 | $733.00 | $367.23–$589.33 | 186% above | 75% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office/OP Consult Level 4 New 99244 | $183.25 | $733.00 | $476.45–$546.82 | — | 75% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office/OP Consult Level 4 Est 99244 | $183.25 | $733.00 | $476.45–$546.82 | — | 75% |
| Speech and language evaluation CPT 92523 SLP Eval Lang Comprehension,Express Unit | $142.50 | $570.00 | $285.57–$458.28 | 56% below | 75% |
| Speech and language evaluation inpatient CPT 92523 SLP Eval Lang Comprehension,Express Unit | $142.50 | $570.00 | $370.50–$425.22 | — | 75% |
| Speech therapy session, individual CPT 92507 SPEECH/HEARING THERAPY 92507 | $59.75 | $239.00 | $119.74–$192.16 | 63% below | 75% |
| Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units | $59.75 | $239.00 | $119.74–$192.16 | 63% below | 75% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH/HEARING THERAPY 92507 | $59.75 | $239.00 | $155.35–$178.29 | — | 75% |
| Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units | $59.75 | $239.00 | $155.35–$178.29 | — | 75% |
| Spirometry (breathing test) CPT 94010 CPA Simple Spirometry | $95.25 | $381.00 | $190.88–$306.32 | 32% below | 75% |
| Spirometry (breathing test) CPT 94010 Spirometry POC | $95.25 | $381.00 | $190.88–$306.32 | 32% below | 75% |
| Spirometry (breathing test) CPT 94010 RT CHARGE Spirometry CPA -> Simple Spirometry | $95.25 | $381.00 | $190.88–$306.32 | 32% below | 75% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry POC | $95.25 | $381.00 | $247.65–$284.23 | — | 75% |
| Spirometry (breathing test) inpatient CPT 94010 CPA Simple Spirometry | $95.25 | $381.00 | $247.65–$284.23 | — | 75% |
| Spirometry (breathing test) inpatient CPT 94010 RT CHARGE Spirometry CPA -> Simple Spirometry | $95.25 | $381.00 | $247.65–$284.23 | — | 75% |
| Spirometry before and after a bronchodilator CPT 94060 RT CHARGE Spirometry CPA -> PFT W/ Bronchodilator | $333.50 | $1,334.00 | $668.33–$1,072.54 | 4% above | 75% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 RT CHARGE Spirometry CPA -> PFT W/ Bronchodilator | $333.50 | $1,334.00 | $867.10–$995.16 | — | 75% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 SLP Therapeutic Activities Units | $23.75 | $95.00 | $47.60–$76.38 | 79% below | 75% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Assistant Units | $23.75 | $95.00 | $47.60–$76.38 | 79% below | 75% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units | $23.75 | $95.00 | $47.60–$76.38 | 79% below | 75% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Assistant Units | $23.75 | $95.00 | $47.60–$76.38 | 79% below | 75% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Units | $23.75 | $95.00 | $47.60–$76.38 | 79% below | 75% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Units | $23.75 | $95.00 | $61.75–$70.87 | — | 75% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Assistant Units | $23.75 | $95.00 | $61.75–$70.87 | — | 75% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units | $23.75 | $95.00 | $61.75–$70.87 | — | 75% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Assistant Units | $23.75 | $95.00 | $61.75–$70.87 | — | 75% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 SLP Therapeutic Activities Units | $23.75 | $95.00 | $61.75–$70.87 | — | 75% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy, Therapeutic (Separate Procedure) 99195 | $105.75 | $423.00 | $211.92–$340.09 | 32% below | 75% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic 99195 | $105.75 | $423.00 | $211.92–$340.09 | 32% below | 75% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy MCH | $105.75 | $423.00 | $211.92–$340.09 | 32% below | 75% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 BP CHARGE Therapeutic Phlebotomy -> Yes | $105.75 | $423.00 | $211.92–$340.09 | 32% below | 75% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic 99195 | $105.75 | $423.00 | $274.95–$315.56 | — | 75% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy, Therapeutic (Separate Procedure) 99195 | $105.75 | $423.00 | $274.95–$315.56 | — | 75% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 BP CHARGE Therapeutic Phlebotomy -> Yes | $105.75 | $423.00 | $274.95–$315.56 | — | 75% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy MCH | $105.75 | $423.00 | $274.95–$315.56 | — | 75% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 WC$ Pneumococcal Admin Charge -> Done | $75.00 | $300.00 | $150.30–$241.20 | 325% above | 75% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 - ADMIN VAC PERC/IM/SC/INTRADERMAL | $75.00 | $300.00 | $150.30–$241.20 | 325% above | 75% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 WC$ Pneumococcal Admin Charge -> Done | $75.00 | $300.00 | $195.00–$223.80 | — | 75% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 - ADMIN VAC PERC/IM/SC/INTRADERMAL | $75.00 | $300.00 | $195.00–$223.80 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 BCE 90472 - IA Each additional vaccine Influenza | $5.40 | $21.58 | $10.81–$17.35 | 69% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Vaccine Admin Pneumococcal -> 90472 - IA Each additional vaccine pneumococcal | $5.40 | $21.58 | $10.81–$17.35 | 69% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Vaccine Admin Hepatitis B -> 90472 - IA Each additional vaccine Hepatitis B | $5.40 | $21.58 | $10.81–$17.35 | 69% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Vaccine Admin Influenza -> 90472 - IA Each additional vaccine influenza | $5.40 | $21.58 | $10.81–$17.35 | 69% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Vaccine Admin Tdap -> 90472 - IA Each additional vaccine Tdap | $5.40 | $21.58 | $10.81–$17.35 | 69% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Vaccine Administration -> 90472 - IA Each additional injected vaccine | $5.40 | $21.58 | $10.81–$17.35 | 69% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 BCE 90472 - IA Each additional injected vaccine | $5.40 | $21.58 | $10.81–$17.35 | 69% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 BCE 90472 - IA Each additional vaccine Hepatitis B | $5.40 | $21.58 | $10.81–$17.35 | 69% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 BCE 90472 - IA Each additional vaccine Tdap | $5.40 | $21.58 | $10.81–$17.35 | 69% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 BCE 90472 - IA Each additional vaccine pneumococcal | $5.40 | $21.58 | $10.81–$17.35 | 69% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 - IA EACH ADDITIONAL VACCINE INFLU | $5.40 | $21.58 | $10.81–$17.35 | 69% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 - IA EACH ADDITIONAL VACCINE PNEUM | $5.40 | $21.58 | $10.81–$17.35 | 69% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 - ADMIN IMMUNIZATION ADDL | $11.75 | $47.00 | $23.55–$37.79 | 33% below | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 BCE 90472 - IA Each additional vaccine Hepatitis B | $5.40 | $21.58 | $14.03–$16.10 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 BCE 90472 - IA Each additional vaccine Tdap | $5.40 | $21.58 | $14.03–$16.10 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 BCE 90472 - IA Each additional vaccine pneumococcal | $5.40 | $21.58 | $14.03–$16.10 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 - IA EACH ADDITIONAL VACCINE INFLU | $5.40 | $21.58 | $14.03–$16.10 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 - IA EACH ADDITIONAL VACCINE PNEUM | $5.40 | $21.58 | $14.03–$16.10 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 BCE 90472 - IA Each additional injected vaccine | $5.40 | $21.58 | $14.03–$16.10 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 BCE 90472 - IA Each additional vaccine Influenza | $5.40 | $21.58 | $14.03–$16.10 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Admin Vaccine Admin Tdap -> 90472 - IA Each additional vaccine Tdap | $5.40 | $21.58 | $14.03–$16.10 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Admin Vaccine Admin Influenza -> 90472 - IA Each additional vaccine influenza | $5.40 | $21.58 | $14.03–$16.10 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Admin Vaccine Admin Hepatitis B -> 90472 - IA Each additional vaccine Hepatitis B | $5.40 | $21.58 | $14.03–$16.10 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Admin Vaccine Administration -> 90472 - IA Each additional injected vaccine | $5.40 | $21.58 | $14.03–$16.10 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Admin Vaccine Admin Pneumococcal -> 90472 - IA Each additional vaccine pneumococcal | $5.40 | $21.58 | $14.03–$16.10 | — | 75% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 - ADMIN IMMUNIZATION ADDL | $11.75 | $47.00 | $30.55–$35.06 | — | 75% |
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://northernlighthealth.org/NLH/media/Price-Transparency/010198331_Maine-Coast-Hospital_standardcharges.csv