Hospital New York-Newark-Jersey City, NY-NJ

Westchester Medical Center

Westchester Medical Center in Valhalla, NY publishes cash prices for 419 common procedures listed here, from its own machine-readable price file updated Jul 28, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the New York median for 405 of 414 procedures and below it for 9. By typical cash price it ranks #107 of 114 New York hospitals and #65 of 74 hospitals in the New York, NY area, cheapest first. Click a procedure to compare it with other hospitals nearby.

100 Woods Road, Valhalla, NY 10595 Collected Sep 27, 2026 Source price file (914) 493-7000

Acute care hospital Emergency department CMS star rating 2 of 5 CCN 330234 · CMS hospital register NPI 1932280666

The price file shows no self-pay discount

For 1214 of the 1214 prices listed here, the cash price in Westchester Medical Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 4 actions for a hospital named Westchester Medical Center in Valhalla, NY:

May 18, 2021 Warning notice
Oct 27, 2021 Corrective action plan requested
Jan 11, 2022 Case closed
Mar 25, 2025 Met requirements

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/O & W/DYE	$5,260.00	$5,260.00	$218.95–$5,623.00	307% above	—
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/O & W/DYE	$5,260.00	$5,260.00	$1,578.00–$5,260.00	—	—
Abdominal X-ray, 2 views CPT 74019 X-RAY EXAM ABDOMEN 2 VIEWS	$1,542.00	$1,542.00	$20.47–$1,542.00	500% above	—
Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY EXAM ABDOMEN 2 VIEWS	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Ankle X-ray, complete, 3 or more views both sides CPT 73610 X-RAY EXAM OF ANKLE +3V BI	$1,647.00	$1,647.00	$73.15–$1,647.00	—	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY EXAM OF ANKLE +3V RT	$1,099.00	$1,099.00	$73.15–$1,099.00	452% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY EXAM OF ANKLE +3V LT	$1,099.00	$1,099.00	$73.15–$1,099.00	452% above	—
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 X-RAY EXAM OF ANKLE +3V BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 X-RAY EXAM OF ANKLE +3V RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 X-RAY EXAM OF ANKLE +3V LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 UPR/L XTREMITY ART 2 LEVELS BI	$1,223.00	$1,223.00	$164.59–$1,405.00	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$1,223.00	$1,223.00	$164.59–$1,405.00	311% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 UPR/L XTREMITY ART 2 LEVELS BI	$1,223.00	$1,223.00	$366.90–$1,223.00	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$1,223.00	$1,223.00	$366.90–$1,223.00	—	—
Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT UPPER EXTREMITY W/O DYE BI	$3,467.00	$3,467.00	$130.50–$5,623.00	—	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT U EXT WO CONTRAST LT	$2,263.00	$2,263.00	$130.50–$5,623.00	207% above	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT U EXT WO CONTRAST RT	$2,263.00	$2,263.00	$130.50–$5,623.00	207% above	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREMITY W/O DYE LT	$2,311.00	$2,311.00	$130.50–$5,623.00	214% above	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREMITY W/O DYE RT	$2,311.00	$2,311.00	$130.50–$5,623.00	214% above	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT UPPER EXTREMITY W/O DYE BI	$3,467.00	$3,467.00	$1,040.10–$3,467.00	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT U EXT WO CONTRAST RT	$2,263.00	$2,263.00	$678.90–$2,263.00	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT U EXT WO CONTRAST LT	$2,263.00	$2,263.00	$678.90–$2,263.00	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXTREMITY W/O DYE LT	$2,311.00	$2,311.00	$693.30–$2,311.00	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXTREMITY W/O DYE RT	$2,311.00	$2,311.00	$693.30–$2,311.00	—	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$2,505.00	$2,505.00	$168.04–$2,505.00	642% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$2,505.00	$2,505.00	$751.50–$2,505.00	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY	$5,060.00	$5,060.00	$499.03–$5,060.00	430% above	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING WHOLE BODY	$5,060.00	$5,060.00	$1,518.00–$5,060.00	—	—
Breast ultrasound, complete, one breast both sides CPT 76641 ULTRASOUND BREAST COMPLETE BI	$3,467.00	$3,467.00	$74.78–$3,467.00	—	—
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND BREAST COMPLETE LT	$1,542.00	$1,542.00	$74.78–$1,542.00	391% above	—
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND BREAST COMPLETE RT	$1,542.00	$1,542.00	$74.78–$1,542.00	391% above	—
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 ULTRASOUND BREAST COMPLETE BI	$3,467.00	$3,467.00	$1,040.10–$3,467.00	—	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND BREAST COMPLETE RT	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND BREAST COMPLETE LT	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BREAST LIMITED BI	$1,648.00	$1,648.00	$57.01–$1,648.00	—	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRASOUND BREAST LIMITED RT	$1,099.00	$1,099.00	$57.01–$1,099.00	346% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRASOUND BREAST LIMITED LT	$1,099.00	$1,099.00	$57.01–$1,099.00	346% above	—
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US BREAST LIMITED BI	$1,648.00	$1,648.00	$494.40–$1,648.00	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRASOUND BREAST LIMITED LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRASOUND BREAST LIMITED RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD&PELV W/O&W/DYE	$7,871.00	$7,871.00	$246.54–$7,871.00	406% above	—
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD&PELV W/O&W/DYE	$7,871.00	$7,871.00	$2,361.30–$7,871.00	—	—
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD	$5,260.00	$5,260.00	$218.95–$5,623.00	402% above	—
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD	$5,260.00	$5,260.00	$1,578.00–$5,260.00	—	—
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK	$5,260.00	$5,260.00	$218.95–$5,623.00	363% above	—
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK	$5,260.00	$5,260.00	$1,578.00–$5,260.00	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$3,756.00	$3,756.00	$218.95–$5,623.00	197% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST	$3,756.00	$3,756.00	$1,126.80–$3,756.00	—	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE	$3,756.00	$3,756.00	$246.54–$5,623.00	265% above	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HRT W/3D IMAGE	$3,756.00	$3,756.00	$1,126.80–$3,756.00	—	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$1,646.00	$1,646.00	$60.76–$5,623.00	897% above	—
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST	$1,646.00	$1,646.00	$493.80–$1,646.00	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$6,726.00	$6,726.00	$112.38–$6,726.00	524% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST	$6,726.00	$6,726.00	$2,017.80–$6,726.00	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELV W/CONTRAST	$11,018.00	$11,018.00	$218.45–$11,018.00	605% above	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELV W/CONTRAST	$11,018.00	$11,018.00	$3,305.40–$11,018.00	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELV 1/> REGNS W&WO	$11,018.00	$11,018.00	$246.54–$11,018.00	522% above	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELV 1/> REGNS W&WO	$11,018.00	$11,018.00	$3,305.40–$11,018.00	—	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/DYE	$5,260.00	$5,260.00	$218.95–$5,623.00	379% above	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/DYE	$5,260.00	$5,260.00	$1,578.00–$5,260.00	—	—
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O DYE	$3,236.00	$3,236.00	$130.50–$5,623.00	278% above	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O DYE	$3,236.00	$3,236.00	$970.80–$3,236.00	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE	$2,311.00	$2,311.00	$130.50–$5,623.00	198% above	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O DYE	$2,311.00	$2,311.00	$693.30–$2,311.00	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE	$2,311.00	$2,311.00	$130.50–$5,623.00	191% above	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O DYE	$2,311.00	$2,311.00	$693.30–$2,311.00	—	—
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE	$3,756.00	$3,756.00	$218.95–$5,623.00	305% above	—
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/DYE	$3,756.00	$3,756.00	$1,126.80–$3,756.00	—	—
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$3,756.00	$3,756.00	$218.95–$5,623.00	261% above	—
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$3,756.00	$3,756.00	$1,126.80–$3,756.00	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE	$3,236.00	$3,236.00	$130.50–$5,623.00	288% above	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O DYE	$3,236.00	$3,236.00	$970.80–$3,236.00	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE	$3,236.00	$3,236.00	$130.50–$5,623.00	267% above	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT NECK SPINE W/O DYE	$3,236.00	$3,236.00	$970.80–$3,236.00	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE	$3,756.00	$3,756.00	$218.95–$5,623.00	297% above	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/DYE	$3,756.00	$3,756.00	$1,126.80–$3,756.00	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$3,392.00	$3,392.00	$297.84–$3,392.00	—	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$3,392.00	$3,392.00	$1,017.60–$3,392.00	—	—
Chest CT scan without and with contrast CPT 71270 CT THORAX DX C-/C+	$3,756.00	$3,756.00	$218.95–$5,623.00	201% above	—
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX DX C-/C+	$3,756.00	$3,756.00	$1,126.80–$3,756.00	—	—
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$1,099.00	$1,099.00	$18.62–$1,099.00	445% above	—
Chest X-ray, 2 views inpatient CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$1,099.00	$1,099.00	$10.16–$1,099.00	491% above	—
Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Collarbone (clavicle) X-ray, complete both sides CPT 73000 X-RAY EXAM OF COLLAR BONE BI	$1,647.00	$1,647.00	$62.60–$1,647.00	—	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY EXAM OF COLLAR BONE RT	$1,099.00	$1,099.00	$62.60–$1,099.00	445% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY EXAM OF COLLAR BONE LT	$1,099.00	$1,099.00	$62.60–$1,099.00	445% above	—
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 X-RAY EXAM OF COLLAR BONE BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 X-RAY EXAM OF COLLAR BONE LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 X-RAY EXAM OF COLLAR BONE RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$1,542.00	$1,542.00	$130.50–$1,542.00	285% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US EXAM ABDO BACK WALL COMP	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$3,082.00	$3,082.00	$31.15–$3,082.00	1052% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY AXIAL	$3,082.00	$3,082.00	$924.60–$3,082.00	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY/PERIPHERAL	$559.00	$559.00	$16.96–$559.00	288% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY/PERIPHERAL	$559.00	$559.00	$167.70–$559.00	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB ULTRASOUND DETAILED SNGL	$3,204.00	$3,204.00	$296.28–$3,204.00	465% above	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS	$3,204.00	$3,204.00	$296.28–$3,204.00	465% above	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB US DETAILED SNGL FETUS	$3,204.00	$3,204.00	$961.20–$3,204.00	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB ULTRASOUND DETAILED SNGL	$3,204.00	$3,204.00	$961.20–$3,204.00	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C-	$3,236.00	$3,236.00	$130.50–$5,623.00	288% above	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DX C-	$3,236.00	$3,236.00	$970.80–$3,236.00	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+	$3,756.00	$3,756.00	$218.95–$5,623.00	230% above	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX DX C+	$3,756.00	$3,756.00	$1,126.80–$3,756.00	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$1,715.00	$1,715.00	$92.33–$1,715.00	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI	$1,715.00	$1,715.00	$514.50–$1,715.00	—	—
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI RT	$1,347.00	$1,347.00	$71.88–$1,347.00	394% above	—
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI LT	$1,347.00	$1,347.00	$71.88–$1,347.00	394% above	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAMMO INCL CAD UNI RT	$1,347.00	$1,347.00	$404.10–$1,347.00	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAMMO INCL CAD UNI LT	$1,347.00	$1,347.00	$404.10–$1,347.00	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX LE ART/BPG; BILAT	$3,203.00	$3,203.00	$297.84–$3,203.00	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUPLEX LE ART/BPG; BILAT	$3,203.00	$3,203.00	$960.90–$3,203.00	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX EXT VEINS; BILAT	$2,310.00	$2,310.00	$297.84–$2,310.00	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY	$2,310.00	$2,310.00	$297.84–$2,310.00	247% above	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX EXT VEINS; BILAT	$2,310.00	$2,310.00	$693.00–$2,310.00	—	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 EXTREMITY STUDY	$2,310.00	$2,310.00	$693.00–$2,310.00	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$9,126.00	$9,126.00	$142.13–$9,126.00	748% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W DOPPLER COMPLETE NE	$9,126.00	$9,126.00	$142.13–$9,126.00	748% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W OR WO FOL WCON,DOPPLER	$9,126.00	$9,126.00	$142.13–$9,126.00	748% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE	$9,126.00	$9,126.00	$2,737.80–$9,126.00	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W DOPPLER COMPLETE NE	$9,126.00	$9,126.00	$2,737.80–$9,126.00	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W OR WO FOL WCON,DOPPLER	$9,126.00	$9,126.00	$2,737.80–$9,126.00	—	—
Elbow X-ray, 2 views both sides CPT 73070 X-RAY EXAM OF ELBOW 2V BI	$1,647.00	$1,647.00	$54.69–$1,647.00	—	—
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 1 VIEW RIGHT	$1,099.00	$1,099.00	$54.69–$1,099.00	451% above	—
Elbow X-ray, 2 views one side CPT 73070 X-RAY EXAM OF ELBOW 2V LT	$1,099.00	$1,099.00	$54.69–$1,099.00	451% above	—
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 1 VIEW LEFT	$1,099.00	$1,099.00	$54.69–$1,099.00	451% above	—
Elbow X-ray, 2 views one side CPT 73070 X-RAY EXAM OF ELBOW 2V RT	$1,099.00	$1,099.00	$54.69–$1,099.00	451% above	—
Elbow X-ray, 2 views inpatient both sides CPT 73070 X-RAY EXAM OF ELBOW 2V BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 X-RAY EXAM OF ELBOW 2V LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 1 VIEW RIGHT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 1 VIEW LEFT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 X-RAY EXAM OF ELBOW 2V RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Elbow X-ray, complete, 3 or more views both sides CPT 73080 X-RAY EXAM OF ELBOW +3V BI	$1,647.00	$1,647.00	$61.72–$1,647.00	—	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY EXAM OF ELBOW +3V LT	$1,099.00	$1,099.00	$61.72–$1,099.00	445% above	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY EXAM OF ELBOW +3V RT	$1,099.00	$1,099.00	$61.72–$1,099.00	445% above	—
Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 X-RAY EXAM OF ELBOW +3V BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 X-RAY EXAM OF ELBOW +3V RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 X-RAY EXAM OF ELBOW +3V LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE	$2,311.00	$2,311.00	$130.50–$5,623.00	213% above	—
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE	$2,311.00	$2,311.00	$693.30–$2,311.00	—	—
Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY EXAM FACIAL BONES +3V FY	$1,542.00	$1,542.00	$89.86–$1,542.00	492% above	—
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 X-RAY EXAM FACIAL BONES +3V FY	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 X-RAY EXAM OF FOREARM BI	$1,647.00	$1,647.00	$55.56–$1,647.00	—	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 1V RT REDU	$879.00	$879.00	$55.56–$879.00	336% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 1V LT REDU	$879.00	$879.00	$55.56–$879.00	336% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 1 VIEW LEFT	$1,099.00	$1,099.00	$55.56–$1,099.00	445% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY EXAM OF FOREARM LT	$1,099.00	$1,099.00	$55.56–$1,099.00	445% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY EXAM OF FOREARM RT	$1,099.00	$1,099.00	$55.56–$1,099.00	445% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 1 VIEW RIGHT	$1,099.00	$1,099.00	$55.56–$1,099.00	445% above	—
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 X-RAY EXAM OF FOREARM BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 1V LT REDU	$879.00	$879.00	$263.70–$879.00	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 1V RT REDU	$879.00	$879.00	$263.70–$879.00	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 X-RAY EXAM OF FOREARM LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 1 VIEW RIGHT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 X-RAY EXAM OF FOREARM RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 1 VIEW LEFT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$5,060.00	$5,060.00	$282.47–$5,060.00	402% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$5,060.00	$5,060.00	$1,518.00–$5,060.00	—	—
Hand X-ray, 2 views both sides CPT 73120 X-RAY EXAM OF HAND 2V BI	$2,311.00	$2,311.00	$59.97–$2,311.00	—	—
Hand X-ray, 2 views one side CPT 73120 X-RAY EXAM OF HAND 1V RT RED	$1,234.00	$1,234.00	$59.97–$1,234.00	559% above	—
Hand X-ray, 2 views one side CPT 73120 X-RAY EXAM OF HAND 1V LT RED	$1,234.00	$1,234.00	$59.97–$1,234.00	559% above	—
Hand X-ray, 2 views one side CPT 73120 X-RAY EXAM OF HAND 2V LT	$1,542.00	$1,542.00	$59.97–$1,542.00	724% above	—
Hand X-ray, 2 views one side CPT 73120 X-RAY EXAM OF HAND 2V RT	$1,542.00	$1,542.00	$59.97–$1,542.00	724% above	—
Hand X-ray, 2 views inpatient both sides CPT 73120 X-RAY EXAM OF HAND 2V BI	$2,311.00	$2,311.00	$693.30–$2,311.00	—	—
Hand X-ray, 2 views inpatient one side CPT 73120 X-RAY EXAM OF HAND 1V LT RED	$1,234.00	$1,234.00	$370.20–$1,234.00	—	—
Hand X-ray, 2 views inpatient one side CPT 73120 X-RAY EXAM OF HAND 1V RT RED	$1,234.00	$1,234.00	$370.20–$1,234.00	—	—
Hand X-ray, 2 views inpatient one side CPT 73120 X-RAY EXAM OF HAND 2V RT	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Hand X-ray, 2 views inpatient one side CPT 73120 X-RAY EXAM OF HAND 2V LT	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 X-RAY EXAM OF HEEL BI	$1,647.00	$1,647.00	$54.69–$1,647.00	—	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X-RAY EXAM OF HEEL LT	$1,099.00	$1,099.00	$54.69–$1,099.00	499% above	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X-RAY EXAM OF HEEL RT	$1,099.00	$1,099.00	$54.69–$1,099.00	499% above	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 X-RAY EXAM OF HEEL BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 X-RAY EXAM OF HEEL LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 X-RAY EXAM OF HEEL RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT&RESP EFFT	$4,312.00	$4,312.00	$181.26–$5,533.00	977% above	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNAT&RESP EFFT RED	$4,312.00	$4,312.00	$181.26–$5,533.00	977% above	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATT&RESP EFFT	$4,312.00	$4,312.00	$1,293.60–$4,312.00	—	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNAT&RESP EFFT RED	$4,312.00	$4,312.00	$1,293.60–$4,312.00	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM	$10,886.00	$10,886.00	$1,071.95–$10,886.00	455% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM	$10,886.00	$10,886.00	$3,265.80–$10,886.00	—	—
Knee X-ray, 3 views both sides CPT 73562 X-RAY EXAM OF KNEE 3 BI	$1,647.00	$1,647.00	$81.06–$1,647.00	—	—
Knee X-ray, 3 views one side CPT 73562 X-RAY EXAM OF KNEE 3 LT	$1,099.00	$1,099.00	$81.06–$1,099.00	445% above	—
Knee X-ray, 3 views one side CPT 73562 X-RAY EXAM OF KNEE 3 RT	$1,099.00	$1,099.00	$81.06–$1,099.00	445% above	—
Knee X-ray, 3 views inpatient both sides CPT 73562 X-RAY EXAM OF KNEE 3 BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 X-RAY EXAM OF KNEE 3 LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 X-RAY EXAM OF KNEE 3 RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Knee X-ray, complete, 4 or more views CPT 73564 XRAY EXAM KNEE 4 OR MORE VIEWS	$1,542.00	$1,542.00	$89.16–$1,542.00	460% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY EXAM KNEE 4 OR MORE LT	$1,542.00	$1,542.00	$89.16–$1,542.00	460% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY EXAM KNEE 4 OR MORE RT	$1,542.00	$1,542.00	$89.16–$1,542.00	460% above	—
Knee X-ray, complete, 4 or more views inpatient CPT 73564 XRAY EXAM KNEE 4 OR MORE VIEWS	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 X-RAY EXAM KNEE 4 OR MORE LT	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 X-RAY EXAM KNEE 4 OR MORE RT	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT LOWER EXTREMITY W/O DYE BI	$3,467.00	$3,467.00	$130.50–$5,623.00	—	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREMITY W/O DYE RT	$2,311.00	$2,311.00	$130.50–$5,623.00	223% above	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREMITY W/O DYE LT	$2,311.00	$2,311.00	$130.50–$5,623.00	223% above	—
Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT LOWER EXTREMITY W/O DYE BI	$3,467.00	$3,467.00	$1,040.10–$3,467.00	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXTREMITY W/O DYE RT	$2,311.00	$2,311.00	$693.30–$2,311.00	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXTREMITY W/O DYE LT	$2,311.00	$2,311.00	$693.30–$2,311.00	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$1,542.00	$1,542.00	$130.50–$1,542.00	370% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 US LMTD JT/NONVASC XTR STRX BI	$1,080.00	$1,080.00	$32.11–$1,080.00	—	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US XTR NON-VASC LMTD	$292.00	$292.00	$32.11–$342.58	19% above	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/NONVASC XTR STRUX	$1,080.00	$1,080.00	$32.11–$1,080.00	341% above	—
Limited ultrasound of an arm or leg (non-vascular) inpatient both sides CPT 76882 US LMTD JT/NONVASC XTR STRX BI	$1,080.00	$1,080.00	$324.00–$1,080.00	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US XTR NON-VASC LMTD	$292.00	$292.00	$87.60–$292.00	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JT/NONVASC XTR STRUX	$1,080.00	$1,080.00	$324.00–$1,080.00	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C-	$1,646.00	$1,646.00	$96.00–$5,623.00	278% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LUNG CANCER SCR C-	$1,646.00	$1,646.00	$493.80–$1,646.00	—	—
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 X-RAY EXAM OF LOWER LEG BI	$1,647.00	$1,647.00	$61.72–$1,647.00	—	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA FIBULA 1V RT REDU	$879.00	$879.00	$61.72–$879.00	336% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA FIBULA 1V LT REDU	$879.00	$879.00	$61.72–$879.00	336% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY EXAM OF LOWER LEG RT	$1,099.00	$1,099.00	$61.72–$1,099.00	445% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 1 VIEW RIGHT	$1,099.00	$1,099.00	$61.72–$1,099.00	445% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY EXAM OF LOWER LEG LT	$1,099.00	$1,099.00	$61.72–$1,099.00	445% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 1 VIEW LEFT	$1,099.00	$1,099.00	$61.72–$1,099.00	445% above	—
Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 X-RAY EXAM OF LOWER LEG BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA FIBULA 1V LT REDU	$879.00	$879.00	$263.70–$879.00	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA FIBULA 1V RT REDU	$879.00	$879.00	$263.70–$879.00	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 1 VIEW RIGHT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 X-RAY EXAM OF LOWER LEG LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 X-RAY EXAM OF LOWER LEG RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 1 VIEW LEFT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE	$4,804.00	$4,804.00	$297.84–$4,917.07	287% above	—
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE	$4,804.00	$4,804.00	$1,441.20–$4,804.00	—	—
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST C-+ W/CAD BI	$7,871.00	$7,871.00	$353.74–$7,871.00	—	—
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST C-+ W/CAD BI	$7,871.00	$7,871.00	$2,361.30–$7,871.00	—	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JNT OF LWR EXTR W/O DYE LT	$4,804.00	$4,804.00	$297.84–$4,804.00	377% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE LT	$4,804.00	$4,804.00	$297.84–$4,804.00	377% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JNT OF LWR EXTR W/O DYE RT	$4,804.00	$4,804.00	$297.84–$4,804.00	377% above	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE LT	$4,804.00	$4,804.00	$1,441.20–$4,804.00	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI JNT OF LWR EXTR W/O DYE LT	$4,804.00	$4,804.00	$1,441.20–$4,804.00	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI JNT OF LWR EXTR W/O DYE RT	$4,804.00	$4,804.00	$1,441.20–$4,804.00	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI JOINT LWR EXT W/O&W/DYE RT	$7,871.00	$7,871.00	$435.49–$10,656.49	330% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI JOINT LWR EXT W/O&W/DYE LT	$7,871.00	$7,871.00	$435.49–$10,656.49	330% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI JOINT LWR EXT W/O&W/DYE LT	$7,871.00	$7,871.00	$2,361.30–$7,871.00	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI JOINT LWR EXT W/O&W/DYE RT	$7,871.00	$7,871.00	$2,361.30–$7,871.00	—	—
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O DYE	$6,405.00	$6,405.00	$297.84–$6,405.00	519% above	—
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O DYE	$6,405.00	$6,405.00	$1,921.50–$6,405.00	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/O & W/DYE	$10,494.00	$10,494.00	$435.49–$10,701.99	536% above	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/O & W/DYE	$10,494.00	$10,494.00	$3,148.20–$10,494.00	—	—
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE	$6,405.00	$6,405.00	$297.84–$6,405.00	514% above	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN STEM W/O DYE	$6,405.00	$6,405.00	$1,921.50–$6,405.00	—	—
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM WO & W DYE W 59	$4,517.00	$4,517.00	$435.49–$10,923.84	174% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE	$10,494.00	$10,494.00	$435.49–$10,923.84	536% above	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN STEM WO & W DYE W 59	$4,517.00	$4,517.00	$1,355.10–$4,517.00	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN STEM W/O & W/DYE	$10,494.00	$10,494.00	$3,148.20–$10,494.00	—	—
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE	$6,405.00	$6,405.00	$297.84–$6,405.00	465% above	—
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O DYE	$6,405.00	$6,405.00	$1,921.50–$6,405.00	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$10,494.00	$10,494.00	$435.49–$10,923.84	532% above	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$10,494.00	$10,494.00	$3,148.20–$10,494.00	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE	$6,405.00	$6,405.00	$297.84–$6,405.00	531% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI CHEST SPINE W/O DYE	$6,405.00	$6,405.00	$1,921.50–$6,405.00	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE	$10,494.00	$10,494.00	$435.49–$10,923.84	548% above	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI NECK SPINE W/O & W/DYE	$10,494.00	$10,494.00	$3,148.20–$10,494.00	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE	$6,405.00	$6,405.00	$297.84–$6,405.00	536% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI NECK SPINE W/O DYE	$6,405.00	$6,405.00	$1,921.50–$6,405.00	—	—
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE	$7,871.00	$7,871.00	$435.49–$10,701.99	408% above	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O & W/DYE	$7,871.00	$7,871.00	$2,361.30–$7,871.00	—	—
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE	$4,804.00	$4,804.00	$297.84–$4,837.34	367% above	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O DYE	$4,804.00	$4,804.00	$1,441.20–$4,804.00	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JOINT UPR EXTRM W/O DYE LT	$6,405.00	$6,405.00	$297.84–$6,405.00	433% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JOINT UPR EXTM W/O DYE RT	$6,405.00	$6,405.00	$297.84–$6,405.00	433% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI JOINT UPR EXTRM W/O DYE LT	$6,405.00	$6,405.00	$1,921.50–$6,405.00	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI JOINT UPR EXTM W/O DYE RT	$6,405.00	$6,405.00	$1,921.50–$6,405.00	—	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$1,542.00	$1,542.00	$102.16–$1,542.00	460% above	—
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/DYE	$3,756.00	$3,756.00	$218.95–$5,623.00	281% above	—
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/DYE	$3,756.00	$3,756.00	$1,126.80–$3,756.00	—	—
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O DYE	$2,311.00	$2,311.00	$130.50–$5,623.00	191% above	—
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O DYE	$2,311.00	$2,311.00	$693.30–$2,311.00	—	—
Neck soft tissue X-ray CPT 70360 X-RAY EXAM OF NECK	$1,099.00	$1,099.00	$59.08–$1,099.00	471% above	—
Neck soft tissue X-ray inpatient CPT 70360 X-RAY EXAM OF NECK	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT	$6,993.00	$6,993.00	$400.53–$6,993.00	199% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM BONE SCAN SCAN THREE PHASE	$6,993.00	$6,993.00	$400.53–$6,993.00	199% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM CARDIAC STRESS TEST 2ND	$6,993.00	$6,993.00	$400.53–$6,993.00	199% above	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM CARDIAC STRESS TEST 2ND	$6,993.00	$6,993.00	$2,097.90–$6,993.00	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM BONE SCAN SCAN THREE PHASE	$6,993.00	$6,993.00	$2,097.90–$6,993.00	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HT MUSCLE IMAGE SPECT MULT	$6,993.00	$6,993.00	$2,097.90–$6,993.00	—	—
OCT scan of the retina (optical coherence tomography) CPT 92134 COMPUT OPHTHALMIC IMAGING	$385.00	$385.00	$49.26–$568.00	448% above	—
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 COMPUT OPHTHALMIC IMAGING	$385.00	$385.00	$115.50–$385.00	—	—
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGE W/CT SKULL-THIGH PI	$7,934.00	$7,934.00	$369.60–$8,000.91	106% above	—
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGE W/CT SKULL-THIGH PS	$7,934.00	$7,934.00	$369.60–$8,000.91	106% above	—
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMAGE W/CT SKULL-THIGH PS	$7,934.00	$7,934.00	$2,380.20–$7,934.00	—	—
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMAGE W/CT SKULL-THIGH PI	$7,934.00	$7,934.00	$2,380.20–$7,934.00	—	—
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O DYE	$2,311.00	$2,311.00	$130.50–$5,623.00	182% above	—
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O DYE	$2,311.00	$2,311.00	$693.30–$2,311.00	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$1,542.00	$1,542.00	$89.45–$1,542.00	468% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$1,542.00	$1,542.00	$130.50–$1,542.00	286% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US EXAM PELVIC COMPLETE	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WKS SNGL FETUS	$1,542.00	$1,542.00	$130.50–$1,542.00	341% above	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >= 14 WKS SNGL FETUS	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$1,542.00	$1,542.00	$130.50–$1,542.00	394% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 WKS SINGLE FETUS	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$1,542.00	$1,542.00	$130.50–$1,542.00	432% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETUS(S)	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Rib X-ray, one side, 2 views CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS	$1,099.00	$1,099.00	$66.99–$1,099.00	445% above	—
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS LEFT	$464.00	$464.00	$66.99–$464.00	130% above	—
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS RIGHT	$464.00	$464.00	$66.99–$464.00	130% above	—
Rib X-ray, one side, 2 views inpatient CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS LEFT	$464.00	$464.00	$139.20–$464.00	—	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS RIGHT	$464.00	$464.00	$139.20–$464.00	—	—
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RIBS-L-3 VIEW PA CHEST	$261.00	$261.00	$78.30–$430.68	18% above	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 RIBS-L-3 VIEW PA CHEST	$261.00	$261.00	$78.30–$261.00	—	—
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD	$1,423.00	$1,423.00	$76.05–$1,423.00	—	—
Screening mammogram, both breasts one side CPT 77067 MAMMOGRAM SCREEN UNI RT CAD 3D	$1,330.00	$1,330.00	$76.05–$1,330.00	591% above	—
Screening mammogram, both breasts one side CPT 77067 MAMMOGRAM SCREEN UNI RT CAD	$1,330.00	$1,330.00	$76.05–$1,330.00	591% above	—
Screening mammogram, both breasts one side CPT 77067 MAMMOGRAM SCREENING UNI LT/CAD	$1,330.00	$1,330.00	$76.05–$1,330.00	591% above	—
Screening mammogram, both breasts one side CPT 77067 MAMMOGRAM SCREEN UNI LT/CAD/3D	$1,330.00	$1,330.00	$76.05–$1,330.00	591% above	—
Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BI INCL CAD	$1,423.00	$1,423.00	$426.90–$1,423.00	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMOGRAM SCREEN UNI RT CAD	$1,330.00	$1,330.00	$399.00–$1,330.00	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMOGRAM SCREENING UNI LT/CAD	$1,330.00	$1,330.00	$399.00–$1,330.00	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMOGRAM SCREEN UNI RT CAD 3D	$1,330.00	$1,330.00	$399.00–$1,330.00	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMOGRAM SCREEN UNI LT/CAD/3D	$1,330.00	$1,330.00	$399.00–$1,330.00	—	—
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 X-RAY EXAM OF SHOULDER +2V BI	$1,647.00	$1,647.00	$65.24–$1,647.00	—	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY EXAM OF SHOULDER +2V LT	$1,099.00	$1,099.00	$65.24–$1,099.00	438% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY EXAM OF SHOULDER +2V RT	$1,099.00	$1,099.00	$65.24–$1,099.00	438% above	—
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 X-RAY EXAM OF SHOULDER +2V BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 X-RAY EXAM OF SHOULDER +2V LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 X-RAY EXAM OF SHOULDER +2V RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY EXAM OF SINUSES +3V	$1,099.00	$1,099.00	$70.51–$1,099.00	445% above	—
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 X-RAY EXAM OF SINUSES +3V	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Skull X-ray, fewer than 4 views CPT 70250 X-RAY EXAM OF SKULL <4V	$1,542.00	$1,542.00	$69.63–$1,542.00	627% above	—
Skull X-ray, fewer than 4 views inpatient CPT 70250 X-RAY EXAM OF SKULL <4V	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$10,045.00	$10,045.00	$1,071.95–$10,045.00	438% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$10,045.00	$10,045.00	$3,013.50–$10,045.00	—	—
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE	$5,410.00	$5,410.00	$155.38–$5,410.00	427% above	—
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE COMPLETE	$5,410.00	$5,410.00	$1,623.00–$5,410.00	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+	$3,756.00	$3,756.00	$185.72–$3,756.00	1010% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 X-RAY XM SWLNG FUNCJ C+	$3,756.00	$3,756.00	$1,126.80–$3,756.00	—	—
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 X-RAY EXAM OF FEMUR 2/> BI	$3,292.00	$3,292.00	$22.84–$3,292.00	—	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY EXAM OF FEMUR 2/> LT	$2,195.00	$2,195.00	$22.84–$2,195.00	1088% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY EXAM OF FEMUR 2/> RT	$2,195.00	$2,195.00	$22.84–$2,195.00	1088% above	—
Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 X-RAY EXAM OF FEMUR 2/> BI	$3,292.00	$3,292.00	$987.60–$3,292.00	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 X-RAY EXAM OF FEMUR 2/> LT	$2,195.00	$2,195.00	$658.50–$2,195.00	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 X-RAY EXAM OF FEMUR 2/> RT	$2,195.00	$2,195.00	$658.50–$2,195.00	—	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT CHEST SPINE W/O DYE	$3,236.00	$3,236.00	$130.50–$5,623.00	274% above	—
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT CHEST SPINE W/O DYE	$3,236.00	$3,236.00	$970.80–$3,236.00	—	—
Toe X-ray, 2 or more views both sides CPT 73660 XR TOE(S) 2+ VIEWS BILAT	$368.00	$368.00	$59.08–$368.00	—	—
Toe X-ray, 2 or more views CPT 73660 X-RAY EXAM OF TOE(S)	$1,099.00	$1,099.00	$59.08–$1,099.00	523% above	—
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2+ VIEWS LT	$245.00	$245.00	$59.08–$356.60	39% above	—
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2+ VIEWS RT	$245.00	$245.00	$59.08–$356.60	39% above	—
Toe X-ray, 2 or more views inpatient both sides CPT 73660 XR TOE(S) 2+ VIEWS BILAT	$368.00	$368.00	$110.40–$368.00	—	—
Toe X-ray, 2 or more views inpatient CPT 73660 X-RAY EXAM OF TOE(S)	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) 2+ VIEWS LT	$245.00	$245.00	$73.50–$245.00	—	—
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) 2+ VIEWS RT	$245.00	$245.00	$73.50–$245.00	—	—
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB	$1,542.00	$1,542.00	$130.50–$1,542.00	314% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL US NON-OB	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$1,542.00	$1,542.00	$130.50–$1,542.00	432% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL US OBSTETRIC	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE	$1,542.00	$1,542.00	$130.50–$1,542.00	244% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOM COMPLETE	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM	$1,542.00	$1,542.00	$130.50–$1,542.00	337% above	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US EXAM SCROTUM	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$1,542.00	$1,542.00	$130.50–$1,542.00	366% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$5,009.00	$5,009.00	$207.35–$5,009.00	1094% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$5,009.00	$5,009.00	$1,502.70–$5,009.00	—	—
Upper arm X-ray (humerus), 2 views both sides CPT 73060 X-RAY EXAM OF HUMERUS BI	$1,647.00	$1,647.00	$62.60–$1,647.00	—	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY EXAM OF HUMERUS RT	$1,099.00	$1,099.00	$62.60–$1,099.00	471% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY EXAM OF HUMERUS LT	$1,099.00	$1,099.00	$62.60–$1,099.00	471% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 1 VIEW RIGHT	$1,099.00	$1,099.00	$62.60–$1,099.00	471% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 1 VIEW LEFT	$1,099.00	$1,099.00	$62.60–$1,099.00	471% above	—
Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 X-RAY EXAM OF HUMERUS BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 X-RAY EXAM OF HUMERUS LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 1 VIEW LEFT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 X-RAY EXAM OF HUMERUS RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 1 VIEW RIGHT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$1,920.00	$1,920.00	$130.50–$1,920.00	427% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX EXT VEINS; UNIL/LIMIT	$1,920.00	$1,920.00	$130.50–$1,920.00	427% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DOPPLER UNILATERAL RT	$1,442.00	$1,442.00	$130.50–$1,442.00	296% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DOPPLER UNILATERAL LT	$1,442.00	$1,442.00	$130.50–$1,442.00	296% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX EXT VEINS; UNIL/LIMIT	$1,920.00	$1,920.00	$576.00–$1,920.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 EXTREMITY STUDY	$1,920.00	$1,920.00	$576.00–$1,920.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DOPPLER UNILATERAL LT	$1,442.00	$1,442.00	$432.60–$1,442.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DOPPLER UNILATERAL RT	$1,442.00	$1,442.00	$432.60–$1,442.00	—	—
Wrist X-ray, 2 views both sides CPT 73100 X-RAY EXAM OF WRIST 2V BI	$1,647.00	$1,647.00	$66.99–$1,647.00	—	—
Wrist X-ray, 2 views one side CPT 73100 XR WRST 1V RT REDU	$879.00	$879.00	$66.99–$879.00	379% above	—
Wrist X-ray, 2 views one side CPT 73100 XR WRST 1V LT REDU	$879.00	$879.00	$66.99–$879.00	379% above	—
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 1 VIEW RIGHT	$1,099.00	$1,099.00	$66.99–$1,099.00	499% above	—
Wrist X-ray, 2 views one side CPT 73100 X-RAY EXAM OF WRIST 2V RT	$1,099.00	$1,099.00	$66.99–$1,099.00	499% above	—
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 1 VIEW LEFT	$1,099.00	$1,099.00	$66.99–$1,099.00	499% above	—
Wrist X-ray, 2 views one side CPT 73100 X-RAY EXAM OF WRIST 2V LT	$1,099.00	$1,099.00	$66.99–$1,099.00	499% above	—
Wrist X-ray, 2 views inpatient both sides CPT 73100 X-RAY EXAM OF WRIST 2V BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRST 1V LT REDU	$879.00	$879.00	$263.70–$879.00	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRST 1V RT REDU	$879.00	$879.00	$263.70–$879.00	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 X-RAY EXAM OF WRIST 2V LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 X-RAY EXAM OF WRIST 2V RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 1 VIEW RIGHT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 1 VIEW LEFT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Wrist X-ray, complete, 3 or more views both sides CPT 73110 X-RAY EXAM OF WRIST +3V BI	$1,647.00	$1,647.00	$73.60–$1,647.00	—	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY EXAM OF WRIST +3V RT	$1,099.00	$1,099.00	$73.60–$1,099.00	445% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY EXAM OF WRIST +3V LT	$1,099.00	$1,099.00	$73.60–$1,099.00	445% above	—
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 X-RAY EXAM OF WRIST +3V BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 X-RAY EXAM OF WRIST +3V LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 X-RAY EXAM OF WRIST +3V RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY EXAM HIP UNI 2-3 VWS RT	$1,099.00	$1,099.00	$29.42–$1,099.00	444% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY EXAM HIP UNI 2-3 VWS LT	$1,099.00	$1,099.00	$29.42–$1,099.00	444% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY EXAM HIP UNI 2-3 VWS LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY EXAM HIP UNI 2-3 VWS RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the abdomen, 1 view CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW	$1,099.00	$1,099.00	$17.12–$1,099.00	445% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the ankle, 2 views both sides CPT 73600 X-RAY EXAM OF ANKLE 2V BI	$1,647.00	$1,647.00	$63.47–$1,647.00	—	—
X-ray of the ankle, 2 views one side CPT 73600 XR ANKL 1V LT REDU	$879.00	$879.00	$63.47–$879.00	357% above	—
X-ray of the ankle, 2 views one side CPT 73600 XR ANKL 1V RT REDU	$879.00	$879.00	$63.47–$879.00	357% above	—
X-ray of the ankle, 2 views one side CPT 73600 X-RAY EXAM OF ANKLE 2V RT	$1,099.00	$1,099.00	$63.47–$1,099.00	471% above	—
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 1 VIEW RIGHT	$1,099.00	$1,099.00	$63.47–$1,099.00	471% above	—
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 1 VIEW LEFT	$1,099.00	$1,099.00	$63.47–$1,099.00	471% above	—
X-ray of the ankle, 2 views one side CPT 73600 X-RAY EXAM OF ANKLE 2V LT	$1,099.00	$1,099.00	$63.47–$1,099.00	471% above	—
X-ray of the ankle, 2 views inpatient both sides CPT 73600 X-RAY EXAM OF ANKLE 2V BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKL 1V RT REDU	$879.00	$879.00	$263.70–$879.00	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKL 1V LT REDU	$879.00	$879.00	$263.70–$879.00	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 X-RAY EXAM OF ANKLE 2V LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1 VIEW RIGHT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 X-RAY EXAM OF ANKLE 2V RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1 VIEW LEFT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the finger(s), 2 or more views both sides CPT 73140 XR FINGER 2+ VIEWS BILAT	$368.00	$368.00	$59.11–$368.00	—	—
X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER(5TH DIGIT) 2+ VIEWS	$1,009.00	$1,009.00	$59.11–$1,009.00	479% above	—
X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER 3RD DIGIT 2+ VIEWS	$1,009.00	$1,009.00	$59.11–$1,009.00	479% above	—
X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER(4TH DIGIT) 2+ VIEWS	$1,009.00	$1,009.00	$59.11–$1,009.00	479% above	—
X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER(2ND DIGIT) 2+ VIEWS	$1,099.00	$1,099.00	$59.11–$1,099.00	531% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 1V RT REDU	$879.00	$879.00	$59.11–$879.00	404% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 1V LT REDU	$879.00	$879.00	$59.11–$879.00	404% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 X-RAY EXAM OF FINGER(S) LT	$1,099.00	$1,099.00	$59.11–$1,099.00	531% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 X-RAY EXAM OF FINGER(S) RT FY	$1,099.00	$1,099.00	$59.11–$1,099.00	531% above	—
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 XR FINGER 2+ VIEWS BILAT	$368.00	$368.00	$110.40–$368.00	—	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER(4TH DIGIT) 2+ VIEWS	$1,009.00	$1,009.00	$302.70–$1,009.00	—	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER 3RD DIGIT 2+ VIEWS	$1,009.00	$1,009.00	$302.70–$1,009.00	—	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER(5TH DIGIT) 2+ VIEWS	$1,009.00	$1,009.00	$302.70–$1,009.00	—	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER(2ND DIGIT) 2+ VIEWS	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 1V RT REDU	$879.00	$879.00	$263.70–$879.00	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 1V LT REDU	$879.00	$879.00	$263.70–$879.00	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 X-RAY EXAM OF FINGER(S) RT FY	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 X-RAY EXAM OF FINGER(S) LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the foot, 2 views both sides CPT 73620 X-RAY EXAM OF FOOT 2V BI	$1,647.00	$1,647.00	$54.69–$1,647.00	—	—
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 1V LT REDU	$879.00	$879.00	$54.69–$879.00	378% above	—
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 1V RT REDU	$879.00	$879.00	$54.69–$879.00	378% above	—
X-ray of the foot, 2 views one side CPT 73620 X-RAY EXAM OF FOOT 2V RT	$1,099.00	$1,099.00	$54.69–$1,099.00	497% above	—
X-ray of the foot, 2 views one side CPT 73620 X-RAY EXAM OF FOOT 2V LT	$1,099.00	$1,099.00	$54.69–$1,099.00	497% above	—
X-ray of the foot, 2 views inpatient both sides CPT 73620 X-RAY EXAM OF FOOT 2V BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 1V LT REDU	$879.00	$879.00	$263.70–$879.00	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 1V RT REDU	$879.00	$879.00	$263.70–$879.00	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 X-RAY EXAM OF FOOT 2V RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 X-RAY EXAM OF FOOT 2V LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the foot, complete, 3 or more views both sides CPT 73630 FOOT, MIN 3 VIEWS, BILAT	$212.00	$212.00	$63.60–$356.60	—	—
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 FOOT, MIN 3 VIEWS, BILAT	$212.00	$212.00	$63.60–$212.00	—	—
X-ray of the hand, 3 or more views both sides CPT 73130 X-RAY EXAM OF HAND +3V BI	$1,647.00	$1,647.00	$72.26–$1,647.00	—	—
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY EXAM OF HAND +3V LT	$1,099.00	$1,099.00	$72.26–$1,099.00	445% above	—
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY EXAM OF HAND +3V RT	$1,099.00	$1,099.00	$72.26–$1,099.00	445% above	—
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 X-RAY EXAM OF HAND +3V BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 X-RAY EXAM OF HAND +3V LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 X-RAY EXAM OF HAND +3V RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the knee, 1 or 2 views both sides CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 BI	$1,647.00	$1,647.00	$67.88–$1,647.00	—	—
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 RT	$1,099.00	$1,099.00	$67.88–$1,099.00	445% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 LT	$1,099.00	$1,099.00	$67.88–$1,099.00	445% above	—
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 BI	$1,647.00	$1,647.00	$494.10–$1,647.00	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 RT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 LT	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$1,542.00	$1,542.00	$74.90–$1,542.00	460% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$1,542.00	$1,542.00	$98.63–$1,542.00	412% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$1,542.00	$1,542.00	$59.08–$1,542.00	586% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES +3V	$1,099.00	$1,099.00	$72.30–$1,099.00	507% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-RAY EXAM OF NASAL BONES +3V	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$1,099.00	$1,099.00	$74.04–$1,099.00	445% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS 1-2V	$1,542.00	$1,542.00	$50.28–$1,542.00	587% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-RAY EXAM OF PELVIS 1-2V	$1,542.00	$1,542.00	$462.60–$1,542.00	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE	$1,099.00	$1,099.00	$61.72–$1,099.00	499% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY EXAM SACRUM TAILBONE	$1,099.00	$1,099.00	$329.70–$1,099.00	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
ACTH blood test CPT 82024 ASSAY OF ACTH	$462.00	$462.00	$27.03–$462.00	229% above	—
ACTH blood test inpatient CPT 82024 ASSAY OF ACTH	$462.00	$462.00	$138.60–$462.00	—	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT)	$64.00	$64.00	$3.71–$64.00	184% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) FLUID	$64.00	$64.00	$3.71–$64.00	184% above	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO (ALT) (SGPT)	$64.00	$64.00	$19.20–$64.00	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) FLUID	$64.00	$64.00	$19.20–$64.00	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT)	$63.00	$63.00	$3.63–$63.00	187% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) FLUID	$63.00	$63.00	$3.63–$63.00	187% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT) FLUID	$63.00	$63.00	$18.90–$63.00	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE (AST) (SGOT)	$63.00	$63.00	$18.90–$63.00	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$569.00	$569.00	$33.34–$569.00	230% above	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$569.00	$569.00	$170.70–$569.00	—	—
Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN	$61.00	$61.00	$3.46–$61.00	234% above	—
Albumin blood test inpatient CPT 82040 ASSAY OF SERUM ALBUMIN	$61.00	$61.00	$18.30–$61.00	—	—
Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE	$487.00	$487.00	$28.52–$487.00	254% above	—
Aldosterone blood test inpatient CPT 82088 ASSAY OF ALDOSTERONE	$487.00	$487.00	$146.10–$487.00	—	—
Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE	$63.00	$63.00	$3.63–$63.00	223% above	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ASSAY ALKALINE PHOSPHATASE	$63.00	$63.00	$18.90–$63.00	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 DUCK FEATHERS IGE E86	$63.00	$63.00	$3.65–$63.00	336% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$63.00	$63.00	$3.65–$63.00	336% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-GRAPEFRUIT IGE	$63.00	$63.00	$3.65–$63.00	336% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-CARROT	$63.00	$63.00	$3.65–$63.00	336% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-GRAPEFRUIT IGE	$63.00	$63.00	$18.90–$63.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$63.00	$63.00	$18.90–$63.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-CARROT	$63.00	$63.00	$18.90–$63.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DUCK FEATHERS IGE E86	$63.00	$63.00	$18.90–$63.00	—	—
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM	$201.00	$201.00	$11.74–$201.00	225% above	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM	$201.00	$201.00	$60.30–$201.00	—	—
Ammonia blood test CPT 82140 ASSAY OF AMMONIA	$175.00	$175.00	$10.20–$175.00	232% above	—
Ammonia blood test inpatient CPT 82140 ASSAY OF AMMONIA	$175.00	$175.00	$52.50–$175.00	—	—
Amylase blood test CPT 82150 ASSAY OF AMYLASE	$79.00	$79.00	$4.54–$79.00	161% above	—
Amylase blood test inpatient CPT 82150 ASSAY OF AMYLASE	$79.00	$79.00	$23.70–$79.00	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$156.00	$156.00	$9.06–$156.00	233% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY	$156.00	$156.00	$46.80–$156.00	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$146.00	$146.00	$8.46–$146.00	230% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$146.00	$146.00	$43.80–$146.00	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$470.00	$470.00	$27.48–$470.00	283% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$470.00	$470.00	$141.00–$470.00	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE - OTHR SOURC	$104.00	$104.00	$6.03–$104.00	163% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$104.00	$104.00	$6.03–$104.00	163% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$104.00	$104.00	$31.20–$104.00	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BACTERIAL CULTURE - OTHR SOURC	$104.00	$104.00	$31.20–$104.00	—	—
Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL TOTAL CA	$102.00	$102.00	$5.92–$102.00	68% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 METABOLIC PANEL TOTAL CA	$102.00	$102.00	$30.60–$102.00	—	—
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$61.00	$61.00	$3.51–$61.00	195% above	—
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$61.00	$61.00	$18.30–$61.00	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST	$507.00	$507.00	$65.05–$534.86	250% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EX BY PATHOLOGIST LV 4	$681.00	$681.00	$65.05–$681.00	370% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM BY PATHOLOGIST	$507.00	$507.00	$152.10–$507.00	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EX BY PATHOLOGIST LV 4	$681.00	$681.00	$204.30–$681.00	—	—
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA	$125.00	$125.00	$7.22–$125.00	106% above	—
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE FOR BACTERIA	$125.00	$125.00	$37.50–$125.00	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$23.00	$23.00	$0.01–$42.96	56% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE	$45.00	$45.00	$0.01–$45.00	204% above	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$23.00	$23.00	$6.90–$23.00	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE	$45.00	$45.00	$13.50–$45.00	—	—
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$73.00	$73.00	$2.75–$73.00	306% above	—
Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$73.00	$73.00	$21.90–$73.00	—	—
Blood lead test CPT 83655 ASSAY OF LEAD	$146.00	$146.00	$8.48–$146.00	239% above	—
Blood lead test inpatient CPT 83655 ASSAY OF LEAD	$146.00	$146.00	$43.80–$146.00	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$92.00	$92.00	$5.26–$92.00	183% above	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$92.00	$92.00	$27.60–$92.00	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$1,500.00	$1,500.00	$4.49–$1,500.00	883% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO	$1,500.00	$1,500.00	$450.00–$1,500.00	—	—
Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN QUAN	$73.00	$73.00	$2.77–$73.00	236% above	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 ASSAY OF UREA NITROGEN QUAN	$73.00	$73.00	$21.90–$73.00	—	—
C-peptide blood test CPT 84681 ASSAY OF C-PEPTIDE	$250.00	$250.00	$14.57–$250.00	225% above	—
C-peptide blood test inpatient CPT 84681 ASSAY OF C-PEPTIDE	$250.00	$250.00	$75.00–$250.00	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$63.00	$63.00	$3.63–$63.00	138% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$63.00	$63.00	$18.90–$63.00	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$446.00	$446.00	$19.88–$446.00	269% above	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$446.00	$446.00	$133.80–$446.00	—	—
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$250.00	$250.00	$14.57–$250.00	232% above	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$250.00	$250.00	$75.00–$250.00	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125	$250.00	$250.00	$14.57–$250.00	225% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY TUMOR CA 125	$250.00	$250.00	$75.00–$250.00	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$215.00	$215.00	$35.92–$284.83	139% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$215.00	$215.00	$64.50–$215.00	—	—
Calcium blood test, total CPT 82310 ASSAY OF CALCIUM TOTAL	$63.00	$63.00	$3.61–$63.00	231% above	—
Calcium blood test, total inpatient CPT 82310 ASSAY OF CALCIUM TOTAL	$63.00	$63.00	$18.90–$63.00	—	—
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN	$228.00	$228.00	$13.27–$228.00	226% above	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN	$228.00	$228.00	$68.40–$228.00	—	—
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY	$155.00	$155.00	$9.02–$155.00	273% above	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER ANTIBODY	$155.00	$155.00	$46.50–$155.00	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AMP PROBE	$419.00	$419.00	$24.56–$419.00	402% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH DNA AMP PROBE	$419.00	$419.00	$125.70–$419.00	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$162.00	$162.00	$9.37–$162.00	142% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$162.00	$162.00	$48.60–$162.00	—	—
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$95.00	$95.00	$5.44–$95.00	148% above	—
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$95.00	$95.00	$28.50–$95.00	—	—
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED	$79.00	$79.00	$4.53–$79.00	178% above	—
Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED	$79.00	$79.00	$23.70–$79.00	—	—
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL	$128.00	$128.00	$7.39–$128.00	57% above	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL	$128.00	$128.00	$38.40–$128.00	—	—
Cortisol blood test, total CPT 82533 CORTISOL 30 MINUTE	$196.00	$196.00	$11.41–$196.00	286% above	—
Cortisol blood test, total CPT 82533 CORTISOL 150 MINUTE	$196.00	$196.00	$11.41–$196.00	286% above	—
Cortisol blood test, total CPT 82533 CORTISOL 180 MINUTE	$196.00	$196.00	$11.41–$196.00	286% above	—
Cortisol blood test, total CPT 82533 TOTAL CORTISOL	$196.00	$196.00	$11.41–$196.00	286% above	—
Cortisol blood test, total CPT 82533 CORTISOL 120 MINUTE	$196.00	$196.00	$11.41–$196.00	286% above	—
Cortisol blood test, total CPT 82533 CORTISOL 60 MINUTE	$196.00	$196.00	$11.41–$196.00	286% above	—
Cortisol blood test, total CPT 82533 CORTISOL 20 MINUTE	$196.00	$196.00	$11.41–$196.00	286% above	—
Cortisol blood test, total CPT 82533 CORTISOL 40 MINUTE	$196.00	$196.00	$11.41–$196.00	286% above	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL 20 MINUTE	$196.00	$196.00	$58.80–$196.00	—	—
Cortisol blood test, total inpatient CPT 82533 TOTAL CORTISOL	$196.00	$196.00	$58.80–$196.00	—	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL 180 MINUTE	$196.00	$196.00	$58.80–$196.00	—	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL 150 MINUTE	$196.00	$196.00	$58.80–$196.00	—	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL 120 MINUTE	$196.00	$196.00	$58.80–$196.00	—	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL 40 MINUTE	$196.00	$196.00	$58.80–$196.00	—	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL 60 MINUTE	$196.00	$196.00	$58.80–$196.00	—	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL 30 MINUTE	$196.00	$196.00	$58.80–$196.00	—	—
Creatine kinase (CK) blood test, total CPT 82550 CPK FLUID	$79.00	$79.00	$4.56–$79.00	203% above	—
Creatine kinase (CK) blood test, total CPT 82550 ASSAY OF CK (CPK)	$79.00	$79.00	$4.56–$79.00	203% above	—
Creatine kinase (CK) blood test, total inpatient CPT 82550 ASSAY OF CK (CPK)	$79.00	$79.00	$23.70–$79.00	—	—
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK FLUID	$79.00	$79.00	$23.70–$79.00	—	—
Creatinine blood test CPT 82565 ASSAY OF CREATININE	$62.00	$62.00	$3.58–$62.00	165% above	—
Creatinine blood test inpatient CPT 82565 ASSAY OF CREATININE	$62.00	$62.00	$18.60–$62.00	—	—
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$173.00	$173.00	$10.07–$173.00	246% above	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY	$173.00	$173.00	$51.90–$173.00	—	—
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT	$123.00	$123.00	$7.13–$123.00	230% above	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION QUANT	$123.00	$123.00	$36.90–$123.00	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE	$265.00	$265.00	$15.56–$265.00	223% above	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE	$265.00	$265.00	$79.50–$265.00	—	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL SCREEN	$741.00	$741.00	$31.92–$741.00	508% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TOX MONITOR W/ CONF UR	$741.00	$741.00	$31.92–$741.00	508% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$741.00	$741.00	$31.92–$741.00	508% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG CONFIRMATION EA PRODEDURE	$741.00	$741.00	$31.92–$741.00	508% above	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TOX MONITOR W/ CONF UR	$741.00	$741.00	$222.30–$741.00	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$741.00	$741.00	$222.30–$741.00	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL SCREEN	$741.00	$741.00	$222.30–$741.00	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG CONFIRMATION EA PRODEDURE	$741.00	$741.00	$222.30–$741.00	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$84.00	$84.00	$4.91–$84.00	129% above	—
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$84.00	$84.00	$25.20–$84.00	—	—
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR CAPSID VCA	$289.00	$289.00	$12.70–$289.00	557% above	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR CAPSID VCA	$289.00	$289.00	$86.70–$289.00	—	—
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$333.00	$333.00	$19.56–$333.00	243% above	—
Estradiol blood test inpatient CPT 82670 ASSAY OF TOTAL ESTRADIOL	$333.00	$333.00	$99.90–$333.00	—	—
FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$223.00	$223.00	$13.01–$223.00	225% above	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$223.00	$223.00	$66.90–$223.00	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$235.00	$235.00	$11.12–$235.00	159% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$235.00	$235.00	$70.50–$235.00	—	—
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN	$164.00	$164.00	$9.54–$164.00	195% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN	$164.00	$164.00	$49.20–$164.00	—	—
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$117.00	$117.00	$6.80–$117.00	209% above	—
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$117.00	$117.00	$35.10–$117.00	—	—
Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM	$176.00	$176.00	$10.29–$176.00	224% above	—
Folate (folic acid) blood test inpatient CPT 82746 ASSAY OF FOLIC ACID SERUM	$176.00	$176.00	$52.80–$176.00	—	—
Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3)	$203.00	$203.00	$11.86–$203.00	169% above	—
Free T3 thyroid hormone test inpatient CPT 84481 FREE ASSAY (FT-3)	$203.00	$203.00	$60.90–$203.00	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$109.00	$109.00	$6.31–$109.00	125% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE	$109.00	$109.00	$32.70–$109.00	—	—
Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE	$305.00	$305.00	$17.83–$305.00	231% above	—
Free testosterone test inpatient CPT 84402 ASSAY OF FREE TESTOSTERONE	$305.00	$305.00	$91.50–$305.00	—	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT	$87.00	$87.00	$5.04–$87.00	227% above	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 ASSAY OF GGT	$87.00	$87.00	$26.10–$87.00	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE; POST GLUCOSE DOSE	$59.00	$59.00	$3.32–$59.00	232% above	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE; POST GLUCOSE DOSE	$59.00	$59.00	$17.70–$59.00	—	—
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$155.00	$155.00	$9.01–$155.00	206% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$155.00	$155.00	$46.50–$155.00	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB	$419.00	$419.00	$24.56–$419.00	355% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE DNA AMP PROB	$419.00	$419.00	$125.70–$419.00	—	—
H. pylori antibody blood test CPT 86677 H.PYLORI AB	$290.00	$290.00	$11.79–$290.00	452% above	—
H. pylori antibody blood test inpatient CPT 86677 H.PYLORI AB	$290.00	$290.00	$87.00–$290.00	—	—
H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA	$173.00	$173.00	$10.07–$173.00	218% above	—
H. pylori stool antigen test inpatient CPT 87338 HPYLORI STOOL AG IA	$173.00	$173.00	$51.90–$173.00	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$1,015.00	$1,015.00	$59.57–$1,015.00	346% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QT BY DNA V3.0	$1,015.00	$1,015.00	$59.57–$1,015.00	346% above	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QT BY DNA V3.0	$1,015.00	$1,015.00	$304.50–$1,015.00	—	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$1,015.00	$1,015.00	$304.50–$1,015.00	—	—
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY	$165.00	$165.00	$9.60–$165.00	233% above	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY	$165.00	$165.00	$49.50–$165.00	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1&2 AB AG IA	$288.00	$288.00	$13.65–$288.00	253% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1&2 AB AG IA	$288.00	$288.00	$86.40–$288.00	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH-RISK TYPES	$419.00	$419.00	$19.10–$419.00	443% above	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH-RISK TYPES	$419.00	$419.00	$125.70–$419.00	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLOBIN TEST	$117.00	$117.00	$6.80–$117.00	224% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HEMOGLOBIN TEST	$117.00	$117.00	$35.10–$117.00	—	—
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$44.00	$44.00	$1.66–$44.00	205% above	—
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$44.00	$44.00	$13.20–$44.00	—	—
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL	$146.00	$146.00	$8.44–$146.00	235% above	—
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY TOTAL	$146.00	$146.00	$43.80–$146.00	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$129.00	$129.00	$7.52–$129.00	229% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$129.00	$129.00	$38.70–$129.00	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA	$125.00	$125.00	$7.23–$125.00	234% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG IA	$125.00	$125.00	$37.50–$125.00	—	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST	$172.00	$172.00	$9.99–$172.00	221% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB TEST	$172.00	$172.00	$51.60–$172.00	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$510.00	$510.00	$29.99–$510.00	292% above	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$510.00	$510.00	$153.00–$510.00	—	—
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$159.00	$159.00	$9.23–$159.00	354% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$159.00	$159.00	$47.70–$159.00	—	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$233.00	$233.00	$13.54–$233.00	320% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$233.00	$233.00	$69.90–$233.00	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$156.00	$156.00	$9.06–$156.00	233% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HS	$156.00	$156.00	$46.80–$156.00	—	—
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTINE	$215.00	$215.00	$12.54–$215.00	224% above	—
Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTINE	$215.00	$215.00	$64.50–$215.00	—	—
Insulin blood test CPT 83525 ASSAY OF INSULIN TOTAL	$137.00	$137.00	$8.00–$137.00	225% above	—
Insulin blood test inpatient CPT 83525 ASSAY OF INSULIN TOTAL	$137.00	$137.00	$41.10–$137.00	—	—
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$79.00	$79.00	$4.53–$79.00	204% above	—
Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON	$79.00	$79.00	$23.70–$79.00	—	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST	$105.00	$105.00	$6.12–$105.00	177% above	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING TEST	$105.00	$105.00	$31.50–$105.00	—	—
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$105.00	$105.00	$6.08–$105.00	56% above	—
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$105.00	$105.00	$31.50–$105.00	—	—
LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH)	$221.00	$221.00	$12.96–$221.00	223% above	—
LH (luteinizing hormone) test inpatient CPT 83002 ASSAY OF GONADOTROPIN (LH)	$221.00	$221.00	$66.30–$221.00	—	—
Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID	$140.00	$140.00	$8.10–$140.00	248% above	—
Lactate (lactic acid) blood test inpatient CPT 83605 ASSAY OF LACTIC ACID	$140.00	$140.00	$42.00–$140.00	—	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME	$74.00	$74.00	$4.23–$74.00	235% above	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE (LD) (LDH) ENZYME	$74.00	$74.00	$22.20–$74.00	—	—
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE	$83.00	$83.00	$4.82–$83.00	195% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY OF LIPASE	$83.00	$83.00	$24.90–$83.00	—	—
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$99.00	$99.00	$5.72–$99.00	63% above	—
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$99.00	$99.00	$29.70–$99.00	—	—
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$204.00	$204.00	$11.92–$204.00	344% above	—
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY	$204.00	$204.00	$61.20–$204.00	—	—
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$81.00	$81.00	$4.69–$81.00	228% above	—
Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM	$81.00	$81.00	$24.30–$81.00	—	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$155.00	$155.00	$9.02–$155.00	247% above	—
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$155.00	$155.00	$46.50–$155.00	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN	$63.00	$63.00	$3.63–$63.00	91% above	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODY SCREEN	$63.00	$63.00	$18.90–$63.00	—	—
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$158.00	$158.00	$9.13–$158.00	272% above	—
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY	$158.00	$158.00	$47.40–$158.00	—	—
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$235.00	$235.00	$23.01–$265.40	122% above	—
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$235.00	$235.00	$70.50–$235.00	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE	$220.00	$220.00	$12.87–$220.00	272% above	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ASSAY OF PSA FREE	$220.00	$220.00	$66.00–$220.00	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$220.00	$220.00	$12.87–$220.00	235% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ASSAY OF PSA TOTAL	$220.00	$220.00	$66.00–$220.00	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER	$150.00	$150.00	$14.18–$171.27	114% above	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH C/V THIN LAYER	$150.00	$150.00	$45.00–$150.00	—	—
Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE	$493.00	$493.00	$28.90–$493.00	282% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 ASSAY OF PARATHORMONE	$493.00	$493.00	$147.90–$493.00	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$74.00	$74.00	$4.21–$74.00	225% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL	$74.00	$74.00	$22.20–$74.00	—	—
Phosphorus (phosphate) blood test CPT 84100 ASSAY OF PHOSPHORUS	$58.00	$58.00	$3.32–$58.00	183% above	—
Phosphorus (phosphate) blood test inpatient CPT 84100 ASSAY OF PHOSPHORUS	$58.00	$58.00	$17.40–$58.00	—	—
Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM	$59.00	$59.00	$3.33–$59.00	160% above	—
Potassium blood test inpatient CPT 84132 ASSAY OF SERUM POTASSIUM	$59.00	$59.00	$17.70–$59.00	—	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPLOIDY	$6,329.00	$6,329.00	$531.33–$6,329.00	492% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FETAL CHRMOML ANEUPLOIDY	$6,329.00	$6,329.00	$1,898.70–$6,329.00	—	—
Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE	$251.00	$251.00	$14.60–$251.00	193% above	—
Progesterone blood test inpatient CPT 84144 ASSAY OF PROGESTERONE	$251.00	$251.00	$75.30–$251.00	—	—
Prolactin blood test CPT 84146 ASSAY OF PROLACTIN	$233.00	$233.00	$13.57–$233.00	226% above	—
Prolactin blood test inpatient CPT 84146 ASSAY OF PROLACTIN	$233.00	$233.00	$69.90–$233.00	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$53.00	$53.00	$3.00–$53.00	231% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$53.00	$53.00	$15.90–$53.00	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE CUP DRUG SCREEN	$741.00	$741.00	$5.98–$741.00	2018% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE CUP DRUG SCREEN	$741.00	$741.00	$222.30–$741.00	—	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$199.00	$199.00	$11.58–$199.00	389% above	—
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC	$199.00	$199.00	$59.70–$199.00	—	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC	$198.00	$198.00	$11.57–$198.00	395% above	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC	$198.00	$198.00	$59.40–$198.00	—	—
Renin blood test CPT 84244 ASSAY OF RENIN	$263.00	$263.00	$15.39–$263.00	230% above	—
Renin blood test inpatient CPT 84244 ASSAY OF RENIN	$263.00	$263.00	$78.90–$263.00	—	—
Rh blood typing CPT 86901 BLOOD TYPING; RH(D)	$462.00	$462.00	$1.69–$462.00	895% above	—
Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH(D)	$462.00	$462.00	$1.69–$462.00	895% above	—
Rh blood typing inpatient CPT 86901 BLOOD TYPING; RH(D)	$462.00	$462.00	$138.60–$462.00	—	—
Rh blood typing inpatient CPT 86901 BLOOD TYPING SEROLOGIC RH(D)	$462.00	$462.00	$138.60–$462.00	—	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$69.00	$69.00	$3.97–$69.00	230% above	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$69.00	$69.00	$20.70–$69.00	—	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$173.00	$173.00	$10.07–$173.00	302% above	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$173.00	$173.00	$51.90–$173.00	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED	$50.00	$50.00	$1.89–$50.00	108% above	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE AUTOMATED	$50.00	$50.00	$15.00–$50.00	—	—
Sodium blood test CPT 84295 ASSAY OF SERUM SODIUM	$59.00	$59.00	$3.37–$59.00	212% above	—
Sodium blood test inpatient CPT 84295 ASSAY OF SERUM SODIUM	$59.00	$59.00	$17.70–$59.00	—	—
Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS	$108.00	$108.00	$6.23–$108.00	229% above	—
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES SMEARS	$108.00	$108.00	$32.40–$108.00	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$55.00	$55.00	$3.07–$55.00	320% above	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES	$55.00	$55.00	$16.50–$55.00	—	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL	$254.00	$254.00	$11.14–$254.00	464% above	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 ASSAY TEST FOR BLOOD FECAL	$254.00	$254.00	$76.20–$254.00	—	—
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$159.00	$159.00	$7.50–$159.00	277% above	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM	$159.00	$159.00	$47.70–$159.00	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$53.00	$53.00	$2.99–$53.00	236% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL	$53.00	$53.00	$15.90–$53.00	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$740.00	$740.00	$43.39–$740.00	393% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE	$740.00	$740.00	$222.00–$740.00	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$309.00	$309.00	$18.07–$309.00	256% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$309.00	$309.00	$92.70–$309.00	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$175.00	$175.00	$10.19–$175.00	232% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH	$175.00	$175.00	$52.50–$175.00	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$201.00	$201.00	$11.76–$201.00	175% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE	$201.00	$201.00	$60.30–$201.00	—	—
Total IgE blood test CPT 82785 ASSAY OF IGE	$198.00	$198.00	$11.52–$198.00	232% above	—
Total IgE blood test inpatient CPT 82785 ASSAY OF IGE	$198.00	$198.00	$59.40–$198.00	—	—
Total cholesterol blood test CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$55.00	$55.00	$3.04–$55.00	172% above	—
Total cholesterol blood test inpatient CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$55.00	$55.00	$16.50–$55.00	—	—
Total thyroxine (T4) blood test CPT 84436 ASSAY OF TOTAL THYROXINE	$83.00	$83.00	$4.81–$83.00	190% above	—
Total thyroxine (T4) blood test inpatient CPT 84436 ASSAY OF TOTAL THYROXINE	$83.00	$83.00	$24.90–$83.00	—	—
Total triiodothyronine (T3) blood test CPT 84480 ASSAY TRIIODOTHYRONINE (T3)	$170.00	$170.00	$9.93–$170.00	201% above	—
Total triiodothyronine (T3) blood test inpatient CPT 84480 ASSAY TRIIODOTHYRONINE (T3)	$170.00	$170.00	$51.00–$170.00	—	—
Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN	$153.00	$153.00	$8.93–$153.00	228% above	—
Transferrin blood test inpatient CPT 84466 ASSAY OF TRANSFERRIN	$153.00	$153.00	$45.90–$153.00	—	—
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$419.00	$419.00	$19.15–$419.00	494% above	—
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$419.00	$419.00	$125.70–$419.00	—	—
Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES	$69.00	$69.00	$4.02–$69.00	165% above	—
Triglycerides blood test inpatient CPT 84478 ASSAY OF TRIGLYCERIDES	$69.00	$69.00	$20.70–$69.00	—	—
Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANT	$150.00	$150.00	$8.73–$150.00	267% above	—
Troponin test, quantitative inpatient CPT 84484 ASSAY OF TROPONIN QUANT	$150.00	$150.00	$45.00–$150.00	—	—
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID	$56.00	$56.00	$3.16–$56.00	135% above	—
Uric acid blood test inpatient CPT 84550 ASSAY OF BLOOD/URIC ACID	$56.00	$56.00	$16.80–$56.00	—	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE	$59.00	$59.00	$2.22–$59.00	119% above	—
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE	$59.00	$59.00	$17.70–$59.00	—	—
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$42.00	$42.00	$1.57–$42.00	233% above	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE	$42.00	$42.00	$12.60–$42.00	—	—
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$63.00	$63.00	$2.44–$63.00	505% above	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$63.00	$63.00	$18.90–$63.00	—	—
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT	$98.00	$98.00	$5.65–$98.00	157% above	—
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE/COLONY COUNT	$98.00	$98.00	$29.40–$98.00	—	—
Urine microalbumin (albumin) test CPT 82043 UR ALBUMIN QUANTITATIVE	$72.00	$72.00	$4.05–$72.00	154% above	—
Urine microalbumin (albumin) test inpatient CPT 82043 UR ALBUMIN QUANTITATIVE	$72.00	$72.00	$21.60–$72.00	—	—
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$61.00	$61.00	$6.03–$74.36	131% above	—
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE	$181.00	$181.00	$6.03–$181.00	587% above	—
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY VISUAL COLOR	$181.00	$181.00	$6.03–$181.00	587% above	—
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$61.00	$61.00	$18.30–$61.00	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY VISUAL COLOR	$181.00	$181.00	$54.30–$181.00	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE	$181.00	$181.00	$54.30–$181.00	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$182.00	$182.00	$10.56–$182.00	227% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$182.00	$182.00	$54.60–$182.00	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$353.00	$353.00	$20.72–$353.00	297% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$353.00	$353.00	$105.90–$353.00	—	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY	$459.00	$459.00	$26.95–$459.00	366% above	—
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1 25-DIHYDROXY	$459.00	$459.00	$137.70–$459.00	—	—
Zinc blood test CPT 84630 ASSAY OF ZINC	$137.00	$137.00	$7.97–$137.00	303% above	—
Zinc blood test inpatient CPT 84630 ASSAY OF ZINC	$137.00	$137.00	$41.10–$137.00	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST	$182.00	$182.00	$10.54–$182.00	227% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN TEST	$182.00	$182.00	$54.60–$182.00	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CL TX DSTL FIB FX WO MANIP	$5,357.00	$5,357.00	$250.00–$5,357.00	922% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CL TX DSTL FIB FX WO MANIP	$5,357.00	$5,357.00	$1,607.10–$5,357.00	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 ELECTIVE CARDIOVERSION	$3,903.00	$3,903.00	$365.94–$3,903.00	386% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$3,903.00	$3,903.00	$365.94–$3,903.00	386% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ELECTIVE CARDIOVERSION	$3,903.00	$3,903.00	$1,170.90–$3,903.00	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$3,903.00	$3,903.00	$1,170.90–$3,903.00	—	—
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$2,789.00	$2,789.00	$258.78–$7,849.00	90% above	—
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX	$2,789.00	$2,789.00	$836.70–$2,789.00	—	—
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM 28 DAYS OR OLDER	$6,363.00	$6,363.00	$680.58–$6,363.00	105% above	—
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUM 28 DAYS OR OLDER	$6,363.00	$6,363.00	$1,908.90–$6,363.00	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$7,362.00	$7,362.00	$327.18–$7,362.00	204% above	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$7,362.00	$7,362.00	$2,208.60–$7,362.00	—	—
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE <=28 DAYS	$4,016.00	$4,016.00	$498.18–$4,016.00	213% above	—
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION NEONATE <=28 DAYS	$4,016.00	$4,016.00	$1,204.80–$4,016.00	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TRT FRACTUR RADIUS/ULNA	$588.00	$588.00	$176.40–$3,573.00	6% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TRT FRACTUR RADIUS/ULNA	$588.00	$588.00	$176.40–$588.00	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$4,314.00	$4,314.00	$870.42–$8,355.00	199% above	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$4,314.00	$4,314.00	$272.46–$7,849.00	199% above	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$4,314.00	$4,314.00	$1,294.20–$4,314.00	—	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$4,314.00	$4,314.00	$1,294.20–$4,314.00	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 CAUTERY OF WOUND ELECTRICAL	$286.00	$286.00	$85.80–$7,849.00	10% above	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 CAUTERY OF WOUND ELECTRICAL	$286.00	$286.00	$85.80–$286.00	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$361.00	$361.00	$53.58–$7,849.00	198% above	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI	$361.00	$361.00	$108.30–$361.00	—	—
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$617.00	$617.00	$73.64–$7,849.00	375% above	—
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX UNI	$617.00	$617.00	$185.10–$617.00	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$2,193.00	$2,193.00	$250.00–$3,573.00	376% above	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING	$2,193.00	$2,193.00	$657.90–$2,193.00	—	—
Eye injection into the vitreous (intravitreal injection) CPT 67028 INJECTION EYE DRUG	$2,597.00	$2,597.00	$250.00–$3,573.00	261% above	—
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INJECTION EYE DRUG	$2,597.00	$2,597.00	$779.10–$2,597.00	—	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HYSTEROSON INJECTION	$367.00	$367.00	$110.10–$16,502.00	20% above	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$592.00	$592.00	$177.60–$16,502.00	93% above	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HYSTEROSON INJECTION	$367.00	$367.00	$110.10–$367.00	—	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATHETER FOR HYSTEROGRAPHY	$592.00	$592.00	$177.60–$592.00	—	—
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$611.00	$611.00	$50.39–$611.00	122% above	—
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE	$611.00	$611.00	$183.30–$611.00	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS SNGL	$1,041.00	$1,041.00	$250.45–$7,849.00	161% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS SMPL	$1,041.00	$1,041.00	$250.00–$3,573.00	161% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABSCESS SMPL	$1,041.00	$1,041.00	$312.30–$1,041.00	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABSCESS SNGL	$1,041.00	$1,041.00	$312.30–$1,041.00	—	—
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INGUINAL HERNIA	$11,436.00	$11,436.00	$250.00–$15,274.00	174% above	—
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR INGUINAL HERNIA	$11,436.00	$11,436.00	$3,430.80–$11,436.00	—	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDON/LIGAMENT/C	$1,007.00	$1,007.00	$250.00–$3,573.00	107% above	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT TENDON/LIGAMENT/C	$1,007.00	$1,007.00	$302.10–$1,007.00	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ MJR JNT/BURSA W/O US	$1,182.00	$1,182.00	$121.56–$1,182.00	155% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ MJR JNT/BURSA W/O US	$1,182.00	$1,182.00	$354.60–$1,182.00	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ INT JNT/BURSA W/O US	$1,133.00	$1,133.00	$96.74–$1,133.00	182% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ INT JNT/BURSA W/O US	$1,133.00	$1,133.00	$339.90–$1,133.00	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ SML JNT/BURSA W/O US	$1,511.00	$1,511.00	$93.48–$1,511.00	260% above	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ SML JNT/BURSA W/O US	$1,511.00	$1,511.00	$453.30–$1,511.00	—	—
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY	$20,018.00	$20,018.00	$250.00–$20,018.00	190% above	—
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY APPENDECTOMY	$20,018.00	$20,018.00	$6,005.40–$20,018.00	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$2,846.00	$2,846.00	$250.00–$3,573.00	382% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$2,846.00	$2,846.00	$853.80–$2,846.00	—	—
Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE	$10,846.00	$10,846.00	$250.00–$15,274.00	176% above	—
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 CARE OF MISCARRIAGE	$10,846.00	$10,846.00	$3,253.80–$10,846.00	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REMOVAL OF SKIN LESION	$1,836.00	$1,836.00	$250.00–$3,573.00	70% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 REMOVAL OF SKIN LESION	$1,836.00	$1,836.00	$550.80–$1,836.00	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$3,333.00	$3,333.00	$250.00–$3,573.00	230% above	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$3,333.00	$3,333.00	$999.90–$3,333.00	—	—
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$840.00	$840.00	$183.54–$7,849.00	159% above	—
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE	$840.00	$840.00	$252.00–$840.00	—	—
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$1,213.00	$1,213.00	$250.00–$3,573.00	189% above	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 NJX AA&/STRD GR OCPL NRV	$1,213.00	$1,213.00	$363.90–$1,213.00	—	—
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$2,007.00	$2,007.00	$359.10–$16,502.00	42% above	—
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$2,007.00	$2,007.00	$602.10–$2,007.00	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$2,592.00	$2,592.00	$349.98–$7,849.00	258% above	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED	$2,592.00	$2,592.00	$777.60–$2,592.00	—	—
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY SMPL	$1,522.00	$1,522.00	$250.00–$3,573.00	136% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY SMPL	$1,522.00	$1,522.00	$456.60–$1,522.00	—	—
Septoplasty to straighten the nasal septum CPT 30520 REPAIR OF NASAL SEPTUM	$11,514.00	$11,514.00	$2,303.94–$15,274.00	200% above	—
Septoplasty to straighten the nasal septum inpatient CPT 30520 REPAIR OF NASAL SEPTUM	$11,514.00	$11,514.00	$3,454.20–$11,514.00	—	—
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST	$1,205.00	$1,205.00	$250.00–$3,573.00	194% above	—
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF FOREARM CAST	$1,205.00	$1,205.00	$361.50–$1,205.00	—	—
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$784.00	$784.00	$166.08–$3,573.00	281% above	—
Short arm splint (forearm and hand) one side CPT 29125 APPLY FOREARM SPLINT LT	$784.00	$784.00	$140.22–$7,849.00	281% above	—
Short arm splint (forearm and hand) one side CPT 29125 APPLY FOREARM SPLINT RT	$784.00	$784.00	$140.22–$7,849.00	281% above	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT	$784.00	$784.00	$235.20–$784.00	—	—
Short arm splint (forearm and hand) inpatient one side CPT 29125 APPLY FOREARM SPLINT LT	$784.00	$784.00	$235.20–$784.00	—	—
Short arm splint (forearm and hand) inpatient one side CPT 29125 APPLY FOREARM SPLINT RT	$784.00	$784.00	$235.20–$784.00	—	—
Short leg cast (below the knee) CPT 29405 APLY SHORT LEG CAST BLW KN	$1,603.00	$1,603.00	$250.00–$3,573.00	271% above	—
Short leg cast (below the knee) inpatient CPT 29405 APLY SHORT LEG CAST BLW KN	$1,603.00	$1,603.00	$480.90–$1,603.00	—	—
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$850.00	$850.00	$173.28–$7,849.00	255% above	—
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION LOWER LEG SPLINT	$850.00	$850.00	$255.00–$850.00	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$1,514.00	$1,514.00	$250.00–$3,573.00	301% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$1,514.00	$1,514.00	$454.20–$1,514.00	—	—
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$892.00	$892.00	$159.60–$7,849.00	30% above	—
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$892.00	$892.00	$267.60–$892.00	—	—
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS <W/15	$740.00	$740.00	$222.00–$3,573.00	114% above	—
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS <W/15	$740.00	$740.00	$222.00–$740.00	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$1,568.00	$1,568.00	$220.02–$16,502.00	39% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$2,612.00	$2,612.00	$250.00–$3,573.00	132% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$1,568.00	$1,568.00	$470.40–$1,568.00	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DX LMBR SPI PNXR	$2,612.00	$2,612.00	$783.60–$2,612.00	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$1,912.00	$1,912.00	$250.00–$3,573.00	386% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$1,912.00	$1,912.00	$573.60–$1,912.00	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$1,912.00	$1,912.00	$250.00–$3,573.00	406% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$1,912.00	$1,912.00	$573.60–$1,912.00	—	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$837.00	$837.00	$127.68–$7,849.00	81% above	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES	$837.00	$837.00	$251.10–$837.00	—	—
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W IMAGING	$2,246.00	$2,246.00	$365.94–$16,502.00	79% above	—
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$2,323.00	$2,323.00	$250.00–$3,573.00	85% above	—
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W IMAGING	$2,246.00	$2,246.00	$673.80–$2,246.00	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$2,323.00	$2,323.00	$696.90–$2,323.00	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$1,422.00	$1,422.00	$250.00–$3,573.00	240% above	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$1,422.00	$1,422.00	$426.60–$1,422.00	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$3,580.00	$3,580.00	$516.42–$16,502.00	23% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST 1ST LESION US IMAG	$3,580.00	$3,580.00	$1,074.00–$3,580.00	—	—
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH ENDOSCOPY, DILATIO	$4,157.00	$4,157.00	$250.00–$5,006.00	85% above	—
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ESOPH ENDOSCOPY, DILATIO	$4,157.00	$4,157.00	$1,247.10–$4,157.00	—	—
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY, BIOP	$2,640.00	$2,640.00	$250.00–$5,006.00	72% above	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDOSCOPY, BIOP	$2,640.00	$2,640.00	$792.00–$2,640.00	—	—
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$3,951.00	$3,951.00	$250.00–$5,006.00	254% above	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$3,951.00	$3,951.00	$1,185.30–$3,951.00	—	—
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 VBAC DELIVERY	$15,449.00	$15,449.00	$4,634.70–$15,449.00	208% above	—
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 VBAC DELIVERY	$15,449.00	$15,449.00	$4,634.70–$15,449.00	—	—
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$7,273.00	$7,273.00	$796.86–$7,849.00	82% above	—
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$7,273.00	$7,273.00	$796.86–$16,502.00	82% above	—
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$7,273.00	$7,273.00	$2,181.90–$7,273.00	—	—
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 REMOVAL OF SPERM DUCT(S)	$7,273.00	$7,273.00	$2,181.90–$7,273.00	—	—
Wart removal, up to 14 warts CPT 17110 DESTRUCT LESION 1-14	$1,278.00	$1,278.00	$250.00–$3,573.00	295% above	—
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT LESION 1-14	$1,278.00	$1,278.00	$383.40–$1,278.00	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$2,919.00	$2,919.00	$207.48–$7,849.00	249% above	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$2,919.00	$2,919.00	$875.70–$2,919.00	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD	$4,917.00	$4,917.00	$147.06–$7,849.00	555% above	—
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR BLOOD COM	$4,917.00	$4,917.00	$147.06–$7,849.00	555% above	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE	$4,917.00	$4,917.00	$147.06–$7,849.00	555% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD	$4,917.00	$4,917.00	$1,475.10–$4,917.00	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE	$4,917.00	$4,917.00	$1,475.10–$4,917.00	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD OR BLOOD COM	$4,917.00	$4,917.00	$1,475.10–$4,917.00	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$874.00	$874.00	$27.36–$874.00	363% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$874.00	$874.00	$262.20–$874.00	—	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$1,487.00	$1,487.00	$412.32–$2,554.00	143% above	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN INFUSION UP TO 1HR	$1,487.00	$1,487.00	$412.32–$2,554.00	143% above	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1 HR	$1,487.00	$1,487.00	$446.10–$1,487.00	—	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMIN INFUSION UP TO 1HR	$1,487.00	$1,487.00	$446.10–$1,487.00	—	—
Comprehensive eye exam by an eye doctor, new patient CPT 92004 EYE EXAM NEW PT 1+VSTS CMPHNSV	$535.00	$535.00	$160.50–$568.00	195% above	—
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 EYE EXAM NEW PT 1+VSTS CMPHNSV	$535.00	$535.00	$160.50–$535.00	—	—
Comprehensive eye exam, returning patient CPT 92014 EYE EXAM&TX ESTAB PT 1/>VST	$489.00	$489.00	$146.70–$568.00	150% above	—
Comprehensive eye exam, returning patient inpatient CPT 92014 EYE EXAM&TX ESTAB PT 1/>VST	$489.00	$489.00	$146.70–$489.00	—	—
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE HEARING TEST	$678.00	$678.00	$108.30–$678.00	250% above	—
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE HEARING TEST	$678.00	$678.00	$203.40–$678.00	—	—
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$9,183.00	$9,183.00	$250.00–$9,183.00	465% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST HOUR	$9,183.00	$9,183.00	$2,754.90–$9,183.00	—	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$2,217.00	$2,217.00	$250.00–$3,573.00	233% above	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY	$2,217.00	$2,217.00	$665.10–$2,217.00	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$708.00	$708.00	$15.04–$1,153.00	413% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$708.00	$708.00	$15.04–$1,153.00	413% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$708.00	$708.00	$212.40–$708.00	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING	$708.00	$708.00	$212.40–$708.00	—	—
Electroconvulsive therapy (ECT), one session CPT 90870 ELECTROCONVULSIVE THERAPY	$3,228.00	$3,228.00	$84.68–$3,228.00	333% above	—
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ELECTROCONVULSIVE THERAPY	$3,228.00	$3,228.00	$968.40–$3,228.00	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT VISIT LEV 1 TG	$2,481.00	$2,481.00	$105.26–$3,573.00	895% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT VISIT LEV 1 OB	$2,481.00	$2,481.00	$105.26–$3,573.00	895% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT VISIT LEVEL 1	$2,481.00	$2,481.00	$105.26–$3,573.00	895% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPT VISIT LEVEL 1	$2,481.00	$2,481.00	$744.30–$2,481.00	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPT VISIT LEV 1 TG	$2,481.00	$2,481.00	$744.30–$2,481.00	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPT VISIT LEV 1 OB	$2,481.00	$2,481.00	$744.30–$2,481.00	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT LEVEL 2	$3,685.00	$3,685.00	$191.67–$3,685.00	907% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT LEV 2 OB	$3,685.00	$3,685.00	$191.67–$3,685.00	907% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT LEV 2 OB	$3,685.00	$3,685.00	$1,105.50–$3,685.00	—	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT LEVEL 2	$3,685.00	$3,685.00	$1,105.50–$3,685.00	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LEVEL 3	$5,157.00	$5,157.00	$250.00–$5,157.00	871% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LEV 3 OB	$5,157.00	$5,157.00	$250.00–$5,157.00	871% above	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT LEV 3 OB	$5,157.00	$5,157.00	$1,547.10–$5,157.00	—	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT LEVEL 3	$5,157.00	$5,157.00	$1,547.10–$5,157.00	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT LEV 4 OB	$6,447.00	$6,447.00	$250.00–$6,447.00	676% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT LEVEL 4	$6,447.00	$6,447.00	$250.00–$6,447.00	676% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT LEVEL 4	$6,447.00	$6,447.00	$1,934.10–$6,447.00	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT LEV 4 OB	$6,447.00	$6,447.00	$1,934.10–$6,447.00	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT LEVEL 5	$8,288.00	$8,288.00	$250.00–$8,288.00	615% above	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT LEV 5 OB	$8,288.00	$8,288.00	$250.00–$8,288.00	615% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT LEVEL 5	$8,288.00	$8,288.00	$2,486.40–$8,288.00	—	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT LEV 5 OB	$8,288.00	$8,288.00	$2,486.40–$8,288.00	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST	$1,712.00	$1,712.00	$83.32–$1,712.00	214% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOVASCULAR STRESS TEST	$1,712.00	$1,712.00	$513.60–$1,712.00	—	—
Eye exam, returning patient, intermediate CPT 92012 EYE EXAM ESTABLISH PT INTERIM	$489.00	$489.00	$146.70–$568.00	113% above	—
Eye exam, returning patient, intermediate inpatient CPT 92012 EYE EXAM ESTABLISH PT INTERIM	$489.00	$489.00	$146.70–$489.00	—	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/PT 50 MIN	$1,224.00	$1,224.00	$60.00–$1,224.00	354% above	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W/PT 50 MIN	$1,224.00	$1,224.00	$367.20–$1,224.00	—	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PT 50 MIN	$554.00	$554.00	$60.00–$554.00	114% above	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYTX W/O PT 50 MIN	$554.00	$554.00	$166.20–$554.00	—	—
Group psychotherapy session CPT 90853 GROUP THERAPY NOT MULTI-FAMILY	$223.00	$223.00	$45.00–$526.00	81% above	—
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY	$399.00	$399.00	$45.00–$526.00	224% above	—
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY NOT MULTI-FAMILY	$223.00	$223.00	$66.90–$223.00	—	—
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY	$399.00	$399.00	$119.70–$399.00	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$876.00	$876.00	$106.02–$1,648.00	149% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$876.00	$876.00	$262.80–$876.00	—	—
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$1,424.00	$1,424.00	$74.22–$1,648.00	233% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT	$1,424.00	$1,424.00	$427.20–$1,424.00	—	—
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$965.00	$965.00	$119.70–$1,487.68	278% above	—
IV push of a medicine, first drug inpatient CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$965.00	$965.00	$289.50–$965.00	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HYPERBARIC; INJECTION SQ/IM	$403.00	$403.00	$49.02–$1,487.68	303% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER PROPH DIAG INJ SC IM	$403.00	$403.00	$49.02–$1,487.68	303% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$403.00	$403.00	$49.02–$1,648.00	303% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$403.00	$403.00	$120.90–$403.00	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER PROPH DIAG INJ SC IM	$403.00	$403.00	$120.90–$403.00	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HYPERBARIC; INJECTION SQ/IM	$403.00	$403.00	$120.90–$403.00	—	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$423.00	$423.00	$78.00–$584.00	76% above	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$423.00	$423.00	$126.90–$423.00	—	—
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CNDJ TEST 7-8 STUDIES	$1,109.00	$1,109.00	$169.50–$1,238.00	191% above	—
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NRV CNDJ TEST 7-8 STUDIES	$1,109.00	$1,109.00	$332.70–$1,109.00	—	—
New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30-44 MIN	$223.00	$223.00	$66.90–$7,849.00	9% above	—
New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPAT VISIT NEW 30 MIN	$345.00	$345.00	$71.00–$584.00	68% above	—
New patient office visit, about 30 minutes CPT 99203 HYPERBARIC OP NEW INT.	$378.00	$378.00	$71.00–$7,849.00	84% above	—
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE O/P NEW LOW 30-44 MIN	$223.00	$223.00	$66.90–$223.00	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OUTPAT VISIT NEW 30 MIN	$345.00	$345.00	$103.50–$345.00	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 HYPERBARIC OP NEW INT.	$378.00	$378.00	$113.40–$378.00	—	—
New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45-59 MIN	$223.00	$223.00	$66.90–$7,849.00	25% below	—
New patient office visit, about 45 minutes CPT 99204 HYPERBARIC NEW PT. EXTENSIVE	$347.00	$347.00	$104.10–$7,849.00	16% above	—
New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPAT VISIT NEW 45 MIN	$460.00	$460.00	$108.00–$716.44	54% above	—
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE O/P NEW MOD 45-59 MIN	$223.00	$223.00	$66.90–$223.00	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 HYPERBARIC NEW PT. EXTENSIVE	$347.00	$347.00	$104.10–$347.00	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OUTPAT VISIT NEW 45 MIN	$460.00	$460.00	$138.00–$460.00	—	—
New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60-74 MIN	$223.00	$223.00	$66.90–$7,849.00	32% below	—
New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPAT VISIT NEW 60 MIN	$628.00	$628.00	$133.00–$975.01	93% above	—
New patient office visit, about 60 minutes CPT 99205 E/M PROV ESKETAMINE <OR =56MG	$4,441.00	$4,441.00	$133.00–$4,441.00	1262% above	—
New patient office visit, about 60 minutes CPT 99205 E/M PROV. ESKETAMINE <OR =56MG	$4,441.00	$4,441.00	$133.00–$4,441.00	1262% above	—
New patient office visit, about 60 minutes CPT 99205 E/M PROV ESKETAMINE >56MG N	$6,738.00	$6,738.00	$133.00–$6,738.00	1966% above	—
New patient office visit, about 60 minutes CPT 99205 E/M PROV. ESKETAMINE >56MG N	$6,738.00	$6,738.00	$133.00–$6,738.00	1966% above	—
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE O/P NEW HI 60-74 MIN	$223.00	$223.00	$66.90–$223.00	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE/OUTPAT VISIT NEW 60 MIN	$628.00	$628.00	$188.40–$628.00	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 E/M PROV. ESKETAMINE <OR =56MG	$4,441.00	$4,441.00	$1,332.30–$4,441.00	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 E/M PROV ESKETAMINE <OR =56MG	$4,441.00	$4,441.00	$1,332.30–$4,441.00	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 E/M PROV ESKETAMINE >56MG N	$6,738.00	$6,738.00	$2,021.40–$6,738.00	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 E/M PROV. ESKETAMINE >56MG N	$6,738.00	$6,738.00	$2,021.40–$6,738.00	—	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15-29 MIN	$223.00	$223.00	$49.00–$7,849.00	39% above	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE O/P NEW SF 15-29 MIN	$223.00	$223.00	$66.90–$223.00	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 INIT NUTRITION THER EA 15M	$156.00	$156.00	$24.82–$824.00	188% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 INIT NUTRITION THER EA 15M	$156.00	$156.00	$46.80–$156.00	—	—
Preventive checkup, new patient aged 18–39 CPT 99385 PED HLTH SPVSN NEW 18 TO 39YR	$251.00	$251.00	$75.30–$568.00	24% above	—
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PED HLTH SPVSN NEW 18 TO 39YR	$251.00	$251.00	$75.30–$251.00	—	—
Preventive checkup, new patient aged 40–64 CPT 99386 PREV VISIT NEW AGE 40-64	$364.00	$364.00	$109.20–$568.00	56% above	—
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREV VISIT NEW AGE 40-64	$364.00	$364.00	$109.20–$364.00	—	—
Preventive checkup, new patient aged 65 or older CPT 99387 INT PM E/M NEW PAT 65+ YRS	$666.00	$666.00	$120.21–$666.00	160% above	—
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 INT PM E/M NEW PAT 65+ YRS	$666.00	$666.00	$199.80–$666.00	—	—
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV VISIT EST AGE 18-39	$341.00	$341.00	$84.11–$568.00	55% above	—
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREV VISIT EST AGE 18-39	$341.00	$341.00	$102.30–$341.00	—	—
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV VISIT EST AGE 40-64	$302.00	$302.00	$90.60–$568.00	20% above	—
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PREV VISIT EST AGE 40-64	$302.00	$302.00	$90.60–$302.00	—	—
Preventive checkup, returning patient aged 65 or older CPT 99397 PER PM REEVAL EST PAT 65+ YRS	$524.00	$524.00	$95.59–$568.00	151% above	—
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PER PM REEVAL EST PAT 65+ YRS	$524.00	$524.00	$157.20–$524.00	—	—
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W/MD	$423.00	$423.00	$78.00–$584.00	47% above	—
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W/MED SRVCS	$795.00	$795.00	$78.00–$795.00	176% above	—
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL W/MD	$423.00	$423.00	$126.90–$423.00	—	—
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL W/MED SRVCS	$795.00	$795.00	$238.50–$795.00	—	—
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$1,106.00	$1,106.00	$91.86–$1,106.00	371% above	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$1,106.00	$1,106.00	$331.80–$1,106.00	—	—
Psychotherapy session, 30 minutes CPT 90832 PSYTX PT&/FAMILY 30 MIN	$349.00	$349.00	$40.00–$526.00	81% above	—
Psychotherapy session, 30 minutes CPT 90832 PSYTX W PT 30 MINUTES	$554.00	$554.00	$40.00–$554.00	188% above	—
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX PT&/FAMILY 30 MIN	$349.00	$349.00	$104.70–$349.00	—	—
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX W PT 30 MINUTES	$554.00	$554.00	$166.20–$554.00	—	—
Psychotherapy session, 45 minutes CPT 90834 1500 PSYTX PT&/FAMILY 45 MINU	$349.00	$349.00	$80.00–$526.00	37% above	—
Psychotherapy session, 45 minutes CPT 90834 PSYTX PT&/FAMILY 45 MIN	$423.00	$423.00	$80.00–$526.00	67% above	—
Psychotherapy session, 45 minutes CPT 90834 PSYTX W PT 45 MINUTES	$554.00	$554.00	$80.00–$554.00	118% above	—
Psychotherapy session, 45 minutes inpatient CPT 90834 1500 PSYTX PT&/FAMILY 45 MINU	$349.00	$349.00	$104.70–$349.00	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX PT&/FAMILY 45 MIN	$423.00	$423.00	$126.90–$423.00	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX W PT 45 MINUTES	$554.00	$554.00	$166.20–$554.00	—	—
Psychotherapy session, 60 minutes CPT 90837 PSYTX W PT 60 MINUTES	$609.00	$609.00	$91.86–$609.00	104% above	—
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYTX W PT 60 MINUTES	$609.00	$609.00	$182.70–$609.00	—	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$121.00	$121.00	$36.30–$824.00	169% above	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$121.00	$121.00	$36.30–$121.00	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40-54 MIN	$223.00	$223.00	$25.00–$7,849.00	10% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OUTPAT VISIT EST 40 MIN	$440.00	$440.00	$25.00–$584.00	78% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HYPERBARIC EST. PT. COMPLEX	$711.00	$711.00	$25.00–$7,849.00	187% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E/M PROV ESKETAMINE <OR =56MG	$4,441.00	$4,441.00	$25.00–$4,441.00	1692% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E/M PROV. ESKETAMINE <OR =56MG	$4,441.00	$4,441.00	$25.00–$4,441.00	1692% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E/M PROV ESKETAMINE >56MG -ES	$6,738.00	$6,738.00	$25.00–$6,738.00	2619% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E/M PROV. ESKETAMINE >56MG -ES	$6,738.00	$6,738.00	$25.00–$6,738.00	2619% above	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE O/P EST HI 40-54 MIN	$223.00	$223.00	$66.90–$223.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OUTPAT VISIT EST 40 MIN	$440.00	$440.00	$132.00–$440.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HYPERBARIC EST. PT. COMPLEX	$711.00	$711.00	$213.30–$711.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E/M PROV ESKETAMINE <OR =56MG	$4,441.00	$4,441.00	$1,332.30–$4,441.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E/M PROV. ESKETAMINE <OR =56MG	$4,441.00	$4,441.00	$1,332.30–$4,441.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E/M PROV. ESKETAMINE >56MG -ES	$6,738.00	$6,738.00	$2,021.40–$6,738.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E/M PROV ESKETAMINE >56MG -ES	$6,738.00	$6,738.00	$2,021.40–$6,738.00	—	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20-29 MIN	$223.00	$223.00	$25.00–$7,849.00	22% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPAT VISIT EST 20 MIN	$259.00	$259.00	$25.00–$584.00	42% above	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE O/P EST LOW 20-29 MIN	$223.00	$223.00	$66.90–$223.00	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPAT VISIT EST 20 MIN	$259.00	$259.00	$77.70–$259.00	—	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30-39 MIN	$223.00	$223.00	$25.00–$7,849.00	10% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPAT VISIT EST 30 MIN	$340.00	$340.00	$25.00–$584.00	68% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HYPERBARIC OP CONT. EXT.	$484.00	$484.00	$25.00–$7,849.00	140% above	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE O/P EST MOD 30-39 MIN	$223.00	$223.00	$66.90–$223.00	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OUTPAT VISIT EST 30 MIN	$340.00	$340.00	$102.00–$340.00	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HYPERBARIC OP CONT. EXT.	$484.00	$484.00	$145.20–$484.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10-19 MIN	$223.00	$223.00	$25.00–$7,849.00	73% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPAT VISIT EST 10 MIN	$259.00	$259.00	$25.00–$584.00	101% above	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE O/P EST SF 10-19 MIN	$223.00	$223.00	$66.90–$223.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPAT VISIT EST 10 MIN	$259.00	$259.00	$77.70–$259.00	—	—
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$1,258.00	$1,258.00	$177.41–$1,258.00	220% above	—
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN	$1,258.00	$1,258.00	$377.40–$1,258.00	—	—
Speech therapy session, individual CPT 92507 SPEECH/HEARING THERAPY INDV CC	$605.00	$605.00	$59.74–$661.00	260% above	—
Speech therapy session, individual inpatient CPT 92507 SPEECH/HEARING THERAPY INDV CC	$605.00	$605.00	$181.50–$605.00	—	—
Spirometry (breathing test) CPT 94010 SPIROMETRY	$696.00	$696.00	$66.12–$2,827.00	218% above	—
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$696.00	$696.00	$208.80–$696.00	—	—
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$1,089.00	$1,089.00	$97.28–$2,827.00	189% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 EVALUATION OF WHEEZING	$1,089.00	$1,089.00	$326.70–$1,089.00	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEU ACTIVITY DIRECT	$363.00	$363.00	$28.06–$482.00	322% above	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEU ACTIVITY DIRECT	$363.00	$363.00	$108.90–$363.00	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$620.00	$620.00	$166.08–$824.00	192% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$620.00	$620.00	$186.00–$620.00	—	—
Visual field test, extended CPT 92083 VISUAL FIELD EXAMINATION(S)	$1,007.00	$1,007.00	$122.96–$1,007.00	200% above	—
Visual field test, extended inpatient CPT 92083 VISUAL FIELD EXAMINATION(S)	$1,007.00	$1,007.00	$302.10–$1,007.00	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VACCINE(FLUAD)0.5SYR	$311.00	$311.00	$32.65–$311.00	193% above	—
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA VACCINE(FLUAD)0.5SYR	$311.00	$311.00	$93.30–$311.00	—	—
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM	$511.00	$511.00	$53.66–$511.00	149% above	—
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM	$511.00	$511.00	$153.30–$511.00	—	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACC INJ 0.5ML	$692.00	$692.00	$203.64–$692.00	161% above	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACC INJ 0.5ML	$692.00	$692.00	$207.60–$692.00	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH/TET/PERT(DTAP) PED 0.5ML	$103.00	$103.00	$30.90–$103.00	101% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH/TET/PERT(DTAP) PED 0.5ML	$103.00	$103.00	$30.90–$103.00	—	—
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DIP/HAEMO/PER/TET/POLIO IM KIT	$470.00	$470.00	$141.00–$470.00	222% above	—
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DIP/HAEMO/PER/TET/POLIO IM KIT	$470.00	$470.00	$141.00–$470.00	—	—
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DTAP-IPV-HIB (VALEXIS) VACCINE	$565.00	$565.00	$166.10–$565.00	146% above	—
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DTAP-IPV-HIB (VALEXIS) VACCINE	$565.00	$565.00	$169.50–$565.00	—	—
Flu shot, recombinant, egg-free (Flublok) CPT 90673 INFLUTRIVALENT PF (FLUBLOK)0.5	$310.00	$310.00	$32.55–$310.00	192% above	—
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 INFLUTRIVALENT PF (FLUBLOK)0.5	$310.00	$310.00	$93.00–$310.00	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLU TRIVALPF(FLULAVAL)0.5	$71.00	$71.00	$7.46–$71.00	146% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUVPF(FLUARIX)TRIVALENT 0.5	$72.00	$72.00	$7.56–$72.00	150% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUTRIVAL(FLUZONE)0.5	$75.00	$75.00	$7.87–$75.00	160% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 AFLURIA VACCINE PF 0.5 ML	$81.00	$81.00	$8.50–$81.00	181% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLU TRIVALPF(FLULAVAL)0.5	$71.00	$71.00	$21.30–$71.00	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUVPF(FLUARIX)TRIVALENT 0.5	$72.00	$72.00	$21.60–$72.00	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUTRIVAL(FLUZONE)0.5	$75.00	$75.00	$22.50–$75.00	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 AFLURIA VACCINE PF 0.5 ML	$81.00	$81.00	$24.30–$81.00	—	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV VACCINE 9-VALENT PF	$1,185.00	$1,185.00	$348.84–$1,185.00	132% above	—
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV VACCINE 9-VALENT PF	$1,185.00	$1,185.00	$355.50–$1,185.00	—	—
Hepatitis A vaccine, adult dose CPT 90632 HAVRIX 1440 UNIT/0.5ML SYRINGE	$320.00	$320.00	$96.00–$320.00	211% above	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX 1440 UNIT/0.5ML SYRINGE	$320.00	$320.00	$96.00–$320.00	—	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX 720 UNIT/0.5 ML SYRINGE	$143.00	$143.00	$42.90–$143.00	139% above	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPS A PED VAC 25 U/0.5 IM SUS	$149.00	$149.00	$44.70–$149.00	149% above	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX 720 UNIT/0.5 ML SYRINGE	$143.00	$143.00	$42.90–$143.00	—	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPS A PED VAC 25 U/0.5 IM SUS	$149.00	$149.00	$44.70–$149.00	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX B 20MCG/ML IM 1ML VIAL	$268.00	$268.00	$28.14–$268.00	200% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX B 20MCG/ML IM 1ML VIAL	$268.00	$268.00	$80.40–$268.00	—	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPLISAV-B 20 MCG/0.5 ML INJ	$1,122.00	$1,122.00	$117.81–$1,122.00	364% above	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPLISAV-B 20 MCG/0.5 ML INJ	$1,122.00	$1,122.00	$336.60–$1,122.00	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B PEDI 10 MCG/0.5ML	$106.00	$106.00	$11.13–$106.00	134% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B PEDI 10 MCG/0.5ML	$106.00	$106.00	$31.80–$106.00	—	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB VACCINE	$49.00	$49.00	$14.70–$49.00	53% above	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ACTHIB VACCINE	$49.00	$49.00	$14.70–$49.00	—	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUBELLA VACCINE	$353.00	$353.00	$105.90–$353.00	162% above	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMPS/RUBELLA VACCINE	$353.00	$353.00	$105.90–$353.00	—	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEAS/MUM/RUB/VAR VIRUS VACC SQ	$1,042.00	$1,042.00	$306.52–$1,042.00	138% above	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEAS/MUM/RUB/VAR VIRUS VACC SQ	$1,042.00	$1,042.00	$312.60–$1,042.00	—	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCC VACC ACYW 0.5ML	$510.00	$510.00	$153.00–$510.00	150% above	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCC VACC ACYW 0.5ML	$510.00	$510.00	$153.00–$510.00	—	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI IM SOLN 0.5 ML	$620.00	$620.00	$185.92–$620.00	122% above	—
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENQUADFI IM SOLN 0.5 ML	$620.00	$620.00	$186.00–$620.00	—	—
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCB VACC OMV ADJUV 0.5ML	$903.00	$903.00	$251.35–$903.00	167% above	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCB VACC OMV ADJUV 0.5ML	$903.00	$903.00	$270.90–$903.00	—	—
Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611 SMALLPOX AND MONKEYPOX VACCINE	$1,251.00	$1,251.00	$375.30–$1,251.00	71% above	—
Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611 SMALLPOX AND MONKEYPOX VACCINE	$1,251.00	$1,251.00	$375.30–$1,251.00	—	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOC 13-VAL CONJ 0.5ML	$838.00	$838.00	$87.99–$838.00	156% above	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOC 13-VAL CONJ 0.5ML	$838.00	$838.00	$251.40–$838.00	—	—
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PNEUMOCOCCAL 15 (VAXNEUVANCE)	$867.00	$867.00	$91.03–$867.00	156% above	—
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 PNEUMOCOCCAL 15 (VAXNEUVANCE)	$867.00	$867.00	$260.10–$867.00	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20	$1,078.00	$1,078.00	$113.19–$1,078.00	152% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20	$1,078.00	$1,078.00	$323.40–$1,078.00	—	—
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 CAPVAXIVE PCV-21 VACCINE	$1,088.00	$1,088.00	$114.24–$1,088.00	161% above	—
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 CAPVAXIVE PCV-21 VACCINE	$1,088.00	$1,088.00	$326.40–$1,088.00	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOC 23-POLYVAL VAC 0.5ML	$422.00	$422.00	$44.31–$422.00	176% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOC 23-POLYVAL VAC 0.5ML	$422.00	$422.00	$126.60–$422.00	—	—
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACC INACT INJ 5ML	$177.00	$177.00	$53.10–$177.00	103% above	—
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACC INACT INJ 5ML	$177.00	$177.00	$53.10–$177.00	—	—
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB 100MG/1ML INJ	$2,143.00	$2,143.00	$630.77–$2,143.00	107% above	—
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB 100MG/1ML INJ	$2,143.00	$2,143.00	$642.90–$2,143.00	—	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB 50MG/0.5ML INJ	$2,143.00	$2,143.00	$630.77–$2,143.00	108% above	—
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB 50MG/0.5ML INJ	$2,143.00	$2,143.00	$642.90–$2,143.00	—	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO RSV VACCINE PF 0.5 ML	$1,149.00	$1,149.00	$325.21–$1,149.00	171% above	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 ABRYSVO RSV VACCINE PF 0.5 ML	$1,149.00	$1,149.00	$344.70–$1,149.00	—	—
Rabies vaccine, one dose CPT 90675 RABIE VAC EMBRY CELL 2.5UN INJ	$1,565.00	$1,565.00	$469.50–$1,565.00	232% above	—
Rabies vaccine, one dose inpatient CPT 90675 RABIE VAC EMBRY CELL 2.5UN INJ	$1,565.00	$1,565.00	$469.50–$1,565.00	—	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VACC INACT ADJUV IM INJ	$845.00	$845.00	$228.44–$845.00	114% above	—
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VACC INACT ADJUV IM INJ	$845.00	$845.00	$253.50–$845.00	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPHTH-TET TOX (DT) PED 0.5ML	$475.00	$475.00	$38.97–$475.00	796% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPHTH-TET TOX (DT) PED 0.5ML	$475.00	$475.00	$142.50–$475.00	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL TDAP IM SUSP 0.5ML	$173.00	$173.00	$51.90–$173.00	212% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS/DIPHTH/PERTUSSIS 0.5ML	$184.00	$184.00	$55.20–$184.00	232% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL TDAP IM SUSP 0.5ML	$173.00	$173.00	$51.90–$173.00	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS/DIPHTH/PERTUSSIS 0.5ML	$184.00	$184.00	$55.20–$184.00	—	—
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE INACTIV 0.5ML	$582.00	$582.00	$174.60–$582.00	150% above	—
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE INACTIV 0.5ML	$582.00	$582.00	$174.60–$582.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNE ADMIN	$270.00	$270.00	$70.68–$270.00	221% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNE ADMIN FLU	$270.00	$270.00	$70.68–$270.00	221% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$270.00	$270.00	$70.68–$270.00	221% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNE ADMIN HEPATITIS B	$270.00	$270.00	$70.68–$270.00	221% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNE ADMIN PNEUMOCOCCAL	$270.00	$270.00	$70.68–$270.00	221% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNE ADMIN	$270.00	$270.00	$81.00–$270.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNE ADMIN FLU	$270.00	$270.00	$81.00–$270.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNE ADMIN PNEUMOCOCCAL	$270.00	$270.00	$81.00–$270.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNE ADMIN HEPATITIS B	$270.00	$270.00	$81.00–$270.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$270.00	$270.00	$81.00–$270.00	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$219.00	$219.00	$65.70–$3,573.00	387% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNE ADMIN EACH ADD	$219.00	$219.00	$50.16–$235.00	387% above	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNE ADMIN EACH ADD	$219.00	$219.00	$65.70–$219.00	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD	$219.00	$219.00	$65.70–$219.00	—	—

Dental

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant CDT D4341 PERIODONTAL SCALING & ROOT	$204.00	$204.00	$61.20–$807.00	81% below	—
Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant inpatient CDT D4341 PERIODONTAL SCALING & ROOT	$204.00	$204.00	$61.20–$204.00	—	—
Dental implant, surgical placement CDT D6010 ODONTICS ENDOSTEAL IMPLANT	$827.00	$827.00	$248.10–$827.00	32% below	—
Dental implant, surgical placement inpatient CDT D6010 ODONTICS ENDOSTEAL IMPLANT	$827.00	$827.00	$248.10–$827.00	—	—
Porcelain crown CDT D2740 CROWN PORCELAIN/CERAMIC	$1,524.00	$1,524.00	$457.20–$1,524.00	41% above	—
Porcelain crown inpatient CDT D2740 CROWN PORCELAIN/CERAMIC	$1,524.00	$1,524.00	$457.20–$1,524.00	—	—
Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240 IMPACT TOOTH REMOV COMP BONY	$773.00	$773.00	$231.90–$807.00	9% below	—
Removal of an impacted tooth fully covered by bone, often a wisdom tooth inpatient CDT D7240 IMPACT TOOTH REMOV COMP BONY	$773.00	$773.00	$231.90–$773.00	—	—
Root canal treatment on a molar (back tooth), not including the final crown CDT D3330 END THXPY, MOLAR TOOTH	$1,212.00	$1,212.00	$363.60–$1,212.00	36% below	—
Root canal treatment on a molar (back tooth), not including the final crown inpatient CDT D3330 END THXPY, MOLAR TOOTH	$1,212.00	$1,212.00	$363.60–$1,212.00	—	—
Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 DENTAL PROPHYLAXIS ADULT	$141.00	$141.00	$42.30–$166.19	8% below	—
Routine teeth cleaning (prophylaxis), adult or teen inpatient CDT D1110 DENTAL PROPHYLAXIS ADULT	$141.00	$141.00	$42.30–$141.00	—	—
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACTION ERUPTED TOOTH/EXR	$369.00	$369.00	$52.50–$807.00	52% below	—
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 EXTRACTION ERUPTED TOOTH/EXR	$369.00	$369.00	$110.70–$369.00	—	—

Source file: https://www.wmchealth.org/wp-content/uploads/2026/08/133964321-westchester-medical-center_standardcharges.csv