Hospital Fayetteville-Springdale-Rogers, AR

Ozarks Community Hospital

Ozarks Community Hospital in Gravette, AR publishes cash prices for 428 common procedures listed here, from its own machine-readable price file updated Aug 13, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Arkansas median for 207 of 423 procedures and above it for 207. By typical cash price it ranks #27 of 57 Arkansas hospitals and #1 of 7 hospitals in the Fayetteville, AR area, cheapest first. Select a procedure to compare it with other hospitals nearby.

1101 SW Jackson St., Gravette, AR 72736 Collected Sep 22, 2026 Source price file Check a bill from this hospital (479) 787-5291

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 041331 · CMS hospital register NPI 1568643005

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WWO	$750.00	$1,751.00	$158.12–$910.52	25% below	57%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WWO	$750.00	$1,751.00	$158.12–$910.52	—	57%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS	$419.20	$1,048.00	$24.26–$544.96	212% above	60%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS	$419.20	$1,048.00	$24.26–$544.96	—	60%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE (3V) RT	$250.00	$866.00	$18.00–$450.32	89% above	71%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE (3V) LT	$250.00	$866.00	$18.00–$450.32	89% above	71%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE (3V) RT	$250.00	$866.00	$18.00–$450.32	—	71%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE (3V) LT	$250.00	$866.00	$18.00–$450.32	—	71%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US SINGLE LEVEL ABI	$487.20	$1,218.00	$27.30–$633.36	186% above	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US SINGLE LEVEL ABI	$487.20	$1,218.00	$27.30–$633.36	—	60%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREM LT WO	$750.00	$1,048.00	$94.24–$750.00	17% above	28%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREM RT WO	$750.00	$1,048.00	$94.24–$750.00	17% above	28%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXTREM LT WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXTREM RT WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN PELVIS	$1,466.00	$3,665.00	$314.49–$1,905.80	18% above	60%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN PELVIS	$1,466.00	$3,665.00	$314.49–$1,905.80	—	60%
CT angiography (CTA) of the head CPT 70496 CTA HEAD	$700.40	$1,751.00	$158.12–$910.52	29% below	60%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD	$700.40	$1,751.00	$158.12–$910.52	—	60%
CT angiography (CTA) of the neck CPT 70498 CTA NECK	$700.40	$1,751.00	$158.12–$910.52	16% below	60%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK	$700.40	$1,751.00	$158.12–$910.52	—	60%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST	$700.40	$1,751.00	$158.12–$910.52	at median	60%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST	$700.40	$1,751.00	$158.12–$910.52	—	60%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA/CTA HEART W/CONTRAST	$926.00	$2,315.00	$279.27–$1,203.80	46% above	60%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA/CTA HEART W/CONTRAST	$926.00	$2,315.00	$279.27–$1,203.80	—	60%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CALCIUM SCORING ONLY	$50.00	$866.00	$50.00–$550.00	25% below	94%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CALCIUM SCORING ONLY	$50.00	$866.00	$50.00–$550.00	—	94%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN PELVIS WO	$750.00	$2,335.00	$108.30–$1,214.20	26% below	68%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN PELVIS WO	$750.00	$2,335.00	$108.30–$1,214.20	—	68%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN PELVIS W	$750.00	$3,665.00	$206.27–$1,905.80	47% below	80%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN PELVIS W	$750.00	$3,665.00	$206.27–$1,905.80	—	80%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN PELVIS WWO	$750.00	$3,665.00	$272.95–$1,905.80	53% below	80%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN PELVIS WWO	$750.00	$3,665.00	$272.95–$1,905.80	—	80%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W	$750.00	$1,751.00	$158.12–$910.52	19% below	57%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W	$750.00	$1,751.00	$158.12–$910.52	—	57%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO	$750.00	$1,048.00	$94.24–$750.00	24% above	28%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT ORBITS WO CONTRAST	$750.00	$1,048.00	$94.24–$750.00	8% above	28%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS	$750.00	$1,048.00	$94.24–$750.00	8% above	28%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES WO	$750.00	$1,048.00	$94.24–$750.00	8% above	28%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT ORBITS WO CONTRAST	$750.00	$1,048.00	$94.24–$750.00	—	28%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS	$750.00	$1,048.00	$94.24–$750.00	—	28%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST	$750.00	$1,048.00	$91.57–$750.00	14% above	28%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO	$750.00	$1,048.00	$91.57–$750.00	14% above	28%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONTRAST	$750.00	$1,048.00	$91.57–$750.00	—	28%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO	$750.00	$1,048.00	$91.57–$750.00	—	28%
CT scan of the head with contrast CPT 70460 CT HEAD W	$750.00	$1,751.00	$127.25–$910.52	14% below	57%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W	$750.00	$1,751.00	$127.25–$910.52	—	57%
CT scan of the head without and with contrast CPT 70470 CT HEAD WWO	$750.00	$1,751.00	$148.35–$910.52	22% below	57%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WWO	$750.00	$1,751.00	$148.35–$910.52	—	57%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR WO	$750.00	$1,048.00	$94.24–$750.00	3% above	28%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL WO	$750.00	$1,048.00	$94.24–$750.00	11% above	28%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W	$750.00	$1,751.00	$158.12–$910.52	12% below	57%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST ONLY	$750.00	$1,751.00	$100.00–$910.52	12% below	57%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W	$750.00	$1,751.00	$158.12–$910.52	—	57%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST ONLY	$750.00	$1,751.00	$100.00–$910.52	—	57%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DUPLEX	$840.00	$2,335.00	$70.00–$1,214.20	129% above	64%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DUPLEX	$840.00	$2,335.00	$70.00–$1,214.20	—	64%
Chest CT scan without and with contrast CPT 71270 CT CHEST WWO	$750.00	$1,751.00	$158.12–$910.52	17% below	57%
Chest CT scan without and with contrast CPT 71270 CT CHEST WITH & W/OUT CONTRST (TR)	$750.00	$1,751.00	$158.12–$910.52	17% below	57%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST WITH & W/OUT CONTRST (TR)	$750.00	$1,751.00	$158.12–$910.52	—	57%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST WWO	$750.00	$1,751.00	$158.12–$910.52	—	57%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$265.00	$866.00	$21.87–$450.32	86% above	69%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS	$265.00	$866.00	$21.87–$450.32	—	69%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW PORTABLE	$346.40	$866.00	$11.86–$450.32	212% above	60%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$346.40	$866.00	$11.86–$450.32	212% above	60%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW PORTABLE	$346.40	$866.00	$11.86–$450.32	—	60%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW	$346.40	$866.00	$11.86–$450.32	—	60%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE RT	$346.40	$866.00	$15.00–$450.32	223% above	60%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE LT	$346.40	$866.00	$15.00–$450.32	223% above	60%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE LT	$346.40	$866.00	$15.00–$450.32	—	60%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE RT	$346.40	$866.00	$15.00–$450.32	—	60%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE	$450.00	$1,048.00	$44.00–$544.96	37% above	57%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE	$450.00	$1,048.00	$44.00–$544.96	—	57%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXASCAN-AXIAL	$419.20	$1,048.00	$33.51–$544.96	131% above	60%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXASCAN-AXIAL	$419.20	$1,048.00	$33.51–$544.96	—	60%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXASCAN-PERIPHERAL	$346.40	$866.00	$27.10–$450.32	259% above	60%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXASCAN-PERIPHERAL	$346.40	$866.00	$27.10–$450.32	—	60%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO	$750.00	$1,048.00	$94.24–$750.00	24% above	28%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W	$750.00	$1,751.00	$142.68–$910.52	4% below	57%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W	$750.00	$1,751.00	$142.68–$910.52	—	57%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIAL LOWER EXTREMITY BILAT	$934.00	$2,335.00	$73.00–$1,214.20	—	60%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIAL LOWER EXTREMITY BILAT W/ ABI	$934.00	$2,335.00	$73.00–$1,214.20	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ARTERIAL LOWER EXTREMITY BILAT	$934.00	$2,335.00	$73.00–$1,214.20	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ARTERIAL LOWER EXTREMITY BILAT W/ ABI	$934.00	$2,335.00	$73.00–$1,214.20	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS DOPPLER EXT BILAT	$1,040.00	$2,335.00	$42.00–$1,214.20	—	55%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS DOPPLER EXT BILAT	$1,040.00	$2,335.00	$42.00–$1,214.20	—	55%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO CARDIOGRAPHY 2D, W/COLOR	$1,810.00	$5,257.00	$168.77–$2,733.64	80% above	66%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO CARDIOGRAPHY 2D, W/COLOR	$1,810.00	$5,257.00	$168.77–$2,733.64	—	66%
Elbow X-ray, 2 views one side CPT 73070 ELBOW (2V) RT	$346.40	$866.00	$18.00–$450.32	277% above	60%
Elbow X-ray, 2 views one side CPT 73070 ELBOW (2V) LT	$346.40	$866.00	$18.00–$450.32	277% above	60%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW (2V) LT	$346.40	$866.00	$18.00–$450.32	—	60%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW (2V) RT	$346.40	$866.00	$18.00–$450.32	—	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW (3V) RT	$346.40	$866.00	$19.00–$450.32	223% above	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW (3V) LT	$346.40	$866.00	$19.00–$450.32	223% above	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW (3V) LT	$346.40	$866.00	$19.00–$450.32	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW (3V) RT	$346.40	$866.00	$19.00–$450.32	—	60%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC WO	$750.00	$1,048.00	$94.24–$750.00	8% above	28%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS WO	$750.00	$1,048.00	$94.24–$750.00	8% above	28%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES (3V)	$419.20	$1,048.00	$18.00–$544.96	248% above	60%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES (3V)	$419.20	$1,048.00	$18.00–$544.96	—	60%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM (2V) RT	$346.40	$866.00	$19.00–$450.32	223% above	60%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM (2V) LT	$346.40	$866.00	$19.00–$450.32	223% above	60%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM (2V) LT	$346.40	$866.00	$19.00–$450.32	—	60%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM (2V) RT	$346.40	$866.00	$19.00–$450.32	—	60%
Hand X-ray, 2 views one side CPT 73120 HAND (2V) RT	$419.20	$1,048.00	$17.00–$544.96	291% above	60%
Hand X-ray, 2 views one side CPT 73120 HAND (2V) LT	$419.20	$1,048.00	$17.00–$544.96	291% above	60%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND (2V) LT	$419.20	$1,048.00	$17.00–$544.96	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND (2V) RT	$419.20	$1,048.00	$17.00–$544.96	—	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OS CALCIS (2V) RT	$346.40	$866.00	$13.00–$450.32	246% above	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OS CALCIS (2V) LT	$346.40	$866.00	$13.00–$450.32	246% above	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OS CALCIS (2V) LT	$346.40	$866.00	$13.00–$450.32	—	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OS CALCIS (2V) RT	$346.40	$866.00	$13.00–$450.32	—	60%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY, UNATTENDED	$416.80	$1,042.00	$89.06–$541.84	16% above	60%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY, UNATTENDED	$416.80	$1,042.00	$89.06–$541.84	—	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNGRAPHY WITH CONTINUOUS	$1,320.00	$3,300.00	$205.37–$1,716.00	25% below	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY 4 W/CPAP	$2,789.60	$6,974.00	$205.37–$3,626.48	58% above	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNGRAPHY WITH CONTINUOUS	$1,320.00	$3,300.00	$205.37–$1,716.00	—	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY 4 W/CPAP	$2,789.60	$6,974.00	$205.37–$3,626.48	—	60%
Knee X-ray, 3 views one side CPT 73562 KNEE (3V) LT	$346.40	$866.00	$35.00–$450.32	168% above	60%
Knee X-ray, 3 views one side CPT 73562 PATELLA (3V) RT	$346.40	$866.00	$35.00–$450.32	168% above	60%
Knee X-ray, 3 views one side CPT 73562 KNEE (3V) RT	$346.40	$866.00	$35.00–$450.32	168% above	60%
Knee X-ray, 3 views one side CPT 73562 PATELLA (3V) LT	$346.40	$866.00	$35.00–$450.32	168% above	60%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE (3V) LT	$346.40	$866.00	$35.00–$450.32	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE (3V) RT	$346.40	$866.00	$35.00–$450.32	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 PATELLA (3V) RT	$346.40	$866.00	$35.00–$450.32	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 PATELLA (3V) LT	$346.40	$866.00	$35.00–$450.32	—	60%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE (4V) RT	$419.20	$1,048.00	$37.00–$544.96	190% above	60%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE (4V) LT	$419.20	$1,048.00	$37.00–$544.96	190% above	60%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE (4V) LT	$419.20	$1,048.00	$37.00–$544.96	—	60%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE (4V) RT	$419.20	$1,048.00	$37.00–$544.96	—	60%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREM RT WO	$750.00	$1,048.00	$94.24–$750.00	23% above	28%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREM LT WO	$750.00	$1,048.00	$94.24–$750.00	23% above	28%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXTREM LT WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXTREM RT WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US HEPATIC	$450.00	$1,048.00	$20.00–$544.96	86% above	57%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN	$450.00	$1,048.00	$20.00–$544.96	86% above	57%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED STUDY	$450.00	$1,048.00	$20.00–$544.96	86% above	57%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS	$450.00	$1,048.00	$20.00–$544.96	86% above	57%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER BILE DUCTS	$450.00	$1,048.00	$20.00–$544.96	86% above	57%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER/RUQ	$450.00	$1,048.00	$20.00–$544.96	86% above	57%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER/RUQ	$450.00	$1,048.00	$20.00–$544.96	—	57%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED STUDY	$450.00	$1,048.00	$20.00–$544.96	—	57%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US HEPATIC	$450.00	$1,048.00	$20.00–$544.96	—	57%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS	$450.00	$1,048.00	$20.00–$544.96	—	57%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN	$450.00	$1,048.00	$20.00–$544.96	—	57%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER BILE DUCTS	$450.00	$1,048.00	$20.00–$544.96	—	57%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMITY NONVASCULAR REAL TIME W/IMA	$419.20	$1,048.00	$11.99–$544.96	156% above	60%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY NONVASCULAR LIMITED RIGHT	$419.20	$1,048.00	$11.99–$544.96	156% above	60%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY NONVASCULAR LIMITED LEFT	$419.20	$1,048.00	$11.99–$544.96	156% above	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXTREMITY NONVASCULAR REAL TIME W/IMA	$419.20	$1,048.00	$11.99–$544.96	—	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY NONVASCULAR LIMITED LEFT	$419.20	$1,048.00	$11.99–$544.96	—	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY NONVASCULAR LIMITED RIGHT	$419.20	$1,048.00	$11.99–$544.96	—	60%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG SCREENING	$419.20	$1,048.00	$94.24–$550.00	51% above	60%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LOW DOSE LUNG SCREENING	$419.20	$1,048.00	$94.24–$550.00	—	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB LEFT	$346.40	$866.00	$25.00–$450.32	208% above	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB RIGHT	$346.40	$866.00	$25.00–$450.32	208% above	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB RIGHT	$346.40	$866.00	$25.00–$450.32	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB LEFT	$346.40	$866.00	$25.00–$450.32	—	60%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO	$934.00	$2,335.00	$182.91–$1,214.20	3% above	60%
MR angiography (MRA) of the head without contrast CPT 70544 MRV HEAD	$934.00	$2,335.00	$182.91–$1,214.20	3% above	60%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV HEAD	$934.00	$2,335.00	$182.91–$1,214.20	—	60%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO	$934.00	$2,335.00	$182.91–$1,214.20	—	60%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI BILAT LOWER EXT ANY JOINT W/O CONT	$900.00	$2,335.00	$174.81–$1,214.20	—	61%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOWER EXTREMITY ANY JOINT WO LEFT	$900.00	$2,335.00	$174.81–$1,214.20	3% above	61%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOWER EXTREMITY ANY JOINT WO RIGHT	$900.00	$2,335.00	$174.81–$1,214.20	3% above	61%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI BILAT LOWER EXT ANY JOINT W/O CONT	$900.00	$2,335.00	$174.81–$1,214.20	—	61%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOWER EXTREMITY ANY JOINT WO LEFT	$900.00	$2,335.00	$174.81–$1,214.20	—	61%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOWER EXTREMITY ANY JOINT WO RIGHT	$900.00	$2,335.00	$174.81–$1,214.20	—	61%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWER EXTREMITY ANY JOINT WWO RIGHT	$900.00	$3,665.00	$314.49–$1,905.80	13% below	75%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWER EXTREMITY ANY JOINT WWO LEFT	$900.00	$3,665.00	$314.49–$1,905.80	13% below	75%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOWER EXTREMITY ANY JOINT WWO RIGHT	$900.00	$3,665.00	$314.49–$1,905.80	—	75%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOWER EXTREMITY ANY JOINT WWO LEFT	$900.00	$3,665.00	$314.49–$1,905.80	—	75%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$900.00	$2,335.00	$166.24–$1,214.20	1% below	61%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST	$900.00	$2,335.00	$166.24–$1,214.20	—	61%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/O & W/ CONTRAST	$900.00	$2,335.00	$287.26–$1,214.20	22% below	61%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/O & W/ CONTRAST	$900.00	$2,335.00	$287.26–$1,214.20	—	61%
MRI of the brain, no contrast dye CPT 70551 MRI HEAD WO	$900.00	$2,335.00	$167.67–$1,214.20	1% below	61%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI HEAD WO	$900.00	$2,335.00	$167.67–$1,214.20	—	61%
MRI of the brain, with and without contrast dye CPT 70553 MRI HEAD WWO	$900.00	$3,665.00	$271.65–$1,905.80	41% below	75%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI HEAD WWO	$900.00	$3,665.00	$271.65–$1,905.80	—	75%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO	$900.00	$2,335.00	$164.61–$1,214.20	1% above	61%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WO	$900.00	$2,335.00	$164.61–$1,214.20	—	61%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE WWO	$900.00	$3,665.00	$272.76–$1,905.80	33% below	75%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE WWO	$900.00	$3,665.00	$272.76–$1,905.80	—	75%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE WO	$900.00	$2,335.00	$163.49–$1,214.20	at median	61%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE WO	$900.00	$2,335.00	$163.49–$1,214.20	—	61%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE WWO	$900.00	$3,665.00	$272.48–$1,905.80	35% below	75%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE WWO	$900.00	$3,665.00	$272.48–$1,905.80	—	75%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE WO	$900.00	$2,335.00	$163.77–$1,214.20	3% below	61%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE WO	$900.00	$2,335.00	$163.77–$1,214.20	—	61%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WWO	$900.00	$3,665.00	$285.86–$1,905.80	16% below	75%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WWO	$900.00	$3,665.00	$285.86–$1,905.80	—	75%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO	$900.00	$3,665.00	$194.38–$1,905.80	6% above	75%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO	$900.00	$3,665.00	$194.38–$1,905.80	—	75%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPER EXTREMITY ANY JOINT WO LEFT	$900.00	$2,335.00	$175.37–$1,214.20	1% above	61%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPER EXTREMITY ANY JOINT WO RIGHT	$900.00	$2,335.00	$175.37–$1,214.20	1% above	61%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UPPER EXTREMITY ANY JOINT WO LEFT	$900.00	$2,335.00	$175.37–$1,214.20	—	61%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UPPER EXTREMITY ANY JOINT WO RIGHT	$900.00	$2,335.00	$175.37–$1,214.20	—	61%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SPINE (5V-OM)	$419.20	$1,048.00	$32.00–$544.96	150% above	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SPINE (5V)	$419.20	$1,048.00	$32.00–$544.96	150% above	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL SPINE (5V)	$419.20	$1,048.00	$32.00–$544.96	—	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL SPINE (5V-OM)	$419.20	$1,048.00	$32.00–$544.96	—	60%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W	$750.00	$1,751.00	$157.36–$910.52	6% below	57%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W	$750.00	$1,751.00	$157.36–$910.52	—	57%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO	$750.00	$1,048.00	$94.24–$750.00	24% above	28%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
Neck soft tissue X-ray CPT 70360 CERVICAL SPINE SOFT TISSUE	$346.40	$866.00	$10.00–$450.32	243% above	60%
Neck soft tissue X-ray inpatient CPT 70360 CERVICAL SPINE SOFT TISSUE	$346.40	$866.00	$10.00–$450.32	—	60%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO	$750.00	$1,048.00	$94.24–$750.00	15% above	28%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC (NON OB) LIMITED/FOLLOWUP	$419.20	$1,048.00	$24.00–$544.96	169% above	60%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC (NON OB) LIMITED/FOLLOWUP	$419.20	$1,048.00	$24.00–$544.96	—	60%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC	$450.00	$1,048.00	$40.00–$544.96	57% above	57%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC	$450.00	$1,048.00	$40.00–$544.96	—	57%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB COMPLETE	$419.20	$1,048.00	$56.00–$544.96	76% above	60%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB COMPLETE	$419.20	$1,048.00	$56.00–$544.96	—	60%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 1ST TRIMESTER	$419.20	$1,048.00	$42.75–$544.96	87% above	60%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB 1ST TRIMESTER	$419.20	$1,048.00	$42.75–$544.96	—	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED	$419.20	$1,048.00	$26.00–$544.96	170% above	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED	$419.20	$1,048.00	$26.00–$544.96	—	60%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS (2V) RT	$346.40	$866.00	$17.00–$450.32	223% above	60%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS (2V) LT	$346.40	$866.00	$17.00–$450.32	223% above	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS (2V) LT	$346.40	$866.00	$17.00–$450.32	—	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS (2V) RT	$346.40	$866.00	$17.00–$450.32	—	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS (3V) LT W/CHEST	$419.20	$1,048.00	$17.00–$544.96	234% above	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS (3V) RT W/CHEST	$419.20	$1,048.00	$17.00–$544.96	234% above	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS (3V) RT W/CHEST	$419.20	$1,048.00	$17.00–$544.96	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS (3V) LT W/CHEST	$419.20	$1,048.00	$17.00–$544.96	—	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER (3V) LT	$346.40	$866.00	$20.00–$450.32	204% above	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER (2V) RT	$346.40	$866.00	$20.00–$450.32	204% above	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER (3V) RT	$346.40	$866.00	$20.00–$450.32	204% above	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER (2V) LT	$346.40	$866.00	$20.00–$450.32	204% above	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER (2V) RT	$346.40	$866.00	$20.00–$450.32	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER (2V) LT	$346.40	$866.00	$20.00–$450.32	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER (3V) LT	$346.40	$866.00	$20.00–$450.32	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER (3V) RT	$346.40	$866.00	$20.00–$450.32	—	60%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES 3 VIEWS	$346.40	$866.00	$30.00–$450.32	162% above	60%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES 3 VIEWS	$346.40	$866.00	$30.00–$450.32	—	60%
Skull X-ray, fewer than 4 views CPT 70250 SKULL (2V)	$419.20	$1,048.00	$22.00–$544.96	262% above	60%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL (2V)	$419.20	$1,048.00	$22.00–$544.96	—	60%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY 4 OR MORE	$2,789.60	$6,974.00	$122.00–$3,626.48	82% above	60%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 4 OR MORE	$2,789.60	$6,974.00	$122.00–$3,626.48	—	60%
Swallow study (modified barium swallow, video X-ray) CPT 74230 BARIUM SWALLOW MODIFIED	$700.40	$1,751.00	$29.00–$910.52	237% above	60%
Swallow study (modified barium swallow, video X-ray) CPT 74230 BARIUM SWALLOW MODIFIED NO IMAGES	$700.40	$1,751.00	$29.00–$910.52	237% above	60%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BARIUM SWALLOW MODIFIED	$700.40	$1,751.00	$29.00–$910.52	—	60%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BARIUM SWALLOW MODIFIED NO IMAGES	$700.40	$1,751.00	$29.00–$910.52	—	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR (2V) LT	$346.40	$866.00	$21.18–$450.32	206% above	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR (2V) RT	$346.40	$866.00	$21.18–$450.32	206% above	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR (2V) LT	$346.40	$866.00	$21.18–$450.32	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR (2V) RT	$346.40	$866.00	$21.18–$450.32	—	60%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPINE THORACIC WO	$750.00	$1,048.00	$94.24–$750.00	8% above	28%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPINE THORACIC WO	$750.00	$1,048.00	$94.24–$750.00	—	28%
Toe X-ray, 2 or more views CPT 73660 TOES	$346.40	$866.00	$13.00–$450.32	223% above	60%
Toe X-ray, 2 or more views inpatient CPT 73660 TOES	$346.40	$866.00	$13.00–$450.32	—	60%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$450.00	$1,048.00	$68.00–$544.96	92% above	57%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$450.00	$1,048.00	$68.00–$544.96	—	57%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$419.20	$1,048.00	$58.50–$544.96	127% above	60%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL	$419.20	$1,048.00	$58.50–$544.96	—	60%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$450.00	$1,048.00	$56.00–$544.96	19% above	57%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$450.00	$1,048.00	$56.00–$544.96	—	57%
Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR	$419.20	$1,048.00	$31.00–$544.96	68% above	60%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR	$419.20	$1,048.00	$31.00–$544.96	—	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE ABDOMEN	$450.00	$1,048.00	$54.00–$544.96	92% above	57%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$450.00	$1,048.00	$54.00–$544.96	92% above	57%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE NECK	$450.00	$1,048.00	$54.00–$544.96	92% above	57%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE ABDOMEN	$450.00	$1,048.00	$54.00–$544.96	—	57%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE NECK	$450.00	$1,048.00	$54.00–$544.96	—	57%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$450.00	$1,048.00	$54.00–$544.96	—	57%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS RIGHT	$346.40	$866.00	$22.00–$450.32	185% above	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS LEFT	$346.40	$866.00	$22.00–$450.32	185% above	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS LEFT	$346.40	$866.00	$22.00–$450.32	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS RIGHT	$346.40	$866.00	$22.00–$450.32	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DOPPLER EXT RT	$660.00	$1,048.00	$73.00–$660.00	171% above	37%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DOPPLER EXT LT	$660.00	$1,048.00	$73.00–$660.00	171% above	37%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DOPPLER EXT RT	$660.00	$1,048.00	$73.00–$660.00	—	37%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DOPPLER EXT LT	$660.00	$1,048.00	$73.00–$660.00	—	37%
Wrist X-ray, 2 views one side CPT 73100 WRIST (2V) RT	$346.40	$866.00	$19.00–$450.32	223% above	60%
Wrist X-ray, 2 views one side CPT 73100 WRIST (2V) LT	$346.40	$866.00	$19.00–$450.32	223% above	60%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST (2V) LT	$346.40	$866.00	$19.00–$450.32	—	60%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST (2V) RT	$346.40	$866.00	$19.00–$450.32	—	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST (3V) LT	$250.00	$866.00	$23.00–$450.32	99% above	71%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST (3V) RT	$250.00	$866.00	$23.00–$450.32	99% above	71%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST (3V) LT	$250.00	$866.00	$23.00–$450.32	—	71%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST (3V) RT	$250.00	$866.00	$23.00–$450.32	—	71%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP (2-3V) RT WITH PELVIS	$140.00	$866.00	$27.84–$450.32	20% above	84%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP (2-3V) LT	$140.00	$866.00	$27.84–$450.32	20% above	84%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP (2-3V) RT	$140.00	$866.00	$27.84–$450.32	20% above	84%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP (2-3V) LT WITH PELVIS	$140.00	$866.00	$27.84–$450.32	20% above	84%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP (2-3V) LT WITH PELVIS	$140.00	$866.00	$27.84–$450.32	—	84%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP (2-3V) RT	$140.00	$866.00	$27.84–$450.32	—	84%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP (2-3V) LT	$140.00	$866.00	$27.84–$450.32	—	84%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP (2-3V) RT WITH PELVIS	$140.00	$866.00	$27.84–$450.32	—	84%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW	$346.40	$866.00	$20.26–$450.32	205% above	60%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW	$346.40	$866.00	$20.26–$450.32	—	60%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE (2V) RT	$346.40	$866.00	$27.53–$450.32	225% above	60%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE (2V) LT	$346.40	$866.00	$27.53–$450.32	225% above	60%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE (2V) LT	$346.40	$866.00	$27.53–$450.32	—	60%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE (2V) RT	$346.40	$866.00	$27.53–$450.32	—	60%
X-ray of the finger(s), 2 or more views CPT 73140 FINGERS (3V)	$346.40	$866.00	$16.00–$450.32	261% above	60%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGERS (3V)	$346.40	$866.00	$16.00–$450.32	—	60%
X-ray of the foot, 2 views one side CPT 73620 FOOT (2V) RT	$346.40	$866.00	$23.00–$450.32	284% above	60%
X-ray of the foot, 2 views one side CPT 73620 FOOT (2V) LT	$346.40	$866.00	$23.00–$450.32	284% above	60%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT (2V) RT	$346.40	$866.00	$23.00–$450.32	—	60%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT (2V) LT	$346.40	$866.00	$23.00–$450.32	—	60%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT (3V) RT	$250.00	$866.00	$28.00–$450.32	91% above	71%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT (3V) LT	$250.00	$866.00	$28.00–$450.32	91% above	71%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT (3V) RT	$250.00	$866.00	$28.00–$450.32	—	71%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT (3V) LT	$250.00	$866.00	$28.00–$450.32	—	71%
X-ray of the hand, 3 or more views one side CPT 73130 HAND (3V) RT	$250.00	$866.00	$25.00–$450.32	104% above	71%
X-ray of the hand, 3 or more views one side CPT 73130 HAND (3V) LT	$250.00	$866.00	$25.00–$450.32	104% above	71%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND (3V) LT	$250.00	$866.00	$25.00–$450.32	—	71%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND (3V) RT	$250.00	$866.00	$25.00–$450.32	—	71%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE (2V) LT	$255.00	$866.00	$25.00–$450.32	114% above	71%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE (2V) RT	$255.00	$866.00	$25.00–$450.32	114% above	71%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE (2V) RT	$255.00	$866.00	$25.00–$450.32	—	71%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE (2V) LT	$255.00	$866.00	$25.00–$450.32	—	71%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE (3V)	$250.00	$1,048.00	$28.00–$544.96	97% above	76%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE (3V)	$250.00	$1,048.00	$28.00–$544.96	—	76%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE (5V)	$419.20	$1,048.00	$40.00–$544.96	156% above	60%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE (5V)	$419.20	$1,048.00	$40.00–$544.96	—	60%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE (2V)	$419.20	$1,048.00	$24.00–$544.96	215% above	60%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE (2V)	$419.20	$1,048.00	$24.00–$544.96	—	60%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES	$346.40	$866.00	$23.00–$450.32	223% above	60%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES	$346.40	$866.00	$23.00–$450.32	—	60%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE (2V)	$250.00	$866.00	$28.00–$450.32	108% above	71%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE (2V)	$250.00	$866.00	$28.00–$450.32	—	71%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS (1V)	$419.20	$1,048.00	$21.00–$544.96	270% above	60%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS (1V)	$419.20	$1,048.00	$21.00–$544.96	—	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX (2V)	$346.40	$866.00	$17.00–$450.32	203% above	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM/COCCYX (2V)	$346.40	$866.00	$17.00–$450.32	—	60%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
ACTH blood test CPT 82024 ACTH, PLASMA 211 QT	$154.80	$387.00	$23.66–$201.24	68% above	60%
ACTH blood test inpatient CPT 82024 ACTH, PLASMA 211 QT	$154.80	$387.00	$23.66–$201.24	—	60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT & AST - GRV	$21.20	$53.00	$4.71–$27.56	1% above	60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) - GRV	$21.20	$53.00	$4.71–$27.56	1% above	60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 CHG ALT 84460	$21.20	$53.00	$4.71–$27.56	1% above	60%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT & AST - GRV	$21.20	$53.00	$4.71–$27.56	—	60%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 CHG ALT 84460	$21.20	$53.00	$4.71–$27.56	—	60%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) - GRV	$21.20	$53.00	$4.71–$27.56	—	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 CHG 84450 Transferase(ast)(sgot)	$20.80	$52.00	$4.61–$27.04	12% above	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) - GRV	$20.80	$52.00	$4.61–$27.04	12% above	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 Liver Fibrosis,Fibrosis-4IndexPL30555 QT	$21.60	$54.00	$4.61–$28.08	17% above	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT) - GRV	$20.80	$52.00	$4.61–$27.04	—	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 CHG 84450 Transferase(ast)(sgot)	$20.80	$52.00	$4.61–$27.04	—	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Liver Fibrosis,Fibrosis-4IndexPL30555 QT	$21.60	$54.00	$4.61–$28.08	—	60%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE w/RFX CONF10306 QT	$190.80	$477.00	$42.37–$248.04	at median	60%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE w/RFX CONF10306 QT	$190.80	$477.00	$42.37–$248.04	—	60%
Albumin blood test CPT 82040 Albumin 223 QT	$6.80	$17.00	$4.40–$8.84	69% below	60%
Albumin blood test CPT 82040 TESTOST FREE BIO TTL MALE(adult)30741 QT	$20.00	$50.00	$4.40–$26.00	10% below	60%
Albumin blood test CPT 82040 ALBUMIN - GRV	$20.00	$50.00	$4.40–$26.00	10% below	60%
Albumin blood test CPT 82040 Testosterone,Free,Bio &Total,MS 14966 QT	$20.00	$50.00	$4.40–$26.00	10% below	60%
Albumin blood test inpatient CPT 82040 Albumin 223 QT	$6.80	$17.00	$4.40–$8.84	—	60%
Albumin blood test inpatient CPT 82040 ALBUMIN - GRV	$20.00	$50.00	$4.40–$26.00	—	60%
Albumin blood test inpatient CPT 82040 TESTOST FREE BIO TTL MALE(adult)30741 QT	$20.00	$50.00	$4.40–$26.00	—	60%
Albumin blood test inpatient CPT 82040 Testosterone,Free,Bio &Total,MS 14966 QT	$20.00	$50.00	$4.40–$26.00	—	60%
Aldosterone blood test CPT 82088 Aldosterone/Plasma Renin Ratio 16845 QT	$163.20	$408.00	$36.25–$212.16	63% above	60%
Aldosterone blood test CPT 82088 Aldosterone, LC/MS/MS 17181 QT	$163.20	$408.00	$36.25–$212.16	63% above	60%
Aldosterone blood test inpatient CPT 82088 Aldosterone/Plasma Renin Ratio 16845 QT	$163.20	$408.00	$36.25–$212.16	—	60%
Aldosterone blood test inpatient CPT 82088 Aldosterone, LC/MS/MS 17181 QT	$163.20	$408.00	$36.25–$212.16	—	60%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS ISOENZYME 231 QT	$6.80	$17.00	$4.61–$8.84	68% below	60%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHOTASE - GRV	$20.80	$52.00	$4.61–$27.04	1% below	60%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOS ISOENZYME 231 QT	$6.80	$17.00	$4.61–$8.84	—	60%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHOTASE - GRV	$20.80	$52.00	$4.61–$27.04	—	60%
Allergy blood test, specific IgE, per allergen CPT 86003 English Plantain (w9) IgE 2409 QT	$6.80	$17.00	$4.64–$8.84	55% below	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Latex (k82) IgE 8927 QT	$6.80	$17.00	$4.64–$8.84	55% below	60%
Allergy blood test, specific IgE, per allergen CPT 86003 COMMON RAGWEED (SHORT) (w1) IgE 2401 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL 15 CEREAL GROUP 7915 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN (f79) IgE 2854 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Cocoa (f93) IgE 2875 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL 18 NUT MIX GROUP 7918 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific IgE Lactase 14779 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CHG 86003 X11 Resp Allergy 10651 QTb	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CHG 86003 X8 Resp Allergy QTb	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CHG 86003 (x11) Allg spec ige QTb	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Egg Mix (Yolk & White)(f245) IgE 2919 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CHG 86003 Allg spc ige crud ea x10 91682	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 COW'S MILK (f2) IgE 2802 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CHG 86003 Allg spec ige crud ea x4 91682	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Food Allergy Profile w/Reflexes 91682 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Tetanus Toxoid (rc208) IgE 93395 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Panel, Animal Group 94216 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Penicilloyl V (c2) IgE 703 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Cat Dander (e1) IgE 2601 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL REGION 5 TREES 7975 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CHG 86003 Allg Spec IgE each	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CHG 86003 Allg Spec IgE Crude1101697	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Chicken Meat (f83) IgE 2857 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL 19 SEAFOOD GROUP 7919 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy-Shellfish Panel 11270 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CHG 86003 Allg Spec IgE Crude 1101696	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE 10715 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 AVOCADO (F96) IGE 8928 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Cocchi Ex(Dactyl Coc)(f340) IgE 10625 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 PORK (SUS SPP) IGE 2826 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 BEEF (BOS SPP) IGE 2827 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ONION IgE 2848 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Wheat (F4) IgE 2804 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CHG 86003 X1 Child Allerg Food/10659 QTb	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL 16 VEGETABLE GROUP 7916 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CORN, GRASS (g202) IgE 3490 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 RYE (f5) IgE 2805 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER (e5) IgE 2605 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS (g6) IgE 2306 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS (COCKSFOOT) IgE 2303 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS (g2) IgE 2302 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PAN REG 6 GRASSES 7956 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL REG 6 WEEDS 7986 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL 14 PEDIATRIC GROUP 7914 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL 17 SALAD GROUP 7917 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL 11 MOLD GROUP 7911 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CHG 86003 Allg Spec IgE Crude ea	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Food/Tree Nut Allerg Pw/Rx Com 36763 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Banana (f92) IgE 8926 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy PL 13 StingingInsect Gp 7913 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Food/Tree Nut Allergy Panel 36762 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Childhood/TreeNutAllerg Pw/RxCom36766 QT	$21.20	$53.00	$4.64–$27.56	41% above	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Latex (k82) IgE 8927 QT	$6.80	$17.00	$4.64–$8.84	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 English Plantain (w9) IgE 2409 QT	$6.80	$17.00	$4.64–$8.84	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN, GRASS (g202) IgE 3490 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Banana (f92) IgE 8926 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORCHARD GRASS (COCKSFOOT) IgE 2303 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL 16 VEGETABLE GROUP 7916 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Childhood/TreeNutAllerg Pw/RxCom36766 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG 86003 X8 Resp Allergy QTb	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN (f79) IgE 2854 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG 86003 Allg Spec IgE Crude ea	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food/Tree Nut Allerg Pw/Rx Com 36763 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy-Shellfish Panel 11270 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL 19 SEAFOOD GROUP 7919 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY PROFILE 10715 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AVOCADO (F96) IGE 8928 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cocchi Ex(Dactyl Coc)(f340) IgE 10625 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chicken Meat (f83) IgE 2857 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG 86003 Allg Spec IgE Crude 1101696	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG 86003 Allg Spec IgE Crude1101697	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL REGION 5 TREES 7975 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cat Dander (e1) IgE 2601 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK (SUS SPP) IGE 2826 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEEF (BOS SPP) IGE 2827 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG 86003 Allg Spec IgE each	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ONION IgE 2848 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Wheat (F4) IgE 2804 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG 86003 X1 Child Allerg Food/10659 QTb	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE (f5) IgE 2805 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG 86003 X11 Resp Allergy 10651 QTb	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER (e5) IgE 2605 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Specific IgE Lactase 14779 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON RAGWEED (SHORT) (w1) IgE 2401 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicilloyl V (c2) IgE 703 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL 15 CEREAL GROUP 7915 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy Panel, Animal Group 94216 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tetanus Toxoid (rc208) IgE 93395 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS (g6) IgE 2306 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL 18 NUT MIX GROUP 7918 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS (g2) IgE 2302 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PAN REG 6 GRASSES 7956 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy PL 13 StingingInsect Gp 7913 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL REG 6 WEEDS 7986 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL 14 PEDIATRIC GROUP 7914 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food/Tree Nut Allergy Panel 36762 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL 17 SALAD GROUP 7917 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cocoa (f93) IgE 2875 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food Allergy Profile w/Reflexes 91682 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG 86003 Allg spec ige crud ea x4 91682	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COW'S MILK (f2) IgE 2802 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG 86003 Allg spc ige crud ea x10 91682	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg Mix (Yolk & White)(f245) IgE 2919 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG 86003 (x11) Allg spec ige QTb	$21.20	$53.00	$4.64–$27.56	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL 11 MOLD GROUP 7911 QT	$21.20	$53.00	$4.64–$27.56	—	60%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN, TUMOR MARKER 237 QT	$67.20	$168.00	$14.92–$87.36	19% below	60%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN, TUMOR MARKER 237 QT	$67.20	$168.00	$14.92–$87.36	—	60%
Ammonia blood test CPT 82140 Stone Risk Diagnositc Profile 442 QT	$19.20	$48.00	$12.49–$24.96	65% below	60%
Ammonia blood test CPT 82140 AMMONIA 5509 QT	$58.40	$146.00	$12.49–$75.92	7% above	60%
Ammonia blood test CPT 82140 AMMONIA-GRV	$58.40	$146.00	$12.49–$75.92	7% above	60%
Ammonia blood test inpatient CPT 82140 Stone Risk Diagnositc Profile 442 QT	$19.20	$48.00	$12.49–$24.96	—	60%
Ammonia blood test inpatient CPT 82140 AMMONIA 5509 QT	$58.40	$146.00	$12.49–$75.92	—	60%
Ammonia blood test inpatient CPT 82140 AMMONIA-GRV	$58.40	$146.00	$12.49–$75.92	—	60%
Amylase blood test CPT 82150 AMYLASE - GRV	$45.00	$65.00	$5.76–$45.00	71% above	31%
Amylase blood test CPT 82150 AMYLASE 243 QT	$45.00	$65.00	$5.76–$45.00	71% above	31%
Amylase blood test CPT 82150 AMYLASE, RANDOM URINE (WCREAT) 8464 QT	$45.00	$22.00	$5.76–$45.00	71% above	-105%
Amylase blood test inpatient CPT 82150 AMYLASE - GRV	$45.00	$65.00	$5.76–$45.00	—	31%
Amylase blood test inpatient CPT 82150 AMYLASE 243 QT	$45.00	$65.00	$5.76–$45.00	—	31%
Amylase blood test inpatient CPT 82150 AMYLASE, RANDOM URINE (WCREAT) 8464 QT	$45.00	$22.00	$5.76–$45.00	—	-105%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Rheumatoid Arthritis Diag PL 3 19878 QT	$17.20	$43.00	$11.52–$22.36	62% below	60%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic CitrullinatedPeptide IgG 11173 QT	$52.00	$130.00	$11.52–$67.60	15% above	60%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CHG 86200 Ccp antibody	$52.00	$130.00	$11.52–$67.60	15% above	60%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Rheumatoid Arthritis Diag PL 1 17669 QT	$52.00	$130.00	$11.52–$67.60	15% above	60%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Rheumatoid Arthritis Diag PL 3 19878 QT	$17.20	$43.00	$11.52–$22.36	—	60%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CHG 86200 Ccp antibody	$52.00	$130.00	$11.52–$67.60	—	60%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Rheumatoid Arthritis Diag PL 1 17669 QT	$52.00	$130.00	$11.52–$67.60	—	60%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic CitrullinatedPeptide IgG 11173 QT	$52.00	$130.00	$11.52–$67.60	—	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Lupus Pnl 2w/ANA,IFAw/Rx Tit Pat29839 QT	$16.00	$40.00	$10.75–$20.80	65% below	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CENTROMERE B ANTIBODY 16088 QT	$16.00	$40.00	$10.75–$20.80	65% below	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Mixed Conn Tiss Dis Pnl (RNP AB 19875 QT	$16.00	$40.00	$10.75–$20.80	65% below	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Sjogren's Pn w/RheuFact ANA,IFA 90077QT	$16.00	$40.00	$10.75–$20.80	65% below	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA MULTIPLEX w/RFX to dsDNA 10547 QT	$48.40	$121.00	$10.75–$62.92	7% above	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Lupus Pnl 3w/ANA,IFAw/Rlx Tit Pa 19881QT	$48.40	$121.00	$10.75–$62.92	7% above	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA ScrnIFA T/P RX Mplx 11Ab Cas94954 QT	$48.40	$121.00	$10.75–$62.92	7% above	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA MULTI RFX 11 ABY CASCADE 19946 QT	$48.40	$121.00	$10.75–$62.92	7% above	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Cascade(ANA,IFAw/Rx Tit/Pat 16814 QT	$48.40	$121.00	$10.75–$62.92	7% above	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Lupus Pnl 1w/ANA,IFA w/RfxTi Pa 90072 QT	$48.40	$121.00	$10.75–$62.92	7% above	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCR RFX RA PANEL 1 90071 QT	$48.40	$121.00	$10.75–$62.92	7% above	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CHG 86038 Antinuclear antibodies	$48.40	$121.00	$10.75–$62.92	7% above	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA IFA SCRN W/REFL TITER & PATTE 249 QT	$48.40	$121.00	$10.75–$62.92	7% above	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CENTROMERE B ANTIBODY 16088 QT	$16.00	$40.00	$10.75–$20.80	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Mixed Conn Tiss Dis Pnl (RNP AB 19875 QT	$16.00	$40.00	$10.75–$20.80	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Lupus Pnl 2w/ANA,IFAw/Rx Tit Pat29839 QT	$16.00	$40.00	$10.75–$20.80	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Sjogren's Pn w/RheuFact ANA,IFA 90077QT	$16.00	$40.00	$10.75–$20.80	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Cascade(ANA,IFAw/Rx Tit/Pat 16814 QT	$48.40	$121.00	$10.75–$62.92	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCR RFX RA PANEL 1 90071 QT	$48.40	$121.00	$10.75–$62.92	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA IFA SCRN W/REFL TITER & PATTE 249 QT	$48.40	$121.00	$10.75–$62.92	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Lupus Pnl 3w/ANA,IFAw/Rlx Tit Pa 19881QT	$48.40	$121.00	$10.75–$62.92	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA ScrnIFA T/P RX Mplx 11Ab Cas94954 QT	$48.40	$121.00	$10.75–$62.92	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA MULTIPLEX w/RFX to dsDNA 10547 QT	$48.40	$121.00	$10.75–$62.92	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA MULTI RFX 11 ABY CASCADE 19946 QT	$48.40	$121.00	$10.75–$62.92	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CHG 86038 Antinuclear antibodies	$48.40	$121.00	$10.75–$62.92	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Lupus Pnl 1w/ANA,IFA w/RfxTi Pa 90072 QT	$48.40	$121.00	$10.75–$62.92	—	60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP, Pro - NT II GRV	$215.00	$393.00	$34.92–$215.00	236% above	45%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP 37386 QT	$215.00	$194.00	$34.92–$215.00	236% above	-11%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP, Pro - NT II GRV	$215.00	$393.00	$34.92–$215.00	—	45%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP 37386 QT	$215.00	$194.00	$34.92–$215.00	—	-11%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EAR EXTERNAL 4477 QT	$11.60	$29.00	$7.67–$15.08	70% below	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE 4480 QT	$11.60	$29.00	$7.67–$15.08	70% below	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL 4558 QT	$34.80	$87.00	$7.67–$45.24	10% below	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC BACTERIA 4550 QT	$34.80	$87.00	$7.67–$45.24	10% below	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF 388 QT	$34.80	$87.00	$7.67–$45.24	10% below	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CHG 87070 CULTURE OTHER SPEC. AEROBIC	$34.80	$87.00	$7.67–$45.24	10% below	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE THROAT 394 QT	$34.80	$87.00	$7.67–$45.24	10% below	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Throat Spec w/Grp A Str 14541 QT	$34.80	$87.00	$7.67–$45.24	10% below	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM/LR W/GRAM STAIN 4556 QT	$34.80	$87.00	$7.67–$45.24	10% below	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EAR EXTERNAL 4477 QT	$11.60	$29.00	$7.67–$15.08	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EYE 4480 QT	$11.60	$29.00	$7.67–$15.08	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CHG 87070 CULTURE OTHER SPEC. AEROBIC	$34.80	$87.00	$7.67–$45.24	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SPUTUM/LR W/GRAM STAIN 4556 QT	$34.80	$87.00	$7.67–$45.24	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GENITAL 4558 QT	$34.80	$87.00	$7.67–$45.24	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Throat Spec w/Grp A Str 14541 QT	$34.80	$87.00	$7.67–$45.24	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF 388 QT	$34.80	$87.00	$7.67–$45.24	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE THROAT 394 QT	$34.80	$87.00	$7.67–$45.24	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC BACTERIA 4550 QT	$34.80	$87.00	$7.67–$45.24	—	60%
Basic metabolic panel (blood test) CPT 80048 BASIC METAB PAN 10165 QT	$55.00	$28.00	$7.53–$55.00	41% below	-96%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL - GRV	$55.00	$85.00	$7.53–$55.00	41% below	35%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METAB PAN 10165 QT	$55.00	$28.00	$7.53–$55.00	—	-96%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL - GRV	$55.00	$85.00	$7.53–$55.00	—	35%
Bilirubin blood test, total CPT 82247 BILIRUBIN BODY FLUID 93806 QT	$20.40	$51.00	$4.47–$26.52	48% below	60%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL - GRV	$20.40	$51.00	$4.47–$26.52	48% below	60%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL - GRV	$20.40	$51.00	$4.47–$26.52	—	60%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN BODY FLUID 93806 QT	$20.40	$51.00	$4.47–$26.52	—	60%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CHG 88305 Path TISSU Gross/MicrEX LVL IV	$107.20	$268.00	$28.00–$139.36	39% above	60%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CHG 88305 Path TISSU Gross/MicrEX LVL IV	$107.20	$268.00	$28.00–$139.36	—	60%
Blood culture for bacteria CPT 87040 CULTURE BLOOD 389 QT	$41.60	$104.00	$9.18–$54.08	16% below	60%
Blood culture for bacteria CPT 87040 Culture Blood w/Rx to Molec ID 13954 QT	$41.60	$104.00	$9.18–$54.08	16% below	60%
Blood culture for bacteria inpatient CPT 87040 Culture Blood w/Rx to Molec ID 13954 QT	$41.60	$104.00	$9.18–$54.08	—	60%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD 389 QT	$41.60	$104.00	$9.18–$54.08	—	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 CHG VENIPUNCTURE COLLECTION	$10.00	$32.00	$8.31–$16.64	11% above	69%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE; BLOOD COLLECTION	$10.00	$32.00	$8.31–$16.64	11% above	69%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION OF VENOUS BLOOD BY VENIPU	$10.00	$32.00	$8.31–$16.64	11% above	69%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION OF VENOUS BLOOD BY VENIPU	$10.00	$32.00	$8.31–$16.64	—	69%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE; BLOOD COLLECTION	$10.00	$32.00	$8.31–$16.64	—	69%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 CHG VENIPUNCTURE COLLECTION	$10.00	$32.00	$8.31–$16.64	—	69%
Blood glucose (sugar) test CPT 82947 C GLUCOSE	$15.20	$38.00	$3.50–$19.76	18% below	60%
Blood glucose (sugar) test CPT 82947 GLUCOSE - GRV	$16.00	$40.00	$3.50–$20.80	14% below	60%
Blood glucose (sugar) test inpatient CPT 82947 C GLUCOSE	$15.20	$38.00	$3.50–$19.76	—	60%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE - GRV	$16.00	$40.00	$3.50–$20.80	—	60%
Blood lead test CPT 83655 LEAD - GRV	$43.60	$109.00	$10.77–$56.68	47% above	60%
Blood lead test CPT 83655 LEAD BLOOD (VENOUS) 599 QT	$48.80	$122.00	$10.77–$63.44	64% above	60%
Blood lead test CPT 83655 Lead, Capillary 39027 QT	$48.80	$122.00	$10.77–$63.44	64% above	60%
Blood lead test CPT 83655 CHG 83655 Assay of Lead	$48.80	$122.00	$10.77–$63.44	64% above	60%
Blood lead test inpatient CPT 83655 LEAD - GRV	$43.60	$109.00	$10.77–$56.68	—	60%
Blood lead test inpatient CPT 83655 Lead, Capillary 39027 QT	$48.80	$122.00	$10.77–$63.44	—	60%
Blood lead test inpatient CPT 83655 CHG 83655 Assay of Lead	$48.80	$122.00	$10.77–$63.44	—	60%
Blood lead test inpatient CPT 83655 LEAD BLOOD (VENOUS) 599 QT	$48.80	$122.00	$10.77–$63.44	—	60%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO RE-TYPE	$487.20	$1,218.00	$2.66–$633.36	733% above	60%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO TYPING	$487.20	$1,218.00	$2.66–$633.36	733% above	60%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO TYPING	$487.20	$1,218.00	$2.66–$633.36	—	60%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO RE-TYPE	$487.20	$1,218.00	$2.66–$633.36	—	60%
Blood urea nitrogen (BUN) test CPT 84520 BUN - GRV	$16.00	$40.00	$3.51–$20.80	37% below	60%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN - GRV	$16.00	$40.00	$3.51–$20.80	—	60%
C-peptide blood test CPT 84681 C-PEPTIDE 372 QT	$83.60	$209.00	$18.51–$108.68	34% above	60%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE 372 QT	$83.60	$209.00	$18.51–$108.68	—	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN 4420 QT	$40.00	$17.00	$4.61–$40.00	39% above	-135%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN GRV	$40.00	$52.00	$4.61–$40.00	39% above	23%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN 4420 QT	$40.00	$17.00	$4.61–$40.00	—	-135%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN GRV	$40.00	$52.00	$4.61–$40.00	—	23%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium diff ToxB Qua RTPCR 16377 QT	$149.20	$373.00	$33.15–$193.96	68% above	60%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium diff ToxB Qua RTPCR 16377 QT	$149.20	$373.00	$33.15–$193.96	—	60%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 4698 QT	$83.60	$209.00	$18.51–$108.68	34% above	60%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 4698 QT	$83.60	$209.00	$18.51–$108.68	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 SARS Cov-2 VirusQLSwab ID NOW RT IA	$205.60	$514.00	$45.64–$267.28	111% above	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 SARS Cov-2 VirusQLSwab ID NOW RT IA	$205.60	$514.00	$45.64–$267.28	—	60%
Calcium blood test, total CPT 82310 Calcium 303 QT	$6.80	$17.00	$4.59–$8.84	66% below	60%
Calcium blood test, total CPT 82310 PTH INTACT & IONIZED CALCIUM 36736 QT	$20.80	$52.00	$4.59–$27.04	5% above	60%
Calcium blood test, total CPT 82310 CALCIUM - GRV	$20.80	$52.00	$4.59–$27.04	5% above	60%
Calcium blood test, total CPT 82310 CHG 82310 ASSAY OF CALCIUM	$20.80	$52.00	$4.59–$27.04	5% above	60%
Calcium blood test, total inpatient CPT 82310 Calcium 303 QT	$6.80	$17.00	$4.59–$8.84	—	60%
Calcium blood test, total inpatient CPT 82310 PTH INTACT & IONIZED CALCIUM 36736 QT	$20.80	$52.00	$4.59–$27.04	—	60%
Calcium blood test, total inpatient CPT 82310 CHG 82310 ASSAY OF CALCIUM	$20.80	$52.00	$4.59–$27.04	—	60%
Calcium blood test, total inpatient CPT 82310 CALCIUM - GRV	$20.80	$52.00	$4.59–$27.04	—	60%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA 978 QT	$76.00	$190.00	$16.86–$98.80	26% above	60%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA 978 QT	$76.00	$190.00	$16.86–$98.80	—	60%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER VIRUS ANTIB(IGG)4439 QT	$16.80	$42.00	$11.46–$21.84	51% below	60%
Chickenpox (varicella) immunity blood test CPT 86787 CHG 86787 Varecella-Zoster Antibodies	$51.60	$129.00	$11.46–$67.08	50% above	60%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOST AB(IMMUNITY SCR)14505 QT	$51.60	$129.00	$11.46–$67.08	50% above	60%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster AB IgG IgM 34128 QT	$51.60	$129.00	$11.46–$67.08	50% above	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER VIRUS ANTIB(IGG)4439 QT	$16.80	$42.00	$11.46–$21.84	—	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOST AB(IMMUNITY SCR)14505 QT	$51.60	$129.00	$11.46–$67.08	—	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 CHG 86787 Varecella-Zoster Antibodies	$51.60	$129.00	$11.46–$67.08	—	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster AB IgG IgM 34128 QT	$51.60	$129.00	$11.46–$67.08	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMY/TRCH TMA UROGENITAL 15031 QT	$46.00	$115.00	$31.21–$59.80	27% below	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 SUREPATH IMAGPAP RX HPV DNA&CHL 92251 QT	$46.00	$115.00	$31.21–$59.80	27% below	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlam/Ne gon w/Rx AlterTarg uro 91773 QT	$140.40	$351.00	$31.21–$182.52	123% above	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 ThinPrep (TIS) Chlamydia/NG 58355 QT	$140.40	$351.00	$31.21–$182.52	123% above	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/N. GONORRHOEAE RNA,TMA 11363QT	$140.40	$351.00	$31.21–$182.52	123% above	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Sureswab Adv Vaginiti(BV),CT/NG 10123 QT	$140.40	$351.00	$31.21–$182.52	123% above	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHG 87491 Chylmd trach dna amp probe	$140.40	$351.00	$31.21–$182.52	123% above	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis N Gonorrhea GRV	$140.40	$351.00	$31.21–$182.52	123% above	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 SUREPATH IMAGPAP RX HPV DNA&CHL 92251 QT	$46.00	$115.00	$31.21–$59.80	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMY/TRCH TMA UROGENITAL 15031 QT	$46.00	$115.00	$31.21–$59.80	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis N Gonorrhea GRV	$140.40	$351.00	$31.21–$182.52	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlam/Ne gon w/Rx AlterTarg uro 91773 QT	$140.40	$351.00	$31.21–$182.52	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Sureswab Adv Vaginiti(BV),CT/NG 10123 QT	$140.40	$351.00	$31.21–$182.52	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/N. GONORRHOEAE RNA,TMA 11363QT	$140.40	$351.00	$31.21–$182.52	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHG 87491 Chylmd trach dna amp probe	$140.40	$351.00	$31.21–$182.52	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 ThinPrep (TIS) Chlamydia/NG 58355 QT	$140.40	$351.00	$31.21–$182.52	—	60%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIO IQ(R) ADV LIPID PANEL 92145 QT	$85.00	$134.00	$11.91–$85.00	19% above	37%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL - GRV	$85.00	$134.00	$11.91–$85.00	19% above	37%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL 7600 QT	$85.00	$44.00	$11.91–$85.00	19% above	-93%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CHG 80061 LIPID	$85.00	$44.00	$11.91–$85.00	19% above	-93%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CHG 80061 LIPID	$85.00	$44.00	$11.91–$85.00	—	-93%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIO IQ(R) ADV LIPID PANEL 92145 QT	$85.00	$134.00	$11.91–$85.00	—	37%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL 7600 QT	$85.00	$44.00	$11.91–$85.00	—	-93%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL - GRV	$85.00	$134.00	$11.91–$85.00	—	37%
Complete blood count (CBC) with differential CPT 85025 CHG CBC/W AUTOMATED DIFFERENTIAL - GRV	$50.00	$69.00	$6.91–$50.00	63% above	28%
Complete blood count (CBC) with differential CPT 85025 CBC- 5 Part Diff - XN1000R	$50.00	$78.00	$6.91–$50.00	63% above	36%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC- 5 Part Diff - XN1000R	$50.00	$78.00	$6.91–$50.00	—	36%
Complete blood count (CBC) with differential inpatient CPT 85025 CHG CBC/W AUTOMATED DIFFERENTIAL - GRV	$50.00	$69.00	$6.91–$50.00	—	28%
Complete blood count (CBC), no differential CPT 85027 C H & H - CLINIC	$45.00	$24.00	$5.75–$45.00	88% above	-88%
Complete blood count (CBC), no differential CPT 85027 CHG HEMOGRAM/WPLATELETS	$45.00	$65.00	$5.75–$45.00	88% above	31%
Complete blood count (CBC), no differential CPT 85027 C HEMOGLOBIN	$45.00	$22.00	$5.75–$45.00	88% above	-105%
Complete blood count (CBC), no differential CPT 85027 HEMOGLOBIN AND HEMATOCRIT-GRV	$45.00	$24.00	$5.75–$45.00	88% above	-88%
Complete blood count (CBC), no differential CPT 85027 CBC NO DIFF HEMOGRAM/PLT ONLY-GRV	$45.00	$65.00	$5.75–$45.00	88% above	31%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGLOBIN AND HEMATOCRIT-GRV	$45.00	$24.00	$5.75–$45.00	—	-88%
Complete blood count (CBC), no differential inpatient CPT 85027 CHG HEMOGRAM/WPLATELETS	$45.00	$65.00	$5.75–$45.00	—	31%
Complete blood count (CBC), no differential inpatient CPT 85027 C H & H - CLINIC	$45.00	$24.00	$5.75–$45.00	—	-88%
Complete blood count (CBC), no differential inpatient CPT 85027 C HEMOGLOBIN	$45.00	$22.00	$5.75–$45.00	—	-105%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC NO DIFF HEMOGRAM/PLT ONLY-GRV	$45.00	$65.00	$5.75–$45.00	—	31%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PLASMA 90839 QT	$70.00	$35.00	$9.39–$70.00	48% below	-100%
Comprehensive metabolic panel (blood test) CPT 80053 OCH CMP, LIPID, TSH PANEL	$70.00	$35.00	$9.39–$70.00	48% below	-100%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL - GRV	$70.00	$106.00	$9.39–$70.00	48% below	34%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE META PANEL SERUM 10231 QT	$70.00	$35.00	$9.39–$70.00	48% below	-100%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL - GRV	$70.00	$106.00	$9.39–$70.00	—	34%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE META PANEL SERUM 10231 QT	$70.00	$35.00	$9.39–$70.00	—	-100%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PLASMA 90839 QT	$70.00	$35.00	$9.39–$70.00	—	-100%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 OCH CMP, LIPID, TSH PANEL	$70.00	$35.00	$9.39–$70.00	—	-100%
Cortisol blood test, total CPT 82533 CORTISOL, TOTAL 367 QT	$65.20	$163.00	$14.50–$84.76	12% above	60%
Cortisol blood test, total CPT 82533 CHG 82533 CHG Total Cortisol	$65.20	$163.00	$14.50–$84.76	12% above	60%
Cortisol blood test, total CPT 82533 CORTISOL P.M. 4213 QT	$65.20	$163.00	$14.50–$84.76	12% above	60%
Cortisol blood test, total CPT 82533 CORTISOL, AM 4212 QT	$65.20	$163.00	$14.50–$84.76	12% above	60%
Cortisol blood test, total inpatient CPT 82533 CHG 82533 CHG Total Cortisol	$65.20	$163.00	$14.50–$84.76	—	60%
Cortisol blood test, total inpatient CPT 82533 CORTISOL, TOTAL 367 QT	$65.20	$163.00	$14.50–$84.76	—	60%
Cortisol blood test, total inpatient CPT 82533 CORTISOL, AM 4212 QT	$65.20	$163.00	$14.50–$84.76	—	60%
Cortisol blood test, total inpatient CPT 82533 CORTISOL P.M. 4213 QT	$65.20	$163.00	$14.50–$84.76	—	60%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE - GRV	$45.00	$66.00	$5.79–$45.00	29% above	32%
Creatine kinase (CK) blood test, total CPT 82550 Cardiac CREATINE KINASE, TOTAL 374 QT	$45.00	$22.00	$5.79–$45.00	29% above	-105%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE - GRV	$45.00	$66.00	$5.79–$45.00	—	32%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Cardiac CREATINE KINASE, TOTAL 374 QT	$45.00	$22.00	$5.79–$45.00	—	-105%
Creatinine blood test CPT 82565 CREATININE - GRV	$20.80	$52.00	$4.55–$27.04	2% above	60%
Creatinine blood test inpatient CPT 82565 CREATININE - GRV	$20.80	$52.00	$4.55–$27.04	—	60%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS ANTIBOD(IgG,IgM) 6732 QT	$57.60	$144.00	$12.80–$74.88	11% above	60%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS ANTIBODY (IGG) 403 QT	$57.60	$144.00	$12.80–$74.88	11% above	60%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS ANTIBODY (IGG) 403 QT	$57.60	$144.00	$12.80–$74.88	—	60%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS ANTIBOD(IgG,IgM) 6732 QT	$57.60	$144.00	$12.80–$74.88	—	60%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANTITATIVE 8659 QT	$40.80	$102.00	$9.05–$53.04	17% below	60%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANTITATIVE 8659 QT	$40.80	$102.00	$9.05–$53.04	—	60%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE 402 QT	$89.20	$223.00	$19.77–$115.96	34% above	60%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE 402 QT	$89.20	$223.00	$19.77–$115.96	—	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN 10 PL VITROS	$50.00	$622.00	$50.00–$323.44	11% below	92%
Drug screen by lab instrument (any number of drug classes) CPT 80307 CHG 80307 Drug Presumptive Chem Analyzer	$50.00	$622.00	$50.00–$323.44	11% below	92%
Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMINE screen W/CONF URINE 16885 QT	$50.00	$202.00	$50.00–$105.04	11% below	75%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BARBITURATE Screen W/CONF URINE 16886 QT	$50.00	$202.00	$50.00–$105.04	11% below	75%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PM PROF 5 & CONF NO MM 90318	$50.00	$202.00	$50.00–$105.04	11% below	75%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BENZODIAZEPINES screen W/CONF 16887 QT	$50.00	$202.00	$50.00–$105.04	11% below	75%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN 10 PL VITROS	$50.00	$622.00	$50.00–$323.44	—	92%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AMPHETAMINE screen W/CONF URINE 16885 QT	$50.00	$202.00	$50.00–$105.04	—	75%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BARBITURATE Screen W/CONF URINE 16886 QT	$50.00	$202.00	$50.00–$105.04	—	75%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BENZODIAZEPINES screen W/CONF 16887 QT	$50.00	$202.00	$50.00–$105.04	—	75%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PM PROF 5 & CONF NO MM 90318	$50.00	$202.00	$50.00–$105.04	—	75%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CHG 80307 Drug Presumptive Chem Analyzer	$50.00	$622.00	$50.00–$323.44	—	92%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES - GRV	$28.40	$71.00	$6.24–$36.92	51% below	60%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES - GRV	$28.40	$71.00	$6.24–$36.92	—	60%
Epstein-Barr virus (EBV) antibody test CPT 86665 CHG EPSTEIN BARR VIRUS VCA AB (IGG)	$23.60	$59.00	$16.14–$30.68	50% below	60%
Epstein-Barr virus (EBV) antibody test CPT 86665 CHG EPSTEIN BARR VIRUS VCA AB (IGM)	$23.60	$59.00	$16.14–$30.68	50% below	60%
Epstein-Barr virus (EBV) antibody test CPT 86665 CHG 86665 Epstein-barr caspid vca	$72.80	$182.00	$16.14–$94.64	53% above	60%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID AG (VCA) AB(IgM)8426 QT	$72.80	$182.00	$16.14–$94.64	53% above	60%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 CHG EPSTEIN BARR VIRUS VCA AB (IGM)	$23.60	$59.00	$16.14–$30.68	—	60%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 CHG EPSTEIN BARR VIRUS VCA AB (IGG)	$23.60	$59.00	$16.14–$30.68	—	60%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 CHG 86665 Epstein-barr caspid vca	$72.80	$182.00	$16.14–$94.64	—	60%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID AG (VCA) AB(IgM)8426 QT	$72.80	$182.00	$16.14–$94.64	—	60%
Estradiol blood test CPT 82670 ESTRADIOL 4021 QT	$112.00	$280.00	$24.85–$145.60	27% above	60%
Estradiol blood test inpatient CPT 82670 ESTRADIOL 4021 QT	$112.00	$280.00	$24.85–$145.60	—	60%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE 470 QT	$74.40	$186.00	$16.53–$96.72	12% above	60%
FSH (follicle-stimulating hormone) test CPT 83001 FSH AND LH 7137 QT	$74.40	$186.00	$16.53–$96.72	12% above	60%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE 470 QT	$74.40	$186.00	$16.53–$96.72	—	60%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH AND LH 7137 QT	$74.40	$186.00	$16.53–$96.72	—	60%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Stool 16796 QT	$78.80	$197.00	$17.46–$102.44	17% below	60%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Stool 16796 QT	$78.80	$197.00	$17.46–$102.44	—	60%
Ferritin blood test (iron stores) CPT 82728 FERRITIN 457 QT	$18.00	$45.00	$12.12–$23.40	64% below	60%
Ferritin blood test (iron stores) CPT 82728 FERRITIN - GRV	$54.80	$137.00	$12.12–$71.24	9% above	60%
Ferritin blood test (iron stores) CPT 82728 CHG 82728 Assay of ferritin	$54.80	$137.00	$12.12–$71.24	9% above	60%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN 457 QT	$18.00	$45.00	$12.12–$23.40	—	60%
Ferritin blood test (iron stores) inpatient CPT 82728 CHG 82728 Assay of ferritin	$54.80	$137.00	$12.12–$71.24	—	60%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN - GRV	$54.80	$137.00	$12.12–$71.24	—	60%
Fibrinogen blood test CPT 85384 Fibrinogen Activity, Clauss 461 QT	$39.20	$98.00	$8.65–$50.96	34% above	60%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen Activity, Clauss 461 QT	$39.20	$98.00	$8.65–$50.96	—	60%
Folate (folic acid) blood test CPT 82746 FOLIC ACID -GRV	$90.00	$147.00	$13.08–$90.00	69% above	39%
Folate (folic acid) blood test CPT 82746 CHG 82746 Folic Acid Serum	$90.00	$147.00	$13.08–$90.00	69% above	39%
Folate (folic acid) blood test CPT 82746 MICRONUTRIENTS B-VIT PANEL 10195 QT	$90.00	$148.00	$13.08–$90.00	69% above	39%
Folate (folic acid) blood test CPT 82746 FOLIC ACID 466 QT	$90.00	$147.00	$13.08–$90.00	69% above	39%
Folate (folic acid) blood test CPT 82746 Micronutrient Folate 10188 QT	$90.00	$147.00	$13.08–$90.00	69% above	39%
Folate (folic acid) blood test inpatient CPT 82746 Micronutrient Folate 10188 QT	$90.00	$147.00	$13.08–$90.00	—	39%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID -GRV	$90.00	$147.00	$13.08–$90.00	—	39%
Folate (folic acid) blood test inpatient CPT 82746 CHG 82746 Folic Acid Serum	$90.00	$147.00	$13.08–$90.00	—	39%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID 466 QT	$90.00	$147.00	$13.08–$90.00	—	39%
Folate (folic acid) blood test inpatient CPT 82746 MICRONUTRIENTS B-VIT PANEL 10195 QT	$90.00	$148.00	$13.08–$90.00	—	39%
Free T3 thyroid hormone test CPT 84481 T3 FREE 34429 QT	$68.00	$170.00	$15.07–$88.40	12% above	60%
Free T3 thyroid hormone test CPT 84481 T3 FREE - GRV	$68.00	$170.00	$15.07–$88.40	12% above	60%
Free T3 thyroid hormone test CPT 84481 CHG 84481 FT3	$68.00	$170.00	$15.07–$88.40	12% above	60%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE - GRV	$68.00	$170.00	$15.07–$88.40	—	60%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE 34429 QT	$68.00	$170.00	$15.07–$88.40	—	60%
Free T3 thyroid hormone test inpatient CPT 84481 CHG 84481 FT3	$68.00	$170.00	$15.07–$88.40	—	60%
Free T4 (free thyroxine) thyroid blood test CPT 84439 CHG 84439 FT4	$60.00	$91.00	$8.02–$60.00	88% above	34%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE -GRV	$60.00	$91.00	$8.02–$60.00	88% above	34%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE 866 QT	$60.00	$30.00	$8.02–$60.00	88% above	-100%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE -GRV	$60.00	$91.00	$8.02–$60.00	—	34%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE 866 QT	$60.00	$30.00	$8.02–$60.00	—	-100%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 CHG 84439 FT4	$60.00	$91.00	$8.02–$60.00	—	34%
Free testosterone test CPT 84402 TESTOSTERONE FREE 18944 QT	$102.00	$255.00	$22.66–$132.60	41% above	60%
Free testosterone test CPT 84402 TESTOSTER FREE (Dialysis)TOTAL 36170 QT	$102.00	$255.00	$22.66–$132.60	41% above	60%
Free testosterone test inpatient CPT 84402 TESTOSTER FREE (Dialysis)TOTAL 36170 QT	$102.00	$255.00	$22.66–$132.60	—	60%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE 18944 QT	$102.00	$255.00	$22.66–$132.60	—	60%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT 482 QT	$28.80	$72.00	$6.40–$37.44	24% below	60%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT 482 QT	$28.80	$72.00	$6.40–$37.44	—	60%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 5HR - GRV	$16.80	$42.00	$11.45–$21.84	64% below	60%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 2HR - GRV	$16.80	$42.00	$11.45–$21.84	64% below	60%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3HR - GRV	$51.60	$129.00	$11.45–$67.08	12% above	60%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 4HR - GRV	$51.60	$129.00	$11.45–$67.08	12% above	60%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 2HR - GRV	$16.80	$42.00	$11.45–$21.84	—	60%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 5HR - GRV	$16.80	$42.00	$11.45–$21.84	—	60%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3HR - GRV	$51.60	$129.00	$11.45–$67.08	—	60%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 4HR - GRV	$51.60	$129.00	$11.45–$67.08	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHG 87591 NEISSERIA GON. RNA,TMA	$140.40	$351.00	$31.21–$182.52	104% above	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CHG 87591 NEISSERIA GON. RNA,TMA	$140.40	$351.00	$31.21–$182.52	—	60%
H. pylori stool antigen test CPT 87338 H PYLORI ANTIG STOOL EIA 34838 QT	$57.60	$144.00	$6.12–$74.88	7% above	60%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI ANTIG STOOL EIA 34838 QT	$57.60	$144.00	$6.12–$74.88	—	60%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV RNA QN RT PCR RX GENOTYPE 91691 QT	$167.60	$419.00	$75.70–$217.88	1% below	60%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV-1 RNA, Quant RT, PCR 40085 QT	$340.80	$852.00	$75.70–$443.04	102% above	60%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HIV RNA QN RT PCR RX GENOTYPE 91691 QT	$167.60	$419.00	$75.70–$217.88	—	60%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HIV-1 RNA, Quant RT, PCR 40085 QT	$340.80	$852.00	$75.70–$443.04	—	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 AB/AG,4TH GEN,W/REFLEX 91431 QT	$96.40	$241.00	$21.42–$125.32	98% above	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIVCombo 1, 2, and p24- GRV	$96.40	$241.00	$21.42–$125.32	98% above	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 AB/AG,4TH GEN,W/REFLEX 91431 QT	$96.40	$241.00	$21.42–$125.32	—	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIVCombo 1, 2, and p24- GRV	$96.40	$241.00	$21.42–$125.32	—	60%
HPV test for high-risk types, one combined (pooled) result CPT 87624 CHG 87624 HPV high-risk types	$140.40	$351.00	$31.21–$182.52	137% above	60%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPVmRNA E6/E7,PostHYST VAG W/REF 93136QT	$140.40	$351.00	$31.21–$182.52	137% above	60%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV mRNAE6/E7 POST-HYSTER VAG 93101 QT	$140.40	$351.00	$31.21–$182.52	137% above	60%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV mRNAE6/E7 POST-HYSTER VAG 93101 QT	$140.40	$351.00	$31.21–$182.52	—	60%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPVmRNA E6/E7,PostHYST VAG W/REF 93136QT	$140.40	$351.00	$31.21–$182.52	—	60%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 CHG 87624 HPV high-risk types	$140.40	$351.00	$31.21–$182.52	—	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C 496 QT	$65.00	$98.00	$8.64–$65.00	89% above	34%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 A1C - GLYCOHEMOGLOBIN A1C - GRV	$65.00	$98.00	$8.64–$65.00	89% above	34%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 A1C - GLYCOHEMOGLOBIN A1C - GRV	$65.00	$98.00	$8.64–$65.00	—	34%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C 496 QT	$65.00	$98.00	$8.64–$65.00	—	34%
Hemoglobin blood test CPT 85018 CHG 85018 Hemoglobin	$9.60	$24.00	$2.11–$12.48	19% below	60%
Hemoglobin blood test inpatient CPT 85018 CHG 85018 Hemoglobin	$9.60	$24.00	$2.11–$12.48	—	60%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB TOTAL 501 QT	$16.00	$40.00	$10.72–$20.80	52% below	60%
Hepatitis B core antibody test (total) CPT 86704 CSR Hepatitis PL General(refl) 93323 QT	$16.00	$40.00	$10.72–$20.80	52% below	60%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTALw/RFX to IgM 37676 QT	$48.40	$121.00	$10.72–$62.92	44% above	60%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY - GRV	$48.40	$121.00	$10.72–$62.92	44% above	60%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis Panel General 6462 QT	$48.40	$121.00	$10.72–$62.92	44% above	60%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis Panel (REFL) 6519 QT	$48.40	$121.00	$10.72–$62.92	44% above	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB TOTAL 501 QT	$16.00	$40.00	$10.72–$20.80	—	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 CSR Hepatitis PL General(refl) 93323 QT	$16.00	$40.00	$10.72–$20.80	—	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB TOTALw/RFX to IgM 37676 QT	$48.40	$121.00	$10.72–$62.92	—	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY - GRV	$48.40	$121.00	$10.72–$62.92	—	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis Panel General 6462 QT	$48.40	$121.00	$10.72–$62.92	—	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis Panel (REFL) 6519 QT	$48.40	$121.00	$10.72–$62.92	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY IMMUN - GRV	$43.20	$108.00	$9.55–$56.16	12% below	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY 499 QT	$43.20	$108.00	$9.55–$56.16	12% below	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 CHG 86706 HepB Surf Antibody	$43.20	$108.00	$9.55–$56.16	12% below	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY 499 QT	$43.20	$108.00	$9.55–$56.16	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 CHG 86706 HepB Surf Antibody	$43.20	$108.00	$9.55–$56.16	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY IMMUN - GRV	$43.20	$108.00	$9.55–$56.16	—	60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 CHG 87340 Hepatitis B Surface ag ia	$41.60	$104.00	$9.19–$54.08	12% above	60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURF ANTIGEN RFX CONF 498 QT	$41.60	$104.00	$9.19–$54.08	12% above	60%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURF ANTIGEN RFX CONF 498 QT	$41.60	$104.00	$9.19–$54.08	—	60%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 CHG 87340 Hepatitis B Surface ag ia	$41.60	$104.00	$9.19–$54.08	—	60%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBOD W/RFLX GENO 94345 QT	$18.80	$47.00	$12.69–$24.44	64% below	60%
Hepatitis C antibody blood test (screening) CPT 86803 CHG 86803 Hep C AB Test	$57.20	$143.00	$12.69–$74.36	9% above	60%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB RFX QUANT RTPCR 8472 QT	$57.20	$143.00	$12.69–$74.36	9% above	60%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C Vir AB/RF RNA Geno11348- GRV	$57.20	$143.00	$12.69–$74.36	9% above	60%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBOD W/RFLX GENO 94345 QT	$18.80	$47.00	$12.69–$24.44	—	60%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 CHG 86803 Hep C AB Test	$57.20	$143.00	$12.69–$74.36	—	60%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C Vir AB/RF RNA Geno11348- GRV	$57.20	$143.00	$12.69–$74.36	—	60%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB RFX QUANT RTPCR 8472 QT	$57.20	$143.00	$12.69–$74.36	—	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 CHG 87522 Hep C revrs trnscrpj	$56.00	$140.00	$38.11–$72.80	57% below	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRAL RNA, QUANT 35645 QT	$56.00	$140.00	$38.11–$72.80	57% below	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 CHG 87902 Genotype dna/rna hep C	$56.00	$140.00	$38.11–$72.80	57% below	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C V RNA,Qnt RTPCRw/RF 93873 QT	$171.60	$429.00	$38.11–$223.08	31% above	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Vir RNA,Qnt w/Geno11348 QT	$171.60	$429.00	$38.11–$223.08	31% above	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRAL RNA, QUANT 35645 QT	$56.00	$140.00	$38.11–$72.80	—	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 CHG 87902 Genotype dna/rna hep C	$56.00	$140.00	$38.11–$72.80	—	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 CHG 87522 Hep C revrs trnscrpj	$56.00	$140.00	$38.11–$72.80	—	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Vir RNA,Qnt w/Geno11348 QT	$171.60	$429.00	$38.11–$223.08	—	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C V RNA,Qnt RTPCRw/RF 93873 QT	$171.60	$429.00	$38.11–$223.08	—	60%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1/2 IgG w/HSV-2 Inhibition 17169 QT	$52.80	$132.00	$11.73–$68.64	33% above	60%
Herpes blood test, HSV-1 antibody CPT 86695 Meningoenceph (Enceph)Panel CSF 12600 QT	$52.80	$132.00	$11.73–$68.64	33% above	60%
Herpes blood test, HSV-1 antibody CPT 86695 CHG HSV I AB EACH	$52.80	$132.00	$11.73–$68.64	33% above	60%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES HSV 1/2 IgG, TYPE SPEC AB 6447 QT	$52.80	$132.00	$11.73–$68.64	33% above	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1/2 IgG w/HSV-2 Inhibition 17169 QT	$52.80	$132.00	$11.73–$68.64	—	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES HSV 1/2 IgG, TYPE SPEC AB 6447 QT	$52.80	$132.00	$11.73–$68.64	—	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Meningoenceph (Enceph)Panel CSF 12600 QT	$52.80	$132.00	$11.73–$68.64	—	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 CHG HSV I AB EACH	$52.80	$132.00	$11.73–$68.64	—	60%
Herpes blood test, HSV-2 antibody CPT 86696 CHG HSV 1/2 IGM TITER EACH	$77.60	$194.00	$17.21–$100.88	45% above	60%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 CHG HSV 1/2 IGM TITER EACH	$77.60	$194.00	$17.21–$100.88	—	60%
High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO IQ(R) HS CRP 91737 QT	$52.00	$130.00	$11.52–$67.60	19% above	60%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP 10124 QT	$52.00	$130.00	$11.52–$67.60	19% above	60%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HIGH SENSITIVITY CRP 10124 QT	$52.00	$130.00	$11.52–$67.60	—	60%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CARDIO IQ(R) HS CRP 91737 QT	$52.00	$130.00	$11.52–$67.60	—	60%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE 91003 QT	$72.00	$180.00	$15.94–$93.60	20% above	60%
Homocysteine blood test CPT 83090 HOMOCYSTEINE 31789 QT	$72.00	$180.00	$15.94–$93.60	20% above	60%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE 31789 QT	$72.00	$180.00	$15.94–$93.60	—	60%
Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTEINE 91003 QT	$72.00	$180.00	$15.94–$93.60	—	60%
Insulin blood test CPT 83525 INSULIN 561 QT	$46.00	$115.00	$10.17–$59.80	18% above	60%
Insulin blood test CPT 83525 INSULIN INTACT LC/MS/MS 93103 QT	$46.00	$115.00	$10.17–$59.80	18% above	60%
Insulin blood test inpatient CPT 83525 INSULIN INTACT LC/MS/MS 93103 QT	$46.00	$115.00	$10.17–$59.80	—	60%
Insulin blood test inpatient CPT 83525 INSULIN 561 QT	$46.00	$115.00	$10.17–$59.80	—	60%
Iron blood test (serum iron) CPT 83540 IRON TIBC and FERRITIN PANEL 5616 QT	$8.80	$22.00	$5.75–$11.44	65% below	60%
Iron blood test (serum iron) CPT 83540 IRON TOTAL 571 QT	$8.80	$22.00	$5.75–$11.44	65% below	60%
Iron blood test (serum iron) CPT 83540 CHG 83540 IRON	$26.00	$65.00	$5.75–$33.80	4% above	60%
Iron blood test (serum iron) CPT 83540 IRON & TIBC- GRV	$26.00	$65.00	$5.75–$33.80	4% above	60%
Iron blood test (serum iron) CPT 83540 IRON (FE) - GRV	$26.00	$65.00	$5.75–$33.80	4% above	60%
Iron blood test (serum iron) CPT 83540 IRON,TIBC, & FERRITIN PANEL- GRV	$26.00	$65.00	$5.75–$33.80	4% above	60%
Iron blood test (serum iron) inpatient CPT 83540 IRON TIBC and FERRITIN PANEL 5616 QT	$8.80	$22.00	$5.75–$11.44	—	60%
Iron blood test (serum iron) inpatient CPT 83540 IRON TOTAL 571 QT	$8.80	$22.00	$5.75–$11.44	—	60%
Iron blood test (serum iron) inpatient CPT 83540 CHG 83540 IRON	$26.00	$65.00	$5.75–$33.80	—	60%
Iron blood test (serum iron) inpatient CPT 83540 IRON (FE) - GRV	$26.00	$65.00	$5.75–$33.80	—	60%
Iron blood test (serum iron) inpatient CPT 83540 IRON,TIBC, & FERRITIN PANEL- GRV	$26.00	$65.00	$5.75–$33.80	—	60%
Iron blood test (serum iron) inpatient CPT 83540 IRON & TIBC- GRV	$26.00	$65.00	$5.75–$33.80	—	60%
Iron-binding capacity (TIBC) test CPT 83550 IRON AND TIBC 7573 QT	$11.60	$29.00	$7.77–$15.08	56% below	60%
Iron-binding capacity (TIBC) test CPT 83550 CHG 83550 Iron binding capacity test	$35.20	$88.00	$7.77–$45.76	32% above	60%
Iron-binding capacity (TIBC) test CPT 83550 TIBC Direct - GRV	$35.20	$88.00	$7.77–$45.76	32% above	60%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON AND TIBC 7573 QT	$11.60	$29.00	$7.77–$15.08	—	60%
Iron-binding capacity (TIBC) test inpatient CPT 83550 CHG 83550 Iron binding capacity test	$35.20	$88.00	$7.77–$45.76	—	60%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC Direct - GRV	$35.20	$88.00	$7.77–$45.76	—	60%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL - GRV	$34.80	$87.00	$7.72–$45.24	55% below	60%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL - GRV	$34.80	$87.00	$7.72–$45.24	—	60%
LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE (LH) 615 QT	$74.40	$186.00	$16.47–$96.72	18% above	60%
LH (luteinizing hormone) test CPT 83002 CHG 83002 Gonadotropin Luteinizing	$74.40	$186.00	$16.47–$96.72	18% above	60%
LH (luteinizing hormone) test inpatient CPT 83002 CHG 83002 Gonadotropin Luteinizing	$74.40	$186.00	$16.47–$96.72	—	60%
LH (luteinizing hormone) test inpatient CPT 83002 LUTENIZING HORMONE (LH) 615 QT	$74.40	$186.00	$16.47–$96.72	—	60%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID PLASMA 585 QT	$15.20	$38.00	$10.29–$19.76	64% below	60%
Lactate (lactic acid) blood test CPT 83605 POCT ISTAT LACTIC ACID - GRV	$46.40	$116.00	$10.29–$60.32	9% above	60%
Lactate (lactic acid) blood test CPT 83605 Lactate -Vitros - GRV	$46.40	$116.00	$10.29–$60.32	9% above	60%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID PLASMA 585 QT	$15.20	$38.00	$10.29–$19.76	—	60%
Lactate (lactic acid) blood test inpatient CPT 83605 POCT ISTAT LACTIC ACID - GRV	$46.40	$116.00	$10.29–$60.32	—	60%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactate -Vitros - GRV	$46.40	$116.00	$10.29–$60.32	—	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD ISOENZYME PANEL 4411 QT	$8.00	$20.00	$5.37–$10.40	62% below	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD(LDH), SYNOVIAL FLUID 17658 QT	$8.00	$20.00	$5.37–$10.40	62% below	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD CSF 1687 QT	$8.00	$20.00	$5.37–$10.40	62% below	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD, PERITONEAL FLUID 17588 QT	$24.40	$61.00	$5.37–$31.72	17% above	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH 593 QT	$24.40	$61.00	$5.37–$31.72	17% above	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD CSF 1687 QT	$8.00	$20.00	$5.37–$10.40	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD ISOENZYME PANEL 4411 QT	$8.00	$20.00	$5.37–$10.40	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD(LDH), SYNOVIAL FLUID 17658 QT	$8.00	$20.00	$5.37–$10.40	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH 593 QT	$24.40	$61.00	$5.37–$31.72	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD, PERITONEAL FLUID 17588 QT	$24.40	$61.00	$5.37–$31.72	—	60%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE - GRV	$35.00	$69.00	$6.13–$35.88	29% above	49%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE 606 QT	$35.00	$23.00	$6.13–$35.00	29% above	-52%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE - GRV	$35.00	$69.00	$6.13–$35.88	—	49%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE 606 QT	$35.00	$23.00	$6.13–$35.00	—	-52%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL- GRV	$55.00	$82.00	$7.27–$55.00	14% below	33%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL- GRV	$55.00	$82.00	$7.27–$55.00	—	33%
Lyme disease antibody test CPT 86618 CP377827 Tick Panel QT	$22.40	$56.00	$15.15–$29.12	61% below	60%
Lyme disease antibody test CPT 86618 LYME DIS AB W/REFL BLOT(IGG, IGM) 6646QT	$68.40	$171.00	$15.15–$88.92	20% above	60%
Lyme disease antibody test CPT 86618 CHG 86618 Lyme disease Antibody	$68.40	$171.00	$15.15–$88.92	20% above	60%
Lyme disease antibody test CPT 86618 Tick-Borne DiseaseAB Panl w/Rfx 16220 QT	$68.40	$171.00	$15.15–$88.92	20% above	60%
Lyme disease antibody test inpatient CPT 86618 CP377827 Tick Panel QT	$22.40	$56.00	$15.15–$29.12	—	60%
Lyme disease antibody test inpatient CPT 86618 Tick-Borne DiseaseAB Panl w/Rfx 16220 QT	$68.40	$171.00	$15.15–$88.92	—	60%
Lyme disease antibody test inpatient CPT 86618 CHG 86618 Lyme disease Antibody	$68.40	$171.00	$15.15–$88.92	—	60%
Lyme disease antibody test inpatient CPT 86618 LYME DIS AB W/REFL BLOT(IGG, IGM) 6646QT	$68.40	$171.00	$15.15–$88.92	—	60%
Magnesium blood test CPT 83735 MAGNESIUM - GRV	$45.00	$67.00	$5.96–$45.00	64% above	33%
Magnesium blood test CPT 83735 MAGNESIUM RBC 623 QT	$45.00	$22.00	$5.96–$45.00	64% above	-105%
Magnesium blood test CPT 83735 CHG 83735 Magnesium level	$45.00	$22.00	$5.96–$45.00	64% above	-105%
Magnesium blood test inpatient CPT 83735 CHG 83735 Magnesium level	$45.00	$22.00	$5.96–$45.00	—	-105%
Magnesium blood test inpatient CPT 83735 MAGNESIUM - GRV	$45.00	$67.00	$5.96–$45.00	—	33%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC 623 QT	$45.00	$22.00	$5.96–$45.00	—	-105%
Measles (rubeola) antibody test CPT 86765 Measles Antibody (IgM) 34256 QT	$16.80	$42.00	$11.46–$21.84	51% below	60%
Measles (rubeola) antibody test CPT 86765 Measles Antibodies IgG & IgM 34166 QT	$16.80	$42.00	$11.46–$21.84	51% below	60%
Measles (rubeola) antibody test CPT 86765 CHG 86765 Rubeola Antibody each	$16.80	$42.00	$11.46–$21.84	51% below	60%
Measles (rubeola) antibody test CPT 86765 MEASLES ANTIBODY IGG 964 QT	$51.60	$129.00	$11.46–$67.08	50% above	60%
Measles (rubeola) antibody test inpatient CPT 86765 Measles Antibody (IgM) 34256 QT	$16.80	$42.00	$11.46–$21.84	—	60%
Measles (rubeola) antibody test inpatient CPT 86765 CHG 86765 Rubeola Antibody each	$16.80	$42.00	$11.46–$21.84	—	60%
Measles (rubeola) antibody test inpatient CPT 86765 Measles Antibodies IgG & IgM 34166 QT	$16.80	$42.00	$11.46–$21.84	—	60%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES ANTIBODY IGG 964 QT	$51.60	$129.00	$11.46–$67.08	—	60%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE MONO SCREEN 654 QT	$20.80	$52.00	$4.61–$27.04	8% above	60%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO-TEST - GRV	$20.80	$52.00	$4.61–$27.04	8% above	60%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO-TEST - GRV	$20.80	$52.00	$4.61–$27.04	—	60%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE MONO SCREEN 654 QT	$20.80	$52.00	$4.61–$27.04	—	60%
Mumps immunity blood test CPT 86735 MUMPS VIRUS ANTIBODIES(IGG,IGM) 36564 QT	$17.20	$43.00	$11.61–$22.36	53% below	60%
Mumps immunity blood test CPT 86735 MMR (IgG)PANEL MEAS MUMP RUBELLA 5259 QT	$17.20	$43.00	$11.61–$22.36	53% below	60%
Mumps immunity blood test CPT 86735 CHG 86735 Antibodies to Mumps	$52.40	$131.00	$11.61–$68.12	42% above	60%
Mumps immunity blood test CPT 86735 MUMPS VIRUS ANTIBODY (IGG) 8624 QT	$52.40	$131.00	$11.61–$68.12	42% above	60%
Mumps immunity blood test inpatient CPT 86735 MMR (IgG)PANEL MEAS MUMP RUBELLA 5259 QT	$17.20	$43.00	$11.61–$22.36	—	60%
Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS ANTIBODIES(IGG,IGM) 36564 QT	$17.20	$43.00	$11.61–$22.36	—	60%
Mumps immunity blood test inpatient CPT 86735 CHG 86735 Antibodies to Mumps	$52.40	$131.00	$11.61–$68.12	—	60%
Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS ANTIBODY (IGG) 8624 QT	$52.40	$131.00	$11.61–$68.12	—	60%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL 20210 QT	$191.60	$479.00	$36.52–$249.08	39% above	60%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL 20210 QT	$191.60	$479.00	$36.52–$249.08	—	60%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, Free and Total 31348 QT	$73.60	$184.00	$16.36–$95.68	34% above	60%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, Free and Total 31348 QT	$73.60	$184.00	$16.36–$95.68	—	60%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA,Post Prostatectomy US 14808 QT	$115.00	$60.00	$16.36–$115.00	97% above	-92%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL 5363 QT	$115.00	$184.00	$16.36–$115.00	97% above	38%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA,Prostate Specific Antigen - GRV	$115.00	$184.00	$16.36–$115.00	97% above	38%
PSA (prostate-specific antigen) blood test, total CPT 84153 CHG 84153 PSA Total	$115.00	$184.00	$16.36–$115.00	97% above	38%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA,Prostate Specific Antigen - GRV	$115.00	$184.00	$16.36–$115.00	—	38%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA,Post Prostatectomy US 14808 QT	$115.00	$60.00	$16.36–$115.00	—	-92%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CHG 84153 PSA Total	$115.00	$184.00	$16.36–$115.00	—	38%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL 5363 QT	$115.00	$184.00	$16.36–$115.00	—	38%
Pap test (liquid-based, automated screening with review) CPT 88175 SurePath ImgHPV E6/E7RxHPV16 18 18829 QT	$34.80	$87.00	$20.75–$45.24	18% below	60%
Pap test (liquid-based, automated screening with review) CPT 88175 CHG 88175 CYTO THIN PREP AUTO AND MANUAL	$34.80	$87.00	$20.75–$45.24	18% below	60%
Pap test (liquid-based, automated screening with review) CPT 88175 TH PRP(TIS) PapRx HPVmRNA E6/E7 91911 QT	$34.80	$87.00	$20.75–$45.24	18% below	60%
Pap test (liquid-based, automated screening with review) CPT 88175 SurePath IMG RFX HPV mRNA E6/E7 18811 QT	$34.80	$87.00	$20.75–$45.24	18% below	60%
Pap test (liquid-based, automated screening with review) CPT 88175 CHG 88175 Cytopath c/v auto fluid redo	$34.80	$87.00	$20.75–$45.24	18% below	60%
Pap test (liquid-based, automated screening with review) CPT 88175 ThinPrep Automated Pap HPV CT/NG92012 QT	$106.40	$266.00	$20.75–$138.32	152% above	60%
Pap test (liquid-based, automated screening with review) CPT 88175 SurePath Imaging Pap 18810 QT	$106.80	$267.00	$20.75–$138.84	153% above	60%
Pap test (liquid-based, automated screening with review) CPT 88175 TH PRP (TIS) HPV E6/E7 90933 QT	$106.80	$267.00	$20.75–$138.84	153% above	60%
Pap test (liquid-based, automated screening with review) CPT 88175 TH PRP (TIS) RX HPV mRNA E6/E7 90934 QT	$106.80	$267.00	$20.75–$138.84	153% above	60%
Pap test (liquid-based, automated screening with review) CPT 88175 TH PRP(TIS)HPVmRNAE6E7CT/NG TRI 91906 QT	$106.80	$267.00	$20.75–$138.84	153% above	60%
Pap test (liquid-based, automated screening with review) CPT 88175 TH PRP(TIS HPVmRE6/E7rf16 18/45 91414 QT	$106.80	$267.00	$20.75–$138.84	153% above	60%
Pap test (liquid-based, automated screening with review) CPT 88175 ThinPrep Automated Pap 58315 QT	$106.80	$267.00	$20.75–$138.84	153% above	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SurePath ImgHPV E6/E7RxHPV16 18 18829 QT	$34.80	$87.00	$20.75–$45.24	—	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 TH PRP(TIS) PapRx HPVmRNA E6/E7 91911 QT	$34.80	$87.00	$20.75–$45.24	—	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SurePath IMG RFX HPV mRNA E6/E7 18811 QT	$34.80	$87.00	$20.75–$45.24	—	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CHG 88175 CYTO THIN PREP AUTO AND MANUAL	$34.80	$87.00	$20.75–$45.24	—	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CHG 88175 Cytopath c/v auto fluid redo	$34.80	$87.00	$20.75–$45.24	—	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 ThinPrep Automated Pap HPV CT/NG92012 QT	$106.40	$266.00	$20.75–$138.32	—	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SurePath Imaging Pap 18810 QT	$106.80	$267.00	$20.75–$138.84	—	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 TH PRP(TIS HPVmRE6/E7rf16 18/45 91414 QT	$106.80	$267.00	$20.75–$138.84	—	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 TH PRP (TIS) HPV E6/E7 90933 QT	$106.80	$267.00	$20.75–$138.84	—	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 TH PRP(TIS)HPVmRNAE6E7CT/NG TRI 91906 QT	$106.80	$267.00	$20.75–$138.84	—	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 ThinPrep Automated Pap 58315 QT	$106.80	$267.00	$20.75–$138.84	—	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 TH PRP (TIS) RX HPV mRNA E6/E7 90934 QT	$106.80	$267.00	$20.75–$138.84	—	60%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SurePath Pap w/rx HPVmRNA E6/E714499 QT	$81.20	$203.00	$18.02–$105.56	67% above	60%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SUREPATH PAP 14471 QT	$81.20	$203.00	$18.02–$105.56	67% above	60%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SurePath Pap w/rx HPVmRNA E6/E714499 QT	$81.20	$203.00	$18.02–$105.56	—	60%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SUREPATH PAP 14471 QT	$81.20	$203.00	$18.02–$105.56	—	60%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT W/O CA 35202 QT	$165.20	$413.00	$36.72–$214.76	50% above	60%
Parathyroid hormone (PTH) blood test CPT 83970 Assay of Parathormone	$165.20	$413.00	$36.72–$214.76	50% above	60%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT & CALCIUM 8837 QT	$165.20	$413.00	$36.72–$214.76	50% above	60%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Assay of Parathormone	$165.20	$413.00	$36.72–$214.76	—	60%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT W/O CA 35202 QT	$165.20	$413.00	$36.72–$214.76	—	60%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT & CALCIUM 8837 QT	$165.20	$413.00	$36.72–$214.76	—	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME, ACT 763 QT	$8.00	$20.00	$5.35–$10.40	70% below	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus Anticoag Cardiolipin AB/RF91227 QT	$8.00	$20.00	$5.35–$10.40	70% below	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 CHG 85730 Lupus PTT for 7079QT	$24.40	$61.00	$5.35–$31.72	8% below	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME - GRV	$24.40	$61.00	$5.35–$31.72	8% below	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 von Willebrand Panel 91242 QT	$24.40	$61.00	$5.35–$31.72	8% below	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME, ACT 763 QT	$8.00	$20.00	$5.35–$10.40	—	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lupus Anticoag Cardiolipin AB/RF91227 QT	$8.00	$20.00	$5.35–$10.40	—	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME - GRV	$24.40	$61.00	$5.35–$31.72	—	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 von Willebrand Panel 91242 QT	$24.40	$61.00	$5.35–$31.72	—	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 CHG 85730 Lupus PTT for 7079QT	$24.40	$61.00	$5.35–$31.72	—	60%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS - GRV	$19.20	$48.00	$4.22–$24.96	30% below	60%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS - GRV	$19.20	$48.00	$4.22–$24.96	—	60%
Potassium blood test CPT 84132 POTASSIUM - GRV	$19.20	$48.00	$4.23–$24.96	8% below	60%
Potassium blood test inpatient CPT 84132 POTASSIUM - GRV	$19.20	$48.00	$4.23–$24.96	—	60%
Progesterone blood test CPT 84144 PROGESTERONE 745 QT	$83.60	$209.00	$18.55–$108.68	50% above	60%
Progesterone blood test CPT 84144 Progesterone, LC/MS 17183 QT	$83.60	$209.00	$18.55–$108.68	50% above	60%
Progesterone blood test inpatient CPT 84144 Progesterone, LC/MS 17183 QT	$83.60	$209.00	$18.55–$108.68	—	60%
Progesterone blood test inpatient CPT 84144 PROGESTERONE 745 QT	$83.60	$209.00	$18.55–$108.68	—	60%
Prolactin blood test CPT 84146 Prolactin Total & Monomeric 16122 QT	$25.20	$63.00	$17.24–$32.76	57% below	60%
Prolactin blood test CPT 84146 PROLACTIN 746 QT	$77.60	$194.00	$17.24–$100.88	33% above	60%
Prolactin blood test inpatient CPT 84146 Prolactin Total & Monomeric 16122 QT	$25.20	$63.00	$17.24–$32.76	—	60%
Prolactin blood test inpatient CPT 84146 PROLACTIN 746 QT	$77.60	$194.00	$17.24–$100.88	—	60%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME/INR - GRV	$30.00	$43.00	$3.82–$30.00	50% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 MIXING STUDY 8922 QT	$30.00	$43.00	$3.82–$30.00	50% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME/INR 8847 QT	$30.00	$43.00	$3.82–$30.00	50% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 POCT INR FINGERSTICK	$30.00	$43.00	$3.82–$30.00	50% above	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME/INR 8847 QT	$30.00	$43.00	$3.82–$30.00	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME/INR - GRV	$30.00	$43.00	$3.82–$30.00	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POCT INR FINGERSTICK	$30.00	$43.00	$3.82–$30.00	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 MIXING STUDY 8922 QT	$30.00	$43.00	$3.82–$30.00	—	30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 POCT UDS CUP 12PL	$20.00	$126.00	$11.21–$65.52	26% below	84%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 POCT UDS CUP 12PL	$20.00	$126.00	$11.21–$65.52	—	84%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A&B ANTIGEN IMMUNO 11177 QT	$45.00	$83.00	$12.45–$45.00	5% below	46%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A&B ANTIGEN IMMUNO 11177 QT	$45.00	$83.00	$12.45–$45.00	—	46%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A RAPID A ANTIGEN 10553 QT	$45.00	$84.00	$12.87–$45.00	69% above	46%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A RAPID A ANTIGEN 10553 QT	$45.00	$84.00	$12.87–$45.00	—	46%
Renin blood test CPT 84244 Plasma Renin Activity, LC/MS/MS 16846 QT	$88.00	$220.00	$19.56–$114.40	16% above	60%
Renin blood test CPT 84244 CHG 84244 Assay of Renin	$88.00	$220.00	$19.56–$114.40	16% above	60%
Renin blood test inpatient CPT 84244 Plasma Renin Activity, LC/MS/MS 16846 QT	$88.00	$220.00	$19.56–$114.40	—	60%
Renin blood test inpatient CPT 84244 CHG 84244 Assay of Renin	$88.00	$220.00	$19.56–$114.40	—	60%
Rh blood typing CPT 86901 BB RH TYPING	$153.20	$383.00	$2.66–$199.16	411% above	60%
Rh blood typing CPT 86901 BB RH RE-TYPE	$153.20	$383.00	$2.66–$199.16	411% above	60%
Rh blood typing inpatient CPT 86901 BB RH RE-TYPE	$153.20	$383.00	$2.66–$199.16	—	60%
Rh blood typing inpatient CPT 86901 BB RH TYPING	$153.20	$383.00	$2.66–$199.16	—	60%
Rheumatoid factor (RF) test CPT 86431 CHG 86431 Rheumatoid factor quant	$22.80	$57.00	$5.04–$29.64	21% below	60%
Rheumatoid factor (RF) test CPT 86431 CHG 86431 Rheumatoid Factor Quant	$22.80	$57.00	$5.04–$29.64	21% below	60%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR 4418 QT	$22.80	$57.00	$5.04–$29.64	21% below	60%
Rheumatoid factor (RF) test inpatient CPT 86431 CHG 86431 Rheumatoid factor quant	$22.80	$57.00	$5.04–$29.64	—	60%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR 4418 QT	$22.80	$57.00	$5.04–$29.64	—	60%
Rheumatoid factor (RF) test inpatient CPT 86431 CHG 86431 Rheumatoid Factor Quant	$22.80	$57.00	$5.04–$29.64	—	60%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG 802 QT	$18.80	$47.00	$12.80–$24.44	49% below	60%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies (IgG,IgM) 37673 QT	$18.80	$47.00	$12.80–$24.44	49% below	60%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGM 4422 QT	$18.80	$47.00	$12.80–$24.44	49% below	60%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IgG - GRV	$18.80	$47.00	$12.80–$24.44	49% below	60%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies (IgG,IgM) 37673 QT	$18.80	$47.00	$12.80–$24.44	—	60%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IgG - GRV	$18.80	$47.00	$12.80–$24.44	—	60%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGG 802 QT	$18.80	$47.00	$12.80–$24.44	—	60%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGM 4422 QT	$18.80	$47.00	$12.80–$24.44	—	60%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE BY MODIFIEDWESTERGREN 809 QT	$6.80	$17.00	$2.40–$8.84	70% below	60%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE BY MODIFIEDWESTERGREN 809 QT	$6.80	$17.00	$2.40–$8.84	—	60%
Sodium blood test CPT 84295 SODIUM - GRV	$19.60	$49.00	$4.28–$25.48	8% below	60%
Sodium blood test inpatient CPT 84295 SODIUM - GRV	$19.60	$49.00	$4.28–$25.48	—	60%
Stool ova and parasites exam CPT 87177 OVA & PARASITES 681 QT	$35.60	$89.00	$7.92–$46.28	12% above	60%
Stool ova and parasites exam CPT 87177 Ova & Parasites w/GiardiaAntigen 1748 QT	$35.60	$89.00	$7.92–$46.28	12% above	60%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES 681 QT	$35.60	$89.00	$7.92–$46.28	—	60%
Stool ova and parasites exam inpatient CPT 87177 Ova & Parasites w/GiardiaAntigen 1748 QT	$35.60	$89.00	$7.92–$46.28	—	60%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD F 1 - 3 CRC 82270 SCRN	$17.60	$44.00	$3.90–$22.88	16% below	60%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLD F 1 - 3 CRC 82270 SCRN	$17.60	$44.00	$3.90–$22.88	—	60%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL GLOB BY IMMUNOCHEM 11290 QT	$20.80	$52.00	$14.16–$27.04	35% below	60%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL GLOB BY IMMUNOCHEM 11290 QT	$20.80	$52.00	$14.16–$27.04	—	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS 4112 QT	$17.60	$44.00	$11.78–$22.88	31% below	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 CHG 86780 Treponema pallidum AB(FTA)	$17.60	$44.00	$11.78–$22.88	31% below	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 Congen SyphiSc<6Mo,FTA(IgG,IgM) 34323 QT	$17.60	$44.00	$11.78–$22.88	31% below	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS ANTIBODY CASCADE REFLE 90349 QT	$53.20	$133.00	$11.78–$69.16	110% above	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-ABS 4112 QT	$17.60	$44.00	$11.78–$22.88	—	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Congen SyphiSc<6Mo,FTA(IgG,IgM) 34323 QT	$17.60	$44.00	$11.78–$22.88	—	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 CHG 86780 Treponema pallidum AB(FTA)	$17.60	$44.00	$11.78–$22.88	—	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS ANTIBODY CASCADE REFLE 90349 QT	$53.20	$133.00	$11.78–$69.16	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR (MONITOR) W/REFL TITER 799 QT	$17.20	$43.00	$3.80–$22.36	2% below	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis VDRL Sc w/RxTite Serum 14266 QT	$17.20	$43.00	$3.80–$22.36	2% below	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL Serum 30509 QT	$17.20	$43.00	$3.80–$22.36	2% below	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR w/Reflex to Confirm Testing 36126 QT	$17.20	$43.00	$3.80–$22.36	2% below	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS RAPID RFX TITER -GRV	$17.20	$43.00	$3.80–$22.36	2% below	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL Serum 30509 QT	$17.20	$43.00	$3.80–$22.36	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR (MONITOR) W/REFL TITER 799 QT	$17.20	$43.00	$3.80–$22.36	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis VDRL Sc w/RxTite Serum 14266 QT	$17.20	$43.00	$3.80–$22.36	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS RAPID RFX TITER -GRV	$17.20	$43.00	$3.80–$22.36	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR w/Reflex to Confirm Testing 36126 QT	$17.20	$43.00	$3.80–$22.36	—	60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiferonTB Gold Plus 48hr st 36970 QT	$248.00	$620.00	$55.13–$322.40	206% above	60%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiferonTB Gold Plus 48hr st 36970 QT	$248.00	$620.00	$55.13–$322.40	—	60%
Testosterone blood test, total (not free testosterone) CPT 84403 CHG 84403 TESTOSTERONE TOTAL	$103.60	$259.00	$22.96–$134.68	33% above	60%
Testosterone blood test, total (not free testosterone) CPT 84403 Testo Free(Dls)Total(MS) SexHBG 37073 QT	$103.60	$259.00	$22.96–$134.68	33% above	60%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE,TOTAL,MALES 873 QT	$103.60	$259.00	$22.96–$134.68	33% above	60%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL 15983 QT	$103.60	$259.00	$22.96–$134.68	33% above	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testo Free(Dls)Total(MS) SexHBG 37073 QT	$103.60	$259.00	$22.96–$134.68	—	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL 15983 QT	$103.60	$259.00	$22.96–$134.68	—	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 CHG 84403 TESTOSTERONE TOTAL	$103.60	$259.00	$22.96–$134.68	—	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE,TOTAL,MALES 873 QT	$103.60	$259.00	$22.96–$134.68	—	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase/Thyroglobin AB 7260QT	$58.40	$146.00	$12.94–$75.92	49% above	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 CHG 86376 Microsomal antibody each	$58.40	$146.00	$12.94–$75.92	49% above	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 TPO ANTIBODY ENDPOINT 15116 QT	$58.40	$146.00	$12.94–$75.92	49% above	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE TPO 5081 QT	$58.40	$146.00	$12.94–$75.92	49% above	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 LiverKdy Microsomal(LKM-1)AB IgG15038 QT	$58.40	$146.00	$12.94–$75.92	49% above	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TPO ANTIBODY ENDPOINT 15116 QT	$58.40	$146.00	$12.94–$75.92	—	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase/Thyroglobin AB 7260QT	$58.40	$146.00	$12.94–$75.92	—	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LiverKdy Microsomal(LKM-1)AB IgG15038 QT	$58.40	$146.00	$12.94–$75.92	—	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 CHG 86376 Microsomal antibody each	$58.40	$146.00	$12.94–$75.92	—	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE TPO 5081 QT	$58.40	$146.00	$12.94–$75.92	—	60%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/ABNs Rx T3/T4 Free - GRV	$105.00	$168.00	$14.94–$105.00	120% above	38%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH - GRV	$105.00	$168.00	$14.94–$105.00	120% above	38%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 899 QT	$105.00	$55.00	$14.94–$105.00	120% above	-91%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 CHRONIC URTICARIA PANEL 1 16440 QT	$105.00	$168.00	$14.94–$105.00	120% above	38%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 CHG 84443 TSH	$105.00	$55.00	$14.94–$105.00	120% above	-91%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID PANEL, TSH FT3,TT3,FT4,TT4- GRV	$105.00	$168.00	$14.94–$105.00	120% above	38%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID PANEL, TSH FT3,TT3,FT4,TT4- GRV	$105.00	$168.00	$14.94–$105.00	—	38%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CHG 84443 TSH	$105.00	$55.00	$14.94–$105.00	—	-91%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CHRONIC URTICARIA PANEL 1 16440 QT	$105.00	$168.00	$14.94–$105.00	—	38%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 899 QT	$105.00	$55.00	$14.94–$105.00	—	-91%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH - GRV	$105.00	$168.00	$14.94–$105.00	—	38%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/ABNs Rx T3/T4 Free - GRV	$105.00	$168.00	$14.94–$105.00	—	38%
Total IgE blood test CPT 82785 Immuglobul PL (IgA IgE IgG IgM) 58997 QT	$21.60	$54.00	$14.64–$28.08	50% below	60%
Total IgE blood test CPT 82785 IgE 542 QT	$66.00	$165.00	$14.64–$85.80	53% above	60%
Total IgE blood test CPT 82785 Childhood/Tree Nut Allergy Panel36765 QT	$66.00	$165.00	$14.64–$85.80	53% above	60%
Total IgE blood test CPT 82785 CHILDHOOD ALLERGY(FOOD&ENV) PROF 91683QT	$66.00	$165.00	$14.64–$85.80	53% above	60%
Total IgE blood test CPT 82785 Respirat Allergy Region X:OK,TX 10651 QT	$66.00	$165.00	$14.64–$85.80	53% above	60%
Total IgE blood test CPT 82785 Child Allergy Food/Environmenta10659 QTa	$66.00	$165.00	$14.64–$85.80	53% above	60%
Total IgE blood test CPT 82785 RESP ALLERGY PROF REGION VI 10647 QT	$66.00	$165.00	$14.64–$85.80	53% above	60%
Total IgE blood test CPT 82785 Resp Aller PfileReg VI:IA,IL,MO 10649 QT	$66.00	$165.00	$14.64–$85.80	53% above	60%
Total IgE blood test inpatient CPT 82785 Immuglobul PL (IgA IgE IgG IgM) 58997 QT	$21.60	$54.00	$14.64–$28.08	—	60%
Total IgE blood test inpatient CPT 82785 RESP ALLERGY PROF REGION VI 10647 QT	$66.00	$165.00	$14.64–$85.80	—	60%
Total IgE blood test inpatient CPT 82785 IgE 542 QT	$66.00	$165.00	$14.64–$85.80	—	60%
Total IgE blood test inpatient CPT 82785 Resp Aller PfileReg VI:IA,IL,MO 10649 QT	$66.00	$165.00	$14.64–$85.80	—	60%
Total IgE blood test inpatient CPT 82785 Child Allergy Food/Environmenta10659 QTa	$66.00	$165.00	$14.64–$85.80	—	60%
Total IgE blood test inpatient CPT 82785 CHILDHOOD ALLERGY(FOOD&ENV) PROF 91683QT	$66.00	$165.00	$14.64–$85.80	—	60%
Total IgE blood test inpatient CPT 82785 Respirat Allergy Region X:OK,TX 10651 QT	$66.00	$165.00	$14.64–$85.80	—	60%
Total IgE blood test inpatient CPT 82785 Childhood/Tree Nut Allergy Panel36765 QT	$66.00	$165.00	$14.64–$85.80	—	60%
Total cholesterol blood test CPT 82465 CHOLESTEROL GRV	$17.60	$44.00	$3.87–$22.88	35% below	60%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL GRV	$17.60	$44.00	$3.87–$22.88	—	60%
Total thyroxine (T4) blood test CPT 84436 T4 TOTAL 867 QT	$9.20	$23.00	$6.11–$11.96	64% below	60%
Total thyroxine (T4) blood test CPT 84436 CHG 84436 TT4	$27.60	$69.00	$6.11–$35.88	9% above	60%
Total thyroxine (T4) blood test CPT 84436 T4 TOTAL - GRV	$27.60	$69.00	$6.11–$35.88	9% above	60%
Total thyroxine (T4) blood test CPT 84436 THYROID PANEL 7020 QT	$27.60	$69.00	$6.11–$35.88	9% above	60%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 TOTAL 867 QT	$9.20	$23.00	$6.11–$11.96	—	60%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 TOTAL - GRV	$27.60	$69.00	$6.11–$35.88	—	60%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROID PANEL 7020 QT	$27.60	$69.00	$6.11–$35.88	—	60%
Total thyroxine (T4) blood test inpatient CPT 84436 CHG 84436 TT4	$27.60	$69.00	$6.11–$35.88	—	60%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL 859 QT	$18.80	$47.00	$12.61–$24.44	59% below	60%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL - GRV	$56.80	$142.00	$12.61–$73.84	25% above	60%
Total triiodothyronine (T3) blood test CPT 84480 CHG 84480 TT3	$56.80	$142.00	$12.61–$73.84	25% above	60%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL II - GRV	$56.80	$142.00	$12.61–$73.84	25% above	60%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL 859 QT	$18.80	$47.00	$12.61–$24.44	—	60%
Total triiodothyronine (T3) blood test inpatient CPT 84480 CHG 84480 TT3	$56.80	$142.00	$12.61–$73.84	—	60%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL II - GRV	$56.80	$142.00	$12.61–$73.84	—	60%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL - GRV	$56.80	$142.00	$12.61–$73.84	—	60%
Transferrin blood test CPT 84466 TRANSFERRIN 891 QT	$51.20	$128.00	$11.35–$66.56	43% above	60%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN 891 QT	$51.20	$128.00	$11.35–$66.56	—	60%
Trichomonas test (NAAT) CPT 87661 Chlam/Gon T.vag 91448 QT	$46.00	$115.00	$31.21–$59.80	7% below	60%
Trichomonas test (NAAT) CPT 87661 Trich vaginal RNA Qual 19550 QT	$140.40	$351.00	$31.21–$182.52	183% above	60%
Trichomonas test (NAAT) CPT 87661 Trichomo vagin RNA QualTMA Male 90801 QT	$140.40	$351.00	$31.21–$182.52	183% above	60%
Trichomonas test (NAAT) CPT 87661 CHG 87661 Trichomonas vag amplification	$140.40	$351.00	$31.21–$182.52	183% above	60%
Trichomonas test (NAAT) inpatient CPT 87661 Chlam/Gon T.vag 91448 QT	$46.00	$115.00	$31.21–$59.80	—	60%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomo vagin RNA QualTMA Male 90801 QT	$140.40	$351.00	$31.21–$182.52	—	60%
Trichomonas test (NAAT) inpatient CPT 87661 CHG 87661 Trichomonas vag amplification	$140.40	$351.00	$31.21–$182.52	—	60%
Trichomonas test (NAAT) inpatient CPT 87661 Trich vaginal RNA Qual 19550 QT	$140.40	$351.00	$31.21–$182.52	—	60%
Triglycerides blood test CPT 84478 TRIGLYCERIDES - GRV	$23.20	$58.00	$5.11–$30.16	1% below	60%
Triglycerides blood test CPT 84478 VLDL CHOLESTEROL 319 QT	$23.20	$58.00	$5.11–$30.16	1% below	60%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES - GRV	$23.20	$58.00	$5.11–$30.16	—	60%
Triglycerides blood test inpatient CPT 84478 VLDL CHOLESTEROL 319 QT	$23.20	$58.00	$5.11–$30.16	—	60%
Troponin test, quantitative CPT 84484 TROPONIN I - GRV	$60.00	$125.00	$11.09–$65.00	2% below	52%
Troponin test, quantitative CPT 84484 POCT ISTAT cTnI - GRV	$60.00	$125.00	$11.09–$65.00	2% below	52%
Troponin test, quantitative CPT 84484 Troponin T, HS(hs-TnT) 38685 QT	$60.00	$125.00	$11.09–$65.00	2% below	52%
Troponin test, quantitative inpatient CPT 84484 POCT ISTAT cTnI - GRV	$60.00	$125.00	$11.09–$65.00	—	52%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I - GRV	$60.00	$125.00	$11.09–$65.00	—	52%
Troponin test, quantitative inpatient CPT 84484 Troponin T, HS(hs-TnT) 38685 QT	$60.00	$125.00	$11.09–$65.00	—	52%
Uric acid blood test CPT 84550 URIC ACID - GRV	$35.00	$46.00	$4.02–$35.00	34% above	24%
Uric acid blood test inpatient CPT 84550 URIC ACID - GRV	$35.00	$46.00	$4.02–$35.00	—	24%
Urinalysis with microscope exam, automated CPT 81001 CHG URINALYSIS/W MICROSCOPY	$25.00	$32.00	$2.82–$25.00	41% above	22%
Urinalysis with microscope exam, automated CPT 81001 URINE MICRO- Always w/Culture	$25.00	$31.00	$2.82–$25.00	41% above	19%
Urinalysis with microscope exam, automated CPT 81001 URINE MICRO-Culture Only if Indicated	$25.00	$31.00	$2.82–$25.00	41% above	19%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINE MICRO- Always w/Culture	$25.00	$31.00	$2.82–$25.00	—	19%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINE MICRO-Culture Only if Indicated	$25.00	$31.00	$2.82–$25.00	—	19%
Urinalysis with microscope exam, automated inpatient CPT 81001 CHG URINALYSIS/W MICROSCOPY	$25.00	$32.00	$2.82–$25.00	—	22%
Urinalysis without microscope exam, automated CPT 81003 CHG URINALYSIS/WO MICROSCOPY	$14.00	$23.00	$2.00–$14.00	at median	39%
Urinalysis without microscope exam, automated CPT 81003 CHG.URINALYSIS/WO MICROSCOPY CLB	$14.00	$15.00	$2.00–$14.00	at median	7%
Urinalysis without microscope exam, automated CPT 81003 UA w/REFLEX to MICROSCOPIC 7909	$14.00	$15.00	$2.00–$14.00	at median	7%
Urinalysis without microscope exam, automated CPT 81003 GLUCOSE QUALITATIVE URINE 4719 QT	$14.00	$15.00	$2.00–$14.00	at median	7%
Urinalysis without microscope exam, automated inpatient CPT 81003 GLUCOSE QUALITATIVE URINE 4719 QT	$14.00	$15.00	$2.00–$14.00	—	7%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA w/REFLEX to MICROSCOPIC 7909	$14.00	$15.00	$2.00–$14.00	—	7%
Urinalysis without microscope exam, automated inpatient CPT 81003 CHG.URINALYSIS/WO MICROSCOPY CLB	$14.00	$15.00	$2.00–$14.00	—	7%
Urinalysis without microscope exam, automated inpatient CPT 81003 CHG URINALYSIS/WO MICROSCOPY	$14.00	$23.00	$2.00–$14.00	—	39%
Urine culture for bacteria, with colony count CPT 87086 Culture UA Prenatal w/GBS Susc 91684 QT	$32.40	$81.00	$7.18–$42.12	13% above	60%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE 395 QT	$32.40	$81.00	$7.18–$42.12	13% above	60%
Urine culture for bacteria, with colony count inpatient CPT 87086 Culture UA Prenatal w/GBS Susc 91684 QT	$32.40	$81.00	$7.18–$42.12	—	60%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE 395 QT	$32.40	$81.00	$7.18–$42.12	—	60%
Urine microalbumin (albumin) test CPT 82043 Albumin,24hr Urine w/Creatinine 15281 QT	$25.00	$19.00	$5.14–$25.00	20% above	-32%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN URINE w/CREATINIE 6517 QT	$25.00	$58.00	$5.14–$30.16	20% above	57%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN RANDM UR W/CREATI - GRV	$25.00	$58.00	$5.14–$30.16	20% above	57%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN URINE w/CREATINIE 6517 QT	$25.00	$58.00	$5.14–$30.16	—	57%
Urine microalbumin (albumin) test inpatient CPT 82043 Albumin,24hr Urine w/Creatinine 15281 QT	$25.00	$19.00	$5.14–$25.00	—	-32%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN RANDM UR W/CREATI - GRV	$25.00	$58.00	$5.14–$30.16	—	57%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY QUALITATIVE	$45.00	$87.00	$7.66–$45.24	57% above	48%
Urine pregnancy test, read by color change CPT 81025 SERUM PREGNANCY QUALITATIVE - GRV	$45.00	$76.00	$7.66–$45.00	57% above	41%
Urine pregnancy test, read by color change inpatient CPT 81025 SERUM PREGNANCY QUALITATIVE - GRV	$45.00	$76.00	$7.66–$45.00	—	41%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY QUALITATIVE	$45.00	$87.00	$7.66–$45.24	—	48%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12/FOLATE, SERUM PANEL 7065 QT	$95.00	$151.00	$13.41–$95.00	76% above	37%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 927 QT	$95.00	$151.00	$13.41–$95.00	76% above	37%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 - GRV	$95.00	$151.00	$13.41–$95.00	76% above	37%
Vitamin B12 (cobalamin) blood test CPT 82607 CHG 82607 CYANOCOBALAMIN (VIT B12)	$95.00	$151.00	$13.41–$95.00	76% above	37%
Vitamin B12 (cobalamin) blood test CPT 82607 Micronutrient, Vit B12 10194 QT	$95.00	$151.00	$13.41–$95.00	76% above	37%
Vitamin B12 (cobalamin) blood test CPT 82607 Pernicious Anemia Diag Panel 91304 QT	$95.00	$50.00	$13.41–$95.00	76% above	-90%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Micronutrient, Vit B12 10194 QT	$95.00	$151.00	$13.41–$95.00	—	37%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Pernicious Anemia Diag Panel 91304 QT	$95.00	$50.00	$13.41–$95.00	—	-90%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CHG 82607 CYANOCOBALAMIN (VIT B12)	$95.00	$151.00	$13.41–$95.00	—	37%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 927 QT	$95.00	$151.00	$13.41–$95.00	—	37%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 - GRV	$95.00	$151.00	$13.41–$95.00	—	37%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12/FOLATE, SERUM PANEL 7065 QT	$95.00	$151.00	$13.41–$95.00	—	37%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D,25-HYDROXY 17306 QT	$205.00	$296.00	$26.33–$205.00	177% above	31%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D Total (25-OH) - GRV	$205.00	$296.00	$26.33–$205.00	177% above	31%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D,(D2,D3) 25-HYDROXY 92888 QT	$205.00	$296.00	$26.33–$205.00	177% above	31%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D,25-HYDROXY 17306 QT	$205.00	$296.00	$26.33–$205.00	—	31%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D,(D2,D3) 25-HYDROXY 92888 QT	$205.00	$296.00	$26.33–$205.00	—	31%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D Total (25-OH) - GRV	$205.00	$296.00	$26.33–$205.00	—	31%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Calcitriol1,25-DihydroxyvitaminD 16558QT	$75.60	$189.00	$34.25–$98.28	25% below	60%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Calcitriol1,25-DihydroxyvitaminD 16558QT	$75.60	$189.00	$34.25–$98.28	—	60%
Zinc blood test CPT 84630 ZINC 945 QT	$40.40	$101.00	$10.13–$52.52	7% above	60%
Zinc blood test inpatient CPT 84630 ZINC 945 QT	$40.40	$101.00	$10.13–$52.52	—	60%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 B HCG QUANTITATIVE - GRV	$60.40	$151.00	$11.54–$78.52	52% above	60%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 B HCG QUANTITATIVE - GRV	$60.40	$151.00	$11.54–$78.52	—	60%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 O/R ARTHROSCOPICALLY AIDED ANTERIOR CRUC	$932.00	$2,330.00	$297.00–$9,811.67	67% below	60%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 O/R ARTHROSCOPICALLY AIDED ANTERIOR CRUC	$932.00	$2,330.00	$297.00–$9,811.67	—	60%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 INPT ARTHROSCOP ROTATOR CUFF REPR	$8,200.00	$3,541.00	$363.00–$8,200.00	230% above	-132%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 O/R ARTHROSCOPY SHOULDER SURG W/ ROTATOR	$8,200.00	$3,541.00	$363.00–$8,200.00	230% above	-132%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 O/R ARTHROSCOPY SHOULDER SURG W/ ROTATOR	$8,200.00	$3,541.00	$363.00–$8,200.00	—	-132%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 INPT ARTHROSCOP ROTATOR CUFF REPR	$8,200.00	$3,541.00	$363.00–$8,200.00	—	-132%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 INPT CLOSED TREATMENT OF ANKLE FRACTURE	$372.40	$931.00	$130.00–$630.00	13% above	60%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX OF DISTAL FIBULAR FX	$372.40	$931.00	$130.00–$630.00	13% above	60%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 O/R CLOSED TREATMENT DISTAL FIBULAR FX	$372.40	$931.00	$130.00–$630.00	13% above	60%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX,DISTAL FIBULAR FRACTURE	$437.60	$1,094.00	$130.00–$568.88	33% above	60%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 O/R CLOSED TREATMENT DISTAL FIBULAR FX	$372.40	$931.00	$130.00–$630.00	—	60%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 INPT CLOSED TREATMENT OF ANKLE FRACTURE	$372.40	$931.00	$130.00–$630.00	—	60%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TX OF DISTAL FIBULAR FX	$372.40	$931.00	$130.00–$630.00	—	60%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TX,DISTAL FIBULAR FRACTURE	$437.60	$1,094.00	$130.00–$568.88	—	60%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX OF METATARSAL FX W/OUT MAN	$235.20	$588.00	$130.00–$880.00	43% below	60%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TREATMENT,METATARSAL FRACTURE	$437.60	$1,094.00	$130.00–$568.88	6% above	60%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX OF METATARSAL FX W/OUT MAN	$235.20	$588.00	$130.00–$880.00	—	60%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TREATMENT,METATARSAL FRACTURE	$437.60	$1,094.00	$130.00–$568.88	—	60%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 O/R CORRECTION HALLUX VALGUS	$4,000.00	$1,380.00	$250.00–$4,424.31	9% above	-190%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 O/R CORRECTION HALLUX VALGUS	$4,000.00	$1,380.00	$250.00–$4,424.31	—	-190%
Bunion correction with removal of part of the big toe joint CPT 28292 O/R CORRECTION HALLUX VALGUS	$780.80	$1,952.00	$250.00–$4,424.31	55% below	60%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 O/R CORRECTION HALLUX VALGUS	$780.80	$1,952.00	$250.00–$4,424.31	—	60%
Carpal tunnel release, open surgery CPT 64721 O/R NEUROPLASTY & TRANSPOSITION MEDIAN N	$2,600.00	$1,374.00	$320.00–$2,600.00	5% above	-89%
Carpal tunnel release, open surgery inpatient CPT 64721 O/R NEUROPLASTY & TRANSPOSITION MEDIAN N	$2,600.00	$1,374.00	$320.00–$2,600.00	—	-89%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 O/R CIRCUMCISION 28 DAYS & OLDER	$256.00	$640.00	$161.05–$1,964.35	93% below	60%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 O/R CIRCUMCISION 28 DAYS & OLDER	$256.00	$640.00	$161.05–$1,964.35	—	60%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION NEWBORN	$305.00	$6,400.00	$78.65–$3,328.00	69% below	95%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 O/R CIRCUMCISION W/REGIONAL BLOCK	$305.00	$250.00	$78.65–$1,964.35	69% below	-22%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 O/R CIRCUMCISION W/REGIONAL BLOCK	$305.00	$250.00	$78.65–$1,964.35	—	-22%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION NEWBORN	$305.00	$6,400.00	$78.65–$3,328.00	—	95%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREATMENT,DISTAL RADIAL FRAC	$545.00	$1,094.00	$130.00–$568.88	150% above	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TX DISTAL RADIAL HEAD FX	$545.00	$801.00	$130.00–$880.00	150% above	32%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREATMENT DISTAL RADIAL FX	$545.00	$801.00	$130.00–$880.00	150% above	32%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TX DISTAL RADIAL HEAD FX	$545.00	$801.00	$130.00–$880.00	—	32%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TREATMENT,DISTAL RADIAL FRAC	$545.00	$1,094.00	$130.00–$568.88	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TREATMENT DISTAL RADIAL FX	$545.00	$801.00	$130.00–$880.00	—	32%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY,FLEX,PROX TO SPLENIC FLEX PF	$281.60	$704.00	$208.12–$1,124.49	63% below	60%
Colonoscopy with polyp removal CPT 45385 COLON W/POLYP (W/O CAUTERY)	$1,746.00	$4,365.00	$208.12–$2,269.80	129% above	60%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY,FLEX,PROX TO SPLENIC FLEX PF	$281.60	$704.00	$208.12–$1,124.49	—	60%
Colonoscopy with polyp removal inpatient CPT 45385 COLON W/POLYP (W/O CAUTERY)	$1,746.00	$4,365.00	$208.12–$2,269.80	—	60%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY	$1,700.00	$4,365.00	$164.97–$2,269.80	123% above	61%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY PF	$1,700.00	$511.00	$164.97–$1,700.00	123% above	-233%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BIOPSY PF	$1,700.00	$511.00	$164.97–$1,700.00	—	-233%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BIOPSY	$1,700.00	$4,365.00	$164.97–$2,269.80	—	61%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY PF	$1,500.00	$458.00	$152.47–$1,500.00	27% above	-228%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY	$1,500.00	$458.00	$152.47–$1,500.00	27% above	-228%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$1,500.00	$4,365.00	$152.47–$2,269.80	27% above	66%
Colonoscopy, diagnostic inpatient CPT 45378 DIAGNOSTIC COLONOSCOPY	$1,500.00	$4,365.00	$152.47–$2,269.80	—	66%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY PF	$1,500.00	$458.00	$152.47–$1,500.00	—	-228%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY	$1,500.00	$458.00	$152.47–$1,500.00	—	-228%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLP CERV INCLUDE UPPER ADJ CAF E/ L	$223.60	$559.00	$129.78–$3,041.94	92% below	60%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLP CERV INCLUDE UPPER ADJ CAF E/ L	$223.60	$559.00	$129.78–$3,041.94	—	60%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLP.CERV.INCL UP AJ VAG W/BIO&CURRETAGE	$530.00	$1,000.00	$108.78–$630.00	3% above	47%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLP CERV INCLUDING UPPER AJ. VAG W/	$530.00	$330.00	$108.78–$630.00	3% above	-61%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLP.CERV.INCL UP AJ VAG W/BIO&CURRETAGE	$530.00	$1,000.00	$108.78–$630.00	—	47%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLP CERV INCLUDING UPPER AJ. VAG W/	$530.00	$330.00	$108.78–$630.00	—	-61%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY, SEPARATE PROCEDURE	$245.00	$4,691.00	$66.16–$2,439.32	87% below	95%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$245.00	$452.00	$66.16–$655.25	87% below	46%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$245.00	$452.00	$66.16–$655.25	—	46%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY, SEPARATE PROCEDURE	$245.00	$4,691.00	$66.16–$2,439.32	—	95%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION ANY KIND FIRST LESION	$100.00	$161.00	$43.33–$880.00	32% below	38%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION ANY KIND FIRST LESION	$100.00	$161.00	$43.33–$880.00	—	38%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA	$130.00	$325.00	$108.04–$729.27	72% below	60%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA	$130.00	$325.00	$108.04–$729.27	—	60%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG	$16.00	$40.00	$14.59–$250.00	70% below	60%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED EAR WAX UNILATERAL	$16.00	$40.00	$14.59–$250.00	70% below	60%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG	$16.00	$40.00	$14.59–$250.00	—	60%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED EAR WAX UNILATERAL	$16.00	$40.00	$14.59–$250.00	—	60%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN	$70.00	$101.00	$25.34–$880.00	23% below	31%
Earwax removal with instruments, one ear CPT 69210 EAR LAVAGE	$70.00	$101.00	$25.34–$880.00	23% below	31%
Earwax removal with instruments, one ear one side CPT 69210 REMOVE IMPACTED CERUMEN UNILATERAL	$70.00	$190.00	$25.34–$880.00	23% below	63%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN	$70.00	$101.00	$25.34–$880.00	—	31%
Earwax removal with instruments, one ear inpatient CPT 69210 EAR LAVAGE	$70.00	$101.00	$25.34–$880.00	—	31%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVE IMPACTED CERUMEN UNILATERAL	$70.00	$190.00	$25.34–$880.00	—	63%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX W OR W/OUT ENDOCERVIC	$265.00	$173.00	$50.74–$880.00	28% below	-53%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL SAMPLING-BIOPSY,SEP PROCED	$265.00	$661.00	$50.74–$343.72	28% below	60%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL SAMPLING-BIOPSY,SEP PROCED	$265.00	$661.00	$50.74–$343.72	—	60%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BX W OR W/OUT ENDOCERVIC	$265.00	$173.00	$50.74–$880.00	—	-53%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ DX/THER SBST INTRLMNR CRV/THRC W/IMG	$858.00	$2,145.00	$89.38–$1,115.40	14% above	60%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ DX/THER SBST INTRLMNR CRV/THRC W/IMG	$858.00	$2,145.00	$89.38–$1,115.40	—	60%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT FACET JT LMBR/SAC 1ST LVL	$1,272.00	$3,180.00	$75.74–$1,653.60	39% above	60%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT FACET JT LMBR/SAC 1ST LVL	$1,272.00	$3,180.00	$75.74–$1,653.60	—	60%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 O/R RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$593.60	$1,484.00	$363.00–$6,083.48	87% below	60%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 O/R RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$593.60	$1,484.00	$363.00–$6,083.48	—	60%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 O/R RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$354.40	$886.00	$279.49–$3,364.52	91% below	60%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 O/R RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$354.40	$886.00	$279.49–$3,364.52	—	60%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEX DIAG	$1,200.00	$3,000.00	$48.92–$1,560.00	77% above	60%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEX DIAG	$1,200.00	$3,000.00	$48.92–$1,560.00	—	60%
Gallbladder removal, laparoscopic CPT 47562 O/R LAPAROSCOPIC CHOLECYSTECTOMY	$6,500.00	$1,725.00	$363.00–$6,500.00	21% above	-277%
Gallbladder removal, laparoscopic CPT 47562 INPT LAPAROSCOPIC CHOLECYSTECTOMY	$6,500.00	$1,725.00	$363.00–$6,500.00	21% above	-277%
Gallbladder removal, laparoscopic inpatient CPT 47562 O/R LAPAROSCOPIC CHOLECYSTECTOMY	$6,500.00	$1,725.00	$363.00–$6,500.00	—	-277%
Gallbladder removal, laparoscopic inpatient CPT 47562 INPT LAPAROSCOPIC CHOLECYSTECTOMY	$6,500.00	$1,725.00	$363.00–$6,500.00	—	-277%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 O/R LAPS SURG CHOLECYSTECTOMY W/CHOLANGI	$668.00	$1,670.00	$363.00–$5,681.02	90% below	60%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 O/R LAPS SURG CHOLECYSTECTOMY W/CHOLANGI	$668.00	$1,670.00	$363.00–$5,681.02	—	60%
Gallbladder removal, open surgery through a larger incision CPT 47600 INPT REMOVAL OF GALLBLADDER	$1,393.60	$3,484.00	$375.00–$2,608.30	72% below	60%
Gallbladder removal, open surgery through a larger incision CPT 47600 O/R CHOLECYSTECTOMY	$1,393.60	$3,484.00	$375.00–$2,608.30	72% below	60%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 O/R CHOLECYSTECTOMY	$1,393.60	$3,484.00	$375.00–$2,608.30	—	60%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 INPT REMOVAL OF GALLBLADDER	$1,393.60	$3,484.00	$375.00–$2,608.30	—	60%
Hammertoe correction surgery CPT 28285 O/R CORRECTION HAMMERTOE	$3,800.00	$1,101.00	$250.00–$4,424.31	128% above	-245%
Hammertoe correction surgery inpatient CPT 28285 O/R CORRECTION HAMMERTOE	$3,800.00	$1,101.00	$250.00–$4,424.31	—	-245%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND	$198.00	$495.00	$176.85–$873.89	76% below	60%
Hemorrhoid banding (rubber band ligation) CPT 46221 O/R HEMORRHOIDECTOMY INTERNAL RUBBER BAN	$198.00	$495.00	$176.85–$873.89	76% below	60%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND LI	$1,242.00	$3,105.00	$176.85–$1,614.60	49% above	60%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 O/R HEMORRHOIDECTOMY INTERNAL RUBBER BAN	$198.00	$495.00	$176.85–$873.89	—	60%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND	$198.00	$495.00	$176.85–$873.89	—	60%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND LI	$1,242.00	$3,105.00	$176.85–$1,614.60	—	60%
Hemorrhoidectomy (internal and external), one area CPT 46255 O/R HEMORRHOIDECTOMY NTRNL & XTRNL 1 COL	$3,500.00	$1,131.00	$297.00–$3,500.00	8% above	-209%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 O/R HEMORRHOIDECTOMY NTRNL & XTRNL 1 COL	$3,500.00	$1,131.00	$297.00–$3,500.00	—	-209%
Hysterectomy through an abdominal incision (total) CPT 58150 O/R TOTAL ABDOMINAL HYSTERECT W/WO RMVL	$1,076.40	$2,691.00	$827.76–$2,608.30	86% below	60%
Hysterectomy through an abdominal incision (total) CPT 58150 INPT TOTAL ABDOMINAL HYSTERECT W/WO RMVL	$1,076.40	$2,691.00	$827.76–$2,608.30	86% below	60%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 O/R TOTAL ABDOMINAL HYSTERECT W/WO RMVL	$1,076.40	$2,691.00	$827.76–$2,608.30	—	60%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 INPT TOTAL ABDOMINAL HYSTERECT W/WO RMVL	$1,076.40	$2,691.00	$827.76–$2,608.30	—	60%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IU	$167.20	$418.00	$40.48–$880.00	89% below	60%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE	$239.20	$598.00	$40.48–$310.96	84% below	60%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IU	$167.20	$418.00	$40.48–$880.00	—	60%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE	$239.20	$598.00	$40.48–$310.96	—	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABCESS SINGLE SIMPLE PRO	$107.20	$268.00	$90.92–$880.00	57% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 O/R I&D ABCESS SINGLE; SIMPLE	$107.20	$268.00	$90.92–$880.00	57% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 INPT INCISION & DRAINAGE ABSCESS	$107.20	$268.00	$90.92–$880.00	57% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I/D OF ABSCESS SIMPLE/SINGLE	$107.20	$268.00	$90.92–$880.00	57% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABCESS SINGLE; SIMPLE FAC	$220.00	$550.00	$90.92–$880.00	11% below	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABCESS SINGLE SIMPLE PRO	$107.20	$268.00	$90.92–$880.00	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I/D OF ABSCESS SIMPLE/SINGLE	$107.20	$268.00	$90.92–$880.00	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 O/R I&D ABCESS SINGLE; SIMPLE	$107.20	$268.00	$90.92–$880.00	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INPT INCISION & DRAINAGE ABSCESS	$107.20	$268.00	$90.92–$880.00	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABCESS SINGLE; SIMPLE FAC	$220.00	$550.00	$90.92–$880.00	—	60%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 O/R REPAIR INITIAL ING HERNIA >5 YRS	$4,200.00	$1,692.00	$363.00–$4,841.33	9% below	-148%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 O/R REPAIR INITIAL ING HERNIA >5 YRS	$4,200.00	$1,692.00	$363.00–$4,841.33	—	-148%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH OR LI	$85.00	$145.00	$31.25–$630.00	80% below	41%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 TRIGGER POINT INJECTION	$85.00	$145.00	$31.25–$630.00	80% below	41%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT	$85.00	$1,139.00	$31.25–$592.28	80% below	93%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH OR LI	$85.00	$145.00	$31.25–$630.00	—	41%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT	$85.00	$1,139.00	$31.25–$592.28	—	93%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 TRIGGER POINT INJECTION	$85.00	$145.00	$31.25–$630.00	—	41%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 NEEDLE ASPIRATION MAJOR	$95.00	$126.00	$36.46–$630.00	76% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 O/R ASPIRATION & OR INJ MAJOR JOINT	$95.00	$126.00	$36.46–$630.00	76% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION & OR INJ MAJOR JOINT	$95.00	$126.00	$36.46–$630.00	76% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION &/OR INJ MAJORJOINT OR BURSA	$95.00	$1,139.00	$36.46–$630.00	76% below	92%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION & OR INJ MAJOR JOINT	$95.00	$126.00	$36.46–$630.00	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 NEEDLE ASPIRATION MAJOR	$95.00	$126.00	$36.46–$630.00	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 O/R ASPIRATION & OR INJ MAJOR JOINT	$95.00	$126.00	$36.46–$630.00	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION &/OR INJ MAJORJOINT OR BURSA	$95.00	$1,139.00	$36.46–$630.00	—	92%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION NON BIODEGRADABLE DRUG DEL	$69.20	$173.00	$50.12–$880.00	78% below	60%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION, NONBIO. DRUG DELIVERY IMPLANT	$177.20	$443.00	$50.12–$250.00	44% below	60%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION NON BIODEGRADABLE DRUG DEL	$69.20	$173.00	$50.12–$880.00	—	60%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION, NONBIO. DRUG DELIVERY IMPLANT	$177.20	$443.00	$50.12–$250.00	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 O/R ASPIRATION & OR INJ INTERMEDIATE JOI	$48.80	$122.00	$29.88–$630.00	86% below	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$48.80	$122.00	$29.88–$630.00	86% below	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION & OR INJ INTERMEDIATE JOI	$48.80	$122.00	$29.88–$630.00	86% below	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION &/OR INJ INTER JOINT OR BURSA	$368.00	$920.00	$29.88–$630.00	2% above	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATION & OR INJ INTERMEDIATE JOI	$48.80	$122.00	$29.88–$630.00	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$48.80	$122.00	$29.88–$630.00	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 O/R ASPIRATION & OR INJ INTERMEDIATE JOI	$48.80	$122.00	$29.88–$630.00	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATION &/OR INJ INTER JOINT OR BURSA	$368.00	$920.00	$29.88–$630.00	—	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION & OR INS SMALL JOINT	$36.00	$90.00	$29.21–$630.00	88% below	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 O/R DRAIN/INJ JOINT/BURSA W/O US	$36.00	$90.00	$29.21–$630.00	88% below	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION &/OR INJ SMALL JOINT OR BURSA	$400.00	$1,000.00	$29.21–$630.00	29% above	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRATION & OR INS SMALL JOINT	$36.00	$90.00	$29.21–$630.00	—	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 O/R DRAIN/INJ JOINT/BURSA W/O US	$36.00	$90.00	$29.21–$630.00	—	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRATION &/OR INJ SMALL JOINT OR BURSA	$400.00	$1,000.00	$29.21–$630.00	—	60%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 O/R ARTHROSCOPY KNEE W/MENISCUS RPR MEDI	$800.00	$2,000.00	$250.00–$4,424.31	74% below	60%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 O/R ARTHROSCOPY KNEE W/MENISCUS RPR MEDI	$800.00	$2,000.00	$250.00–$4,424.31	—	60%
Knee arthroscopy with meniscus trim CPT 29881 O/R ARTHROSCOPY KNEE SURGICAL W/MENISCET	$4,000.00	$1,758.00	$297.00–$4,424.31	8% above	-128%
Knee arthroscopy with meniscus trim inpatient CPT 29881 O/R ARTHROSCOPY KNEE SURGICAL W/MENISCET	$4,000.00	$1,758.00	$297.00–$4,424.31	—	-128%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 O/R ARTHROSCOPY KNEE SURGICAL W/ MENISCE	$671.20	$1,678.00	$297.00–$4,424.31	82% below	60%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 O/R ARTHROSCOPY KNEE SURGICAL W/ MENISCE	$671.20	$1,678.00	$297.00–$4,424.31	—	60%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 O/R ARTHROSCOPY KNEE CHONDROPLASTY	$4,000.00	$2,080.00	$297.00–$4,424.31	9% above	-92%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 O/R ARTHROSCOPY KNEE CHONDROPLASTY	$4,000.00	$2,080.00	$297.00–$4,424.31	—	-92%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 INPT LAPAROSCOPY APPENDECTOMY SURGICAL	$6,500.00	$1,911.00	$363.00–$6,500.00	17% above	-240%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 O/R LAPAROSCOPY APPENDECTOMY SURGICAL	$6,500.00	$1,911.00	$363.00–$6,500.00	17% above	-240%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 O/R LAPAROSCOPY APPENDECTOMY SURGICAL	$6,500.00	$1,911.00	$363.00–$6,500.00	—	-240%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 INPT LAPAROSCOPY APPENDECTOMY SURGICAL	$6,500.00	$1,911.00	$363.00–$6,500.00	—	-240%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 O/R LAPAROSCOPY SURG RPR INITIAL INGUINA	$448.80	$1,122.00	$363.00–$8,174.60	91% below	60%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 O/R LAPAROSCOPY SURG RPR INITIAL INGUINA	$448.80	$1,122.00	$363.00–$8,174.60	—	60%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 O/R LAP ING HERNIA REPAIR RECUR	$536.00	$1,340.00	$363.00–$8,174.60	92% below	60%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 O/R LAP ING HERNIA REPAIR RECUR	$536.00	$1,340.00	$363.00–$8,174.60	—	60%
Laparoscopic removal of fallopian tubes and/or ovaries one side CPT 58661 O/R 58661LT LAPAROSCOPY W/RMVL ADNEXAL S	$690.00	$1,725.00	$363.00–$5,681.02	83% below	60%
Laparoscopic removal of fallopian tubes and/or ovaries one side CPT 58661 O/R 58661RT LAPAROSCOPY W/RMVL ADNEXAL S	$690.00	$1,725.00	$363.00–$8,174.60	83% below	60%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient one side CPT 58661 O/R 58661LT LAPAROSCOPY W/RMVL ADNEXAL S	$690.00	$1,725.00	$363.00–$5,681.02	—	60%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient one side CPT 58661 O/R 58661RT LAPAROSCOPY W/RMVL ADNEXAL S	$690.00	$1,725.00	$363.00–$8,174.60	—	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 RPR INTMD S/A/T/EXT 2.5 CM/<	$460.00	$403.00	$121.62–$880.00	18% above	-14%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 O/R REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$460.00	$403.00	$121.62–$880.00	18% above	-14%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE OF WOUND 2.5CM OR LESS	$460.00	$403.00	$121.62–$880.00	18% above	-14%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR,INTERM WNDS OF SLP/AX/TRK <=2.5CM	$460.00	$894.00	$121.62–$464.88	18% above	49%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 O/R REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$460.00	$403.00	$121.62–$880.00	—	-14%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR,INTERM WNDS OF SLP/AX/TRK <=2.5CM	$460.00	$894.00	$121.62–$464.88	—	49%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE OF WOUND 2.5CM OR LESS	$460.00	$403.00	$121.62–$880.00	—	-14%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 RPR INTMD S/A/T/EXT 2.5 CM/<	$460.00	$403.00	$121.62–$880.00	—	-14%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ DX/THER SBST INTRLMNR LMBR/SAC W/IMG	$919.20	$2,298.00	$83.36–$1,194.96	23% above	60%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ DX/THER SBST INTRLMNR LMBR/SAC W/IMG	$919.20	$2,298.00	$83.36–$1,194.96	—	60%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ,TRANS EPIDURAL,LUMBAR/SACRAL,SINGLE	$1,272.00	$3,180.00	$92.72–$1,653.60	41% above	60%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ,TRANS EPIDURAL,LUMBAR/SACRAL,SINGLE	$1,272.00	$3,180.00	$92.72–$1,653.60	—	60%
Lumpectomy (partial mastectomy) CPT 19301 INPT PARTIAL MASTECTOMY	$835.20	$2,088.00	$320.00–$5,294.34	57% below	60%
Lumpectomy (partial mastectomy) inpatient CPT 19301 INPT PARTIAL MASTECTOMY	$835.20	$2,088.00	$320.00–$5,294.34	—	60%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENIGN LES TRUNK/ARM/LEG <.5CM PRO	$86.80	$217.00	$68.93–$665.43	83% below	60%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 O/R EXC BENIGN LES TRUNK/ARM/LEG <.5CM P	$86.80	$217.00	$68.93–$665.43	83% below	60%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENIGN LES TRUNK/ARM/LEG <.5CM FAC	$776.80	$1,942.00	$68.93–$1,009.84	48% above	60%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 O/R EXC BENIGN LES TRUNK/ARM/LEG <.5CM P	$86.80	$217.00	$68.93–$665.43	—	60%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BENIGN LES TRUNK/ARM/LEG <.5CM PRO	$86.80	$217.00	$68.93–$665.43	—	60%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BENIGN LES TRUNK/ARM/LEG <.5CM FAC	$776.80	$1,942.00	$68.93–$1,009.84	—	60%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BEN LES FACE/EARS < .5 CM PRO	$112.80	$282.00	$88.04–$665.43	84% below	60%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 O/R EXC B9 LESION MRGN XCP SK TG F/E/E/N	$112.80	$282.00	$88.04–$665.43	84% below	60%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BEN LES FACE/EARS < .5 CM FAC	$1,148.80	$2,872.00	$88.04–$1,493.44	66% above	60%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BEN LES FACE/EARS < .5 CM PRO	$112.80	$282.00	$88.04–$665.43	—	60%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 O/R EXC B9 LESION MRGN XCP SK TG F/E/E/N	$112.80	$282.00	$88.04–$665.43	—	60%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BEN LES FACE/EARS < .5 CM FAC	$1,148.80	$2,872.00	$88.04–$1,493.44	—	60%
Nail removal (partial or complete), one nail CPT 11730 O/R REMOVAL OF NAIL PLATE SINGLE	$260.00	$170.00	$46.00–$880.00	21% above	-53%
Nail removal (partial or complete), one nail CPT 11730 AVULSION-NAIL PLATE PART OR COMP,SINGLE	$260.00	$620.00	$46.00–$880.00	21% above	58%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL OR COMP	$260.00	$170.00	$46.00–$880.00	21% above	-53%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE,SIMPLE, SINGLE	$260.00	$170.00	$46.00–$880.00	21% above	-53%
Nail removal (partial or complete), one nail CPT 11730 INPT REMOVAL OF NAIL PLATE SINGLE	$260.00	$170.00	$46.00–$880.00	21% above	-53%
Nail removal (partial or complete), one nail inpatient CPT 11730 INPT REMOVAL OF NAIL PLATE SINGLE	$260.00	$170.00	$46.00–$880.00	—	-53%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL OR COMP	$260.00	$170.00	$46.00–$880.00	—	-53%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION-NAIL PLATE PART OR COMP,SINGLE	$260.00	$620.00	$46.00–$880.00	—	58%
Nail removal (partial or complete), one nail inpatient CPT 11730 O/R REMOVAL OF NAIL PLATE SINGLE	$260.00	$170.00	$46.00–$880.00	—	-53%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE,SIMPLE, SINGLE	$260.00	$170.00	$46.00–$880.00	—	-53%
Occipital nerve block (injection for headaches) CPT 64405 OCCIPITAL NERVE BLOCK	$400.00	$1,000.00	$41.72–$520.00	3% below	60%
Occipital nerve block (injection for headaches) inpatient CPT 64405 OCCIPITAL NERVE BLOCK	$400.00	$1,000.00	$41.72–$520.00	—	60%
Paracentesis with imaging guidance CPT 49083 ABDOM PARACENTESIS DX/THER W/IMAGING GUI	$138.00	$345.00	$86.96–$852.30	81% below	60%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOM PARACENTESIS DX/THER W/IMAGING GUI	$138.00	$345.00	$86.96–$852.30	—	60%
Partial knee replacement (one compartment) CPT 27446 O/R ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/L	$1,412.40	$3,531.00	$297.00–$17,360.12	76% below	60%
Partial knee replacement (one compartment) inpatient CPT 27446 O/R ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/L	$1,412.40	$3,531.00	$297.00–$17,360.12	—	60%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION,NAIL&NAIL MATRIX,PAR OR COMP	$320.00	$1,506.00	$86.99–$783.12	44% below	79%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL	$320.00	$276.00	$86.99–$630.00	44% below	-16%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL OR NAIL MATRIX PART OR COMP	$320.00	$276.00	$86.99–$630.00	44% below	-16%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL	$320.00	$276.00	$86.99–$630.00	—	-16%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL OR NAIL MATRIX PART OR COMP	$320.00	$276.00	$86.99–$630.00	—	-16%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION,NAIL&NAIL MATRIX,PAR OR COMP	$320.00	$1,506.00	$86.99–$783.12	—	79%
Removal of a breast lump, open surgery CPT 19120 O/R EXC CYST/ABERRANT BREAST TISSUE OPEN	$523.60	$1,309.00	$320.00–$3,679.35	83% below	60%
Removal of a breast lump, open surgery CPT 19120 EXCISION OF CYST,OPEN,1 OR >	$2,222.40	$5,556.00	$320.00–$5,294.34	28% below	60%
Removal of a breast lump, open surgery inpatient CPT 19120 O/R EXC CYST/ABERRANT BREAST TISSUE OPEN	$523.60	$1,309.00	$320.00–$3,679.35	—	60%
Removal of a breast lump, open surgery inpatient CPT 19120 EXCISION OF CYST,OPEN,1 OR >	$2,222.40	$5,556.00	$320.00–$5,294.34	—	60%
Removal of a foreign object under the skin, simple CPT 10120 INCISION/REMOVAL OF FB, SUBC;SIMPLE PRO	$106.40	$266.00	$92.25–$880.00	70% below	60%
Removal of a foreign object under the skin, simple CPT 10120 INCIS/REMOVAL FOREIGN BODY	$106.40	$266.00	$92.25–$880.00	70% below	60%
Removal of a foreign object under the skin, simple CPT 10120 O/R INCISION & REMOVAL FOREIGN BODY SUBQ	$106.40	$266.00	$92.25–$880.00	70% below	60%
Removal of a foreign object under the skin, simple CPT 10120 INCISION/REMOVAL OF FB, SUBC;SIMPLE FAC	$499.20	$1,248.00	$92.25–$648.96	42% above	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION/REMOVAL OF FB, SUBC;SIMPLE PRO	$106.40	$266.00	$92.25–$880.00	—	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 O/R INCISION & REMOVAL FOREIGN BODY SUBQ	$106.40	$266.00	$92.25–$880.00	—	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCIS/REMOVAL FOREIGN BODY	$106.40	$266.00	$92.25–$880.00	—	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION/REMOVAL OF FB, SUBC;SIMPLE FAC	$499.20	$1,248.00	$92.25–$648.96	—	60%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY SCREENING MEDICARE	$180.00	$450.00	$152.64–$873.89	73% below	60%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY;SCREENING MEDICARE PF	$180.00	$450.00	$152.64–$873.89	73% below	60%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HIGH RSK IND	$2,135.60	$5,339.00	$152.64–$2,776.28	223% above	60%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY;SCREENING MEDICARE PF	$180.00	$450.00	$152.64–$873.89	—	60%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY SCREENING MEDICARE	$180.00	$450.00	$152.64–$873.89	—	60%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLON CA SCRN NOT HIGH RSK IND	$2,135.60	$5,339.00	$152.64–$2,776.28	—	60%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY;SCREEN HIGH RISK PF	$180.00	$450.00	$152.47–$873.89	72% below	60%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY SCREENING HIGH RISK	$180.00	$450.00	$152.47–$873.89	72% below	60%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY SCREENING HIGH RISK	$180.00	$450.00	$152.47–$873.89	—	60%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY;SCREEN HIGH RISK PF	$180.00	$450.00	$152.47–$873.89	—	60%
Septoplasty to straighten the nasal septum CPT 30520 O/R REPAIR OF NASAL SEPTUM	$777.60	$1,944.00	$363.00–$3,115.56	69% below	60%
Septoplasty to straighten the nasal septum inpatient CPT 30520 O/R REPAIR OF NASAL SEPTUM	$777.60	$1,944.00	$363.00–$3,115.56	—	60%
Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW TO FINGER	$115.00	$197.00	$52.68–$880.00	4% below	42%
Short arm cast (elbow to hand) CPT 29075 APPLICATION,CAST,ELBOW-FINGER(SHORT ARM)	$115.00	$894.00	$52.68–$464.88	4% below	87%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION,CAST,ELBOW-FINGER(SHORT ARM)	$115.00	$894.00	$52.68–$464.88	—	87%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW TO FINGER	$115.00	$197.00	$52.68–$880.00	—	42%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM	$38.00	$95.00	$36.75–$880.00	72% below	60%
Short arm splint (forearm and hand) CPT 29125 APPLICATION,SHORT ARM SPLINT	$56.00	$140.00	$36.75–$880.00	58% below	60%
Short arm splint (forearm and hand) CPT 29125 APPLICATION, SHORT ARM SPLINT	$168.00	$420.00	$36.75–$250.00	26% above	60%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM	$38.00	$95.00	$36.75–$880.00	—	60%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION,SHORT ARM SPLINT	$56.00	$140.00	$36.75–$880.00	—	60%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION, SHORT ARM SPLINT	$168.00	$420.00	$36.75–$250.00	—	60%
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT CAST	$82.40	$206.00	$50.34–$880.00	51% below	60%
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST	$528.40	$1,321.00	$50.34–$686.92	216% above	60%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION OF SHORT CAST	$82.40	$206.00	$50.34–$880.00	—	60%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION OF SHORT LEG CAST	$528.40	$1,321.00	$50.34–$686.92	—	60%
Short leg splint (calf to foot) CPT 29515 APPLICATION,SHORT LEG SPLINT	$53.60	$134.00	$44.94–$880.00	61% below	60%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$205.20	$513.00	$44.94–$880.00	51% above	60%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION,SHORT LEG SPLINT	$53.60	$134.00	$44.94–$880.00	—	60%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION LOWER LEG SPLINT	$205.20	$513.00	$44.94–$880.00	—	60%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 O/R ARTHROSCOPY SHOULDER SURGICAL DISTAL	$4,000.00	$1,983.00	$297.00–$4,424.31	39% above	-102%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 O/R ARTHROSCOPY SHOULDER SURGICAL DISTAL	$4,000.00	$1,983.00	$297.00–$4,424.31	—	-102%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 O/R ARTHROSCOPY SHOULDER SURGICAL DECOMP	$242.00	$605.00	$130.00–$880.00	87% below	60%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 O/R ARTHROSCOPY SHOULDER SURGICAL DECOMP	$242.00	$605.00	$130.00–$880.00	—	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SCALP,NECK,AXILLA,TRUNK 2	$520.00	$124.00	$39.86–$880.00	152% above	-319%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SINGLR LAYER UP TO 2.5CM	$520.00	$124.00	$39.86–$880.00	152% above	-319%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE,REP SCALP/NECK/AXIL/TRNK/EX 2.5,<	$520.00	$894.00	$39.86–$880.00	152% above	42%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 INPT RPR SIMPLE S/N/AX/GEN/TRNK 2.5CM	$520.00	$124.00	$39.86–$880.00	152% above	-319%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SCALP,NECK,AXILLA,TRUNK 2	$520.00	$124.00	$39.86–$880.00	—	-319%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 INPT RPR SIMPLE S/N/AX/GEN/TRNK 2.5CM	$520.00	$124.00	$39.86–$880.00	—	-319%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE,REP SCALP/NECK/AXIL/TRNK/EX 2.5,<	$520.00	$894.00	$39.86–$880.00	—	42%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SINGLR LAYER UP TO 2.5CM	$520.00	$124.00	$39.86–$880.00	—	-319%
Skin biopsy, punch, one lesion CPT 11104 O/R PUNCH BIOPSY SKIN SINGLE LESION	$50.80	$127.00	$35.67–$382.00	81% below	60%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$50.80	$127.00	$35.67–$382.00	81% below	60%
Skin biopsy, punch, one lesion inpatient CPT 11104 O/R PUNCH BIOPSY SKIN SINGLE LESION	$50.80	$127.00	$35.67–$382.00	—	60%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$50.80	$127.00	$35.67–$382.00	—	60%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MALIGNANT LESION .05CM OR L	$134.80	$337.00	$98.81–$665.43	84% below	60%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION,MAL LES,TRK/ARM/LEG 0.5 CM<	$1,458.40	$3,646.00	$98.81–$1,895.92	69% above	60%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION .05CM OR L	$134.80	$337.00	$98.81–$665.43	—	60%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION,MAL LES,TRK/ARM/LEG 0.5 CM<	$1,458.40	$3,646.00	$98.81–$1,895.92	—	60%
Skin tag removal, up to 15 tags CPT 11200 O/R REMOVAL SKIN TAGS ANY AREA 1-15	$80.80	$202.00	$62.55–$880.00	64% below	60%
Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAGS ANY AREA 1-15 LESIONS PRO	$80.80	$202.00	$62.55–$880.00	64% below	60%
Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAGS ANY AREA 1-15 LESIONS FAC	$164.40	$411.00	$62.55–$880.00	26% below	60%
Skin tag removal, up to 15 tags inpatient CPT 11200 O/R REMOVAL SKIN TAGS ANY AREA 1-15	$80.80	$202.00	$62.55–$880.00	—	60%
Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKIN TAGS ANY AREA 1-15 LESIONS PRO	$80.80	$202.00	$62.55–$880.00	—	60%
Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKIN TAGS ANY AREA 1-15 LESIONS FAC	$164.40	$411.00	$62.55–$880.00	—	60%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$112.80	$282.00	$53.03–$663.32	83% below	60%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$112.80	$282.00	$53.03–$663.32	83% below	60%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC	$979.20	$2,448.00	$53.03–$1,272.96	44% above	60%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$112.80	$282.00	$53.03–$663.32	—	60%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$112.80	$282.00	$53.03–$663.32	—	60%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC	$979.20	$2,448.00	$53.03–$1,272.96	—	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 INPT SMPL REPAIR SCALP/NECK/AX/GENIT/TRU	$535.00	$161.00	$52.08–$880.00	136% above	-232%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SINGLR LAYER 2.6-7.5CM	$535.00	$161.00	$52.08–$880.00	136% above	-232%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE RPR SCALP,NECK,AXILLA,TRU 2.6	$535.00	$161.00	$52.08–$880.00	136% above	-232%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE,REP SCALP/NECK/AX/TRNK/EX2.6-7.5C	$535.00	$894.00	$52.08–$880.00	136% above	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SINGLR LAYER 2.6-7.5CM	$535.00	$161.00	$52.08–$880.00	—	-232%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 INPT SMPL REPAIR SCALP/NECK/AX/GENIT/TRU	$535.00	$161.00	$52.08–$880.00	—	-232%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE,REP SCALP/NECK/AX/TRNK/EX2.6-7.5C	$535.00	$894.00	$52.08–$880.00	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE RPR SCALP,NECK,AXILLA,TRU 2.6	$535.00	$161.00	$52.08–$880.00	—	-232%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR FACE,EARS,EYE,NOSE,LIPS	$60.00	$150.00	$49.27–$880.00	70% below	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SINGLE LAYER FACE EAR ETC 2.5CM OR LESS	$60.00	$150.00	$49.27–$880.00	70% below	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE,REP FACE/EAR/EYE/NOSE/LIP 2.5C,<	$357.60	$894.00	$49.27–$880.00	77% above	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SINGLE LAYER FACE EAR ETC 2.5CM OR LESS	$60.00	$150.00	$49.27–$880.00	—	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR FACE,EARS,EYE,NOSE,LIPS	$60.00	$150.00	$49.27–$880.00	—	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE,REP FACE/EAR/EYE/NOSE/LIP 2.5C,<	$357.60	$894.00	$49.27–$880.00	—	60%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$48.40	$121.00	$28.29–$382.00	82% below	60%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 PUNCH BIOPSY SKIN SINGLE LESION	$324.00	$810.00	$28.29–$421.20	24% above	60%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$48.40	$121.00	$28.29–$382.00	—	60%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 PUNCH BIOPSY SKIN SINGLE LESION	$324.00	$810.00	$28.29–$421.20	—	60%
Tonsil and adenoid removal, age 12 or older CPT 42821 O/R REMOVE TONSILS AND ADENOIDS	$345.20	$863.00	$240.10–$3,115.56	87% below	60%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 O/R REMOVE TONSILS AND ADENOIDS	$345.20	$863.00	$240.10–$3,115.56	—	60%
Total hip replacement CPT 27130 INPT TOTAL HIP ARTHROPLASTY	$1,200.00	$3,000.00	$320.00–$17,360.12	85% below	60%
Total hip replacement inpatient CPT 27130 INPT TOTAL HIP ARTHROPLASTY	$1,200.00	$3,000.00	$320.00–$17,360.12	—	60%
Total knee replacement CPT 27447 INPT TOTAL KNEE ARTHROPLASTY	$1,479.20	$3,698.00	$320.00–$12,064.58	74% below	60%
Total knee replacement CPT 27447 O/R TOTAL KNEE ARTHROPLASTY	$1,479.20	$3,698.00	$320.00–$17,360.12	74% below	60%
Total knee replacement inpatient CPT 27447 O/R TOTAL KNEE ARTHROPLASTY	$1,479.20	$3,698.00	$320.00–$17,360.12	—	60%
Total knee replacement inpatient CPT 27447 INPT TOTAL KNEE ARTHROPLASTY	$1,479.20	$3,698.00	$320.00–$12,064.58	—	60%
Total shoulder replacement CPT 23472 INPT ARTHROPLASTY GLENOHUMERAL JOINT	$1,400.00	$3,500.00	$363.00–$23,708.76	69% below	60%
Total shoulder replacement inpatient CPT 23472 INPT ARTHROPLASTY GLENOHUMERAL JOINT	$1,400.00	$3,500.00	$363.00–$23,708.76	—	60%
Trigger finger release surgery CPT 26055 O/R INCISE FINGER TENDON SHEATH	$353.20	$883.00	$250.00–$1,511.04	77% below	60%
Trigger finger release surgery inpatient CPT 26055 O/R INCISE FINGER TENDON SHEATH	$353.20	$883.00	$250.00–$1,511.04	—	60%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 M	$50.80	$127.00	$33.07–$630.00	87% below	60%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE OR MULTIPLE TRIGGER	$50.80	$127.00	$33.07–$630.00	87% below	60%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE OR MULT TRIG POINT 1OR2	$455.60	$1,139.00	$33.07–$630.00	16% above	60%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 M	$50.80	$127.00	$33.07–$630.00	—	60%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE OR MULTIPLE TRIGGER	$50.80	$127.00	$33.07–$630.00	—	60%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE OR MULT TRIG POINT 1OR2	$455.60	$1,139.00	$33.07–$630.00	—	60%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 O/R LAPAROSCOPY TUBAL CAUTERY	$360.00	$900.00	$294.96–$5,681.02	86% below	60%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 O/R LAPAROSCOPY TUBAL CAUTERY	$360.00	$900.00	$294.96–$5,681.02	—	60%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD W/ DILATION OF THE ESOPHAGUS	$240.00	$600.00	$126.49–$1,803.21	76% below	60%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD W/ DILATION OF THE ESOPHAGUS	$240.00	$600.00	$126.49–$1,803.21	—	60%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/ BIOPSY	$1,500.00	$382.00	$114.60–$1,500.00	28% above	-293%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD WITH BIOPSY	$1,500.00	$3,416.00	$114.60–$1,776.32	28% above	56%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD-W/BIOPSY PF	$1,500.00	$382.00	$114.60–$1,500.00	28% above	-293%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/ BIOPSY	$1,500.00	$382.00	$114.60–$1,500.00	—	-293%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD-W/BIOPSY PF	$1,500.00	$382.00	$114.60–$1,500.00	—	-293%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD WITH BIOPSY	$1,500.00	$3,416.00	$114.60–$1,776.32	—	56%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD W/REMOVAL OF LESION BY SNARE	$3,692.00	$9,230.00	$160.86–$4,799.60	364% above	60%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD W/REMOVAL OF LESION BY SNARE	$3,692.00	$9,230.00	$160.86–$4,799.60	—	60%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD W/ BRUSHING	$1,500.00	$2,850.00	$102.33–$1,500.00	at median	47%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD	$1,500.00	$339.00	$102.33–$1,500.00	at median	-342%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD PF	$1,500.00	$339.00	$102.33–$1,500.00	at median	-342%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD W/ BRUSHING	$1,500.00	$2,850.00	$102.33–$1,500.00	—	47%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD	$1,500.00	$339.00	$102.33–$1,500.00	—	-342%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD PF	$1,500.00	$339.00	$102.33–$1,500.00	—	-342%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$1,205.00	$6,935.00	$114.84–$3,606.20	31% below	83%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$1,205.00	$6,935.00	$114.84–$3,606.20	—	83%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION FLAT WART MOLLUSCUN UP T	$78.40	$196.00	$56.33–$880.00	54% below	60%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION FLAT WART, MOLLUS.CONT. 14,<	$127.60	$319.00	$56.33–$880.00	26% below	60%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION FLAT WART MOLLUSCUN UP T	$78.40	$196.00	$56.33–$880.00	—	60%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION FLAT WART, MOLLUS.CONT. 14,<	$127.60	$319.00	$56.33–$880.00	—	60%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN & SUBC TISSUE PRO	$60.00	$150.00	$51.29–$745.00	90% below	60%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 O/R DEBRIDEMENT SUB TISS 1ST 20 SQ CM /<	$60.00	$150.00	$51.29–$745.00	90% below	60%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM	$81.60	$204.00	$51.29–$745.00	87% below	60%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN & SUBC TISSUE PRO	$60.00	$150.00	$51.29–$745.00	—	60%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 O/R DEBRIDEMENT SUB TISS 1ST 20 SQ CM /<	$60.00	$150.00	$51.29–$745.00	—	60%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM	$81.60	$204.00	$51.29–$745.00	—	60%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 O/R OPEN TX DISTAL RADIAL EXTRA-ARTICUL	$879.20	$2,198.00	$297.00–$9,811.67	74% below	60%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 O/R OPEN TX DISTAL RADIAL EXTRA-ARTICUL	$879.20	$2,198.00	$297.00–$9,811.67	—	60%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$1,158.40	$2,896.00	$39.49–$1,505.92	146% above	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$1,158.40	$2,896.00	$39.49–$1,505.92	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT FOR DIAG PURPOSES	$266.00	$665.00	$6.00–$345.80	239% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TX SUBS 4TH	$324.80	$812.00	$6.00–$422.24	314% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TX SUBS 3RD	$324.80	$812.00	$6.00–$422.24	314% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TX SUBS 2ND	$324.80	$812.00	$6.00–$422.24	314% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZED MIST TX SUBSEQUENT	$324.80	$812.00	$6.00–$422.24	314% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TX SUBSEQUENT	$324.80	$812.00	$6.00–$422.24	314% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 CAG/HAG (LG VOL NEB SUBS)	$324.80	$812.00	$6.00–$422.24	314% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ULTRASONIC NEBULIZER TX	$324.80	$812.00	$6.00–$422.24	314% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MAXI MYST TREATMENT SUBSEQUENT	$324.80	$812.00	$6.00–$422.24	314% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZED MIST TX 4TH SUBSEQUENT	$324.80	$812.00	$6.00–$422.24	314% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZED MIST TX 2ND SUBSEQUENT	$324.80	$812.00	$6.00–$422.24	314% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZED MIST TX 3RD SUBSEQUENT	$324.80	$812.00	$6.00–$422.24	314% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR DIAG PURPOSES	$266.00	$665.00	$6.00–$345.80	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZED MIST TX 3RD SUBSEQUENT	$324.80	$812.00	$6.00–$422.24	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZED MIST TX 4TH SUBSEQUENT	$324.80	$812.00	$6.00–$422.24	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MAXI MYST TREATMENT SUBSEQUENT	$324.80	$812.00	$6.00–$422.24	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ULTRASONIC NEBULIZER TX	$324.80	$812.00	$6.00–$422.24	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 CAG/HAG (LG VOL NEB SUBS)	$324.80	$812.00	$6.00–$422.24	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TX SUBSEQUENT	$324.80	$812.00	$6.00–$422.24	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZED MIST TX SUBSEQUENT	$324.80	$812.00	$6.00–$422.24	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TX SUBS 2ND	$324.80	$812.00	$6.00–$422.24	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TX SUBS 3RD	$324.80	$812.00	$6.00–$422.24	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TX SUBS 4TH	$324.80	$812.00	$6.00–$422.24	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZED MIST TX 2ND SUBSEQUENT	$324.80	$812.00	$6.00–$422.24	—	60%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE ILL/INJ PT FIRST HOUR 30-7	$320.00	$800.00	$187.84–$744.63	73% below	60%
Critical care, first 30 to 74 minutes CPT 99291 HOSPITAL CRITICAL CARE 1ST HOUR	$320.00	$800.00	$187.84–$744.63	73% below	60%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HOSPITAL CRITICAL CARE 1ST HOUR	$320.00	$800.00	$187.84–$744.63	—	60%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE ILL/INJ PT FIRST HOUR 30-7	$320.00	$800.00	$187.84–$744.63	—	60%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG/RECORD AWAKE/DROWSEY	$412.80	$1,032.00	$25.00–$536.64	20% above	60%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG/RECORD AWAKE/DROWSEY	$412.80	$1,032.00	$25.00–$536.64	—	60%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ROUTINE ECG 12LEADS w/ INTERP/REPORT	$24.00	$60.00	$13.35–$31.20	8% below	60%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG WITH INTERP AND REPORT	$236.00	$590.00	$13.35–$306.80	809% above	60%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ROUTINE ECG 12LEADS w/ INTERP/REPORT	$24.00	$60.00	$13.35–$31.20	—	60%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ECG WITH INTERP AND REPORT	$236.00	$590.00	$13.35–$306.80	—	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ROUTINE	$125.00	$590.00	$5.83–$306.80	64% above	79%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CL ECG ROUTINE	$125.00	$242.00	$5.83–$125.84	64% above	48%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG STAT	$125.00	$590.00	$5.83–$306.80	64% above	79%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$125.00	$56.00	$5.83–$125.00	64% above	-123%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$125.00	$56.00	$5.83–$125.00	—	-123%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CL ECG ROUTINE	$125.00	$242.00	$5.83–$125.84	—	48%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG ROUTINE	$125.00	$590.00	$5.83–$306.80	—	79%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG STAT	$125.00	$590.00	$5.83–$306.80	—	79%
Electroconvulsive therapy (ECT), one session CPT 90870 O/R ELECTROCONVULSIVE THERAPY	$136.00	$340.00	$40.00–$806.96	54% below	60%
Electroconvulsive therapy (ECT), one session CPT 90870 INPT ELECTROCONVULSIVE THERAPY	$136.00	$340.00	$40.00–$806.96	54% below	60%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 INPT ELECTROCONVULSIVE THERAPY	$136.00	$340.00	$40.00–$806.96	—	60%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 O/R ELECTROCONVULSIVE THERAPY	$136.00	$340.00	$40.00–$806.96	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERG DEPT LEVEL ONE VISIT	$300.00	$350.00	$9.97–$315.00	67% above	14%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT LEVEL 1 VISIT 459	$300.00	$350.00	$9.97–$315.00	67% above	14%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERG DEPT LEVEL ONE VISIT	$300.00	$350.00	$9.97–$315.00	—	14%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPT LEVEL 1 VISIT 459	$300.00	$350.00	$9.97–$315.00	—	14%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT LEVEL 2 VISIT 459	$400.00	$630.00	$36.62–$425.00	36% above	37%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERG DEPT LEVEL 2 VISIT	$400.00	$630.00	$36.62–$425.00	36% above	37%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERG DEPT LEVEL 2 VISIT	$400.00	$630.00	$36.62–$425.00	—	37%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT LEVEL 2 VISIT 459	$400.00	$630.00	$36.62–$425.00	—	37%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT LEVEL 3 VISIT 459	$500.00	$1,100.00	$62.92–$572.00	3% above	55%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT LEVEL 3 VISIT	$500.00	$1,100.00	$62.92–$572.00	3% above	55%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT LEVEL 3 VISIT 459	$500.00	$1,100.00	$62.92–$572.00	—	55%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT LEVEL 3 VISIT	$500.00	$1,100.00	$62.92–$572.00	—	55%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT LEVEL 4 VISIT	$600.00	$1,700.00	$107.13–$884.00	10% below	65%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT LEVEL 4 VISIT 459	$600.00	$1,700.00	$107.13–$884.00	10% below	65%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT LEVEL 4 VISIT 459	$600.00	$1,700.00	$107.13–$884.00	—	65%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT LEVEL 4 VISIT	$600.00	$1,700.00	$107.13–$884.00	—	65%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT LEVEL 5 VISIT 459	$700.00	$2,550.00	$155.41–$1,326.00	34% below	73%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT LEVEL 5 VISIT	$700.00	$2,550.00	$155.41–$1,326.00	34% below	73%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT LEVEL 5 VISIT 459	$700.00	$2,550.00	$155.41–$1,326.00	—	73%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT LEVEL 5 VISIT	$700.00	$2,550.00	$155.41–$1,326.00	—	73%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST TRACING	$840.00	$2,100.00	$32.55–$1,092.00	124% above	60%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST TRACING	$840.00	$2,100.00	$32.55–$1,092.00	—	60%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY	$112.80	$282.00	$101.10–$166.79	31% below	60%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY,CONJOINT W/PATIENT	$232.00	$580.00	$101.10–$301.60	42% above	60%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY	$112.80	$282.00	$101.10–$166.79	—	60%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY,CONJOINT W/PATIENT	$232.00	$580.00	$101.10–$301.60	—	60%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PATIENT PRESENT	$128.40	$321.00	$97.60–$166.92	27% below	60%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYTX W/O PATIENT PRESENT	$128.40	$321.00	$97.60–$166.92	—	60%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY	$31.20	$78.00	$24.10–$95.47	70% below	60%
Group psychotherapy session CPT 90853 INPT GROUP PSYCHOTHERAPY	$31.20	$78.00	$24.10–$95.47	70% below	60%
Group psychotherapy session inpatient CPT 90853 INPT GROUP PSYCHOTHERAPY	$31.20	$78.00	$24.10–$95.47	—	60%
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY	$31.20	$78.00	$24.10–$95.47	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION - FIRST HOUR	$256.40	$641.00	$28.42–$333.32	79% above	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INITIAL	$256.40	$641.00	$28.42–$333.32	79% above	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION,HYDRATION,INITIAL,31MIN-1HR	$256.40	$641.00	$28.42–$333.32	79% above	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION,HYDRATION,INITIAL,U	$572.00	$1,430.00	$28.42–$743.60	299% above	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION,HYDRATION,INITIAL,UP TO 1HR	$572.00	$1,430.00	$28.42–$743.60	299% above	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION - FIRST HOUR	$256.40	$641.00	$28.42–$333.32	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL	$256.40	$641.00	$28.42–$333.32	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION,HYDRATION,INITIAL,31MIN-1HR	$256.40	$641.00	$28.42–$333.32	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION,HYDRATION,INITIAL,UP TO 1HR	$572.00	$1,430.00	$28.42–$743.60	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION,HYDRATION,INITIAL,U	$572.00	$1,430.00	$28.42–$743.60	—	60%
IV infusion of a medicine, first hour CPT 96365 IV INFUS THER PROPHY DX INIT UP TO 1	$60.00	$150.00	$56.63–$199.88	65% below	60%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THER/PROPHYLAXIS /DX 1ST HR	$60.00	$150.00	$56.63–$199.88	65% below	60%
IV infusion of a medicine, first hour CPT 96365 TIME INTENSIVE IV THERAPY/TX	$270.00	$675.00	$56.63–$351.00	57% above	60%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION,THERAPY/PROPH/DIAG,INITIAL	$572.00	$1,430.00	$56.63–$743.60	232% above	60%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS THER PROPHY DX INIT UP TO 1	$60.00	$150.00	$56.63–$199.88	—	60%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THER/PROPHYLAXIS /DX 1ST HR	$60.00	$150.00	$56.63–$199.88	—	60%
IV infusion of a medicine, first hour inpatient CPT 96365 TIME INTENSIVE IV THERAPY/TX	$270.00	$675.00	$56.63–$351.00	—	60%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION,THERAPY/PROPH/DIAG,INITIAL	$572.00	$1,430.00	$56.63–$743.60	—	60%
IV push of a medicine, first drug CPT 96374 THERP,PROPHY,DX INJ IVP SINGLE/INIT	$94.40	$236.00	$32.05–$199.88	22% below	60%
IV push of a medicine, first drug CPT 96374 IV START	$268.00	$670.00	$32.05–$348.40	122% above	60%
IV push of a medicine, first drug CPT 96374 THERAPEUTIC,PROPH/DIA INJ,IV PUSH,SINGLE	$572.00	$1,430.00	$32.05–$743.60	373% above	60%
IV push of a medicine, first drug inpatient CPT 96374 THERP,PROPHY,DX INJ IVP SINGLE/INIT	$94.40	$236.00	$32.05–$199.88	—	60%
IV push of a medicine, first drug inpatient CPT 96374 IV START	$268.00	$670.00	$32.05–$348.40	—	60%
IV push of a medicine, first drug inpatient CPT 96374 THERAPEUTIC,PROPH/DIA INJ,IV PUSH,SINGLE	$572.00	$1,430.00	$32.05–$743.60	—	60%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC,PROPH/DIAG INJ,SUBCU OR IM	$45.00	$470.00	$13.37–$244.40	7% below	90%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYACTIC DX INJ SUBQ	$45.00	$40.00	$13.37–$67.66	7% below	-13%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPUTIC OR DIAG INJ, SUBCU OR IM	$45.00	$220.00	$13.37–$114.40	7% below	80%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYACTIC DX INJ SUBQ	$45.00	$40.00	$13.37–$67.66	—	-13%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPUTIC OR DIAG INJ, SUBCU OR IM	$45.00	$220.00	$13.37–$114.40	—	80%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC,PROPH/DIAG INJ,SUBCU OR IM	$45.00	$470.00	$13.37–$244.40	—	90%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION - FAC	$100.00	$988.00	$100.00–$513.76	32% below	90%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION - PRO	$100.00	$380.00	$100.00–$197.60	32% below	74%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION - PRO	$100.00	$380.00	$100.00–$197.60	—	74%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION - FAC	$100.00	$988.00	$100.00–$513.76	—	90%
New patient office visit, about 30 minutes CPT 99203 WC PRO NEW PATIENT LEVEL 3	$100.00	$256.00	$67.43–$133.12	at median	61%
New patient office visit, about 30 minutes CPT 99203 CLINIC FAC NEW PT III	$100.00	$600.00	$67.43–$312.00	at median	83%
New patient office visit, about 30 minutes CPT 99203 WC FAC NEW PATIENT LEVEL 3	$100.00	$600.00	$67.43–$312.00	at median	83%
New patient office visit, about 30 minutes inpatient CPT 99203 WC FAC NEW PATIENT LEVEL 3	$100.00	$600.00	$67.43–$312.00	—	83%
New patient office visit, about 30 minutes inpatient CPT 99203 WC PRO NEW PATIENT LEVEL 3	$100.00	$256.00	$67.43–$133.12	—	61%
New patient office visit, about 30 minutes inpatient CPT 99203 CLINIC FAC NEW PT III	$100.00	$600.00	$67.43–$312.00	—	83%
New patient office visit, about 45 minutes CPT 99204 WC FAC NEW PATIENT LEVEL 4	$100.00	$600.00	$100.00–$312.00	33% below	83%
New patient office visit, about 45 minutes CPT 99204 WC PRO NEW PATIENT LEVEL 4	$100.00	$433.00	$100.00–$225.16	33% below	77%
New patient office visit, about 45 minutes CPT 99204 CLINIC FAC NEW PT IV	$100.00	$600.00	$100.00–$312.00	33% below	83%
New patient office visit, about 45 minutes inpatient CPT 99204 CLINIC FAC NEW PT IV	$100.00	$600.00	$100.00–$312.00	—	83%
New patient office visit, about 45 minutes inpatient CPT 99204 WC PRO NEW PATIENT LEVEL 4	$100.00	$433.00	$100.00–$225.16	—	77%
New patient office visit, about 45 minutes inpatient CPT 99204 WC FAC NEW PATIENT LEVEL 4	$100.00	$600.00	$100.00–$312.00	—	83%
New patient office visit, about 60 minutes CPT 99205 CLINIC FAC NEW PT V	$100.00	$600.00	$12.00–$312.00	47% below	83%
New patient office visit, about 60 minutes inpatient CPT 99205 CLINIC FAC NEW PT V	$100.00	$600.00	$12.00–$312.00	—	83%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC FAC NEW PATIENT LEVEL 2	$100.00	$600.00	$39.06–$312.00	23% above	83%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 CLINIC FAC NEW PT II	$100.00	$600.00	$39.06–$312.00	23% above	83%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC PRO NEW PATIENT LEVEL 2	$100.00	$165.00	$39.06–$100.00	23% above	39%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC PRO NEW PATIENT LEVEL 2	$100.00	$165.00	$39.06–$100.00	—	39%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC FAC NEW PATIENT LEVEL 2	$100.00	$600.00	$39.06–$312.00	—	83%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 CLINIC FAC NEW PT II	$100.00	$600.00	$39.06–$312.00	—	83%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRITION ASSMT&IVNTJ INDIV EA 15 MI	$38.40	$96.00	$25.17–$49.92	12% above	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTRITION ASSMT&IVNTJ INDIV EA 15 MI	$38.40	$96.00	$25.17–$49.92	—	60%
Preventive checkup, new patient aged 18–39 CPT 99385 CLINIC FAC INITIAL PREV 18-39 YEARS	$100.00	$651.00	$91.81–$338.52	at median	85%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 CLINIC FAC INITIAL PREV 18-39 YEARS	$100.00	$651.00	$91.81–$338.52	—	85%
Preventive checkup, new patient aged 40–64 CPT 99386 CLINIC FAC INITIAL PREV 40-64 YEARS	$100.00	$651.00	$100.00–$338.52	20% below	85%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 CLINIC FAC INITIAL PREV 40-64 YEARS	$100.00	$651.00	$100.00–$338.52	—	85%
Preventive checkup, new patient aged 65 or older CPT 99387 CLINIC FAC INITIAL PREV 65 YEARS AND UP	$100.00	$651.00	$100.00–$338.52	at median	85%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 CLINIC FAC INITIAL PREV 65 YEARS AND UP	$100.00	$651.00	$100.00–$338.52	—	85%
Preventive checkup, returning patient aged 18–39 CPT 99395 CLINIC FAC EST PREV 18-39 YEARS	$100.00	$651.00	$91.81–$338.52	at median	85%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 CLINIC FAC EST PREV 18-39 YEARS	$100.00	$651.00	$91.81–$338.52	—	85%
Preventive checkup, returning patient aged 40–64 CPT 99396 CLINIC FAC EST PREV 40-64 YEARS	$100.00	$651.00	$100.00–$338.52	8% below	85%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 CLINIC FAC EST PREV 40-64 YEARS	$100.00	$651.00	$100.00–$338.52	—	85%
Preventive checkup, returning patient aged 65 or older CPT 99397 CLINIC FAC EST PREV 65 AND OVER	$100.00	$651.00	$100.00–$338.52	13% below	85%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 CLINIC FAC EST PREV 65 AND OVER	$100.00	$651.00	$100.00–$338.52	—	85%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAG EVAL W/ MED SVC - FAC	$100.00	$988.00	$100.00–$513.76	33% below	90%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAG EVAL W/ MED SVC - PRO	$100.00	$426.00	$100.00–$221.52	33% below	77%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAG EVAL W/ MED SVC - PRO	$100.00	$426.00	$100.00–$221.52	—	77%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAG EVAL W/ MED SVC - FAC	$100.00	$988.00	$100.00–$513.76	—	90%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCH TST EVAL SVC PHYS/QHP FIRST HOUR	$347.60	$869.00	$97.00–$451.88	—	60%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCH TST EVAL SVC PHYS/QHP FIRST HOUR	$347.60	$869.00	$97.00–$451.88	—	60%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$100.00	$1,040.00	$100.00–$540.80	14% below	90%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$100.00	$1,040.00	$100.00–$540.80	—	90%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MIN W/ PT &/OR FAM - FA	$100.00	$700.00	$69.04–$364.00	26% below	86%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MIN W/ PT &/OR FAM - PR	$100.00	$170.00	$69.04–$166.79	26% below	41%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MIN W/ PT &/OR FAM - PR	$100.00	$170.00	$69.04–$166.79	—	41%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MIN W/ PT &/OR FAM - FA	$100.00	$700.00	$69.04–$364.00	—	86%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45MIN W/ PT &/OR FAM - FAC	$100.00	$700.00	$91.18–$364.00	35% below	86%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45MIN W/ PT &/OR FAM - PRO	$100.00	$225.00	$91.18–$166.79	35% below	56%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45MIN W/ PT &/OR FAM - FAC	$100.00	$700.00	$91.18–$364.00	—	86%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45MIN W/ PT &/OR FAM - PRO	$100.00	$225.00	$91.18–$166.79	—	56%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MIN W/ PT &/OR FAM - PR	$100.00	$336.00	$100.00–$174.72	19% below	70%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MIN W/ PT &/OR FAM - FA	$100.00	$700.00	$100.00–$364.00	19% below	86%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MIN W/ PT &/OR FAM - FA	$100.00	$700.00	$100.00–$364.00	—	86%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MIN W/ PT &/OR FAM - PR	$100.00	$336.00	$100.00–$174.72	—	70%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION COUNSELING INTERM	$16.00	$40.00	$10.13–$35.21	49% below	60%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CESSATION COUNSELING VISIT 3-10M	$36.00	$90.00	$10.13–$100.00	14% above	60%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING&TOBACCO CESS,INTERM,3-10MINUTES	$36.00	$90.00	$10.13–$46.80	14% above	60%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION COUNSELING INTERM	$16.00	$40.00	$10.13–$35.21	—	60%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING&TOBACCO CESS,INTERM,3-10MINUTES	$36.00	$90.00	$10.13–$46.80	—	60%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CESSATION COUNSELING VISIT 3-10M	$36.00	$90.00	$10.13–$100.00	—	60%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTAB VISIT LEVEL 5	$100.00	$600.00	$100.00–$312.00	40% below	83%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CLINIC PRO EST PT V	$100.00	$205.00	$100.00–$169.53	40% below	51%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CONSULTATION LEVEL 5	$100.00	$600.00	$100.00–$312.00	40% below	83%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTAB VISIT LEVEL 5	$100.00	$600.00	$100.00–$312.00	—	83%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CONSULTATION LEVEL 5	$100.00	$600.00	$100.00–$312.00	—	83%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CLINIC PRO EST PT V	$100.00	$205.00	$100.00–$169.53	—	51%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CLINIC FAC EST PT III	$100.00	$600.00	$54.71–$312.00	at median	83%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC PRO EST PATIENT LEVEL 3	$100.00	$171.00	$54.71–$100.00	at median	42%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC FAC EST PATIENT LEVEL 3	$100.00	$600.00	$54.71–$312.00	at median	83%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CONSULTATION LEVEL 3	$100.00	$600.00	$54.71–$312.00	at median	83%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CLINIC FAC EST PT III	$100.00	$600.00	$54.71–$312.00	—	83%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC PRO EST PATIENT LEVEL 3	$100.00	$171.00	$54.71–$100.00	—	42%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC FAC EST PATIENT LEVEL 3	$100.00	$600.00	$54.71–$312.00	—	83%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CONSULTATION LEVEL 3	$100.00	$600.00	$54.71–$312.00	—	83%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CONSULTATION LEVEL 4	$100.00	$600.00	$80.42–$312.00	25% below	83%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CLINIC PRO EST PT IV	$100.00	$259.00	$80.42–$134.68	25% below	61%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CLINIC FAC EST PT IV	$100.00	$600.00	$80.42–$312.00	25% below	83%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC FAC EST PATIENT LEVEL 4	$100.00	$600.00	$80.42–$312.00	25% below	83%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC PRO EST PATIENT LEVEL 4	$100.00	$259.00	$80.42–$134.68	25% below	61%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CLINIC PRO EST PT IV	$100.00	$259.00	$80.42–$134.68	—	61%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC FAC EST PATIENT LEVEL 4	$100.00	$600.00	$80.42–$312.00	—	83%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC PRO EST PATIENT LEVEL 4	$100.00	$259.00	$80.42–$134.68	—	61%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CLINIC FAC EST PT IV	$100.00	$600.00	$80.42–$312.00	—	83%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CONSULTATION LEVEL 4	$100.00	$600.00	$80.42–$312.00	—	83%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CONSULTATION LEVEL 1	$100.00	$600.00	$29.44–$312.00	36% above	83%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC FAC EST PATIENT LEVEL 2	$100.00	$600.00	$29.44–$312.00	36% above	83%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC PRO EST PATIENT LEVEL 2	$100.00	$114.00	$29.44–$100.00	36% above	12%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CLINIC FAC EST PT II	$100.00	$600.00	$29.44–$312.00	36% above	83%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CONSULTATION LEVEL 2	$100.00	$600.00	$29.44–$312.00	36% above	83%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC PRO EST PATIENT LEVEL 2	$100.00	$114.00	$29.44–$100.00	—	12%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC FAC EST PATIENT LEVEL 2	$100.00	$600.00	$29.44–$312.00	—	83%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CLINIC FAC EST PT II	$100.00	$600.00	$29.44–$312.00	—	83%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CONSULTATION LEVEL 2	$100.00	$600.00	$29.44–$312.00	—	83%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CONSULTATION LEVEL 1	$100.00	$600.00	$29.44–$312.00	—	83%
Specialist consultation, low complexity or 30+ minutes CPT 99243 9924325 CONSULT NEW/EST LOW 30 MINUTES	$142.80	$357.00	$142.80–$185.64	32% above	60%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 9924325 CONSULT NEW/EST LOW 30 MINUTES	$142.80	$357.00	$142.80–$185.64	—	60%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OUTPATIENT ADMISSION EVALUATION	$395.20	$988.00	$395.20–$513.76	192% above	60%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OUTPATIENT ADMISSION TREATMENT	$395.20	$988.00	$395.20–$513.76	192% above	60%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT 3 -PRO	$395.20	$988.00	$395.20–$513.76	192% above	60%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OUTPATIENT ADMISSION EVALUATION	$395.20	$988.00	$395.20–$513.76	—	60%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULT 3 -PRO	$395.20	$988.00	$395.20–$513.76	—	60%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OUTPATIENT ADMISSION TREATMENT	$395.20	$988.00	$395.20–$513.76	—	60%
Speech therapy session, individual CPT 92507 ST SPEECH LANGUAGE TREATMENT	$115.00	$371.00	$21.76–$192.92	6% below	69%
Speech therapy session, individual inpatient CPT 92507 ST SPEECH LANGUAGE TREATMENT	$115.00	$371.00	$21.76–$192.92	—	69%
Spirometry (breathing test) CPT 94010 CL SPIROMETRY PRE ONLY	$241.20	$603.00	$24.00–$313.56	55% above	60%
Spirometry (breathing test) CPT 94010 LEVEL 1 PFT	$241.20	$603.00	$24.00–$313.56	55% above	60%
Spirometry (breathing test) CPT 94010 PT INITIATED SPIROMETRIC RECORDING	$241.20	$603.00	$24.00–$313.56	55% above	60%
Spirometry (breathing test) CPT 94010 SPIROMETRY PRE ONLY	$416.72	$1,041.81	$24.00–$541.74	168% above	60%
Spirometry (breathing test) inpatient CPT 94010 LEVEL 1 PFT	$241.20	$603.00	$24.00–$313.56	—	60%
Spirometry (breathing test) inpatient CPT 94010 PT INITIATED SPIROMETRIC RECORDING	$241.20	$603.00	$24.00–$313.56	—	60%
Spirometry (breathing test) inpatient CPT 94010 CL SPIROMETRY PRE ONLY	$241.20	$603.00	$24.00–$313.56	—	60%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY PRE ONLY	$416.72	$1,041.81	$24.00–$541.74	—	60%
Spirometry before and after a bronchodilator CPT 94060 CL SPIROMETRY PRE AND POST	$435.00	$1,102.00	$36.89–$573.04	72% above	61%
Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATION RESPONSIVENESS	$435.00	$1,102.00	$36.89–$573.04	72% above	61%
Spirometry before and after a bronchodilator CPT 94060 LEVEL II PFT	$435.00	$1,102.00	$36.89–$573.04	72% above	61%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY PRE AND POST	$435.00	$2,093.00	$36.89–$1,088.36	72% above	79%
Spirometry before and after a bronchodilator inpatient CPT 94060 CL SPIROMETRY PRE AND POST	$435.00	$1,102.00	$36.89–$573.04	—	61%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY PRE AND POST	$435.00	$2,093.00	$36.89–$1,088.36	—	79%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODILATION RESPONSIVENESS	$435.00	$1,102.00	$36.89–$573.04	—	61%
Spirometry before and after a bronchodilator inpatient CPT 94060 LEVEL II PFT	$435.00	$1,102.00	$36.89–$573.04	—	61%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY -GRV	$487.20	$1,218.00	$81.80–$633.36	363% above	60%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY -GRV	$487.20	$1,218.00	$81.80–$633.36	—	60%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 STRESS TEST WITH INTRP & REPORT	$125.20	$313.00	$63.69–$162.76	—	60%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 STRESS TEST WITH INTRP & REPORT	$125.20	$313.00	$63.69–$162.76	—	60%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX	$188.00	$470.00	$13.14–$244.40	23% below	60%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS (VARIVAX) VACCINE 0.5ML	$188.00	$470.00	$8.07–$244.40	23% below	60%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE,LIVE,FOR SUBCU	$188.00	$470.00	$13.14–$244.40	23% below	60%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS (VARIVAX) VACCINE 0.5ML	$188.00	$470.00	$8.07–$244.40	—	60%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX	$188.00	$470.00	$13.14–$244.40	—	60%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE,LIVE,FOR SUBCU	$188.00	$470.00	$13.14–$244.40	—	60%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX DTAP-IPV VACCINE 4-6 YRS IM	$64.00	$160.00	$13.14–$83.20	17% below	60%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV CHILD 4-6YRS OF AGE IM (KIN	$86.40	$216.00	$13.14–$112.32	12% above	60%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTaP-IPV 0.5ML VACCINE - KINRIX	$89.60	$224.00	$13.14–$116.48	16% above	60%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIPTH/PERT/TET/POLIO (KINRIX) SYG 0.5ML	$250.00	$625.00	$13.14–$325.00	224% above	60%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIPTH/PERT/TET/POLIO (KINRIX) SDV 0.5ML	$250.00	$625.00	$13.14–$325.00	224% above	60%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX DTAP-IPV VACCINE 4-6 YRS IM	$64.00	$160.00	$13.14–$83.20	—	60%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV CHILD 4-6YRS OF AGE IM (KIN	$86.40	$216.00	$13.14–$112.32	—	60%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTaP-IPV 0.5ML VACCINE - KINRIX	$89.60	$224.00	$13.14–$116.48	—	60%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIPTH/PERT/TET/POLIO (KINRIX) SDV 0.5ML	$250.00	$625.00	$13.14–$325.00	—	60%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIPTH/PERT/TET/POLIO (KINRIX) SYG 0.5ML	$250.00	$625.00	$13.14–$325.00	—	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPTH/TET/ACEL PERT (INFANRIX) 0.5ML SDV	$40.80	$102.00	$13.14–$53.04	50% below	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP	$48.40	$121.00	$13.14–$62.92	40% below	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE, IM, <7, DAPTACEL	$52.80	$132.00	$13.14–$68.64	35% below	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPTH/TET/ACEL PERT (INFANRIX) 0.5ML SYG	$118.00	$295.00	$13.14–$153.40	46% above	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTH PERTUSS TET PED (DAPTACEL)	$122.40	$306.00	$13.14–$159.12	51% above	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPTH/TET/ACEL PERT (INFANRIX) 0.5ML SDV	$40.80	$102.00	$13.14–$53.04	—	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP	$48.40	$121.00	$13.14–$62.92	—	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP VACCINE, IM, <7, DAPTACEL	$52.80	$132.00	$13.14–$68.64	—	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPTH/TET/ACEL PERT (INFANRIX) 0.5ML SYG	$118.00	$295.00	$13.14–$153.40	—	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHTH PERTUSS TET PED (DAPTACEL)	$122.40	$306.00	$13.14–$159.12	—	60%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEPB-IPV VACC, IM, PEDIARIX	$90.00	$225.00	$13.14–$117.00	46% below	60%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIRIX	$90.00	$225.00	$13.14–$117.00	46% below	60%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B /DIPH/TET/PERT/POLIO (PEDIARIX)	$417.60	$1,044.00	$13.14–$542.88	149% above	60%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIRIX	$90.00	$225.00	$13.14–$117.00	—	60%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP-HEPB-IPV VACC, IM, PEDIARIX	$90.00	$225.00	$13.14–$117.00	—	60%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HEP B /DIPH/TET/PERT/POLIO (PEDIARIX)	$417.60	$1,044.00	$13.14–$542.88	—	60%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTaP-IPV/HiB 0.5ML VACCINE PENTACEL	$110.00	$275.00	$15.45–$143.00	51% below	60%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP - HIB - IPV	$110.00	$275.00	$15.45–$143.00	51% below	60%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTaP-IPV/Hib (PENTACEL) VACC 0.5ML	$504.80	$1,262.00	$15.45–$656.24	126% above	60%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTaP-IPV/HiB 0.5ML VACCINE PENTACEL	$110.00	$275.00	$15.45–$143.00	—	60%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP - HIB - IPV	$110.00	$275.00	$15.45–$143.00	—	60%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTaP-IPV/Hib (PENTACEL) VACC 0.5ML	$504.80	$1,262.00	$15.45–$656.24	—	60%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS DTAP-IPV-HIB-HEPB VACCINE IM	$136.80	$342.00	$15.45–$177.84	35% below	60%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS DTAP-IPV-HIB-HEPB VACCINE IM	$136.80	$342.00	$15.45–$177.84	—	60%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACCINE	$14.00	$35.00	$8.07–$21.74	57% below	60%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACCINE,SPLIT,3YRS>,IM	$31.20	$78.00	$8.07–$40.56	5% below	60%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VIRUS VACCINE	$14.00	$35.00	$8.07–$21.74	—	60%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VIRUS VACCINE,SPLIT,3YRS>,IM	$31.20	$78.00	$8.07–$40.56	—	60%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PAPILLOMAVIRUS QUAD VACC, HUMAN 0.5ML	$281.60	$704.00	$8.07–$366.08	12% below	60%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV VACCINE 9-VALENT/PF 0.5ML SDV	$1,258.80	$3,147.00	$13.14–$1,636.44	291% above	60%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PAPILLOMAVIRUS QUAD VACC, HUMAN 0.5ML	$281.60	$704.00	$8.07–$366.08	—	60%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV VACCINE 9-VALENT/PF 0.5ML SDV	$1,258.80	$3,147.00	$13.14–$1,636.44	—	60%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A & HEP B VACCINE, ADULT, IM	$170.00	$425.00	$13.14–$221.00	at median	60%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A & HEPATITIS B VACC (TWINRIX)	$542.00	$1,355.00	$13.14–$704.60	219% above	60%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEP A & HEP B VACCINE, ADULT, IM	$170.00	$425.00	$13.14–$221.00	—	60%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A & HEPATITIS B VACC (TWINRIX)	$542.00	$1,355.00	$13.14–$704.60	—	60%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACC,ADULT,IM, HAVRIX	$114.40	$286.00	$61.05–$148.72	30% above	60%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE ADULT	$119.20	$298.00	$61.05–$154.96	36% above	60%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACC,ADULT,IM, VAQTA 50U/1ML	$285.20	$713.00	$61.05–$370.76	225% above	60%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VAC (HAVRIX) 1440U/ML SYG	$342.80	$857.00	$61.05–$445.64	291% above	60%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VAC (HAVRIX) 1440U/ML SDV*	$342.80	$857.00	$61.05–$445.64	291% above	60%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACC,ADULT,IM, HAVRIX	$114.40	$286.00	$61.05–$148.72	—	60%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE ADULT	$119.20	$298.00	$61.05–$154.96	—	60%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACC,ADULT,IM, VAQTA 50U/1ML	$285.20	$713.00	$61.05–$370.76	—	60%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VAC (HAVRIX) 1440U/ML SYG	$342.80	$857.00	$61.05–$445.64	—	60%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VAC (HAVRIX) 1440U/ML SDV*	$342.80	$857.00	$61.05–$445.64	—	60%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEP A VACC,PED/ADOL, IM	$54.00	$135.00	$8.07–$70.20	2% below	60%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEP A (HAVRIX) PEDIATRIC	$62.00	$155.00	$8.07–$80.60	12% above	60%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VAC (VAQTA) 25U/0.5ML PED/AD	$140.00	$350.00	$13.14–$182.00	153% above	60%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACC 720 UNIT/0.5ML PED SYG	$153.60	$384.00	$13.14–$199.68	178% above	60%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A VACC,PED/ADOL, IM	$54.00	$135.00	$8.07–$70.20	—	60%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A (HAVRIX) PEDIATRIC	$62.00	$155.00	$8.07–$80.60	—	60%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VAC (VAQTA) 25U/0.5ML PED/AD	$140.00	$350.00	$13.14–$182.00	—	60%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VACC 720 UNIT/0.5ML PED SYG	$153.60	$384.00	$13.14–$199.68	—	60%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE,ADULT,IM SYG	$106.00	$265.00	$56.70–$137.80	3% below	60%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B ADULT	$106.00	$265.00	$56.70–$137.80	3% below	60%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC 20MCG/ML ADULT SDV	$287.60	$719.00	$56.70–$373.88	164% above	60%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC 20MCG/ML ADULT SYRINGE	$288.00	$720.00	$56.70–$374.40	164% above	60%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B ADULT	$106.00	$265.00	$56.70–$137.80	—	60%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE,ADULT,IM SYG	$106.00	$265.00	$56.70–$137.80	—	60%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC 20MCG/ML ADULT SDV	$287.60	$719.00	$56.70–$373.88	—	60%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC 20MCG/ML ADULT SYRINGE	$288.00	$720.00	$56.70–$374.40	—	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACC PED/ADOL 5 MCG/0.5ML	$44.40	$111.00	$13.14–$57.72	18% below	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACC PED/ADOL 10MCG/0.5ML	$44.40	$111.00	$8.07–$57.72	18% below	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B PEDIATRIC	$44.40	$111.00	$13.14–$57.72	18% below	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACC PED/ADOL 5 MCG/0.5ML	$44.40	$111.00	$13.14–$57.72	—	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACC PED/ADOL 10MCG/0.5ML	$44.40	$111.00	$8.07–$57.72	—	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B PEDIATRIC	$44.40	$111.00	$13.14–$57.72	—	60%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HEMOPHILUS INFLUENZA B VACCINE HIB	$14.00	$35.00	$8.07–$28.77	75% below	60%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 LIQUID PEDVAX HIB	$30.00	$75.00	$15.45–$39.00	47% below	60%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HEMOPHILUS INFLUENZA B VACCINE HIB	$14.00	$35.00	$8.07–$28.77	—	60%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 LIQUID PEDVAX HIB	$30.00	$75.00	$15.45–$39.00	—	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIBERIX HIB PRP-T VACCINE 4 DOSE IM	$52.00	$130.00	$8.07–$67.60	28% above	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS b CONJUGATE VACC	$52.00	$130.00	$12.32–$67.60	28% above	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B CONJUGATE VACC	$53.20	$133.00	$12.32–$69.16	31% above	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS b CONJUGATE VACC (ActHIB)	$54.00	$135.00	$12.32–$70.20	33% above	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS INFL B VACC(Hib),PRP-T,IM,EA	$54.80	$137.00	$8.07–$71.24	35% above	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS b CONJUGATE VACC	$52.00	$130.00	$12.32–$67.60	—	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIBERIX HIB PRP-T VACCINE 4 DOSE IM	$52.00	$130.00	$8.07–$67.60	—	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B CONJUGATE VACC	$53.20	$133.00	$12.32–$69.16	—	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS b CONJUGATE VACC (ActHIB)	$54.00	$135.00	$12.32–$70.20	—	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS INFL B VACC(Hib),PRP-T,IM,EA	$54.80	$137.00	$8.07–$71.24	—	60%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE	$30.40	$76.00	$13.80–$91.91	77% below	60%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE	$30.40	$76.00	$13.80–$91.91	—	60%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR	$106.00	$265.00	$13.14–$137.80	29% below	60%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACC, LIVE,SUBCU	$106.00	$265.00	$13.14–$137.80	29% below	60%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA (MMR II) VACC	$360.40	$901.00	$13.14–$468.52	141% above	60%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACC, LIVE,SUBCU	$106.00	$265.00	$13.14–$137.80	—	60%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR	$106.00	$265.00	$13.14–$137.80	—	60%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA (MMR II) VACC	$360.40	$901.00	$13.14–$468.52	—	60%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV,SUBCU, PROQUAD	$264.00	$660.00	$13.14–$343.20	at median	60%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV	$264.00	$660.00	$13.14–$343.20	at median	60%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEAS,MUMP,RUBEL,VARICELLA VACC(PROQUAD)	$1,155.20	$2,888.00	$13.14–$1,501.76	338% above	60%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MMRV,SUBCU, PROQUAD	$264.00	$660.00	$13.14–$343.20	—	60%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MMRV	$264.00	$660.00	$13.14–$343.20	—	60%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEAS,MUMP,RUBEL,VARICELLA VACC(PROQUAD)	$1,155.20	$2,888.00	$13.14–$1,501.76	—	60%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACCINE MENVEO	$136.00	$340.00	$13.14–$176.80	29% below	60%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACCINE MENACTRA	$140.00	$350.00	$8.07–$182.00	26% below	60%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACC,IM, MENACTRA	$140.00	$350.00	$8.07–$182.00	26% below	60%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGO (MENACTRA) VACC 0.5ML (9M - 55Y)	$676.00	$1,690.00	$13.14–$878.80	255% above	60%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACC (MENVEO) 2Y-55Y	$676.00	$1,690.00	$8.07–$878.80	255% above	60%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACC,IM, MENVEO	$676.00	$1,690.00	$13.14–$878.80	255% above	60%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACCINE MENVEO	$136.00	$340.00	$13.14–$176.80	—	60%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACCINE MENACTRA	$140.00	$350.00	$8.07–$182.00	—	60%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACC,IM, MENACTRA	$140.00	$350.00	$8.07–$182.00	—	60%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACC,IM, MENVEO	$676.00	$1,690.00	$13.14–$878.80	—	60%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGO (MENACTRA) VACC 0.5ML (9M - 55Y)	$676.00	$1,690.00	$13.14–$878.80	—	60%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACC (MENVEO) 2Y-55Y	$676.00	$1,690.00	$8.07–$878.80	—	60%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUAFI MENINGOCOCCAL VACCINE	$136.00	$340.00	$8.07–$176.80	41% below	60%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENQUAFI MENINGOCOCCAL VACCINE	$136.00	$340.00	$8.07–$176.80	—	60%
Meningococcal B vaccine (Trumenba) CPT 90621 TRUMENBA MENB-FHBP VACC 2/3 DOSE IM	$164.00	$410.00	$8.07–$213.20	46% below	60%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 TRUMENBA MENB-FHBP VACC 2/3 DOSE IM	$164.00	$410.00	$8.07–$213.20	—	60%
Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST INFLUENZA VIRUS VACCINE LIVE	$15.20	$38.00	$15.20–$27.82	—	60%
Nasal spray flu vaccine, live (FluMist) CPT 90660 INFLUENZA VIRUS VACCINE,LIVE INTRANASAL	$31.20	$78.00	$5.35–$40.56	—	60%
Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST	$31.20	$78.00	$15.45–$40.56	—	60%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST INFLUENZA VIRUS VACCINE LIVE	$15.20	$38.00	$15.20–$27.82	—	60%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 INFLUENZA VIRUS VACCINE,LIVE INTRANASAL	$31.20	$78.00	$5.35–$40.56	—	60%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST	$31.20	$78.00	$15.45–$40.56	—	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCCAL CONJ VAC 13, IM	$315.60	$789.00	$8.07–$410.28	19% below	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR VACCINE	$445.20	$1,113.00	$13.14–$578.76	15% above	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL CONJ VACC (PREVNAR 13)*	$618.80	$1,547.00	$13.14–$804.44	60% above	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCCAL CONJ VAC 13, IM	$315.60	$789.00	$8.07–$410.28	—	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR VACCINE	$445.20	$1,113.00	$13.14–$578.76	—	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL CONJ VACC (PREVNAR 13)*	$618.80	$1,547.00	$13.14–$804.44	—	60%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 VAXNEUVANCE PCV15 VACCINE IM	$283.60	$709.00	$8.07–$368.68	at median	60%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 VAXNEUVANCE PCV15 VACCINE IM	$283.60	$709.00	$8.07–$368.68	—	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR20 PCV20 VACCINE FOR INTRAMUSCUL	$632.40	$1,581.00	$8.07–$822.12	10% above	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR20 VACCINE FOR INTRAMUSCULAR USE	$632.40	$1,581.00	$8.07–$822.12	10% above	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL CONJ VACC(PREVNAR-20) 0.5ML	$1,100.00	$2,750.00	$283.71–$1,430.00	92% above	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR20 VACCINE FOR INTRAMUSCULAR USE	$632.40	$1,581.00	$8.07–$822.12	—	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR20 PCV20 VACCINE FOR INTRAMUSCUL	$632.40	$1,581.00	$8.07–$822.12	—	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL CONJ VACC(PREVNAR-20) 0.5ML	$1,100.00	$2,750.00	$283.71–$1,430.00	—	60%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL (PNEUMOVAX 23) VACC 0.5ML	$115.00	$1,097.00	$13.14–$570.44	37% below	90%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL POLYSAC.VACC.23-PNEUMOVAX23	$115.00	$375.00	$8.07–$195.00	37% below	69%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX	$115.00	$375.00	$8.07–$195.00	37% below	69%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL (PNEUMOVAX 23) VACC 0.5ML	$115.00	$1,097.00	$13.14–$570.44	—	90%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL POLYSAC.VACC.23-PNEUMOVAX23	$115.00	$375.00	$8.07–$195.00	—	69%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX	$115.00	$375.00	$8.07–$195.00	—	69%
Polio vaccine, inactivated (IPV) CPT 90713 IPV	$40.00	$100.00	$13.14–$52.00	32% below	60%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE MDV (PER DOSE)	$184.80	$462.00	$8.07–$240.24	214% above	60%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPV	$40.00	$100.00	$13.14–$52.00	—	60%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE MDV (PER DOSE)	$184.80	$462.00	$8.07–$240.24	—	60%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO RSV VACC PREF BIVALEN IM	$344.80	$862.00	$276.21–$448.24	49% below	60%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO RSV VACC PREF BIVALENT IM	$344.80	$862.00	$8.07–$448.24	49% below	60%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 ABRYSVO RSV VACC PREF BIVALENT IM	$344.80	$862.00	$8.07–$448.24	—	60%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 ABRYSVO RSV VACC PREF BIVALEN IM	$344.80	$862.00	$276.21–$448.24	—	60%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (RABAVERT) 1ML	$1,148.80	$2,872.00	$262.98–$1,493.44	31% above	60%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (RABAVERT) 1ML	$1,148.80	$2,872.00	$262.98–$1,493.44	—	60%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VACC,HUMAN,ATTEN-ROTARIX	$198.00	$495.00	$13.14–$257.40	1% above	60%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS	$318.80	$797.00	$8.07–$414.44	62% above	60%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VACC,HUMAN,ATTEN-ROTARIX	$198.00	$495.00	$13.14–$257.40	—	60%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS	$318.80	$797.00	$8.07–$414.44	—	60%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE,ORAL,ROTATEQ	$153.20	$383.00	$8.07–$199.16	17% below	60%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTATVIRUS	$242.80	$607.00	$8.07–$315.64	31% above	60%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VAC LIVE ORAL (ROTATEQ) 2ML*	$397.20	$993.00	$13.14–$516.36	114% above	60%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACCINE,ORAL,ROTATEQ	$153.20	$383.00	$8.07–$199.16	—	60%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTATVIRUS	$242.80	$607.00	$8.07–$315.64	—	60%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VAC LIVE ORAL (ROTATEQ) 2ML*	$397.20	$993.00	$13.14–$516.36	—	60%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX HZV VACC RECOMBINANT IM	$936.40	$2,341.00	$112.00–$1,217.32	168% above	60%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX HZV VACC RECOMBINANT IM	$936.40	$2,341.00	$112.00–$1,217.32	—	60%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS DIPTHERIA (DECAVAC) 0.5ML ADULT	$50.00	$125.00	$13.14–$65.00	29% below	60%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS&DIPHTHERIA TOXOID ADSORB,IM,7>	$50.00	$125.00	$13.14–$65.00	29% below	60%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIP/TETANUS	$50.00	$125.00	$13.14–$65.00	29% below	60%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS DIPTHERIA (DECAVAC) 0.5ML ADULT	$50.00	$125.00	$13.14–$65.00	—	60%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS&DIPHTHERIA TOXOID ADSORB,IM,7>	$50.00	$125.00	$13.14–$65.00	—	60%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIP/TETANUS	$50.00	$125.00	$13.14–$65.00	—	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DTAP	$75.00	$125.00	$13.14–$75.00	at median	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX TDAP VACCINE 7 YRS/> IM	$75.00	$125.00	$13.14–$75.00	at median	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPTH/ PERTUSS/TET TOX(BOOSTRIX) PED SDV	$75.00	$494.00	$13.14–$256.88	at median	85%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPTH/ PERTUSS/TET TOX (ADACEL) SYG	$75.00	$988.00	$13.14–$513.76	at median	92%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS, DIPTHERIA (TDAP)	$75.00	$125.00	$13.14–$75.00	at median	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP,TET TOX,DIPT&ACE PERT (ADACEL)	$75.00	$211.00	$13.14–$109.72	at median	64%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPTH/ PERTUSS/TET TOX (ADACEL) SYG	$75.00	$988.00	$13.14–$513.76	—	92%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPTH/ PERTUSS/TET TOX(BOOSTRIX) PED SDV	$75.00	$494.00	$13.14–$256.88	—	85%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP,TET TOX,DIPT&ACE PERT (ADACEL)	$75.00	$211.00	$13.14–$109.72	—	64%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS, DIPTHERIA (TDAP)	$75.00	$125.00	$13.14–$75.00	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX TDAP VACCINE 7 YRS/> IM	$75.00	$125.00	$13.14–$75.00	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DTAP	$75.00	$125.00	$13.14–$75.00	—	40%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE, Vi, IM	$84.40	$211.00	$42.10–$109.72	61% below	60%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE VI CAPSULAR POLYSACC	$156.40	$391.00	$42.10–$203.32	27% below	60%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE, Vi, IM	$84.40	$211.00	$42.10–$109.72	—	60%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE VI CAPSULAR POLYSACC	$156.40	$391.00	$42.10–$203.32	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF SINGLE VACCINE	$18.00	$45.00	$13.14–$67.66	32% below	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUN ADMIN-1 VACCINE	$108.40	$271.00	$13.14–$140.92	308% above	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION OF SINGLE VACCINE	$18.00	$45.00	$13.14–$67.66	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUN ADMIN-1 VACCINE	$108.40	$271.00	$13.14–$140.92	—	60%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMINISTRATION EACH ADDITIONAL VACCI	$13.60	$34.00	$13.14–$17.68	43% below	60%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN- EACH ADDITIONAL VAC	$20.80	$52.00	$13.14–$27.04	13% below	60%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMINISTRATION EACH ADDITIONAL VACCI	$13.60	$34.00	$13.14–$17.68	—	60%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADMIN- EACH ADDITIONAL VAC	$20.80	$52.00	$13.14–$27.04	—	60%

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://ochonline.net/wp-content/uploads/pricing/431592082_Ozarks-Community-Hospital_standardcharges.zip