Hospital

Huggins Hospital

Huggins Hospital in Wolfeboro, NH publishes cash prices for 406 common procedures listed here, from its own machine-readable price file updated May 28, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the New Hampshire median for 219 of 394 procedures and above it for 157. By typical cash price it ranks #11 of 20 New Hampshire hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

240 S Main St,Wolfeboro,NH,03894 Collected Sep 27, 2026 Source price file Check a bill from this hospital (603) 569-7500

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 301312 · CMS hospital register NPI 1366476079

Financial assistance

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

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

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

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

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 Huggins Hospital in Wolfeboro, NH:

Feb 10, 2023 Warning notice
May 16, 2023 Case closed
Apr 15, 2026 Warning notice
May 11, 2026 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

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 Hampshire	Off list
Abdominal CT scan without and with contrast CPT 74170 CT SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST	$2,147.50	$4,295.00	$1,794.01	at median	50%
Abdominal CT scan without and with contrast CPT 74170 CT ABD WO CNTRST FLWD CNTRST	$2,255.00	$4,510.00	$1,794.01	5% above	50%
Abdominal X-ray, 2 views CPT 74019 X-RAY OF ABDOMEN; 2 VIEWS	$243.50	$487.00	$262.25	7% below	50%
Abdominal X-ray, 2 views CPT 74019 RADEX ABDOMEN 2 VIEWS	$255.50	$511.00	$262.25	3% below	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS	$241.50	$483.00	—	12% below	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS	$241.50	$483.00	—	12% below	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY EXAM OF ANKLE	$253.50	$507.00	—	8% below	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY EXAM OF ANKLE	$253.50	$507.00	—	8% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$318.50	$637.00	—	29% below	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SCAN OF ARM WITHOUT CONTRAST	$1,087.50	$2,175.00	—	22% below	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SCAN OF ARM WITHOUT CONTRAST	$1,087.50	$2,175.00	—	22% below	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREMITY W/O DYE	$1,142.00	$2,284.00	—	18% below	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREMITY W/O DYE	$1,142.00	$2,284.00	—	18% below	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 SINGLE CONTRAST X-RAY OF ESOPHAGUS	$368.00	$736.00	$716.82	39% below	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$386.50	$773.00	$716.82	36% below	50%
Bone scan, whole body (nuclear medicine) CPT 78306 NUCLEAR MEDICINE STUDY OF BONE AND/OR JOINT WHOLE BODY	$1,293.50	$2,587.00	$2,375.77	32% below	50%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY	$1,358.00	$2,716.00	$2,375.77	28% below	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST	$261.50	$523.00	$523.00	28% below	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED	$277.50	$555.00	$535.05	24% below	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST	$261.50	$523.00	—	28% below	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST	$261.50	$523.00	—	28% below	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT SCAN OF BLOOD VESSELS OF ABDOMEN AND PELVIS WITH CONTRAST	$2,537.50	$5,075.00	$2,951.59	4% below	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PLVS W/CONTRAST	$2,664.50	$5,329.00	$2,951.59	1% above	50%
CT angiography (CTA) of the head CPT 70496 CT SCAN OF BLOOD VESSELS OF HEAD WITH CONTRAST	$1,971.00	$3,942.00	$1,790.27	5% below	50%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD	$2,069.50	$4,139.00	$1,790.27	1% below	50%
CT angiography (CTA) of the neck CPT 70498 CT SCAN OF BLOOD VESSELS OF NECK WITH CONTRAST	$1,971.00	$3,942.00	$1,790.27	5% below	50%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK	$2,069.50	$4,139.00	$1,790.27	1% below	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT SCAN OF BLOOD VESSELS OF CHEST WITH CONTRAST	$1,423.50	$2,847.00	$1,790.27	32% below	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$1,494.50	$2,989.00	$1,790.27	29% below	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$250.00	$500.00	$500.00	5% below	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT SCAN OF ABDOMEN AND PELVIS WITHOUT CONTRAST	$2,307.50	$4,615.00	$1,080.17	7% below	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$2,423.00	$4,846.00	$1,080.17	2% below	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$2,539.00	$5,078.00	$2,336.25	10% below	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST	$2,666.00	$5,332.00	$2,336.25	6% below	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT SCAN OF ABDOMEN AND PELVIS BEFORE AND AFTER CONTRAST	$2,995.00	$5,990.00	$2,635.91	3% below	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$3,145.00	$6,290.00	$2,635.91	1% above	50%
CT scan of the abdomen with contrast CPT 74160 CT SCAN OF ABDOMEN WITH CONTRAST	$1,548.00	$3,096.00	$1,790.65	7% below	50%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$1,625.50	$3,251.00	$1,790.65	3% below	50%
CT scan of the abdomen without contrast CPT 74150 CT SCAN OF ABDOMEN WITHOUT CONTRAST	$1,374.50	$2,749.00	$861.66	at median	50%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$1,443.00	$2,886.00	$861.66	5% above	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN OF FACE WITHOUT CONTRAST	$1,712.50	$3,425.00	$932.35	9% above	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE	$1,798.00	$3,596.00	$932.35	14% above	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$1,331.50	$2,663.00	$703.39	1% above	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE	$1,398.00	$2,796.00	$703.39	6% above	50%
CT scan of the head with contrast CPT 70460 CT SCAN HEAD OR BRAIN WITH CONTRAST	$1,331.50	$2,663.00	$1,006.50	13% below	50%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE	$1,398.00	$2,796.00	$1,006.50	9% below	50%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$2,053.50	$4,107.00	$1,211.48	5% above	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN OF LOWER SPINE WITHOUT CONTRAST	$1,290.00	$2,580.00	$875.09	8% below	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE	$1,354.50	$2,709.00	$875.09	4% below	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN OF UPPER SPINE WITHOUT CONTRAST	$1,290.00	$2,580.00	$881.90	11% below	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE	$1,354.50	$2,709.00	$881.90	7% below	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN OF PELVIS WITH CONTRAST	$1,462.50	$2,925.00	$1,790.65	10% below	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE	$1,535.50	$3,071.00	$1,790.65	5% below	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$1,336.00	$2,672.00	$1,625.77	—	50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 ULTRASOUND OF BOTH SIDES OF HEAD AND NECK BLOOD FLOW	$1,272.50	$2,545.00	$1,625.77	64% below	50%
Chest CT scan without and with contrast CPT 71270 CT THORAX DX C-/C+	$1,644.00	$3,288.00	$1,464.04	34% below	50%
Chest X-ray, 2 views CPT 71046 X-RAY OF CHEST; 2 VIEWS	$275.50	$551.00	$235.29	7% above	50%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$289.50	$579.00	$235.29	13% above	50%
Chest X-ray, single view CPT 71045 X-RAY OF CHEST; 1 VIEW	$244.50	$489.00	$174.67	9% above	50%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$256.50	$513.00	$174.67	14% above	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY OF COLLAR BONE	$211.00	$422.00	—	17% below	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY OF COLLAR BONE	$211.00	$422.00	—	17% below	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY EXAM OF COLLAR BONE	$221.50	$443.00	—	13% below	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY EXAM OF COLLAR BONE	$221.50	$443.00	—	13% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 COMPLETE ULTRASOUND SCAN BEHIND ABDOMINAL CAVITY	$371.50	$743.00	$743.00	40% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$390.00	$780.00	$750.58	37% below	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY MEASUREMENT OF HIP; PELVIS; SPINE	$283.00	$566.00	$289.20	35% below	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$297.00	$594.00	$289.20	31% below	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY MEASUREMENT OF FOREARM; FINGER; HAND; OR FOOT	$149.50	$299.00	$218.51	71% below	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN OF CHEST WITHOUT CONTRAST	$932.00	$1,864.00	$875.09	33% below	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C-	$978.50	$1,957.00	$875.09	30% below	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN OF CHEST WITH CONTRAST	$1,019.00	$2,038.00	$1,187.89	39% below	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+	$1,070.00	$2,140.00	$1,187.89	36% below	50%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$609.50	$1,219.00	$1,124.29	—	50%
Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$580.50	$1,161.00	$1,124.29	7% above	50%
Diagnostic mammogram, both breasts one side CPT 77066 DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$580.50	$1,161.00	—	7% above	50%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$455.50	$911.00	—	25% below	50%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$455.50	$911.00	—	25% below	50%
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI	$478.50	$957.00	—	21% below	50%
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI	$478.50	$957.00	—	21% below	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 ULTRASOUND STUDY OF ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$996.50	$1,993.00	$1,633.06	77% below	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY	$1,046.50	$2,093.00	$1,633.06	76% below	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ULTRASOUND OF HEART WITH COLOR-DEPICTED BLOOD FLOW; RATE; DIRECTION AND VALVE FUNCTION	$1,429.50	$2,859.00	—	9% below	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$1,501.00	$3,002.00	—	4% below	50%
Elbow X-ray, 2 views one side CPT 73070 X-RAY OF ELBOW; 2 VIEWS	$193.00	$386.00	—	28% below	50%
Elbow X-ray, 2 views one side CPT 73070 X-RAY EXAM OF ELBOW	$202.50	$405.00	—	25% below	50%
Elbow X-ray, 2 views one side CPT 73070 X-RAY EXAM OF ELBOW	$202.50	$405.00	—	25% below	50%
Elbow X-ray, 2 views one side CPT 73070 X-RAY OF ELBOW; 2 VIEWS	$386.00	$772.00	—	43% above	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS	$241.50	$483.00	—	17% below	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS	$241.50	$483.00	—	17% below	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY EXAM OF ELBOW	$253.50	$507.00	—	12% below	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY EXAM OF ELBOW	$253.50	$507.00	—	12% below	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SCAN OF CRANIAL CAVITY WITHOUT CONTRAST	$1,712.50	$3,425.00	$1,043.52	16% above	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE	$1,798.00	$3,596.00	$1,043.52	22% above	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY OF FACE BONES; MINIMUM OF 3 VIEWS	$235.50	$471.00	$349.82	36% below	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY EXAM OF FACIAL BONES	$247.50	$495.00	$349.82	33% below	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY OF FOREARM; 2 VIEWS	$193.00	$386.00	—	24% below	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY OF FOREARM; 2 VIEWS	$193.00	$386.00	—	24% below	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY EXAM OF FOREARM	$202.50	$405.00	—	20% below	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY EXAM OF FOREARM	$202.50	$405.00	—	20% below	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$1,540.50	$3,081.00	$2,705.84	16% below	50%
Hand X-ray, 2 views one side CPT 73120 X-RAY OF HAND; 2 VIEWS	$193.00	$386.00	—	29% below	50%
Hand X-ray, 2 views one side CPT 73120 X-RAY OF HAND; 2 VIEWS	$193.00	$386.00	—	29% below	50%
Hand X-ray, 2 views one side CPT 73120 X-RAY EXAM OF HAND	$202.50	$405.00	—	25% below	50%
Hand X-ray, 2 views one side CPT 73120 X-RAY EXAM OF HAND	$202.50	$405.00	—	25% below	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X-RAY OF HEEL; MINIMUM OF 2 VIEWS	$193.00	$386.00	—	21% below	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X-RAY OF HEEL; MINIMUM OF 2 VIEWS	$193.00	$386.00	—	21% below	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X-RAY EXAM OF HEEL	$202.50	$405.00	—	17% below	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X-RAY EXAM OF HEEL	$202.50	$405.00	—	17% below	50%
Knee X-ray, 3 views one side CPT 73562 X-RAY OF KNEE; 3 VIEWS	$241.50	$483.00	—	30% below	50%
Knee X-ray, 3 views one side CPT 73562 X-RAY OF KNEE; 3 VIEWS	$241.50	$483.00	—	30% below	50%
Knee X-ray, 3 views one side CPT 73562 X-RAY EXAM OF KNEE 3	$253.50	$507.00	—	26% below	50%
Knee X-ray, 3 views one side CPT 73562 X-RAY EXAM OF KNEE 3	$253.50	$507.00	—	26% below	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY OF KNEE; 4 OR MORE VIEWS	$272.00	$544.00	—	18% below	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY OF KNEE; 4 OR MORE VIEWS	$272.00	$544.00	—	18% below	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY EXAM KNEE 4 OR MORE	$285.50	$571.00	—	14% below	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY EXAM KNEE 4 OR MORE	$285.50	$571.00	—	14% below	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST	$1,053.00	$2,106.00	—	24% below	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST	$1,053.00	$2,106.00	—	24% below	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREMITY W/O DYE	$1,105.50	$2,211.00	—	20% below	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREMITY W/O DYE	$1,105.50	$2,211.00	—	20% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ULTRASOUND SCAN OF ABDOMEN	$302.00	$604.00	$604.00	40% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$317.00	$634.00	$609.10	37% below	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS	$387.00	$774.00	—	16% above	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS	$387.00	$774.00	—	16% above	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$406.50	$813.00	—	22% above	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$406.50	$813.00	—	22% above	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT SCAN OF CHEST FOR LUNG CANCER SCREENING	$1,304.50	$2,609.00	$922.28	75% above	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C-	$1,369.50	$2,739.00	$922.28	84% above	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS	$241.50	$483.00	—	10% below	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS	$241.50	$483.00	—	10% below	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY EXAM OF LOWER LEG	$253.50	$507.00	—	6% below	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY EXAM OF LOWER LEG	$253.50	$507.00	—	6% below	50%
MR angiography (MRA) of the head without contrast CPT 70544 MRI SCAN OF BLOOD VESSELS OF HEAD WITHOUT CONTRAST	$1,496.00	$2,992.00	$1,689.65	24% below	50%
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE	$1,571.00	$3,142.00	$1,689.65	21% below	50%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST C-+ W/CAD BI	$1,473.50	$2,947.00	$2,527.33	—	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,069.00	$2,138.00	—	51% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,069.00	$2,138.00	—	51% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$1,122.50	$2,245.00	—	49% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$1,122.50	$2,245.00	—	49% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$2,240.50	$4,481.00	—	43% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$2,240.50	$4,481.00	—	43% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$2,352.50	$4,705.00	—	40% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$2,352.50	$4,705.00	—	40% below	50%
MRI of the abdomen without contrast CPT 74181 MRI SCAN OF ABDOMEN WITHOUT CONTRAST	$1,069.00	$2,138.00	$1,366.39	57% below	50%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$1,122.50	$2,245.00	$1,366.39	55% below	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST	$2,255.50	$4,511.00	$2,527.33	39% below	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$2,368.50	$4,737.00	$2,527.33	36% below	50%
MRI of the brain, no contrast dye CPT 70551 MRI SCAN OF BRAIN WITHOUT CONTRAST	$1,069.00	$2,138.00	$1,349.51	53% below	50%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE	$1,122.50	$2,245.00	$1,349.51	51% below	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$1,781.00	$3,562.00	$2,261.34	51% below	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE	$1,870.00	$3,740.00	$2,261.34	49% below	50%
MRI of the lower back, no contrast dye CPT 72148 MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$1,116.00	$2,232.00	$1,299.06	55% below	50%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE	$1,172.00	$2,344.00	$1,299.06	52% below	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SCAN OF LOWER SPINAL CANAL BEFORE AND AFTER CONTRAST	$1,781.00	$3,562.00	$2,271.41	54% below	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$1,870.00	$3,740.00	$2,271.41	52% below	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SCAN OF MIDDLE SPINAL CANAL WITHOUT CONTRAST	$1,069.00	$2,138.00	$1,292.25	57% below	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE	$1,122.50	$2,245.00	$1,292.25	55% below	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SCAN OF UPPER SPINAL CANAL BEFORE AND AFTER CONTRAST	$1,781.00	$3,562.00	$2,278.12	54% below	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE	$1,870.00	$3,740.00	$2,278.12	51% below	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SCAN OF UPPER SPINAL CANAL WITHOUT CONTRAST	$1,069.00	$2,138.00	$1,292.25	56% below	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE	$1,122.50	$2,245.00	$1,292.25	54% below	50%
MRI of the pelvis without and with contrast CPT 72197 MRI SCAN OF PELVIS BEFORE AND AFTER CONTRAST	$2,255.50	$4,511.00	$2,513.90	36% below	50%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE	$2,368.50	$4,737.00	$2,513.90	32% below	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI SCAN OF PELVIS WITHOUT CONTRAST	$1,069.00	$2,138.00	$1,716.60	60% below	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE	$1,122.50	$2,245.00	$1,716.60	58% below	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$1,069.00	$2,138.00	—	49% below	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$1,069.00	$2,138.00	—	49% below	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$1,122.50	$2,245.00	—	46% below	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$1,122.50	$2,245.00	—	46% below	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY OF UPPER SPINE; 4-5 VIEWS	$275.50	$551.00	$407.09	32% below	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$289.50	$579.00	$407.09	29% below	50%
Neck soft tissue CT scan with contrast CPT 70491 CT SCAN OF SOFT TISSUE OF NECK WITH CONTRAST	$1,498.50	$2,997.00	$1,272.10	5% below	50%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/DYE	$1,573.50	$3,147.00	$1,272.10	1% below	50%
Neck soft tissue CT scan without contrast CPT 70490 CT SCAN OF SOFT TISSUE OF NECK WITHOUT CONTRAST	$1,326.00	$2,652.00	$955.95	5% below	50%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O DYE	$1,392.50	$2,785.00	$955.95	at median	50%
Neck soft tissue X-ray CPT 70360 X-RAY OF SOFT TISSUE OF NECK	$211.50	$423.00	$231.94	4% below	50%
Neck soft tissue X-ray CPT 70360 X-RAY EXAM OF NECK	$222.00	$444.00	$231.94	at median	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NUCLEAR MEDICINE STUDIES OF HEART MUSCLE AT REST AND WITH STRESS AND SPECT	$2,198.00	$4,396.00	$3,657.56	23% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT	$2,308.00	$4,616.00	$3,657.56	20% below	50%
Pelvic CT scan without contrast CPT 72192 CT SCAN OF PELVIS WITHOUT CONTRAST	$1,290.00	$2,580.00	$871.73	12% below	50%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O DYE	$1,354.50	$2,709.00	$871.73	8% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 LIMITED ULTRASOUND SCAN OF PELVIS	$117.00	$234.00	$234.00	68% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$123.00	$246.00	$246.00	66% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 COMPLETE ULTRASOUND SCAN OF PELVIS	$454.50	$909.00	$740.41	21% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$477.00	$954.00	$740.41	17% below	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$442.50	$885.00	$885.00	29% below	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WKS SNGL FETUS	$464.50	$929.00	$898.30	25% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND SCAN OF PREGNANT UTERUS (LESS THAN 14 WEEKS); SINGLE OR FIRST FETUS	$357.00	$714.00	$714.00	40% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$375.00	$750.00	$720.27	37% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$266.00	$532.00	$511.45	37% below	50%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY OF RIBS ON SIDE OF BODY; 2 VIEWS	$227.50	$455.00	—	6% below	50%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY OF RIBS ON SIDE OF BODY; 2 VIEWS	$227.50	$455.00	—	6% below	50%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS	$239.00	$478.00	—	1% below	50%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS	$239.00	$478.00	—	1% below	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY OF RIBS ON SIDE OF BODY; MINIMUM OF 3 VIEWS	$359.50	$719.00	—	1% above	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY OF RIBS ON SIDE OF BODY; MINIMUM OF 3 VIEWS	$359.50	$719.00	—	1% above	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST	$377.50	$755.00	—	6% above	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST	$377.50	$755.00	—	6% above	50%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD	$504.50	$1,009.00	$932.35	—	50%
Screening mammogram, both breasts CPT 77067 SCREENING MAMMOGRAPHY	$480.50	$961.00	$932.35	1% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$202.50	$405.00	—	27% below	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$202.50	$405.00	—	27% below	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY EXAM OF SHOULDER	$212.50	$425.00	—	23% below	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY EXAM OF SHOULDER	$212.50	$425.00	—	23% below	50%
Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY OF PARANASAL SINUS; MINIMUM OF 3 VIEWS	$227.00	$454.00	$275.68	36% below	50%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY OF SKULL; 1-3 VIEWS	$131.50	$263.00	$263.00	52% below	50%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY EXAM OF SKULL	$138.00	$276.00	$275.68	50% below	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 IMAGING FOR EVALUATION OF SWALLOWING FUNCTION	$506.50	$1,013.00	$1,013.00	23% below	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+	$532.00	$1,064.00	$1,030.00	19% below	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY OF THIGH BONE; MINIMUM 2 VIEWS	$241.50	$483.00	—	18% below	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY OF THIGH BONE; MINIMUM 2 VIEWS	$241.50	$483.00	—	18% below	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY EXAM OF FEMUR 2/>	$253.50	$507.00	—	14% below	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY EXAM OF FEMUR 2/>	$253.50	$507.00	—	14% below	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SCAN OF MIDDLE SPINE WITHOUT CONTRAST	$1,290.00	$2,580.00	$881.90	at median	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT CHEST SPINE W/O DYE	$1,354.50	$2,709.00	$881.90	5% above	50%
Toe X-ray, 2 or more views CPT 73660 X-RAY OF TOE; MINIMUM OF 2 VIEWS	$142.00	$284.00	$231.94	36% below	50%
Toe X-ray, 2 or more views CPT 73660 X-RAY EXAM OF TOE(S)	$149.00	$298.00	$231.94	33% below	50%
Toe X-ray, 2 or more views one side CPT 73660 X-RAY OF TOE; MINIMUM OF 2 VIEWS	$142.00	$284.00	—	36% below	50%
Toe X-ray, 2 or more views one side CPT 73660 X-RAY OF TOE; MINIMUM OF 2 VIEWS	$142.00	$284.00	—	36% below	50%
Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$422.50	$845.00	$845.00	24% below	50%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB	$443.50	$887.00	$881.90	20% below	50%
Transvaginal ultrasound during pregnancy CPT 76817 VAGINAL ULTRASOUND OF PREGNANT UTERUS	$286.50	$573.00	$573.00	36% below	50%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$301.00	$602.00	$578.79	32% below	50%
Ultrasound of the abdomen, complete CPT 76700 COMPLETE ULTRASOUND SCAN OF ABDOMEN	$397.50	$795.00	$795.00	41% below	50%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE	$417.50	$835.00	$797.68	38% below	50%
Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND SCAN OF SCROTUM	$360.50	$721.00	$716.82	33% below	50%
Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM	$378.50	$757.00	$716.82	30% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SCAN OF HEAD AND NECK SOFT TISSUE	$426.50	$853.00	$853.00	16% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$448.00	$896.00	$854.94	12% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 SINGLE CONTRAST X-RAY OF UPPER DIGESTIVE TRACT	$427.50	$855.00	$855.00	41% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$449.00	$898.00	$875.09	38% below	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY OF UPPER ARM; MINIMUM OF 2 VIEWS	$241.50	$483.00	—	11% below	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY OF UPPER ARM; MINIMUM OF 2 VIEWS	$241.50	$483.00	—	11% below	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY EXAM OF HUMERUS	$253.50	$507.00	—	7% below	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 X-RAY EXAM OF HUMERUS	$253.50	$507.00	—	7% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$495.00	$990.00	—	40% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$495.00	$990.00	—	40% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 EXTREMITY STUDY	$520.00	$1,040.00	—	37% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 EXTREMITY STUDY	$520.00	$1,040.00	—	37% below	50%
Wrist X-ray, 2 views one side CPT 73100 X-RAY OF WRIST; 2 VIEWS	$193.00	$386.00	—	24% below	50%
Wrist X-ray, 2 views one side CPT 73100 X-RAY OF WRIST; 2 VIEWS	$193.00	$386.00	—	24% below	50%
Wrist X-ray, 2 views one side CPT 73100 X-RAY EXAM OF WRIST	$202.50	$405.00	—	21% below	50%
Wrist X-ray, 2 views one side CPT 73100 X-RAY EXAM OF WRIST	$202.50	$405.00	—	21% below	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$232.00	$464.00	—	17% below	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$232.00	$464.00	—	17% below	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY EXAM OF WRIST	$243.50	$487.00	—	13% below	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY EXAM OF WRIST	$243.50	$487.00	—	13% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$232.00	$464.00	—	29% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$232.00	$464.00	—	29% below	50%
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 VIEWS	$243.50	$487.00	—	25% below	50%
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 VIEWS	$243.50	$487.00	—	25% below	50%
X-ray of the abdomen, 1 view CPT 74018 X-RAY OF ABDOMEN; 1 VIEW	$202.50	$405.00	$215.05	14% below	50%
X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW	$212.50	$425.00	$215.05	10% below	50%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY OF ANKLE; 2 VIEWS	$193.00	$386.00	—	20% below	50%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY OF ANKLE; 2 VIEWS	$193.00	$386.00	—	20% below	50%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY EXAM OF ANKLE	$202.50	$405.00	—	17% below	50%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY EXAM OF ANKLE	$202.50	$405.00	—	17% below	50%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$146.50	$293.00	$293.00	30% below	50%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S)	$154.00	$308.00	$308.00	26% below	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$146.50	$293.00	—	30% below	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$146.50	$293.00	—	30% below	50%
X-ray of the foot, 2 views one side CPT 73620 X-RAY OF FOOT; 2 VIEWS	$185.50	$371.00	—	20% below	50%
X-ray of the foot, 2 views one side CPT 73620 X-RAY OF FOOT; 2 VIEWS	$185.50	$371.00	—	20% below	50%
X-ray of the foot, 2 views one side CPT 73620 X-RAY EXAM OF FOOT	$195.00	$390.00	—	16% below	50%
X-ray of the foot, 2 views one side CPT 73620 X-RAY EXAM OF FOOT	$195.00	$390.00	—	16% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS	$241.50	$483.00	—	23% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS	$241.50	$483.00	—	23% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY EXAM OF FOOT	$253.50	$507.00	—	20% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY EXAM OF FOOT	$253.50	$507.00	—	20% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$241.50	$483.00	—	13% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$241.50	$483.00	—	13% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY EXAM OF HAND	$253.50	$507.00	—	9% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY EXAM OF HAND	$253.50	$507.00	—	9% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY OF KNEE; 1-2 VIEWS	$202.50	$405.00	—	22% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY OF KNEE; 1-2 VIEWS	$202.50	$405.00	—	22% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$212.50	$425.00	—	18% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$212.50	$425.00	—	18% below	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY OF LOWER AND SACRAL SPINE; 2-3 VIEWS	$290.00	$580.00	$295.92	4% below	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$304.50	$609.00	$295.92	at median	50%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$354.00	$708.00	$393.56	10% below	50%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$371.50	$743.00	$393.56	6% below	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY OF MIDDLE SPINE; 2 VIEWS	$290.00	$580.00	$235.29	at median	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$304.50	$609.00	$235.29	5% above	50%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY OF NOSE BONES; MINIMUM OF 3 VIEWS	$216.00	$432.00	$302.63	27% below	50%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES	$227.00	$454.00	$302.63	23% below	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY OF UPPER SPINE; 2-3 VIEWS	$251.50	$503.00	$292.56	9% below	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$264.00	$528.00	$292.56	4% below	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY OF PELVIS; 1-2 VIEWS	$211.50	$423.00	$198.27	19% below	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS	$222.00	$444.00	$198.27	15% below	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY OF SACRUM AND TAILBONE; MINIMUM OF 2 VIEWS	$235.50	$471.00	$245.37	4% below	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE	$247.50	$495.00	$245.37	at median	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH) LEVEL	$260.50	$521.00	$339.53	1% above	50%
ACTH blood test CPT 82024 ASSAY OF ACTH	$273.50	$547.00	$339.53	6% above	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL	$94.50	$189.00	$46.60	55% above	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT)	$99.00	$198.00	$46.60	62% above	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL	$73.50	$147.00	$45.54	40% above	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT)	$77.00	$154.00	$45.54	46% above	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$404.50	$809.00	$418.74	14% above	50%
Albumin blood test CPT 82040 ALBUMIN (PROTEIN) LEVEL	$73.50	$147.00	$43.52	55% above	50%
Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN	$77.00	$154.00	$43.52	63% above	50%
Aldosterone blood test CPT 82088 ALDOSTERONE HORMONE LEVEL	$238.00	$476.00	$358.26	4% below	50%
Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE	$250.00	$500.00	$358.26	1% above	50%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE (ENZYME) LEVEL; ALKALINE	$73.50	$147.00	$45.54	10% above	50%
Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE	$77.00	$154.00	$45.54	15% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$12.50	$25.00	$25.00	62% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH	$13.00	$26.00	$26.00	61% below	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP) LEVEL; SERUM	$192.00	$384.00	$147.44	65% above	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM	$201.50	$403.00	$147.44	73% above	50%
Ammonia blood test CPT 82140 AMMONIA LEVEL	$104.00	$208.00	$128.09	8% above	50%
Ammonia blood test CPT 82140 ASSAY OF AMMONIA	$109.00	$218.00	$128.09	14% above	50%
Amylase blood test CPT 82150 AMYLASE (ENZYME) LEVEL	$94.50	$189.00	$56.97	26% above	50%
Amylase blood test CPT 82150 ASSAY OF AMYLASE	$99.00	$198.00	$56.97	32% above	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT	$132.50	$265.00	$113.85	31% above	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$139.00	$278.00	$113.85	38% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$96.50	$193.00	$106.29	at median	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER	$163.00	$326.00	$106.29	69% above	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL	$213.00	$426.00	$345.16	8% above	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$235.50	$471.00	$345.16	19% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE; ANY OTHER SOURCE EXCEPT URINE; BLOOD OR STOOL; AEROBIC	$130.50	$261.00	$75.78	24% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$174.00	$348.00	$75.78	65% above	50%
Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$67.50	$135.00	$74.38	2% below	50%
Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL TOTAL CA	$71.00	$142.00	$74.38	3% above	50%
Bilirubin blood test, total CPT 82247 BILIRUBIN LEVEL; TOTAL	$51.50	$103.00	$44.13	32% above	50%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$54.00	$108.00	$44.13	39% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY	$222.50	$445.00	—	15% below	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST	$233.50	$467.00	—	11% below	50%
Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE	$157.50	$315.00	$90.73	12% above	50%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA	$234.00	$468.00	$90.73	67% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$12.50	$25.00	$25.00	25% below	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE	$14.50	$29.00	$29.00	13% below	50%
Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL	$104.00	$208.00	$34.55	199% above	50%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$109.00	$218.00	$34.55	213% above	50%
Blood lead test CPT 83655 LEAD LEVEL	$153.50	$307.00	$106.47	109% above	50%
Blood lead test CPT 83655 ASSAY OF LEAD	$161.00	$322.00	$106.47	119% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS	$70.00	$140.00	$66.11	27% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$92.50	$185.00	$66.11	3% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO)	$50.00	$100.00	$26.29	1% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$52.50	$105.00	$26.29	6% above	50%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN LEVEL TO ASSESS KIDNEY FUNCTION; QUANTITATIVE	$79.50	$159.00	$34.73	167% above	50%
Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN	$83.50	$167.00	$34.73	181% above	50%
C-peptide blood test CPT 84681 C-PEPTIDE (PROTEIN) LEVEL	$172.50	$345.00	$182.95	24% above	50%
C-peptide blood test CPT 84681 ASSAY OF C-PEPTIDE	$181.00	$362.00	$182.95	30% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION	$63.50	$127.00	$45.54	7% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$66.50	$133.00	$45.54	2% below	50%
C. difficile toxin gene test (stool PCR) CPT 87493 DETECTION TEST BY NUCLEIC ACID FOR CLOSTRIDIUM DIFFICILE; AMPLIFIED PROBE TECHNIQUE	$179.50	$359.00	$327.66	14% below	50%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$188.50	$377.00	$327.66	10% below	50%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 19-9	$143.00	$286.00	$182.95	at median	50%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$150.00	$300.00	$182.95	5% above	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125	$122.00	$244.00	$182.95	19% below	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125	$128.00	$256.00	$182.95	15% below	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 AMPLIFED DNA OR RNA PROBE DETECTION OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (COVID-19) ANTIGEN	$195.50	$391.00	$391.00	56% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$212.00	$424.00	$424.00	70% above	50%
Calcium blood test, total CPT 82310 CALCIUM LEVEL; TOTAL	$43.00	$86.00	$45.36	28% above	50%
Calcium blood test, total CPT 82310 ASSAY OF CALCIUM	$87.00	$174.00	$45.36	159% above	50%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA) PROTEIN LEVEL	$93.00	$186.00	$166.69	33% below	50%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN	$97.50	$195.00	$166.69	29% below	50%
Chickenpox (varicella) immunity blood test CPT 86787 ANALYSIS FOR ANTIBODY TO VARICELLA-ZOSTER VIRUS (CHICKEN POX)	$106.50	$213.00	$113.24	2% above	50%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY	$112.00	$224.00	$113.24	7% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE	$176.00	$352.00	$308.50	2% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE	$193.00	$386.00	$308.50	12% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$68.00	$136.00	$117.72	44% below	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$71.50	$143.00	$117.72	41% below	50%
Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$40.50	$81.00	$68.31	9% below	50%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$44.50	$89.00	$68.31	at median	50%
Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$34.00	$68.00	$56.88	35% below	50%
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED	$35.50	$71.00	$56.88	32% below	50%
Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$58.00	$116.00	$92.84	39% below	50%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL	$66.50	$133.00	$92.84	30% below	50%
Cortisol blood test, total CPT 82533 CORTISOL (HORMONE) MEASUREMENT; TOTAL	$152.50	$305.00	$143.30	27% above	50%
Cortisol blood test, total CPT 82533 TOTAL CORTISOL	$160.00	$320.00	$143.30	33% above	50%
Creatine kinase (CK) blood test, total CPT 82550 ASSAY OF CK (CPK)	$79.50	$159.00	$57.23	18% above	50%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CARDIAC ENZYME) LEVEL; TOTAL	$134.50	$269.00	$57.23	100% above	50%
Creatinine blood test CPT 82565 BLOOD CREATININE LEVEL	$80.50	$161.00	$45.01	81% above	50%
Creatinine blood test CPT 82565 ASSAY OF CREATININE	$84.50	$169.00	$45.01	90% above	50%
Cytomegalovirus (CMV) antibody test CPT 86644 ANALYSIS FOR ANTIBODY TO CYTOMEGALOVIRUS (CMV)	$197.50	$395.00	$126.51	61% above	50%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$207.50	$415.00	$126.51	69% above	50%
D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE	$189.00	$378.00	$89.50	71% above	50%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT	$198.50	$397.00	$89.50	80% above	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA-S) HORMONE LEVEL	$151.50	$303.00	$195.44	4% above	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE	$159.00	$318.00	$195.44	9% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TESTING FOR PRESENCE OF DRUG; BY CHEMISTRY ANALYZERS	$305.00	$610.00	$546.31	32% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$320.50	$641.00	$546.31	39% above	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 BLOOD TEST PANEL FOR ELECTROLYTES (SODIUM POTASSIUM; CHLORIDE; CARBON DIOXIDE)	$36.50	$73.00	$61.63	31% below	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$38.50	$77.00	$61.63	27% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 ANALYSIS FOR ANTIBODY TO EPSTEIN-BARR VIRUS (MONONUCLEOSIS VIRUS); VIRAL CAPSID	$97.00	$194.00	$159.48	7% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR CAPSID VCA	$102.00	$204.00	$159.48	3% below	50%
Estradiol blood test CPT 82670 MEASUREMENT OF TOTAL ESTRADIOL (HORMONE)	$158.50	$317.00	$245.64	1% below	50%
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$166.50	$333.00	$245.64	4% above	50%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING (REPRODUCTIVE HORMONE) LEVEL	$91.00	$182.00	$163.35	27% below	50%
FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$95.50	$191.00	$163.35	24% below	50%
Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL	$177.50	$355.00	$172.58	17% below	50%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$186.50	$373.00	$172.58	13% below	50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL	$93.50	$187.00	$119.83	13% below	50%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN	$98.00	$196.00	$119.83	9% below	50%
Fibrinogen blood test CPT 85384 FIBRINOGEN (FACTOR 1) ACTIVITY MEASUREMENT	$207.50	$415.00	$85.45	153% above	50%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$218.00	$436.00	$85.45	166% above	50%
Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM	$92.00	$184.00	$129.24	4% above	50%
Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM	$96.50	$193.00	$129.24	9% above	50%
Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE	$210.00	$420.00	$148.93	28% above	50%
Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3)	$220.50	$441.00	$148.93	35% above	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE	$181.50	$363.00	$79.30	85% above	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$190.50	$381.00	$79.30	94% above	50%
Free testosterone test CPT 84402 TESTOSTERONE (HORMONE) LEVEL; FREE	$245.50	$491.00	$223.92	74% above	50%
Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE	$258.00	$516.00	$223.92	83% above	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE (LIVER ENZYME) LEVEL	$74.50	$149.00	$63.30	15% above	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT	$78.00	$156.00	$63.30	20% above	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$269.50	$539.00	$433.78	16% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE	$99.00	$198.00	$41.76	91% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST	$104.00	$208.00	$41.76	101% above	50%
Glucose tolerance test, 3 samples CPT 82951 BLOOD GLUCOSE (SUGAR) TOLERANCE TEST; 3 SPECIMENS	$139.00	$278.00	$113.15	13% above	50%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$146.00	$292.00	$113.15	18% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE	$176.00	$352.00	$308.50	16% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB	$187.00	$374.00	$308.50	11% below	50%
H. pylori antibody blood test CPT 86677 ANALYSIS FOR ANTIBODY TO HELICOBACTER PYLORI (GASTROINTESTINAL BACTERIA)	$136.50	$273.00	$148.14	24% below	50%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY	$261.00	$522.00	$148.14	44% above	50%
H. pylori stool antigen test CPT 87338 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HELICOBACTER PYLORI (GI TRACT BACTERIA) IN STOOL	$230.00	$460.00	$126.42	103% above	50%
H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA	$241.50	$483.00	$126.42	113% above	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 DETECTION TEST BY NUCLEIC ACID FOR HIV-1 VIRUS; QUANTIFICATION	$540.00	$1,080.00	$748.17	26% above	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$567.00	$1,134.00	$748.17	32% above	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT	$196.00	$392.00	$308.50	at median	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 DETECTION TEST BY NUCLEIC ACID FOR HUMAN PAPILLOMAVIRUS (HPV); HIGH-RISK TYPES	$322.50	$645.00	$308.50	65% above	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL	$79.50	$159.00	$85.37	13% above	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$83.50	$167.00	$85.37	18% above	50%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY MEASUREMENT	$89.00	$178.00	$105.94	25% above	50%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL	$93.50	$187.00	$105.94	32% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT	$122.00	$244.00	$94.42	68% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$128.00	$256.00	$94.42	76% above	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN	$66.00	$132.00	$90.82	18% below	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA	$69.50	$139.00	$90.82	13% below	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY MEASUREMENT	$215.50	$431.00	$125.46	38% above	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST	$226.50	$453.00	$125.46	45% above	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 DETECTION TEST BY NUCLEIC ACID FOR HEPATITIS C VIRUS; QUANTIFICATION	$481.50	$963.00	$376.63	at median	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$505.50	$1,011.00	$376.63	5% above	50%
Herpes blood test, HSV-1 antibody CPT 86695 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 1	$171.50	$343.00	$115.96	63% above	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$180.00	$360.00	$115.96	71% above	50%
Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2	$171.50	$343.00	$170.12	40% above	50%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$180.00	$360.00	$170.12	47% above	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY	$103.50	$207.00	$113.85	6% above	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$108.50	$217.00	$113.85	11% above	50%
Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL	$171.50	$343.00	$157.55	31% above	50%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE	$180.00	$360.00	$157.55	37% above	50%
Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL	$144.50	$289.00	$100.49	56% above	50%
Insulin blood test CPT 83525 ASSAY OF INSULIN	$151.50	$303.00	$100.49	64% above	50%
Iron blood test (serum iron) CPT 83540 IRON LEVEL	$104.00	$208.00	$56.88	64% above	50%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$109.00	$218.00	$56.88	72% above	50%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST	$141.00	$282.00	$76.84	174% above	50%
Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL	$152.00	$304.00	$76.31	113% above	50%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$159.50	$319.00	$76.31	124% above	50%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL	$162.00	$324.00	$162.82	23% above	50%
LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH)	$170.00	$340.00	$162.82	29% above	50%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID LEVEL	$165.00	$330.00	$101.72	54% above	50%
Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID	$173.50	$347.00	$101.72	62% above	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (ENZYME) LEVEL	$73.50	$147.00	$53.10	48% above	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME	$133.50	$267.00	$53.10	169% above	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL	$74.50	$149.00	$60.57	at median	50%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE	$78.00	$156.00	$60.57	4% above	50%
Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL	$54.50	$109.00	$71.83	19% below	50%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$57.00	$114.00	$71.83	16% below	50%
Lyme disease antibody test CPT 86618 ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA)	$110.50	$221.00	$149.72	5% above	50%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$189.00	$378.00	$149.72	80% above	50%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL	$43.00	$86.00	$58.90	18% below	50%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$45.00	$90.00	$58.90	15% below	50%
Measles (rubeola) antibody test CPT 86765 ANALYSIS FOR ANTIBODY TO RUBEOLA (MEASLES VIRUS)	$90.00	$180.00	$113.24	3% below	50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$94.50	$189.00	$113.24	2% above	50%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$145.50	$291.00	$114.73	51% above	50%
Mumps immunity blood test CPT 86735 ANALYSIS FOR ANTIBODY TO MUMPS VIRUS	$277.00	$554.00	$114.73	187% above	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; FREE	$181.00	$362.00	$161.68	64% above	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE	$190.00	$380.00	$161.68	72% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$106.50	$213.00	$161.68	2% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$112.00	$224.00	$161.68	7% above	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP TEST; MANUAL SCREENING	$114.00	$228.00	$178.12	6% above	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER	$123.00	$246.00	$178.12	15% above	50%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL	$210.50	$421.00	$362.92	15% below	50%
Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE	$221.00	$442.00	$362.92	10% below	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$69.50	$139.00	$52.84	13% above	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$73.00	$146.00	$52.84	19% above	50%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHATE LEVEL	$194.50	$389.00	$41.67	204% above	50%
Phosphorus (phosphate) blood test CPT 84100 ASSAY OF PHOSPHORUS	$204.00	$408.00	$41.67	219% above	50%
Potassium blood test CPT 84132 BLOOD POTASSIUM LEVEL	$89.00	$178.00	$41.85	65% above	50%
Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM	$93.50	$187.00	$41.85	74% above	50%
Progesterone blood test CPT 84144 PROGESTERONE (REPRODUCTIVE HORMONE) LEVEL	$200.50	$401.00	$183.39	31% above	50%
Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE	$210.50	$421.00	$183.39	38% above	50%
Prolactin blood test CPT 84146 PROLACTIN (MILK PRODUCING HORMONE) LEVEL	$247.00	$494.00	$170.38	74% above	50%
Prolactin blood test CPT 84146 ASSAY OF PROLACTIN	$259.50	$519.00	$170.38	83% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME	$76.50	$153.00	$37.72	70% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$80.50	$161.00	$37.72	78% above	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$27.50	$55.00	$55.00	2% below	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 TESTING FOR PRESENCE OF DRUG; READ BY DIRECT OBSERVATION	$39.50	$79.00	$79.00	41% above	50%
Renin blood test CPT 84244 RENIN (KIDNEY ENZYME) LEVEL	$254.00	$508.00	$193.33	65% above	50%
Renin blood test CPT 84244 ASSAY OF RENIN	$266.50	$533.00	$193.33	73% above	50%
Rh blood typing CPT 86901 BLOOD TYPING FOR RH (D) ANTIGEN	$50.00	$100.00	$26.29	11% below	50%
Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH(D)	$52.50	$105.00	$26.29	6% below	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL	$105.50	$211.00	$49.85	103% above	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$111.00	$222.00	$49.85	114% above	50%
Rubella antibody test (immunity check) CPT 86762 ANALYSIS FOR ANTIBODY TO RUBELLA (GERMAN MEASLES VIRUS)	$70.50	$141.00	$126.51	8% below	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$74.00	$148.00	$126.51	4% below	50%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN EVALUATION VOLUME; SPERM COUNT; MOTILITY AND ANALYSIS	$181.00	$362.00	$108.22	54% below	50%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANAL VOL/COUNT/MOT	$190.00	$380.00	$108.22	51% below	50%
Sodium blood test CPT 84295 BLOOD SODIUM LEVEL	$71.50	$143.00	$42.29	110% above	50%
Sodium blood test CPT 84295 ASSAY OF SERUM SODIUM	$75.00	$150.00	$42.29	120% above	50%
Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES	$111.00	$222.00	$78.25	at median	50%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS	$116.50	$233.00	$78.25	5% above	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$6.00	$12.00	$12.00	84% below	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANALYSIS FOR ANTIBODY; TREPONEMA PALLIDUM	$118.50	$237.00	$116.40	3% above	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$124.50	$249.00	$116.40	8% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST	$45.50	$91.00	$37.54	22% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$48.00	$96.00	$37.54	28% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST; GAMMA INTERFERON	$311.00	$622.00	$544.90	41% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$326.50	$653.00	$544.90	48% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL	$232.00	$464.00	$226.91	47% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$243.50	$487.00	$226.91	54% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT	$145.00	$290.00	$127.92	15% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$152.50	$305.00	$127.92	21% above	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$88.00	$176.00	$147.70	26% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$95.00	$190.00	$147.70	20% below	50%
Total IgE blood test CPT 82785 IGE (IMMUNE SYSTEM PROTEIN) LEVEL	$107.00	$214.00	$144.71	11% above	50%
Total IgE blood test CPT 82785 ASSAY OF IGE	$112.50	$225.00	$144.71	17% above	50%
Total cholesterol blood test CPT 82465 CHOLESTEROL LEVEL	$94.50	$189.00	$38.24	130% above	50%
Total cholesterol blood test CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$99.00	$198.00	$38.24	141% above	50%
Total thyroxine (T4) blood test CPT 84436 THYROXINE (THYROID CHEMICAL); TOTAL	$91.50	$183.00	$60.40	34% above	50%
Total thyroxine (T4) blood test CPT 84436 ASSAY OF TOTAL THYROXINE	$96.00	$192.00	$60.40	41% above	50%
Total triiodothyronine (T3) blood test CPT 84480 THYROID HORMONE; T3 MEASUREMENT; TOTAL	$73.00	$146.00	$124.66	31% below	50%
Total triiodothyronine (T3) blood test CPT 84480 ASSAY TRIIODOTHYRONINE (T3)	$76.50	$153.00	$124.66	28% below	50%
Transferrin blood test CPT 84466 TRANSFERRIN (IRON BINDING PROTEIN) LEVEL	$165.00	$330.00	$112.18	3% above	50%
Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN	$173.50	$347.00	$112.18	9% above	50%
Triglycerides blood test CPT 84478 TRIGLYCERIDES LEVEL	$73.50	$147.00	$50.46	21% above	50%
Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES	$133.50	$267.00	$50.46	120% above	50%
Troponin test, quantitative CPT 84484 TROPONIN (PROTEIN) ANALYSIS; QUANTITATIVE	$159.50	$319.00	$109.63	27% above	50%
Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANT	$167.50	$335.00	$109.63	34% above	50%
Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD	$98.00	$196.00	$39.74	69% above	50%
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID	$103.00	$206.00	$39.74	77% above	50%
Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$80.00	$160.00	$27.87	59% above	50%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE	$84.00	$168.00	$27.87	67% above	50%
Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST	$25.50	$51.00	$19.78	at median	50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$36.00	$72.00	$19.78	42% above	50%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS; MANUAL TEST	$4.50	$9.00	$9.00	76% below	50%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT	$87.00	$174.00	$70.95	6% above	50%
Urine microalbumin (albumin) test CPT 82043 URINE MICROALBUMIN (PROTEIN) LEVEL	$127.50	$255.00	$50.82	50% above	50%
Urine microalbumin (albumin) test CPT 82043 UR ALBUMIN QUANTITATIVE	$134.00	$268.00	$50.82	58% above	50%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$11.00	$22.00	$22.00	70% below	50%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL	$98.00	$196.00	$132.58	1% below	50%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$103.00	$206.00	$132.58	4% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL	$146.00	$292.00	$260.23	26% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$153.50	$307.00	$260.23	23% below	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D; 1; 25 LEVEL	$187.00	$374.00	$338.48	41% below	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY	$196.50	$393.00	$338.48	38% below	50%
Zinc blood test CPT 84630 ZINC LEVEL	$191.50	$383.00	$100.14	104% above	50%
Zinc blood test CPT 84630 ASSAY OF ZINC	$201.00	$402.00	$100.14	114% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL	$247.00	$494.00	$132.31	88% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST	$259.50	$519.00	$132.31	97% above	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Arthroscopic ACL reconstruction or repair of the knee one side CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE	$19,908.00	$39,816.00	—	1499% above	50%
Arthroscopic ACL reconstruction or repair of the knee one side CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE	$26,188.50	$52,377.00	—	2004% above	50%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	$18,367.50	$36,735.00	—	1080% above	50%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	$31,995.00	$63,990.00	—	1955% above	50%
Botox injections for chronic migraine CPT 64615 INJECTION OF CHEMICAL FOR PARALYSIS OF FACIAL AND NECK NERVE MUSCLES ON BOTH SIDES OF FACE	$626.00	$1,252.00	—	76% above	50%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$657.50	$1,315.00	—	85% above	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC	$2,283.00	$4,566.00	—	17% below	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE	$252.50	$505.00	—	at median	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE	$246.00	$492.00	—	2% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT	$250.00	$500.00	—	77% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$262.50	$525.00	—	76% below	50%
Carpal tunnel release, open surgery one side CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE	$3,152.00	$6,304.00	—	75% above	50%
Carpal tunnel release, open surgery one side CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE	$3,546.00	$7,092.00	—	97% above	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DST RDL FX/EPHYS SEP WO	$263.00	$526.00	—	2% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 CLOSED TREATMENT OF BROKEN FOREARM (RADIUS) BONE AT THE WRIST AREA ON THE THUMB SIDE OF THE WRIST WITHOUT MANIPULATION	$250.50	$501.00	—	6% below	50%
Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$2,186.50	$4,373.00	—	10% above	50%
Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,186.50	$4,373.00	—	24% above	50%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,854.50	$3,709.00	—	45% above	50%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BIOPSY AND SCRAPING OF CERVIX USING AN ENDOSCOPE	$78.50	$157.00	—	67% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION OF PRECANCER SKIN GROWTH; 1 GROWTH	$43.00	$86.00	—	41% below	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$20.00	$40.00	—	72% below	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$20.00	$40.00	—	72% below	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING	$20.00	$40.00	—	72% below	50%
Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED EAR WAX	$27.00	$54.00	—	59% below	50%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$111.00	$222.00	—	69% above	50%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL OF IMPACTED EAR WAX	$105.50	$211.00	—	61% above	50%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL OF IMPACTED EAR WAX	$105.50	$211.00	—	61% above	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF LINING OF UTERUS	$56.00	$112.00	—	76% below	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE	$1,271.50	$2,543.00	—	9% above	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$1,335.00	$2,670.00	—	14% above	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$1,487.00	$2,974.00	—	10% above	50%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,416.00	$2,832.00	—	5% above	50%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,487.00	$2,974.00	—	10% above	50%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); 3 CM TO 10 CM; REDUCIBLE	$8,034.00	$16,068.00	—	—	50%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); GREATER THAN 10 CM; REDUCIBLE	$18,532.00	$37,064.00	—	—	50%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE	$3,588.00	$7,176.00	—	at median	50%
Gallbladder removal, laparoscopic CPT 47562 REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$7,144.00	$14,288.00	—	21% above	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 REMOVAL OF GALLBLADDER WITH X-RAY STUDY OF BILE DUCTS USING AN ENDOSCOPE	$6,486.00	$12,972.00	—	—	50%
Hemorrhoid banding (rubber band ligation) CPT 46221 REMOVAL OF EXTERNAL HEMORRHOIDS BY RUBBER BANDING	$984.00	$1,968.00	—	77% above	50%
Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVAL OF SINGLE EXTERNAL AND INTERNAL HEMORRHOID GROUP	$9,516.00	$19,032.00	—	39% above	50%
Hip replacement after an earlier hip surgery (conversion to total hip) one side CPT 27132 TOTAL HIP REPLACEMENT AFTER PREVIOUS HIP SURGERY	$30,303.00	$60,606.00	—	—	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$224.50	$449.00	—	30% below	50%
Hysteroscopy with endometrial ablation CPT 58563 EXAM OF UTERUS WITH DESTRUCTION OF LINING OF UTERUS USING AN ENDOSCOPE	$8,910.00	$17,820.00	—	352% above	50%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$3,420.00	$6,840.00	—	65% above	50%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$35.50	$71.00	—	94% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS	$60.50	$121.00	—	72% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$263.00	$526.00	—	23% above	50%
Incision and drainage of a simple or single skin abscess one side CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS	$60.50	$121.00	—	72% below	50%
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$10,835.00	$21,670.00	—	75% above	50%
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$11,778.00	$23,556.00	—	90% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$438.50	$877.00	—	51% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$473.50	$947.00	—	41% above	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION OF DRUG DELIVERY IMPLANT INTO TISSUE	$70.50	$141.00	—	19% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$438.50	$877.00	—	59% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$438.50	$877.00	—	69% above	50%
Knee arthroscopy with meniscus repair (one side of the knee) one side CPT 29882 REPAIR OF INSIDE OR OUTSIDE KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$21,567.00	$43,134.00	—	706% above	50%
Knee arthroscopy with meniscus repair (one side of the knee) one side CPT 29882 REPAIR OF INSIDE OR OUTSIDE KNEE JOINT CARTILAGE USING AN ENDOSCOPE	$24,648.00	$49,296.00	—	821% above	50%
Knee arthroscopy with meniscus trim one side CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$7,939.50	$15,879.00	—	51% above	50%
Knee arthroscopy with meniscus trim one side CPT 29881 REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$8,413.50	$16,827.00	—	60% above	50%
Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 REMOVAL OF BOTH KNEE CARTILAGES USING AN ENDOSCOPE	$6,043.50	$12,087.00	—	at median	50%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 REMOVAL OF APPENDIX USING AN ENDOSCOPE	$7,878.00	$15,756.00	—	19% above	50%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 STRENGTHENING OF MUSCLE BETWEEN ESOPHAGUS AND STOMACH BY WRAPPING PART OF STOMACH AROUND ESOPHAGUS USING AN ENDOSCOPE	$12,690.00	$25,380.00	—	—	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE	$10,622.00	$21,244.00	—	—	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE	$15,698.00	$31,396.00	—	—	50%
Laparoscopic removal of fallopian tubes and/or ovaries one side CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE	$6,480.00	$12,960.00	—	118% above	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$521.00	$1,042.00	—	44% above	50%
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/<	$547.00	$1,094.00	—	51% above	50%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$1,017.50	$2,035.00	—	1% above	50%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,068.50	$2,137.00	—	6% above	50%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$649.50	$1,299.00	—	27% below	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,164.50	$2,329.00	—	at median	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$1,222.50	$2,445.00	—	5% above	50%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,164.50	$2,329.00	—	at median	50%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,222.50	$2,445.00	—	5% above	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$65.50	$131.00	—	78% below	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REMOVAL OF NONCANCER SKIN GROWTH OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 0.5 CM OR LESS	$71.50	$143.00	—	78% below	50%
Nail removal (partial or complete), one nail CPT 11730 SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL	$175.00	$350.00	—	at median	50%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$184.00	$368.00	—	5% above	50%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$408.50	$817.00	—	7% above	50%
Occipital nerve block (injection for headaches) one side CPT 64405 INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE	$408.50	$817.00	—	7% above	50%
Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE	$539.00	$1,078.00	—	47% below	50%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$566.00	$1,132.00	—	44% below	50%
Partial knee replacement (one compartment) one side CPT 27446 REPLACEMENT OF KNEE JOINT ON SIDE OF KNEE	$23,887.50	$47,775.00	—	—	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$741.50	$1,483.00	—	79% above	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT	$2,418.50	$4,837.00	—	at median	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$2,539.50	$5,079.00	—	5% above	50%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT	$2,418.50	$4,837.00	—	at median	50%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT	$2,418.50	$4,837.00	—	at median	50%
Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$80.00	$160.00	—	74% below	50%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE	$441.00	$882.00	—	44% above	50%
Removal of a foreign object under the skin, simple one side CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE	$80.00	$160.00	—	74% below	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$3,297.50	$6,595.00	$3,266.30	88% above	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK	$1,854.50	$3,709.00	—	7% above	50%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF ELBOW TO FINGER CAST	$45.50	$91.00	—	65% below	50%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST	$432.00	$864.00	—	230% above	50%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$34.50	$69.00	—	71% below	50%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$195.00	$390.00	—	65% above	50%
Short arm splint (forearm and hand) one side CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$185.50	$371.00	—	57% above	50%
Short arm splint (forearm and hand) one side CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$185.50	$371.00	—	57% above	50%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$432.00	$864.00	—	80% above	50%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$38.00	$76.00	—	67% below	50%
Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT	$195.00	$390.00	—	70% above	50%
Short leg splint (calf to foot) one side CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT	$185.50	$371.00	—	62% above	50%
Short leg splint (calf to foot) one side CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT	$185.50	$371.00	—	62% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$209.50	$419.00	—	8% below	50%
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/<	$220.00	$440.00	—	4% below	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$65.50	$131.00	—	58% below	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH	$1,638.00	$3,276.00	—	959% above	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/<	$101.00	$202.00	—	59% below	50%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAG; 1-15 SKIN TAGS	$46.00	$92.00	—	69% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST	$837.50	$1,675.00	—	53% above	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$879.50	$1,759.00	—	60% above	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM	$57.00	$114.00	—	79% below	50%
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	$220.00	$440.00	—	18% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS	$57.50	$115.00	—	76% below	50%
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/<	$220.00	$440.00	—	9% below	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF RELATED SKIN GROWTH; FIRST GROWTH	$52.00	$104.00	—	48% below	50%
Thoracentesis with imaging guidance CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE	$858.50	$1,717.00	—	19% below	50%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$901.50	$1,803.00	—	15% below	50%
Total hip replacement one side CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$25,662.00	$51,324.00	—	318% above	50%
Total hip replacement one side CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$28,528.50	$57,057.00	—	365% above	50%
Total knee replacement one side CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$13,240.50	$26,481.00	—	14% above	50%
Total knee replacement one side CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$25,525.50	$51,051.00	—	121% above	50%
Total shoulder replacement one side CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$26,781.00	$53,562.00	—	346% above	50%
Total shoulder replacement one side CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$29,506.50	$59,013.00	—	392% above	50%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$298.00	$596.00	—	62% below	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$408.50	$817.00	—	48% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BREAST 1ST LESION US IMAG	$2,298.00	$4,596.00	—	47% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BREAST 1ST LESION US IMAG	$2,298.00	$4,596.00	—	47% above	50%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 BALLOON DILATION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE; LESS THAN 3.0 CM	$1,815.50	$3,631.00	—	32% above	50%
Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$1,729.00	$3,458.00	—	26% above	50%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 REMOVAL OF POLYPS OR GROWTHS OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$1,729.00	$3,458.00	—	at median	50%
Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$1,443.00	$2,886.00	—	at median	50%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF SKIN GROWTH; 1-14 GROWTHS	$59.00	$118.00	—	19% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS	$457.50	$915.00	—	39% above	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$480.50	$961.00	—	46% above	50%
Wrist fracture surgery (plate and screws), distal radius one side CPT 25607 TREATMENT OF BROKEN FOREARM BONE ON THUMB SIDE OF WRIST; ABOVE WRIST; WITH PLACEMENT OF STABILIZING DEVICE	$16,353.00	$32,706.00	—	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS	$377.00	$754.00	—	54% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$396.00	$792.00	—	51% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION	$25.00	$50.00	—	81% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION	$66.50	$133.00	$4,366.43	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$70.00	$140.00	$4,366.43	—	50%
Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION OF CHEMOTHERAPY INTO VEIN; 1 HOUR OR LESS	$428.00	$856.00	—	25% below	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$449.50	$899.00	—	21% below	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; FIRST 30-74 MINUTES	$1,587.50	$3,175.00	—	24% below	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$1,667.00	$3,334.00	—	20% below	50%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH INTERPRETATION AND REPORT	$24.00	$48.00	—	52% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING	$175.50	$351.00	—	14% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$184.50	$369.00	—	20% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD SEVERITY	$79.00	$158.00	—	59% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$83.00	$166.00	—	57% below	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY	$139.50	$279.00	—	52% below	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$146.50	$293.00	—	49% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$384.00	$768.00	—	28% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$403.00	$806.00	—	24% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$602.50	$1,205.00	—	35% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$632.50	$1,265.00	—	32% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$788.50	$1,577.00	—	40% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$828.00	$1,656.00	—	36% below	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG)	$535.00	$1,070.00	—	37% below	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST	$562.00	$1,124.00	—	33% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES	$377.00	$754.00	—	13% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$398.00	$796.00	—	19% above	50%
IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS	$373.00	$746.00	—	11% above	50%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$393.00	$786.00	—	17% above	50%
IV push of a medicine, first drug CPT 96374 INJECTION OF DRUG OR SUBSTANCE INTO VEIN	$115.00	$230.00	—	41% below	50%
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$121.50	$243.00	—	37% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE	$40.00	$80.00	—	53% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$42.00	$84.00	—	51% below	50%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$55.00	$110.00	—	65% below	50%
New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN	$58.00	$116.00	—	63% below	50%
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$83.50	$167.00	—	61% below	50%
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$103.00	$206.00	—	62% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 15-29 MINUTES	$38.00	$76.00	—	68% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN	$40.00	$80.00	—	66% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN	$73.50	$147.00	—	23% above	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 THERAPY PROCEDURE FOR NUTRITION MANAGEMENT; EACH 15 MINUTES	$140.00	$280.00	—	135% above	50%
Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW AGE 18-39	$68.50	$137.00	—	38% below	50%
Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (40-64 YEARS)	$76.50	$153.00	—	at median	50%
Preventive checkup, new patient aged 65 or older CPT 99387 INIT PM E/M NEW PAT 65+ YRS	$83.00	$166.00	—	39% below	50%
Preventive checkup, returning patient aged 18–39 CPT 99395 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (18-39 YEARS)	$59.50	$119.00	—	at median	50%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV VISIT EST AGE 40-64	$63.50	$127.00	—	at median	50%
Preventive checkup, returning patient aged 65 or older CPT 99397 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (65 YEAR OLD OR OLDER)	$68.50	$137.00	—	at median	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING AND TOBACCO USE INTENSIVE COUNSELING; 4-10 MINUTES	$7.00	$14.00	—	81% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 40-54 MINUTES	$72.50	$145.00	—	66% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40 MIN	$231.00	$462.00	—	8% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$37.00	$74.00	—	60% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN	$136.00	$272.00	—	47% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$54.50	$109.00	—	61% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30 MIN	$169.00	$338.00	—	21% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES	$22.50	$45.00	—	75% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN	$23.50	$47.00	—	74% below	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF/OP CNSLTJ NEW/EST LOW 30	$60.50	$121.00	—	20% above	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF/OP CNSLTJ NEW/EST MOD 40	$89.50	$179.00	—	11% above	50%
Spirometry (breathing test) CPT 94010 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME	$285.00	$570.00	—	45% above	50%
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$299.50	$599.00	—	52% above	50%
Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION	$437.00	$874.00	—	28% above	50%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$459.00	$918.00	—	35% above	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 DRAWING OF BLOOD FOR A MEDICAL PROBLEM	$91.00	$182.00	—	63% below	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$95.50	$191.00	—	61% below	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Fluad 2025-2026 Formula	$47.50	$95.00	$95.00	30% below	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VACCINE; INACTIVATED	$47.50	$95.00	$95.00	30% below	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Fluad 2024-2025 Formula	$47.50	$95.00	$95.00	30% below	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Flucelvax 2025-2026 Formula PFS	$47.50	$95.00	$95.00	30% below	50%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Spikevax 2024-2025 Formula Ages 12 and up	$146.50	$293.00	$293.00	4% below	50%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM	$146.50	$293.00	$293.00	4% below	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM	$142.50	$285.00	$285.00	29% above	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE SUBQ	$122.00	$244.00	$159.99–$244.00	74% below	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varivax	$256.63	$513.25	$159.99–$513.25	46% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM	$17.50	$35.00	$35.00	34% below	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACCINE 2/3 DOSE IM	$225.00	$450.00	$268.77–$450.00	19% below	50%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B VACC ADULT IM	$111.00	$222.00	$121.40–$222.00	1% above	50%
Hepatitis A vaccine, adult dose CPT 90632 Havrix Pediatric	$73.25	$146.50	$71.85–$146.50	1% below	50%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM	$76.50	$153.00	$71.85–$153.00	4% above	50%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE ADULT DOSAGE	$76.50	$153.00	$71.85–$153.00	4% above	50%
Hepatitis A vaccine, adult dose CPT 90632 Havrix PFS	$165.25	$330.50	$71.85–$330.50	124% above	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPA VACC PED/ADOL 2 DOSE IM	$35.00	$70.00	$34.85–$70.00	8% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$58.50	$117.00	$70.38–$117.00	66% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix-B	$110.10	$220.20	$70.38–$220.20	37% below	50%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 Heplisav-B PFS	$58.50	$117.00	$117.00–$160.28	83% below	50%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPB VACC 2/4 DOSE ADULT IM	$58.50	$117.00	$117.00–$160.28	83% below	50%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 Heplisav-B	$58.50	$117.00	$117.00–$160.28	83% below	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPB VACC 3 DOSE PED/ADOL IM	$21.50	$43.00	$29.90–$43.00	86% below	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB PRP-T VACCINE 4 DOSE IM	$25.50	$51.00	$12.45–$51.00	12% above	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ActHIB	$29.35	$58.70	$12.45–$58.70	29% above	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2019-2020 Formula	$47.50	$95.00	$69.94–$95.00	57% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose Quadrivalent 2023-2024 Formula	$47.50	$95.00	$69.94–$95.00	57% below	50%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 INACTIVATED JE VACC IM	$150.00	$300.00	$287.60–$300.00	—	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC	$65.50	$131.00	$89.87–$131.00	40% below	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II	$153.33	$306.65	$89.87–$306.65	41% above	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV VACCINE SC	$140.50	$281.00	$262.37–$281.00	29% above	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM	$125.00	$250.00	$148.49–$250.00	3% above	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menveo	$125.00	$250.00	$148.49–$250.00	3% above	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menactra	$245.95	$491.90	$148.49–$491.90	102% above	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB-4C VACCINE IM	$156.50	$313.00	$211.32–$313.00	15% below	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PCV13 VACCINE IM	$209.00	$418.00	$257.99–$418.00	67% below	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Prevnar 13	$413.23	$826.45	$257.99–$826.45	35% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM	$223.50	$447.00	$288.66–$447.00	55% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20 PFS	$223.50	$447.00	$288.66–$447.00	55% below	50%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PCV21 VACCINE IM	$223.50	$447.00	$447.00	21% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$96.00	$192.00	$133.47–$192.00	57% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23	$96.00	$192.00	$133.47–$192.00	57% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23 PFS	$209.30	$418.60	$133.47–$418.60	6% below	50%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS IPV SC/IM	$33.00	$66.00	$40.64–$66.00	61% below	50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV VACC PREF RECOMB ADJT IM	$244.00	$488.00	$488.00	—	50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM	$260.50	$521.00	$329.99–$521.00	58% below	50%
Rabies vaccine, one dose CPT 90675 RabAvert	$534.58	$1,069.15	$329.99–$1,069.15	15% below	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM	$165.00	$330.00	$183.41–$330.00	13% below	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Shingrix	$165.00	$330.00	$183.41–$330.00	13% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPHTHERIA AND TETANUS VACCINE (7 YEARS OR OLDER)	$54.00	$108.00	$31.05–$108.00	27% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TDVAX	$54.00	$108.00	$31.05–$108.00	27% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$62.00	$124.00	$31.05–$124.00	17% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tenivac	$84.03	$168.05	$31.05–$168.05	13% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tenivac PFS	$92.25	$184.50	$31.05–$180.06	24% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$45.00	$90.00	$38.75–$90.00	21% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Adacel	$85.70	$171.40	$38.75–$171.40	51% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix PFS	$91.33	$182.65	$38.75–$182.65	61% above	50%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Typhim Vi	$78.50	$157.00	$84.31–$157.00	at median	50%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE IM	$78.50	$157.00	$84.31–$157.00	at median	50%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Typhim Vi PFS	$214.05	$428.10	$84.31–$428.10	173% above	50%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 Vivotif	$78.25	$156.50	$99.23–$156.50	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE	$35.50	$71.00	—	13% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$37.50	$75.00	—	19% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMINISTRATION OF VACCINE; EACH ADDITIONAL VACCINE	$17.00	$34.00	—	48% below	50%
Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACCINE SUBQ	$128.00	$256.00	$140.66–$256.00	30% above	50%

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

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

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

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

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

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

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

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

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

Source file: https://apim.services.craneware.com/api-pricing-transparency/api/public/731ef0e972451ae12e17d777e7ad6cc9/charges/mrf