Hospital

Adena Pike Medical Center

Listed in its price file as “Pike Health Services Inc”.

Adena Pike Medical Center in Waverly, OH publishes cash prices for 414 common procedures listed here, from its own machine-readable price file updated Aug 19, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Ohio median for 317 of 407 procedures and above it for 84. By typical cash price it ranks #9 of 137 Ohio hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

100 Dawn Lane, Waverly, OH 45690 Collected Sep 27, 2026 Source price file Check a bill from this hospital (740) 947-2186

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 361334 · CMS hospital register NPI 1720018971

Financial assistance

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

Adena Pike Medical Center 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

ProcedureCash priceList priceInsurers payvs OhioOff list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W/ & W/O CONTRAST $1,195.23 $2,390.46 $358.40–$2,270.94 9% below 50%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W/ & W/O CONTRAST $1,195.23 $2,390.46 $1,515.55–$2,270.94 — 50%
Abdominal X-ray, 2 views CPT 74019 HC RADIOLOGY EXAM ABDOMEN 2 VIEWS $186.10 $372.19 $89.33–$353.58 46% below 50%
Abdominal X-ray, 2 views inpatient CPT 74019 HC RADIOLOGY EXAM ABDOMEN 2 VIEWS $186.10 $372.19 $235.97–$353.58 — 50%
Ankle X-ray, complete, 3 or more views CPT 73610 HC RADIOLOGY EXAM ANKLE COMPLETE- MIN 3 VIEWS $353.51 $707.02 $169.68–$671.67 9% above 50%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC RADIOLOGY EXAM ANKLE COMPLETE- MIN 3 VIEWS $353.51 $707.02 $448.25–$671.67 — 50%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC LIMITED EXTREMITY STUDY UP TO 2 LEVELS BILATERAL $485.63 $971.25 $233.10–$922.69 — 50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC LIMITED EXTREMITY STUDY UP TO 2 LEVELS BILATERAL $485.63 $971.25 $615.77–$922.69 — 50%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY W/O CONTRAST $1,529.50 $3,059.00 $213.62–$2,906.05 62% above 50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY W/O CONTRAST $1,529.50 $3,059.00 $1,939.41–$2,906.05 — 50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC RADIOLOGY EXAM ESOPHAGUS INCL SCOUT NECK W/SINGLE-CONTRAST $262.09 $524.17 $125.80–$497.96 40% below 50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC RADIOLOGY EXAM ESOPHAGUS INCL SCOUT NECK W/SINGLE-CONTRAST $262.09 $524.17 $332.32–$497.96 — 50%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NUC MED BONE JOINT IMAGING WHOLE BODY $1,324.31 $2,648.61 $635.67–$2,516.18 14% below 50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NUC MED BONE JOINT IMAGING WHOLE BODY $1,324.31 $2,648.61 $1,679.22–$2,516.18 — 50%
Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST UNILATERAL COMPLETE $638.83 $1,277.66 $213.62–$1,213.78 34% above 50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US BREAST UNILATERAL COMPLETE $638.83 $1,277.66 $810.04–$1,213.78 — 50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US BREAST UNILATERAL LIMITED $318.85 $637.70 $153.05–$605.82 22% below 50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC US BREAST UNILATERAL LIMITED $318.85 $637.70 $404.30–$605.82 — 50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN AND PELVIS W/ CONTRAST AND POSTPROCESSING $2,016.23 $4,032.46 $712.86–$3,830.84 5% below 50%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABDOMEN AND PELVIS W/ CONTRAST AND POSTPROCESSING $2,016.23 $4,032.46 $2,556.58–$3,830.84 — 50%
CT angiography (CTA) of the head CPT 70496 HC CTA HEAD W/ CONTRAST AND POSTPROCESSING $1,198.89 $2,397.77 $358.40–$2,277.88 10% below 50%
CT angiography (CTA) of the head inpatient CPT 70496 HC CTA HEAD W/ CONTRAST AND POSTPROCESSING $1,198.89 $2,397.77 $1,520.19–$2,277.88 — 50%
CT angiography (CTA) of the neck CPT 70498 HC CTA NECK W/ CONTRAST AND POSTPROCESSING $1,198.89 $2,397.77 $358.40–$2,277.88 8% below 50%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CTA NECK W/ CONTRAST AND POSTPROCESSING $1,198.89 $2,397.77 $1,520.19–$2,277.88 — 50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA CHEST (NON-CORONARY) W/ CONTRAST AND POSTPROCESSING $1,198.89 $2,397.77 $358.40–$2,277.88 15% below 50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CTA CHEST (NON-CORONARY) W/ CONTRAST AND POSTPROCESSING $1,198.89 $2,397.77 $1,520.19–$2,277.88 — 50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CTA HEART INCLUDING 3D IMAGE POSTPROCESSING $1,969.30 $3,938.59 $712.86–$3,741.66 23% above 50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CTA HEART INCLUDING 3D IMAGE POSTPROCESSING $1,969.30 $3,938.59 $2,497.07–$3,741.66 — 50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HEART W/O CONTRAST QUAN EVAL CORONARY CALCIUM $177.98 $355.95 $85.43–$1,250.00 37% below 50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HEART W/O CONTRAST QUAN EVAL CORONARY CALCIUM $177.98 $355.95 $225.67–$338.15 — 50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABDOMEN & PELVIS W/O CONTRAST $1,526.80 $3,053.60 $487.54–$2,900.92 3% below 50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABDOMEN & PELVIS W/O CONTRAST $1,526.80 $3,053.60 $1,935.98–$2,900.92 — 50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W/ CONTRAST $2,016.23 $4,032.45 $712.86–$3,830.83 4% above 50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W/ CONTRAST $2,016.23 $4,032.45 $2,556.57–$3,830.83 — 50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS W/ & W/O CONTRAST $2,390.47 $4,780.93 $712.86–$4,541.88 3% above 50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN & PELVIS W/ & W/O CONTRAST $2,390.47 $4,780.93 $3,031.11–$4,541.88 — 50%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/ CONTRAST $1,008.12 $2,016.23 $358.40–$1,915.42 14% below 50%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W/ CONTRAST $1,008.12 $2,016.23 $1,278.29–$1,915.42 — 50%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O CONTRAST $764.32 $1,528.63 $213.62–$1,452.20 27% below 50%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O CONTRAST $764.32 $1,528.63 $969.15–$1,452.20 — 50%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O CONTRAST $764.75 $1,529.50 $213.62–$1,453.03 13% below 50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL W/O CONTRAST $764.75 $1,529.50 $969.70–$1,453.03 — 50%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST $764.32 $1,528.63 $213.62–$1,452.20 8% below 50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST $764.32 $1,528.63 $969.15–$1,452.20 — 50%
CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W/ CONTRAST $1,008.12 $2,016.23 $358.40–$1,915.42 at median 50%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD/BRAIN W/ CONTRAST $1,008.12 $2,016.23 $1,278.29–$1,915.42 — 50%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W/ & W/O CONTRAST $1,195.23 $2,390.46 $358.40–$2,270.94 3% above 50%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD/BRAIN W/ & W/O CONTRAST $1,195.23 $2,390.46 $1,515.55–$2,270.94 — 50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE W/O CONTRAST $764.32 $1,528.63 $213.62–$1,452.20 30% below 50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE W/O CONTRAST $764.32 $1,528.63 $969.15–$1,452.20 — 50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST $764.32 $1,528.63 $213.62–$1,452.20 29% below 50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST $764.32 $1,528.63 $969.15–$1,452.20 — 50%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/ CONTRAST $1,008.12 $2,016.23 $358.40–$1,915.42 18% below 50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/ CONTRAST $1,008.12 $2,016.23 $1,278.29–$1,915.42 — 50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX EXTRACRANIAL ARTERIES COMPLETE BILATERAL $590.32 $1,180.64 $283.35–$1,121.61 — 50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX EXTRACRANIAL ARTERIES COMPLETE BILATERAL $590.32 $1,180.64 $748.53–$1,121.61 — 50%
Chest CT scan without and with contrast CPT 71270 HC CT THORAX W/ & W/O CONTRAST $1,195.23 $2,390.46 $358.40–$2,270.94 19% below 50%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT THORAX W/ & W/O CONTRAST $1,195.23 $2,390.46 $1,515.55–$2,270.94 — 50%
Chest X-ray, 2 views CPT 71046 HC RADIOLOGY X-RAY CHEST 2 VIEWS $173.44 $346.87 $83.25–$329.53 36% below 50%
Chest X-ray, 2 views inpatient CPT 71046 HC RADIOLOGY X-RAY CHEST 2 VIEWS $173.44 $346.87 $219.92–$329.53 — 50%
Chest X-ray, single view CPT 71045 HC RADIOLOGY X-RAY CHEST SINGLE VIEW $173.44 $346.87 $83.25–$329.53 26% below 50%
Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGY X-RAY CHEST SINGLE VIEW $173.44 $346.87 $219.92–$329.53 — 50%
Collarbone (clavicle) X-ray, complete CPT 73000 HC RADIOLOGY EXAM CLAVICLE- COMPLETE $176.76 $353.51 $84.84–$335.83 36% below 50%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC RADIOLOGY EXAM CLAVICLE- COMPLETE $176.76 $353.51 $224.13–$335.83 — 50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE $371.92 $743.83 $178.52–$706.64 48% below 50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE $371.92 $743.83 $471.59–$706.64 — 50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC RADIOLOGY BONE DENSITY STUDY AXIAL $291.95 $583.90 $140.14–$554.71 36% below 50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC RADIOLOGY BONE DENSITY STUDY AXIAL $291.95 $583.90 $370.19–$554.71 — 50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC RADIOLOGY BONE DENSITY STUDY APPENDICULAR $154.09 $308.18 $73.96–$292.77 40% below 50%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC RADIOLOGY BONE DENSITY STUDY APPENDICULAR $154.09 $308.18 $195.39–$292.77 — 50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX W/O CONTRAST $764.32 $1,528.63 $213.62–$1,452.20 19% below 50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX W/O CONTRAST $764.32 $1,528.63 $969.15–$1,452.20 — 50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W/ CONTRAST $1,008.12 $2,016.23 $358.40–$1,915.42 12% below 50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX W/ CONTRAST $1,008.12 $2,016.23 $1,278.29–$1,915.42 — 50%
Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMMOGRAM DIAGNOSTIC BILATERAL INCLUDING CAD $374.90 $749.80 $179.95–$712.31 — 50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC MAMMOGRAM DIAGNOSTIC BILATERAL INCLUDING CAD $374.90 $749.80 $475.37–$712.31 — 50%
Diagnostic mammogram, one breast one side CPT 77065 HC MAMMOGRAM DIAGNOSTIC UNILATERAL INCLUDING CAD $326.03 $652.05 $156.49–$619.45 8% below 50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC MAMMOGRAM DIAGNOSTIC UNILATERAL INCLUDING CAD $326.03 $652.05 $413.40–$619.45 — 50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LE ARTERIES OR BYPASS GRAFTS COMPLETE BILATERAL $1,079.72 $2,159.43 $487.54–$2,051.46 — 50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LE ARTERIES OR BYPASS GRAFTS COMPLETE BILATERAL $1,079.72 $2,159.43 $1,369.08–$2,051.46 — 50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREMITY VEINS COMPRESSION COMPLETE BILATERAL $1,079.72 $2,159.43 $487.54–$2,051.46 — 50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREMITY VEINS COMPRESSION COMPLETE BILATERAL $1,079.72 $2,159.43 $1,369.08–$2,051.46 — 50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO COMPLETE W/ DOPPLER W/O CONTRAST $1,911.58 $3,823.16 $917.56–$3,632.00 12% above 50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO COMPLETE W/ BUBBLE STUDY $1,911.58 $3,823.16 $917.56–$3,632.00 12% above 50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO COMPLETE W/ DOPPLER W/O CONTRAST $1,911.58 $3,823.16 $2,423.88–$3,632.00 — 50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO COMPLETE W/ BUBBLE STUDY $1,911.58 $3,823.16 $2,423.88–$3,632.00 — 50%
Elbow X-ray, 2 views CPT 73070 HC RADIOLOGY EXAM ELBOW 2 VIEWS $154.09 $308.18 $73.96–$292.77 42% below 50%
Elbow X-ray, 2 views inpatient CPT 73070 HC RADIOLOGY EXAM ELBOW 2 VIEWS $154.09 $308.18 $195.39–$292.77 — 50%
Elbow X-ray, complete, 3 or more views CPT 73080 HC RADIOLOGY EXAM ELBOW COMPLETE- MIN 3 VIEWS $176.76 $353.51 $84.84–$335.83 45% below 50%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC RADIOLOGY EXAM ELBOW COMPLETE- MIN 3 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT SELLA POSTERIOR FOSSA EAR W/O CONTRAST $764.32 $1,528.63 $213.62–$1,452.20 11% below 50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT SELLA POSTERIOR FOSSA EAR W/O CONTRAST $764.32 $1,528.63 $969.15–$1,452.20 — 50%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC RADIOLOGY EXAM FACIAL BONES COMPLETE- MIN 3 VIEWS $186.10 $372.19 $89.33–$353.58 52% below 50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC RADIOLOGY EXAM FACIAL BONES COMPLETE- MIN 3 VIEWS $186.10 $372.19 $235.97–$353.58 — 50%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC RADIOLOGY EXAM FOREARM 2 VIEWS $176.76 $353.51 $84.84–$335.83 36% below 50%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC RADIOLOGY EXAM FOREARM 2 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NUC MED HEPATOBILIARY SYSTEM IMAGING INCL GALLBLADDER $969.25 $1,938.50 $465.24–$1,841.58 39% below 50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NUC MED HEPATOBILIARY SYSTEM IMAGING INCL GALLBLADDER $969.25 $1,938.50 $1,229.01–$1,841.58 — 50%
Hand X-ray, 2 views CPT 73120 HC RADIOLOGY EXAM HAND 2 VIEWS $372.19 $744.38 $178.65–$707.16 40% above 50%
Hand X-ray, 2 views inpatient CPT 73120 HC RADIOLOGY EXAM HAND 2 VIEWS $372.19 $744.38 $471.94–$707.16 — 50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC RADIOLOGY EXAM CALCANEUS MIN 2 VIEWS $176.76 $353.51 $84.84–$335.83 36% below 50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC RADIOLOGY EXAM CALCANEUS MIN 2 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC CCH SLEEP STUDY UNATTENDED W SIMULT RECORD HR/O2 SAT/RESP FLOW $1,497.17 $2,994.33 $441.20–$2,844.61 113% above 50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC CCH SLEEP STUDY UNATTENDED W SIMULT RECORD HR/O2 SAT/RESP FLOW $1,497.17 $2,994.33 $1,898.41–$2,844.61 — 50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older both sides CPT 95811 HC POLYSOMNOGRAPHY 4+ PARAMETERS W/ CPAP OR BI-LEVEL VENT AGE > 6 YRS $2,697.88 $5,395.76 $1,294.98–$5,125.97 — 50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient both sides CPT 95811 HC POLYSOMNOGRAPHY 4+ PARAMETERS W/ CPAP OR BI-LEVEL VENT AGE > 6 YRS $2,697.88 $5,395.76 $3,420.91–$5,125.97 — 50%
Knee X-ray, 3 views CPT 73562 HC RADIOLOGY EXAM KNEE 3 VIEWS $353.51 $707.02 $169.68–$671.67 at median 50%
Knee X-ray, 3 views inpatient CPT 73562 HC RADIOLOGY EXAM KNEE 3 VIEWS $353.51 $707.02 $448.25–$671.67 — 50%
Knee X-ray, complete, 4 or more views CPT 73564 HC RADIOLOGY EXAM KNEE COMPLETE- 4 OR MORE VIEWS $187.12 $374.23 $89.82–$355.52 53% below 50%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC RADIOLOGY EXAM KNEE COMPLETE- 4 OR MORE VIEWS $187.12 $374.23 $237.26–$355.52 — 50%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY W/O CONTRAST $1,528.63 $3,057.25 $213.62–$2,904.39 62% above 50%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTREMITY W/O CONTRAST $1,528.63 $3,057.25 $1,938.30–$2,904.39 — 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMINAL LIMITED $409.20 $818.40 $196.42–$777.48 26% below 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMINAL LIMITED $409.20 $818.40 $518.87–$777.48 — 50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LIMITED JOINT OR FOCAL EVAL W/IMAGING $268.47 $536.93 $128.86–$510.08 44% below 50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US LIMITED JOINT OR FOCAL EVAL W/IMAGING $268.47 $536.93 $340.41–$510.08 — 50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC LOW DOSE CT LUNG SCREENING $223.78 $447.55 $107.41–$1,250.00 22% below 50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC LOW DOSE CT LUNG SCREENING $223.78 $447.55 $283.75–$425.17 — 50%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC RADIOLOGY EXAM TIBIA FIBULA 2 VIEWS $176.76 $353.51 $84.84–$335.83 36% below 50%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC RADIOLOGY EXAM TIBIA FIBULA 2 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD W/O CONTRAST $1,061.45 $2,122.90 $487.54–$2,016.76 26% below 50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD W/O CONTRAST $1,061.45 $2,122.90 $1,345.92–$2,016.76 — 50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT W/O CONTRAST $2,116.00 $4,232.00 $487.54–$4,020.40 24% above 50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY JOINT W/O CONTRAST $2,116.00 $4,232.00 $2,683.09–$4,020.40 — 50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY JOINT W/ & W/O CONTRAST $2,875.00 $5,750.00 $712.86–$5,462.50 22% above 50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY JOINT W/ & W/O CONTRAST $2,875.00 $5,750.00 $3,645.50–$5,462.50 — 50%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O CONTRAST $1,158.63 $2,317.25 $487.54–$2,201.39 37% below 50%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN W/O CONTRAST $1,158.63 $2,317.25 $1,469.14–$2,201.39 — 50%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W/ & W/O CONTRAST $1,575.50 $3,151.00 $712.86–$2,993.45 30% below 50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN W/ & W/O CONTRAST $1,575.50 $3,151.00 $1,997.73–$2,993.45 — 50%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST $1,159.83 $2,319.65 $487.54–$2,203.67 27% below 50%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST $1,159.83 $2,319.65 $1,470.66–$2,203.67 — 50%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/ & W/O CONTRAST $1,495.18 $2,990.35 $712.86–$2,840.83 32% below 50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W/ & W/O CONTRAST $1,495.18 $2,990.35 $1,895.88–$2,840.83 — 50%
MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINE W/O CONTRAST LUMBAR $1,144.25 $2,288.50 $487.54–$2,174.08 31% below 50%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINE W/O CONTRAST LUMBAR $1,144.25 $2,288.50 $1,450.91–$2,174.08 — 50%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI SPINE W/ & W/O CONTRAST LUMBAR $1,466.25 $2,932.50 $703.80–$2,785.88 37% below 50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI SPINE W/ & W/O CONTRAST LUMBAR $1,466.25 $2,932.50 $1,859.21–$2,785.88 — 50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI SPINE W/O CONTRAST THORACIC $1,155.64 $2,311.27 $487.54–$2,195.71 29% below 50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI SPINE W/O CONTRAST THORACIC $1,155.64 $2,311.27 $1,465.35–$2,195.71 — 50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI SPINE W/ & W/O CONTRAST CERVICAL $1,487.75 $2,975.49 $712.86–$2,826.72 34% below 50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI SPINE W/ & W/O CONTRAST CERVICAL $1,487.75 $2,975.49 $1,886.46–$2,826.72 — 50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI SPINE W/O CONTRAST CERVICAL $1,150.96 $2,301.92 $487.54–$2,186.82 29% below 50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI SPINE W/O CONTRAST CERVICAL $1,150.96 $2,301.92 $1,459.42–$2,186.82 — 50%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W/ & W/O CONTRAST $1,523.75 $3,047.50 $712.86–$2,895.13 22% below 50%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS W/ & W/O CONTRAST $1,523.75 $3,047.50 $1,932.12–$2,895.13 — 50%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O CONTRAST $1,143.10 $2,286.20 $487.54–$2,171.89 25% below 50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS W/O CONTRAST $1,143.10 $2,286.20 $1,449.45–$2,171.89 — 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREMITY JOINT W/O CONTRAST $1,094.12 $2,188.24 $487.54–$2,078.83 25% below 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTREMITY JOINT W/O CONTRAST $1,094.12 $2,188.24 $1,387.34–$2,078.83 — 50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC RADIOLOGY EXAM CERVICAL SPINE 4 OR 5 VIEWS $304.14 $608.28 $145.99–$577.87 33% below 50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC RADIOLOGY EXAM CERVICAL SPINE 4 OR 5 VIEWS $304.14 $608.28 $385.65–$577.87 — 50%
Neck soft tissue CT scan with contrast CPT 70491 HC CT NECK W/ CONTRAST $1,008.12 $2,016.23 $358.40–$1,915.42 14% below 50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT NECK W/ CONTRAST $1,008.12 $2,016.23 $1,278.29–$1,915.42 — 50%
Neck soft tissue CT scan without contrast CPT 70490 HC CT NECK W/O CONTRAST $764.32 $1,528.63 $213.62–$1,452.20 17% below 50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT NECK W/O CONTRAST $764.32 $1,528.63 $969.15–$1,452.20 — 50%
Neck soft tissue X-ray CPT 70360 HC RADIOLOGY EXAM NECK SOFT TISSUE $154.09 $308.18 $73.96–$292.77 41% below 50%
Neck soft tissue X-ray inpatient CPT 70360 HC RADIOLOGY EXAM NECK SOFT TISSUE $154.09 $308.18 $195.39–$292.77 — 50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NUC MED MYOCARDIAL PERFUSION SPECT MULTIPLE REST OR STRESS $3,215.63 $6,431.25 $1,543.50–$6,109.69 22% below 50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NUC MED MYOCARDIAL PERFUSION SPECT MULTIPLE REST OR STRESS $3,215.63 $6,431.25 $4,077.41–$6,109.69 — 50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET CT SKULL BASE TO MID-THIGH $3,375.00 $6,750.00 $1,620.00–$6,412.50 30% below 50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET CT SKULL BASE TO MID-THIGH $3,375.00 $6,750.00 $4,279.50–$6,412.50 — 50%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS W/O CONTRAST $764.32 $1,528.63 $213.62–$1,452.20 24% below 50%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS W/O CONTRAST $764.32 $1,528.63 $969.15–$1,452.20 — 50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIC LIMITED $249.78 $499.56 $119.89–$474.58 43% below 50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIC LIMITED $249.78 $499.56 $316.72–$474.58 — 50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC COMPLETE $409.20 $818.40 $196.42–$777.48 20% below 50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC COMPLETE $409.20 $818.40 $518.87–$777.48 — 50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB AFTER 1ST TRIMESTER TRANSABDOMINAL SINGLE/FIRST GESTATION $177.50 $355.00 $85.20–$337.25 70% below 50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB AFTER 1ST TRIMESTER TRANSABDOMINAL SINGLE/FIRST GESTATION $177.50 $355.00 $225.07–$337.25 — 50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US 1ST TRIMESTER TRANSABDOMINAL SINGLE/FIRST GESTATION $177.50 $355.00 $85.20–$337.25 68% below 50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US 1ST TRIMESTER TRANSABDOMINAL SINGLE/FIRST GESTATION $177.50 $355.00 $225.07–$337.25 — 50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED 1 OR MORE FETUSES $177.50 $355.00 $85.20–$337.25 63% below 50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED 1 OR MORE FETUSES $177.50 $355.00 $225.07–$337.25 — 50%
Rib X-ray, one side, 2 views one side CPT 71100 HC RADIOLOGY EXAM RIBS UNILATERAL 2 VIEWS $176.76 $353.51 $84.84–$335.83 43% below 50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC RADIOLOGY EXAM RIBS UNILATERAL 2 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC RADIOLOGY EXAM RIBS UNILATERAL W/ PA CHEST MIN 3 VIEWS $186.10 $372.19 $89.33–$353.58 53% below 50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC RADIOLOGY EXAM RIBS UNILATERAL W/ PA CHEST MIN 3 VIEWS $186.10 $372.19 $235.97–$353.58 — 50%
Screening mammogram, both breasts both sides CPT 77067 HC MAMMOGRAM SCREENING BILATERAL INCLUDING CAD $143.75 $287.50 $69.00–$273.13 — 50%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC MAMMOGRAM SCREENING BILATERAL INCLUDING CAD $143.75 $287.50 $182.28–$273.13 — 50%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC RADIOLOGY EXAM SHOULDER COMPLETE- MIN 2 VIEWS $353.51 $707.02 $169.68–$671.67 5% above 50%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC RADIOLOGY EXAM SHOULDER COMPLETE- MIN 2 VIEWS $353.51 $707.02 $448.25–$671.67 — 50%
Sinus X-ray, complete, 3 or more views CPT 70220 HC RADIOLOGY EXAM PARANASAL SINUSES COMPLETE- MIN 3 VIEWS $176.76 $353.51 $84.84–$335.83 51% below 50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC RADIOLOGY EXAM PARANASAL SINUSES COMPLETE- MIN 3 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%
Skull X-ray, fewer than 4 views CPT 70250 HC RADIOLOGY EXAM SKULL < 4 VIEWS $186.10 $372.19 $89.33–$353.58 36% below 50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC RADIOLOGY EXAM SKULL < 4 VIEWS $186.10 $372.19 $235.97–$353.58 — 50%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY 4+ PARAMETERS AGE > 6 YRS $2,697.88 $5,395.76 $1,294.98–$5,125.97 25% below 50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY 4+ PARAMETERS AGE > 6 YRS $2,697.88 $5,395.76 $3,420.91–$5,125.97 — 50%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC CCH ECHO STRESS COMPLETE $1,172.65 $2,345.30 $562.87–$2,228.04 43% below 50%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC CCH ECHO STRESS COMPLETE $1,172.65 $2,345.30 $1,486.92–$2,228.04 — 50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC RADIOLOGY EXAM SWALOWING FUNCTION INCL SCOUT NECK W/CONTRAST $311.54 $623.07 $149.54–$591.92 38% below 50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC RADIOLOGY EXAM SWALOWING FUNCTION INCL SCOUT NECK W/CONTRAST $311.54 $623.07 $395.03–$591.92 — 50%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC RADIOLOGY EXAM FEMUR MINIMUM 2 VIEWS $176.76 $353.51 $84.84–$335.83 35% below 50%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC RADIOLOGY EXAM FEMUR MINIMUM 2 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SPINE W/O CONTRAST $764.32 $1,528.63 $213.62–$1,452.20 14% below 50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT THORACIC SPINE W/O CONTRAST $764.32 $1,528.63 $969.15–$1,452.20 — 50%
Toe X-ray, 2 or more views CPT 73660 HC RADIOLOGY EXAM TOE(S) MIN 2 VIEWS $176.76 $353.51 $84.84–$335.83 30% below 50%
Toe X-ray, 2 or more views inpatient CPT 73660 HC RADIOLOGY EXAM TOE(S) MIN 2 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL $409.20 $818.40 $196.42–$777.48 26% below 50%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL $409.20 $818.40 $518.87–$777.48 — 50%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL $177.50 $355.00 $85.20–$337.25 65% below 50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL $177.50 $355.00 $225.07–$337.25 — 50%
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMINAL COMPLETE $409.20 $818.40 $196.42–$777.48 35% below 50%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMINAL COMPLETE $409.20 $818.40 $518.87–$777.48 — 50%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM $409.20 $818.40 $196.42–$777.48 23% below 50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM $409.20 $818.40 $518.87–$777.48 — 50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US HEAD AND NECK $409.20 $818.40 $196.42–$777.48 28% below 50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US HEAD AND NECK $409.20 $818.40 $518.87–$777.48 — 50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC RADIOLOGY EXAM UPPER GI INCL SCOUT ABDOMINAL W/SINGLE-CONTRAST $311.54 $623.07 $149.54–$591.92 47% below 50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC RADIOLOGY EXAM UPPER GI INCL SCOUT ABDOMINAL W/SINGLE-CONTRAST $311.54 $623.07 $395.03–$591.92 — 50%
Upper arm X-ray (humerus), 2 views CPT 73060 HC RADIOLOGY EXAM HUMERUS MIN 2 VIEWS $176.76 $353.51 $84.84–$335.83 37% below 50%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC RADIOLOGY EXAM HUMERUS MIN 2 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX EXTREMITY VEINS COMPRESSION UNILATERAL OR LIMITED $684.52 $1,369.04 $213.62–$1,300.59 7% below 50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUPLEX EXTREMITY VEINS COMPRESSION UNILATERAL OR LIMITED $684.52 $1,369.04 $867.97–$1,300.59 — 50%
Wrist X-ray, 2 views CPT 73100 HC RADIOLOGY EXAM WRIST 2 VIEWS $154.09 $308.18 $73.96–$292.77 41% below 50%
Wrist X-ray, 2 views inpatient CPT 73100 HC RADIOLOGY EXAM WRIST 2 VIEWS $154.09 $308.18 $195.39–$292.77 — 50%
Wrist X-ray, complete, 3 or more views CPT 73110 HC RADIOLOGY EXAM WRIST COMPLETE- MIN 3 VIEWS $353.51 $707.02 $169.68–$671.67 3% above 50%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC RADIOLOGY EXAM WRIST COMPLETE- MIN 3 VIEWS $353.51 $707.02 $448.25–$671.67 — 50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC RADIOLOGY EXAM HIP W/ PELVIS WHEN PERFORMED UNILATERAL 2 -3 VIEWS $176.76 $353.51 $84.84–$335.83 43% below 50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC RADIOLOGY EXAM HIP W/ PELVIS WHEN PERFORMED UNILATERAL 2 -3 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%
X-ray of the abdomen, 1 view CPT 74018 HC RADIOLOGY EXAM ABDOMEN SINGLE VIEW $154.09 $308.18 $73.96–$292.77 40% below 50%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC RADIOLOGY EXAM ABDOMEN SINGLE VIEW $154.09 $308.18 $195.39–$292.77 — 50%
X-ray of the ankle, 2 views CPT 73600 HC RADIOLOGY EXAM ANKLE 2 VIEWS $154.09 $308.18 $73.96–$292.77 41% below 50%
X-ray of the ankle, 2 views inpatient CPT 73600 HC RADIOLOGY EXAM ANKLE 2 VIEWS $154.09 $308.18 $195.39–$292.77 — 50%
X-ray of the finger(s), 2 or more views CPT 73140 HC RADIOLOGY EXAM FINGER(S) MIN 2 VIEWS $353.51 $707.02 $169.68–$671.67 36% above 50%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC RADIOLOGY EXAM FINGER(S) MIN 2 VIEWS $353.51 $707.02 $448.25–$671.67 — 50%
X-ray of the foot, 2 views CPT 73620 HC RADIOLOGY EXAM FOOT 2 VIEWS $154.09 $308.18 $73.96–$292.77 34% below 50%
X-ray of the foot, 2 views inpatient CPT 73620 HC RADIOLOGY EXAM FOOT 2 VIEWS $154.09 $308.18 $195.39–$292.77 — 50%
X-ray of the foot, complete, 3 or more views CPT 73630 HC RADIOLOGY EXAM FOOT COMPLETE- MIN 3 VIEWS $353.51 $707.02 $169.68–$671.67 15% above 50%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC RADIOLOGY EXAM FOOT COMPLETE- MIN 3 VIEWS $353.51 $707.02 $448.25–$671.67 — 50%
X-ray of the hand, 3 or more views CPT 73130 HC RADIOLOGY EXAM HAND MIN 3 VIEWS $353.51 $707.02 $169.68–$671.67 7% above 50%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC RADIOLOGY EXAM HAND MIN 3 VIEWS $353.51 $707.02 $448.25–$671.67 — 50%
X-ray of the knee, 1 or 2 views CPT 73560 HC RADIOLOGY EXAM KNEE 1 OR 2 VIEWS $353.51 $707.02 $169.68–$671.67 27% above 50%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC RADIOLOGY EXAM KNEE 1 OR 2 VIEWS $353.51 $707.02 $448.25–$671.67 — 50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC RADIOLOGY EXAM LUMBOSACRAL SPINE 2 OR 3 VIEWS $186.10 $372.19 $89.33–$353.58 43% below 50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC RADIOLOGY EXAM LUMBOSACRAL SPINE 2 OR 3 VIEWS $186.10 $372.19 $235.97–$353.58 — 50%
X-ray of the lower back, 4 or more views CPT 72110 HC RADIOLOGY EXAM LUMBOSACRAL SPINE MIN 4 VIEWS $304.14 $608.28 $145.99–$577.87 35% below 50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC RADIOLOGY EXAM LUMBOSACRAL SPINE MIN 4 VIEWS $304.14 $608.28 $385.65–$577.87 — 50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC RADIOLOGY EXAM THORACIC SPINE 2 VIEWS $186.10 $372.19 $89.33–$353.58 39% below 50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC RADIOLOGY EXAM THORACIC SPINE 2 VIEWS $186.10 $372.19 $235.97–$353.58 — 50%
X-ray of the nasal bones, 3 or more views CPT 70160 HC RADIOLOGY EXAM NASAL BONES COMPLETE-MIN 3 VIEWS $176.76 $353.51 $84.84–$335.83 40% below 50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC RADIOLOGY EXAM NASAL BONES COMPLETE-MIN 3 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC RADIOLOGY EXAM CERVICAL SPINE 2 OR 3 VIEWS $176.76 $353.51 $84.84–$335.83 48% below 50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC RADIOLOGY EXAM CERVICAL SPINE 2 OR 3 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC RADIOLOGY EXAM PELVIS 1 OR 2 VIEWS $186.10 $372.19 $89.33–$353.58 26% below 50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC RADIOLOGY EXAM PELVIS 1 OR 2 VIEWS $186.10 $372.19 $235.97–$353.58 — 50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC RADIOLOGY EXAM SACRUM & COCCYX MIN 2 VIEWS $176.76 $353.51 $84.84–$335.83 40% below 50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC RADIOLOGY EXAM SACRUM & COCCYX MIN 2 VIEWS $176.76 $353.51 $224.13–$335.83 — 50%

Lab tests

ProcedureCash priceList priceInsurers payvs OhioOff list
ACTH blood test CPT 82024 HC ACTH $92.07 $184.14 $44.19–$278.17 30% below 50%
ACTH blood test CPT 82024 HC SO ACTH $92.07 $184.14 $44.19–$278.17 30% below 50%
ACTH blood test inpatient CPT 82024 HC ACTH $92.07 $184.14 $116.74–$174.93 — 50%
ACTH blood test inpatient CPT 82024 HC SO ACTH $92.07 $184.14 $116.74–$174.93 — 50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SO TRANSFERASE ALANINE AMINO $12.64 $25.27 $6.06–$80.00 56% below 50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO $12.64 $25.27 $6.06–$80.00 56% below 50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SO TRANSFERASE ALANINE AMINO $12.64 $25.27 $16.02–$24.01 — 50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO $12.64 $25.27 $16.02–$24.01 — 50%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC AST OR SGOT $12.34 $24.68 $5.92–$80.00 51% below 50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC AST OR SGOT $12.34 $24.68 $15.65–$23.45 — 50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC ACUTE HEPATITIS PANEL $124.78 $249.55 $59.89–$343.05 42% below 50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC ACUTE HEPATITIS PANEL $124.78 $249.55 $158.21–$237.07 — 50%
Albumin blood test CPT 82040 HC SO ASSAY OF SERUM ALBUMIN $11.80 $23.59 $5.66–$80.00 47% below 50%
Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN $11.80 $23.59 $5.66–$80.00 47% below 50%
Albumin blood test inpatient CPT 82040 HC SO ASSAY OF SERUM ALBUMIN $11.80 $23.59 $14.96–$22.41 — 50%
Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN $11.80 $23.59 $14.96–$22.41 — 50%
Aldosterone blood test CPT 82088 HC SO ALDOSTERONE $97.15 $194.29 $46.63–$293.50 31% below 50%
Aldosterone blood test inpatient CPT 82088 HC SO ALDOSTERONE $97.15 $194.29 $123.18–$184.58 — 50%
Alkaline phosphatase (ALP) blood test CPT 84075 HC SO ALKALINE PHOSPHATASE $12.34 $24.68 $5.92–$80.00 49% below 50%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOSPHATASE $12.34 $24.68 $5.92–$80.00 49% below 50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOSPHATASE $12.34 $24.68 $15.65–$23.45 — 50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC SO ALKALINE PHOSPHATASE $12.34 $24.68 $15.65–$23.45 — 50%
Allergy blood test, specific IgE, per allergen CPT 86003 HC SO ALLERGEN SPECIFIC IGE- EA - A $12.45 $24.89 $5.97–$80.00 47% below 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC SO ALLERGEN SPECIFIC IGE- EA - A $12.45 $24.89 $15.78–$23.65 — 50%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC SO ALPHA-FETOPROTEIN- SERUM $39.99 $79.98 $19.20–$120.79 34% below 50%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM $39.99 $79.98 $19.20–$120.79 34% below 50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM $39.99 $79.98 $50.71–$75.98 — 50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC SO ALPHA-FETOPROTEIN- SERUM $39.99 $79.98 $50.71–$75.98 — 50%
Ammonia blood test CPT 82140 HC AMMONIA $34.74 $69.48 $16.68–$104.94 37% below 50%
Ammonia blood test inpatient CPT 82140 HC AMMONIA $34.74 $69.48 $44.05–$66.01 — 50%
Amylase blood test CPT 82150 HC AMYLASE $15.46 $30.91 $7.42–$80.00 69% below 50%
Amylase blood test CPT 82150 HC SO AMYLASE $15.46 $30.91 $7.42–$80.00 69% below 50%
Amylase blood test inpatient CPT 82150 HC AMYLASE $15.46 $30.91 $19.60–$29.36 — 50%
Amylase blood test inpatient CPT 82150 HC SO AMYLASE $15.46 $30.91 $19.60–$29.36 — 50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCH SO CCP ANTIBODY $30.86 $61.71 $14.81–$93.27 47% below 50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP ANTIBODY $30.86 $61.71 $14.81–$93.27 47% below 50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCH SO CCP ANTIBODY $30.86 $61.71 $39.12–$58.62 — 50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP ANTIBODY $30.86 $61.71 $39.12–$58.62 — 50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC SO ANTINUCLEAR AB (ANA) $28.83 $57.65 $13.84–$87.08 48% below 50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC SO ANTINUCLEAR AB (ANA) $28.83 $57.65 $36.55–$54.77 — 50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIUERETIC PEPTIDE $80.92 $161.84 $38.84–$282.77 46% below 50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC SO NATRIUERETIC PEPTIDE $80.92 $161.84 $38.84–$282.77 46% below 50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC SO NATRIUERETIC PEPTIDE $80.92 $161.84 $102.61–$153.75 — 50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIUERETIC PEPTIDE $80.92 $161.84 $102.61–$153.75 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC BACTERIAL CULTURE OTHER SOURCE $23.50 $46.99 $11.28–$80.00 66% below 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC BACTERIAL CULTURE OTHER SOURCE $23.50 $46.99 $29.79–$44.64 — 50%
Basic metabolic panel (blood test) CPT 80048 HC METABOLIC PANEL TOTAL CA $20.11 $40.22 $9.65–$80.00 69% below 50%
Basic metabolic panel (blood test) inpatient CPT 80048 HC METABOLIC PANEL TOTAL CA $20.11 $40.22 $25.50–$38.21 — 50%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL $9.63 $19.25 $4.62–$80.00 60% below 50%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL $9.63 $19.25 $12.20–$18.29 — 50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURG PATH LEVEL IV EXCEPT PROSTATE NEEDLE BIOPSY $97.75 $195.50 $46.92–$278.02 52% below 50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURG PATH LEVEL IV EXCEPT PROSTATE NEEDLE BIOPSY $97.75 $195.50 $123.95–$185.73 — 50%
Blood culture for bacteria CPT 87040 HC AEROB BACTERIAL BLOOD CULTURE $28.15 $56.30 $13.51–$80.00 70% below 50%
Blood culture for bacteria inpatient CPT 87040 HC AEROB BACTERIAL BLOOD CULTURE $28.15 $56.30 $35.69–$53.49 — 50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE $15.91 $31.82 $7.64–$80.00 at median 50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC VENIPUNCTURE $15.91 $31.82 $20.17–$30.23 — 50%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUAN BLOOD $9.37 $18.73 $4.50–$80.00 60% below 50%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUAN BLOOD $9.37 $18.73 $11.87–$17.79 — 50%
Blood lead test CPT 83655 HC SO LEAD - A $28.86 $57.72 $13.85–$87.23 41% below 50%
Blood lead test inpatient CPT 83655 HC SO LEAD - A $28.86 $57.72 $36.59–$54.83 — 50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC HCG QUAL $17.93 $35.85 $8.60–$80.00 69% below 50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC HCG QUAL $17.93 $35.85 $22.73–$34.06 — 50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING ABO $225.58 $451.15 $21.54–$428.59 295% above 50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING ABO $225.58 $451.15 $286.03–$428.59 — 50%
Blood urea nitrogen (BUN) test CPT 84520 HC SO UREA NITROGEN QUAN $9.42 $18.83 $4.52–$80.00 60% below 50%
Blood urea nitrogen (BUN) test CPT 84520 HC UREA NITROGEN QUAN $9.42 $18.83 $4.52–$80.00 60% below 50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC UREA NITROGEN QUAN $9.42 $18.83 $11.94–$17.89 — 50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC SO UREA NITROGEN QUAN $9.42 $18.83 $11.94–$17.89 — 50%
C-peptide blood test CPT 84681 HC CCH SO C-PEPTIDE $49.62 $99.23 $23.82–$149.88 35% below 50%
C-peptide blood test inpatient CPT 84681 HC CCH SO C-PEPTIDE $49.62 $99.23 $62.91–$94.27 — 50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN $12.34 $24.68 $5.92–$80.00 76% below 50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN $12.34 $24.68 $15.65–$23.45 — 50%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFF AMPLIFIED PROBE $95.63 $191.26 $45.90–$268.43 28% below 50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFF AMPLIFIED PROBE $95.63 $191.26 $121.26–$181.70 — 50%
CA 19-9 blood test (tumor marker) CPT 86301 HC SO IA- QUANT CA 19-9 $34.08 $68.15 $16.36–$149.88 53% below 50%
CA 19-9 blood test (tumor marker) CPT 86301 HC IA QUANT CA 19-9 $36.42 $72.84 $17.48–$149.88 50% below 50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC SO IA- QUANT CA 19-9 $34.08 $68.15 $43.21–$64.74 — 50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IA QUANT CA 19-9 $36.42 $72.84 $46.18–$69.20 — 50%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC IA QUANT CA 125 $36.42 $72.84 $17.48–$149.88 61% below 50%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC CCH SO IA-QUANT CA 125 $193.82 $387.63 $41.62–$368.25 107% above 50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IA QUANT CA 125 $36.42 $72.84 $46.18–$69.20 — 50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC CCH SO IA-QUANT CA 125 $193.82 $387.63 $245.76–$368.25 — 50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC SARS-COV-2 COVID-19 AMP PRB $108.47 $216.93 $52.06–$206.08 23% below 50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC SO SARS-COV-2 COVID-19 AMP PRB $134.90 $269.79 $64.75–$256.30 4% below 50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC SARS-COV-2 COVID-19 AMP PRB $108.47 $216.93 $137.53–$206.08 — 50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC SO SARS-COV-2 COVID-19 AMP PRB $134.90 $269.79 $171.05–$256.30 — 50%
Calcium blood test, total CPT 82310 HC CALCIUM TOTAL $12.31 $24.61 $5.91–$80.00 61% below 50%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM TOTAL $12.31 $24.61 $15.60–$23.38 — 50%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CCH SO CARCINOEMBRYONIC ANTIGEN (CEA) $45.22 $90.44 $21.71–$136.57 47% below 50%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN (CEA) $45.22 $90.44 $21.71–$136.57 47% below 50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRYONIC ANTIGEN (CEA) $45.22 $90.44 $57.34–$85.92 — 50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CCH SO CARCINOEMBRYONIC ANTIGEN (CEA) $45.22 $90.44 $57.34–$85.92 — 50%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER ANTIBODY $30.72 $61.43 $14.74–$92.77 47% below 50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER ANTIBODY $30.72 $61.43 $38.95–$58.36 — 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC SO CHLAMYDIA TRACHOMATIS AMPLIF NA PROBE $95.63 $191.26 $45.90–$252.73 2% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIF NA PROBE $95.63 $191.26 $45.90–$252.73 2% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIF NA PROBE $95.63 $191.26 $121.26–$181.70 — 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC SO CHLAMYDIA TRACHOMATIS AMPLIF NA PROBE $95.63 $191.26 $121.26–$181.70 — 50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL $34.88 $69.76 $16.74–$96.45 35% below 50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC SO LIPID PANEL $34.88 $69.76 $16.74–$96.45 35% below 50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC SO LIPID PANEL $34.88 $69.76 $44.23–$66.27 — 50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL $34.88 $69.76 $44.23–$66.27 — 50%
Complete blood count (CBC) with differential CPT 85025 HC CBC EDIFF & PLATELET $21.32 $42.63 $10.23–$80.00 41% below 50%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC EDIFF & PLATELET $21.32 $42.63 $27.03–$40.50 — 50%
Complete blood count (CBC), no differential CPT 85027 HC CBC & PLATELET $17.74 $35.47 $8.51–$80.00 46% below 50%
Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC & PLATELET $17.74 $35.47 $22.49–$33.70 — 50%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL $28.97 $57.93 $13.90–$80.00 54% below 50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL $28.97 $57.93 $36.73–$55.03 — 50%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL $38.87 $77.74 $18.66–$117.41 46% below 50%
Cortisol blood test, total CPT 82533 HC SO CORTISOL-TOTAL $38.87 $77.74 $18.66–$117.41 46% below 50%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL $38.87 $77.74 $49.29–$73.85 — 50%
Cortisol blood test, total inpatient CPT 82533 HC SO CORTISOL-TOTAL $38.87 $77.74 $49.29–$73.85 — 50%
Creatine kinase (CK) blood test, total CPT 82550 HC CPK TOTAL $15.53 $31.05 $7.45–$80.00 55% below 50%
Creatine kinase (CK) blood test, total CPT 82550 HC SO CPK TOTAL $15.53 $31.05 $7.45–$80.00 55% below 50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CPK TOTAL $15.53 $31.05 $19.69–$29.50 — 50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC SO CPK TOTAL $15.53 $31.05 $19.69–$29.50 — 50%
Creatinine blood test CPT 82565 HC CREATININE BLOOD $12.22 $24.43 $5.86–$80.00 50% below 50%
Creatinine blood test CPT 82565 HC SO CREATININE BLOOD $18.64 $37.28 $8.95–$80.00 24% below 50%
Creatinine blood test inpatient CPT 82565 HC CREATININE BLOOD $12.22 $24.43 $15.49–$23.21 — 50%
Creatinine blood test inpatient CPT 82565 HC SO CREATININE BLOOD $18.64 $37.28 $23.64–$35.42 — 50%
Cytomegalovirus (CMV) antibody test CPT 86644 HC SO CYTOMEGALOVIRUS AB $34.32 $68.64 $16.47–$103.65 49% below 50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC SO CYTOMEGALOVIRUS AB $34.32 $68.64 $43.52–$65.21 — 50%
D-dimer blood test (blood clot marker) CPT 85379 HC D-DIMER - QUAN $27.92 $55.83 $13.40–$80.00 60% below 50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D-DIMER - QUAN $27.92 $55.83 $35.40–$53.04 — 50%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC CCH SO DHEA-S $53.01 $106.02 $25.44–$160.11 47% below 50%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DHEA-S $53.01 $106.02 $25.44–$160.11 47% below 50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC CCH SO DHEA-S $53.01 $106.02 $67.22–$100.72 — 50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DHEA-S $53.01 $106.02 $67.22–$100.72 — 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC SO DRUG TEST PRESUMPTIVE ANY DRUG CLASS ANY DEVICE/PROCEDURE BY INSTRUMENT ANALYZER $97.18 $194.35 $46.64–$447.57 at median 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRESUMPTIVE ANY DRUG CLASS ANY DEVICE $112.72 $225.44 $54.11–$447.57 16% above 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC SO DRUG TEST PRESUMPTIVE ANY DRUG CLASS ANY DEVICE/PROCEDURE BY INSTRUMENT ANALYZER $97.18 $194.35 $123.22–$184.63 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRESUMPTIVE ANY DRUG CLASS ANY DEVICE $112.72 $225.44 $142.93–$214.17 — 50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL $12.60 $25.20 $6.05–$80.00 74% below 50%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL $12.60 $25.20 $15.98–$23.94 — 50%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC SO AB EB VCA $32.80 $65.59 $15.74–$130.66 50% below 50%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC AB EB VCA $32.80 $65.59 $15.74–$130.66 50% below 50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC AB EB VCA $32.80 $65.59 $41.58–$62.31 — 50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC SO AB EB VCA $32.80 $65.59 $41.58–$62.31 — 50%
Estradiol blood test CPT 82670 HC SO ESTRADIOL $65.63 $131.25 $31.50–$201.24 41% below 50%
Estradiol blood test CPT 82670 HC ESTRADIOL $66.61 $133.21 $31.97–$201.24 41% below 50%
Estradiol blood test inpatient CPT 82670 HC SO ESTRADIOL $65.63 $131.25 $83.21–$124.69 — 50%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL $66.61 $133.21 $84.46–$126.55 — 50%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FSH $44.30 $88.59 $21.26–$133.82 48% below 50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FSH $44.30 $88.59 $56.17–$84.16 — 50%
Fecal calprotectin (stool inflammation test) CPT 83993 HC SO CALPROTECTIN FECAL $46.80 $93.60 $22.46–$141.38 69% below 50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC SO CALPROTECTIN FECAL $46.80 $93.60 $59.34–$88.92 — 50%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN $32.50 $65.00 $15.60–$98.17 57% below 50%
Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN $32.50 $65.00 $41.21–$61.75 — 50%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN ACTIVITY $23.29 $46.58 $11.18–$80.00 48% below 50%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN ACTIVITY $23.29 $46.58 $29.53–$44.25 — 50%
Folate (folic acid) blood test CPT 82746 HC FOLIC ACID SERUM $35.06 $70.11 $16.83–$105.89 48% below 50%
Folate (folic acid) blood test inpatient CPT 82746 HC FOLIC ACID SERUM $35.06 $70.11 $44.45–$66.60 — 50%
Free T3 thyroid hormone test CPT 84481 HC T3 FREE $40.38 $80.75 $19.38–$122.01 45% below 50%
Free T3 thyroid hormone test inpatient CPT 84481 HC T3 FREE $40.38 $80.75 $51.20–$76.71 — 50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC FREE THYROXINE $21.49 $42.98 $10.32–$80.00 48% below 50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC FREE THYROXINE $21.49 $42.98 $27.25–$40.83 — 50%
Free testosterone test CPT 84402 HC SO TESTOSTERONE FREE $26.00 $52.00 $12.48–$183.44 73% below 50%
Free testosterone test inpatient CPT 84402 HC SO TESTOSTERONE FREE $26.00 $52.00 $32.97–$49.40 — 50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GLUTAMYLTRANSFERASE GAMMA $17.17 $34.34 $8.24–$80.00 60% below 50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC SO GLUTAMYLTRANSFERASE GAMMA $17.17 $34.34 $8.24–$80.00 60% below 50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GLUTAMYLTRANSFERASE GAMMA $17.17 $34.34 $21.77–$32.62 — 50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC SO GLUTAMYLTRANSFERASE GAMMA $17.17 $34.34 $21.77–$32.62 — 50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC CCH GENERAL HEALTH PANEL $317.35 $634.70 $80.00–$602.97 46% above 50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC CCH GENERAL HEALTH PANEL $317.35 $634.70 $402.40–$602.97 — 50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE $11.33 $22.65 $5.44–$80.00 68% below 50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE $11.33 $22.65 $14.36–$21.52 — 50%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST INCL 3 SPECIMENS $23.31 $46.62 $11.19–$92.69 65% below 50%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST INCL 3 SPECIMENS $23.31 $46.62 $29.56–$44.29 — 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC SO NEISSERIA AMPLIF NA PROBE $95.63 $191.26 $45.90–$252.73 3% above 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC NEISSERIA AMPLIF NA PROBE $95.63 $191.26 $45.90–$252.73 3% above 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC SO NEISSERIA AMPLIF NA PROBE $95.63 $191.26 $121.26–$181.70 — 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC NEISSERIA AMPLIF NA PROBE $95.63 $191.26 $121.26–$181.70 — 50%
H. pylori antibody blood test CPT 86677 HC SO AB HELICOBACTER PYLORI $34.60 $69.20 $16.61–$121.37 51% below 50%
H. pylori antibody blood test inpatient CPT 86677 HC SO AB HELICOBACTER PYLORI $34.60 $69.20 $43.87–$65.74 — 50%
H. pylori stool antigen test CPT 87338 HC SO HPYLORI STOOL- EIA $39.20 $78.39 $18.81–$103.57 44% below 50%
H. pylori stool antigen test inpatient CPT 87338 HC SO HPYLORI STOOL- EIA $39.20 $78.39 $49.70–$74.47 — 50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC SO HIV-1 REVERSE TRANSCRIPTION & NA QUAN $231.91 $463.82 $80.00–$612.94 35% below 50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC SO HIV-1 REVERSE TRANSCRIPTION & NA QUAN $231.91 $463.82 $294.06–$440.63 — 50%
HIV-1 and HIV-2 antibody test CPT 86703 HC SO ANTI HIV 1\HIV 2 $32.68 $65.35 $15.68–$98.75 47% below 50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC SO ANTI HIV 1\HIV 2 $32.68 $65.35 $41.43–$62.08 — 50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB $65.62 $131.24 $31.50–$173.44 11% below 50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC CCH SO HIV-1 AG W/HIV-1 & HIV-2 AB $65.62 $131.24 $31.50–$173.44 11% below 50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC CCH SO HIV-1 AG W/HIV-1 & HIV-2 AB $65.62 $131.24 $83.21–$124.68 — 50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB $65.62 $131.24 $83.21–$124.68 — 50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC SO HPV HIGH-RISK TYPES POOLED $42.87 $85.74 $20.58–$252.73 64% below 50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC SO HPV HIGH-RISK TYPES POOLED $42.87 $85.74 $54.36–$81.45 — 50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HGB GLYCOSYLATED (A1C) $23.14 $46.28 $11.11–$80.00 49% below 50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HGB GLYCOSYLATED (A1C) $23.14 $46.28 $29.34–$43.97 — 50%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN $4.78 $9.55 $2.29–$80.00 70% below 50%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN $4.78 $9.55 $6.05–$9.07 — 50%
Hepatitis B core antibody test (total) CPT 86704 HC SO HEPATITIS B CORE AB- TOTAL $28.72 $57.44 $13.79–$86.80 47% below 50%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC SO HEPATITIS B CORE AB- TOTAL $28.72 $57.44 $36.42–$54.57 — 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF AB $25.61 $51.21 $12.29–$80.00 47% below 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF AB $25.61 $51.21 $32.47–$48.65 — 50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC SO HEPATITIS B SURFACE AG- EIA $25.38 $50.75 $12.18–$80.00 45% below 50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE AG EIA $25.38 $50.75 $12.18–$80.00 45% below 50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC SO HEPATITIS B SURFACE AG- EIA $25.38 $50.75 $32.18–$48.21 — 50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEPATITIS B SURFACE AG EIA $25.38 $50.75 $32.18–$48.21 — 50%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY $31.42 $62.83 $15.08–$102.77 51% below 50%
Hepatitis C antibody blood test (screening) CPT 86803 HC SO HEPATITIS C ANTIBODY $31.42 $62.83 $15.08–$102.77 51% below 50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC SO HEPATITIS C ANTIBODY $31.42 $62.83 $39.83–$59.69 — 50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY $31.42 $62.83 $39.83–$59.69 — 50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC SO HEP-C REVERSE TRANSCRIPTION & NA QUAN $116.74 $233.48 $56.04–$308.55 39% below 50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC SO HEP-C REVERSE TRANSCRIPTION & NA QUAN $116.74 $233.48 $148.03–$221.81 — 50%
Herpes blood test, HSV-1 antibody CPT 86695 HC SO HERPES SIMPLEX- TYPE I $34.95 $69.90 $16.78–$95.01 41% below 50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC SO HERPES SIMPLEX- TYPE I $34.95 $69.90 $44.32–$66.41 — 50%
Herpes blood test, HSV-2 antibody CPT 86696 HC SO AB HSV II $46.15 $92.30 $22.15–$139.36 30% below 50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC SO AB HSV II $46.15 $92.30 $58.52–$87.69 — 50%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC SO C-REACTIVE PROTEIN HS $30.86 $61.71 $14.81–$93.27 54% below 50%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HS $30.86 $61.71 $14.81–$93.27 54% below 50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC SO C-REACTIVE PROTEIN HS $30.86 $61.71 $39.12–$58.62 — 50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HS $30.86 $61.71 $39.12–$58.62 — 50%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE $31.36 $62.72 $15.05–$129.06 61% below 50%
Homocysteine blood test CPT 83090 HC SO ASSAY OF HOMOCYSTINE $40.22 $80.43 $19.30–$129.06 50% below 50%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTINE $31.36 $62.72 $39.76–$59.58 — 50%
Homocysteine blood test inpatient CPT 83090 HC SO ASSAY OF HOMOCYSTINE $40.22 $80.43 $50.99–$76.41 — 50%
Insulin blood test CPT 83525 HC INSULIN TOTAL $27.25 $54.50 $13.08–$82.32 47% below 50%
Insulin blood test CPT 83525 HC SO INSULIN TOTAL $27.25 $54.50 $13.08–$82.32 47% below 50%
Insulin blood test inpatient CPT 83525 HC INSULIN TOTAL $27.25 $54.50 $34.55–$51.78 — 50%
Insulin blood test inpatient CPT 83525 HC SO INSULIN TOTAL $27.25 $54.50 $34.55–$51.78 — 50%
Iron blood test (serum iron) CPT 83540 HC IRON $15.44 $30.87 $7.41–$80.00 59% below 50%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON $15.44 $30.87 $19.57–$29.33 — 50%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL $23.81 $47.62 $11.43–$80.00 67% below 50%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL $23.81 $47.62 $30.19–$45.24 — 50%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE $44.14 $88.27 $21.18–$133.39 54% below 50%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE $44.14 $88.27 $55.96–$83.86 — 50%
Lactate (lactic acid) blood test CPT 83605 HC LACTATE (LACTIC ACID) $25.47 $50.93 $12.22–$83.33 51% below 50%
Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTATE (LACTIC ACID) $25.47 $50.93 $32.29–$48.38 — 50%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE (LD) (LDH) $14.39 $28.77 $6.90–$80.00 47% below 50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE (LD) (LDH) $14.39 $28.77 $18.24–$27.33 — 50%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE $16.42 $32.83 $7.88–$80.00 72% below 50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE $16.42 $32.83 $20.81–$31.19 — 50%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL $17.33 $34.66 $8.32–$80.00 72% below 50%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL $17.33 $34.66 $21.97–$32.93 — 50%
Lyme disease antibody test CPT 86618 HC AB LYME'S DISEASE $40.60 $81.20 $19.49–$122.66 47% below 50%
Lyme disease antibody test CPT 86618 HC SO AB LYME'S DISEASE $40.60 $81.20 $19.49–$122.66 47% below 50%
Lyme disease antibody test inpatient CPT 86618 HC AB LYME'S DISEASE $40.60 $81.20 $51.48–$77.14 — 50%
Lyme disease antibody test inpatient CPT 86618 HC SO AB LYME'S DISEASE $40.60 $81.20 $51.48–$77.14 — 50%
Magnesium blood test CPT 83735 HC MAGNESIUM $13.76 $27.52 $6.60–$80.00 59% below 50%
Magnesium blood test CPT 83735 HC SO MAGNESIUM $13.76 $27.51 $6.60–$80.00 59% below 50%
Magnesium blood test inpatient CPT 83735 HC SO MAGNESIUM $13.76 $27.51 $17.44–$26.13 — 50%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM $13.76 $27.52 $17.45–$26.14 — 50%
Measles (rubeola) antibody test CPT 86765 HC AB RUBEOLA $30.72 $61.43 $14.74–$92.77 46% below 50%
Measles (rubeola) antibody test CPT 86765 HC SO AB RUBEOLA $30.72 $61.43 $14.74–$92.77 46% below 50%
Measles (rubeola) antibody test inpatient CPT 86765 HC AB RUBEOLA $30.72 $61.43 $38.95–$58.36 — 50%
Measles (rubeola) antibody test inpatient CPT 86765 HC SO AB RUBEOLA $30.72 $61.43 $38.95–$58.36 — 50%
Mono test (heterophile antibody, Monospot) CPT 86308 HC QUAL HETEROPHILE AB $12.34 $24.68 $5.92–$80.00 76% below 50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC QUAL HETEROPHILE AB $12.34 $24.68 $15.65–$23.45 — 50%
Mumps immunity blood test CPT 86735 HC MUMPS ANTIBODY $31.10 $62.20 $14.93–$94.00 47% below 50%
Mumps immunity blood test CPT 86735 HC SO MUMPS ANTIBODY $31.10 $62.20 $14.93–$94.00 47% below 50%
Mumps immunity blood test inpatient CPT 86735 HC SO MUMPS ANTIBODY $31.10 $62.20 $39.43–$59.09 — 50%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS ANTIBODY $31.10 $62.20 $39.43–$59.09 — 50%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC SO PSA FREE $43.86 $87.71 $21.05–$132.46 47% below 50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC SO PSA FREE $43.86 $87.71 $55.61–$83.32 — 50%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL $43.86 $87.71 $21.05–$132.46 45% below 50%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC SO PSA TOTAL $43.86 $87.71 $21.05–$132.46 45% below 50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA TOTAL $43.86 $87.71 $55.61–$83.32 — 50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC SO PSA TOTAL $43.86 $87.71 $55.61–$83.32 — 50%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CCH SO CYTOPATH C/V AUTO FLUID REDO (DIAGNOSTIC) $69.00 $138.00 $33.12–$191.65 31% below 50%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTOPATHOLOGY THIN LAYER AUTOMATED AND MANUAL $69.00 $138.00 $33.12–$191.65 31% below 50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CCH SO CYTOPATH C/V AUTO FLUID REDO (DIAGNOSTIC) $69.00 $138.00 $87.49–$131.10 — 50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTOPATHOLOGY THIN LAYER AUTOMATED AND MANUAL $69.00 $138.00 $87.49–$131.10 — 50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CP CERV/VAG ATL MANUAL SCRN $28.75 $57.50 $13.80–$145.92 68% below 50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CP CERV/VAG ATL MANUAL SCRN $28.75 $57.50 $36.46–$54.63 — 50%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE $98.41 $196.81 $47.23–$297.32 30% below 50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE $98.41 $196.81 $124.78–$186.97 — 50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC CCH SO PTT PLASMA OR WHOLE BLOOD $16.47 $32.94 $7.91–$80.00 56% below 50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT PLASMA OR WHOLE BLOOD $16.47 $32.94 $7.91–$80.00 56% below 50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT PLASMA OR WHOLE BLOOD $16.47 $32.94 $20.88–$31.29 — 50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC CCH SO PTT PLASMA OR WHOLE BLOOD $16.47 $32.94 $20.88–$31.29 — 50%
Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHATE INORGANIC $11.31 $22.61 $5.43–$80.00 68% below 50%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHATE INORGANIC $11.31 $22.61 $14.33–$21.48 — 50%
Potassium blood test CPT 84132 HC ASSAY OF SERUM POTASSIUM $10.96 $21.91 $5.26–$80.00 53% below 50%
Potassium blood test inpatient CPT 84132 HC ASSAY OF SERUM POTASSIUM $10.96 $21.91 $13.89–$20.81 — 50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY ANALYSIS $379.53 $759.05 $80.00–$5,467.06 74% below 50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC CCH SO FETAL CHROMOSOMAL ANEUPLOIDY ANALYSIS $2,362.84 $4,725.67 $80.00–$5,467.06 62% above 50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY ANALYSIS $379.53 $759.05 $481.24–$721.10 — 50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC CCH SO FETAL CHROMOSOMAL ANEUPLOIDY ANALYSIS $2,362.84 $4,725.67 $2,996.07–$4,489.39 — 50%
Progesterone blood test CPT 84144 HC PROGESTERONE $45.68 $91.35 $21.92–$150.24 44% below 50%
Progesterone blood test inpatient CPT 84144 HC PROGESTERONE $45.68 $91.35 $57.92–$86.78 — 50%
Prolactin blood test CPT 84146 HC PROLACTIN ASSAY $46.20 $92.40 $22.18–$139.58 47% below 50%
Prolactin blood test inpatient CPT 84146 HC PROLACTIN ASSAY $46.20 $92.40 $58.58–$87.78 — 50%
Prothrombin time (PT/INR) clotting test CPT 85610 HC CCH SO PROTHROMBIN TIME $10.80 $21.59 $5.18–$80.00 55% below 50%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHOMBIN TIME $10.80 $21.59 $5.18–$80.00 55% below 50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHOMBIN TIME $10.80 $21.59 $13.69–$20.51 — 50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC CCH SO PROTHROMBIN TIME $10.80 $21.59 $13.69–$20.51 — 50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC SO DRUG TEST PRESUMPTIVE DIRECT OPTICAL OBSERVATION $25.36 $50.72 $12.17–$90.75 56% below 50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC SO DRUG TEST PRESUMPTIVE DIRECT OPTICAL OBSERVATION $25.36 $50.72 $32.16–$48.18 — 50%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA IA W DIRECT OPTICAL $32.68 $65.35 $15.68–$119.20 50% below 50%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA IA W DIRECT OPTICAL $32.68 $65.35 $41.43–$62.08 — 50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC CCH STREP A ASSAY W/ OPTIC $32.68 $65.35 $15.68–$119.07 43% below 50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC CCH STREP A ASSAY W/ OPTIC $32.68 $65.35 $41.43–$62.08 — 50%
Renin blood test CPT 84244 HC SO RENIN $41.92 $83.83 $20.12–$158.39 51% below 50%
Renin blood test inpatient CPT 84244 HC SO RENIN $41.92 $83.83 $53.15–$79.64 — 50%
Rh blood typing CPT 86901 HC BLOOD TYPING RH D $68.69 $137.38 $21.54–$130.51 84% above 50%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING RH D $68.69 $137.38 $87.10–$130.51 — 50%
Rheumatoid factor (RF) test CPT 86431 HC QUAN RHEUM FACTOR $13.53 $27.06 $6.49–$80.00 59% below 50%
Rheumatoid factor (RF) test CPT 86431 HC SO QUAN RHEUM FACTOR $13.53 $27.06 $6.49–$80.00 59% below 50%
Rheumatoid factor (RF) test inpatient CPT 86431 HC QUAN RHEUM FACTOR $13.53 $27.06 $17.16–$25.71 — 50%
Rheumatoid factor (RF) test inpatient CPT 86431 HC SO QUAN RHEUM FACTOR $13.53 $27.06 $17.16–$25.71 — 50%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY $34.32 $68.64 $16.47–$103.65 29% below 50%
Rubella antibody test (immunity check) CPT 86762 HC SO RUBELLA ANTIBODY $34.32 $68.64 $16.47–$103.65 29% below 50%
Rubella antibody test (immunity check) inpatient CPT 86762 HC SO RUBELLA ANTIBODY $34.32 $68.64 $43.52–$65.21 — 50%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY $34.32 $68.64 $43.52–$65.21 — 50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC AUTOM ERYTHROCTYE SED RATE $7.41 $14.82 $3.56–$80.00 80% below 50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC AUTOM ERYTHROCTYE SED RATE $7.41 $14.82 $9.40–$14.08 — 50%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC CCH SEMEN ANALYSIS VOLUME/COUNT/MOTILITY $33.03 $66.06 $15.85–$88.67 75% below 50%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC CCH SEMEN ANALYSIS VOLUME/COUNT/MOTILITY $33.03 $66.06 $41.88–$62.76 — 50%
Sodium blood test CPT 84295 HC ASSAY OF SERUM SODIUM $11.48 $22.96 $5.51–$80.00 58% below 50%
Sodium blood test inpatient CPT 84295 HC ASSAY OF SERUM SODIUM $11.48 $22.96 $14.56–$21.81 — 50%
Stool ova and parasites exam CPT 87177 HC SO OVA & PARASITES DIR SMR W ID $56.02 $112.03 $17.80–$106.43 41% above 50%
Stool ova and parasites exam inpatient CPT 87177 HC SO OVA & PARASITES DIR SMR W ID $56.02 $112.03 $71.03–$106.43 — 50%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM $31.56 $63.11 $15.15–$95.35 45% below 50%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC SO TREPONEMA PALLIDUM $31.56 $63.11 $15.15–$95.35 45% below 50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC TREPONEMA PALLIDUM $31.56 $63.11 $40.01–$59.95 — 50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC SO TREPONEMA PALLIDUM $31.56 $63.11 $40.01–$59.95 — 50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST $10.19 $20.37 $4.89–$80.00 58% below 50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SO SYPHILIS TEST $10.19 $20.37 $4.89–$80.00 58% below 50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SO SYPHILIS TEST $10.19 $20.37 $12.91–$19.35 — 50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST $10.19 $20.37 $12.91–$19.35 — 50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB TEST CELL IMMUN MEASURE $147.76 $295.51 $70.92–$446.40 18% above 50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC SO TB TEST- CELL IMMUN MEASURE $147.76 $295.51 $70.92–$446.40 18% above 50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB TEST CELL IMMUN MEASURE $147.76 $295.51 $187.35–$280.73 — 50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC SO TB TEST- CELL IMMUN MEASURE $147.76 $295.51 $187.35–$280.73 — 50%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL $48.57 $97.13 $23.31–$185.89 47% below 50%
Testosterone blood test, total (not free testosterone) CPT 84403 HC SO TESTOSTERONE TOTAL $48.57 $97.13 $23.31–$185.89 47% below 50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL $48.57 $97.13 $61.58–$92.27 — 50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC SO TESTOSTERONE TOTAL $48.57 $97.13 $61.58–$92.27 — 50%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC CCH SO MICROSOMAL AB EACH $89.94 $179.87 $29.10–$170.88 38% above 50%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL AB EACH $89.94 $179.87 $29.10–$170.88 38% above 50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL AB EACH $89.94 $179.87 $114.04–$170.88 — 50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC CCH SO MICROSOMAL AB EACH $89.94 $179.87 $114.04–$170.88 — 50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE $40.06 $80.12 $19.23–$121.00 47% below 50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC SO THYROID STIMULATING HORMONE $40.06 $80.12 $19.23–$121.00 47% below 50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE $40.06 $80.12 $50.80–$76.11 — 50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC SO THYROID STIMULATING HORMONE $40.06 $80.12 $50.80–$76.11 — 50%
Total IgE blood test CPT 82785 HC SO ASSAY OF IGE $39.26 $78.51 $18.84–$118.55 39% below 50%
Total IgE blood test CPT 82785 HC ASSAY OF IGE $39.26 $78.51 $18.84–$118.55 39% below 50%
Total IgE blood test inpatient CPT 82785 HC SO ASSAY OF IGE $39.26 $78.51 $49.78–$74.58 — 50%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF IGE $39.26 $78.51 $49.78–$74.58 — 50%
Total cholesterol blood test CPT 82465 HC SO SERUM/WB TOT CHOLEST $10.36 $20.72 $4.97–$80.00 72% below 50%
Total cholesterol blood test CPT 82465 HC SERUM/WB TOT CHOLEST $10.36 $20.72 $4.97–$80.00 72% below 50%
Total cholesterol blood test inpatient CPT 82465 HC SO SERUM/WB TOT CHOLEST $10.36 $20.72 $13.14–$19.68 — 50%
Total cholesterol blood test inpatient CPT 82465 HC SERUM/WB TOT CHOLEST $10.36 $20.72 $13.14–$19.68 — 50%
Total thyroxine (T4) blood test CPT 84436 HC THYROXINE TOTAL $16.37 $32.73 $7.86–$80.00 60% below 50%
Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE TOTAL $16.37 $32.73 $20.75–$31.09 — 50%
Total triiodothyronine (T3) blood test CPT 84480 HC T3 TOTAL $33.80 $67.59 $16.22–$102.13 44% below 50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T3 TOTAL $33.80 $67.59 $42.85–$64.21 — 50%
Transferrin blood test CPT 84466 HC TRANSFERRIN $28.91 $57.82 $13.88–$91.91 60% below 50%
Transferrin blood test inpatient CPT 84466 HC TRANSFERRIN $28.91 $57.82 $36.66–$54.93 — 50%
Trichomonas test (NAAT) CPT 87661 HC CCH TRICHOMONAS VAGINALIS AMPLIF $45.73 $91.46 $21.95–$252.73 47% below 50%
Trichomonas test (NAAT) CPT 87661 HC SO TRICHOMONAS VAGINALIS AMPLIF - A $45.73 $91.46 $21.95–$252.73 47% below 50%
Trichomonas test (NAAT) inpatient CPT 87661 HC CCH TRICHOMONAS VAGINALIS AMPLIF $45.73 $91.46 $57.99–$86.89 — 50%
Trichomonas test (NAAT) inpatient CPT 87661 HC SO TRICHOMONAS VAGINALIS AMPLIF - A $45.73 $91.46 $57.99–$86.89 — 50%
Triglycerides blood test CPT 84478 HC SO TRYIGLYCERIDES $13.71 $27.41 $6.58–$80.00 63% below 50%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES $13.71 $27.41 $6.58–$80.00 63% below 50%
Triglycerides blood test inpatient CPT 84478 HC SO TRYIGLYCERIDES $13.71 $27.41 $17.38–$26.04 — 50%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES $13.71 $27.41 $17.38–$26.04 — 50%
Troponin test, quantitative CPT 84484 HC TROPONIN QUAN $23.45 $46.90 $11.26–$89.81 72% below 50%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN QUAN $23.45 $46.90 $29.73–$44.56 — 50%
Uric acid blood test CPT 84550 HC URIC ACID BLOOD $10.78 $21.56 $5.17–$80.00 69% below 50%
Uric acid blood test inpatient CPT 84550 HC URIC ACID BLOOD $10.78 $21.56 $13.67–$20.48 — 50%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS TOTAL AUTOMATED W/ MICRO $8.70 $17.39 $4.17–$80.00 68% below 50%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS TOTAL AUTOMATED W/ MICRO $8.70 $17.39 $11.03–$16.52 — 50%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS TOTAL AUTOMATED W/O MICRO $6.16 $12.32 $2.96–$80.00 74% below 50%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS TOTAL AUTOMATED W/O MICRO $6.16 $12.32 $7.81–$11.70 — 50%
Urinalysis without microscope exam, manual CPT 81002 HC SO URINALYSIS TOTAL NON-AUTOMATED W/O MICRO $6.33 $12.65 $3.04–$80.00 62% below 50%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC SO URINALYSIS TOTAL NON-AUTOMATED W/O MICRO $6.33 $12.65 $8.02–$12.02 — 50%
Urine culture for bacteria, with colony count CPT 87086 HC BACT CULTURE - URINE QUAN COUNT $14.13 $28.25 $6.78–$80.00 75% below 50%
Urine culture for bacteria, with colony count CPT 87086 HC CCH SO BACT CULTURE - URINE QUAN COUNT $22.01 $44.01 $10.56–$80.00 61% below 50%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC BACT CULTURE - URINE QUAN COUNT $14.13 $28.25 $17.91–$26.84 — 50%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CCH SO BACT CULTURE - URINE QUAN COUNT $22.01 $44.01 $27.90–$41.81 — 50%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN URINE QUAN $13.78 $27.55 $6.61–$80.00 73% below 50%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN URINE QUAN $13.78 $27.55 $17.47–$26.17 — 50%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY VISUAL COLOR $17.33 $34.66 $8.32–$80.00 64% below 50%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY VISUAL COLOR $17.33 $34.66 $21.97–$32.93 — 50%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12 LEVEL $35.95 $71.89 $17.25–$108.62 51% below 50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12 LEVEL $35.95 $71.89 $45.58–$68.30 — 50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D 25 HYDROXY $70.58 $141.16 $33.88–$213.19 23% below 50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D 25 HYDROXY $70.58 $141.16 $89.50–$134.10 — 50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC SO VIT D 1- 25-DIHYDROXY $91.77 $183.54 $44.05–$277.31 40% below 50%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC SO VIT D 1- 25-DIHYDROXY $91.77 $183.54 $116.36–$174.36 — 50%
Zinc blood test CPT 84630 HC SO ZINC $27.15 $54.29 $13.03–$82.04 47% below 50%
Zinc blood test inpatient CPT 84630 HC SO ZINC $27.15 $54.29 $34.42–$51.58 — 50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC SO HCG QUAN $35.90 $71.79 $17.23–$108.40 47% below 50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG QUAN $35.90 $71.79 $17.23–$108.40 47% below 50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG QUAN $35.90 $71.79 $45.51–$68.20 — 50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC SO HCG QUAN $35.90 $71.79 $45.51–$68.20 — 50%

Surgery and procedures

ProcedureCash priceList priceInsurers payvs OhioOff list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BREAST BX W/ LOCALIZATION DEVICE & IMAGING OF SPECIMEN FIRST LESION W/ STEREOTACTIC GUIDANCE $4,346.91 $8,693.82 $2,086.52–$8,259.13 8% above 50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BREAST BX W/ LOCALIZATION DEVICE & IMAGING OF SPECIMEN FIRST LESION W/ STEREOTACTIC GUIDANCE $4,346.91 $8,693.82 $5,511.88–$8,259.13 — 50%
Cardiac catheterization with coronary angiogram CPT 93458 HC LHC W/ LV & CORONARY ANGIO $12,523.50 $25,047.00 $4,915.00–$23,794.65 4% above 50%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC LHC W/ LV & CORONARY ANGIO $12,523.50 $25,047.00 $15,879.80–$23,794.65 — 50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE $1,829.29 $3,658.57 $878.06–$3,475.64 11% below 50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTIVE $1,829.29 $3,658.57 $2,319.53–$3,475.64 — 50%
Catheter ablation for atrial fibrillation CPT 93656 HC ABLATION ATRIAL FIBRILLATION BY PULM VEIN ISOLATION W/ HIS RECORDING ATRIAL & RV PACING & RECORD $19,939.20 $39,878.39 $9,570.81–$53,407.98 40% below 50%
Catheter ablation for atrial fibrillation inpatient CPT 93656 HC ABLATION ATRIAL FIBRILLATION BY PULM VEIN ISOLATION W/ HIS RECORDING ATRIAL & RV PACING & RECORD $19,939.20 $39,878.39 $25,282.90–$37,884.47 — 50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CCH CIRCUMCISION W/ REGIONAL BLOCK $3,764.14 $7,528.28 $1,806.79–$7,151.87 99% above 50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CCH CIRCUMCISION W/ REGIONAL BLOCK $3,764.14 $7,528.28 $4,772.93–$7,151.87 — 50%
Colonoscopy with polyp removal CPT 45385 HC COLONOSCOPY FLEXIBLE W/ REMOVAL TUMOR POLYP LESION BY SNARE $3,219.84 $6,439.67 $1,545.52–$6,117.69 6% below 50%
Colonoscopy with polyp removal inpatient CPT 45385 HC COLONOSCOPY FLEXIBLE W/ REMOVAL TUMOR POLYP LESION BY SNARE $3,219.84 $6,439.67 $4,082.75–$6,117.69 — 50%
Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY FLEXIBLE W/ BX $3,336.40 $6,672.80 $1,601.47–$6,339.16 at median 50%
Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY FLEXIBLE W/ BX $3,336.40 $6,672.80 $4,230.56–$6,339.16 — 50%
Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY FLEXIBLE DIAGNOSTIC $2,990.28 $5,980.55 $1,435.33–$5,681.52 9% above 50%
Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY FLEXIBLE DIAGNOSTIC $2,990.28 $5,980.55 $3,791.67–$5,681.52 — 50%
Coronary stent placement, one artery CPT 92928 HC INSERTION NON-DES W/WO ANGIOPLAST SINGLE MAJOR ARTERY/BRANCHES 1 LESION 1+ CORONARY SEGMENTS $31,434.12 $62,868.24 $7,285.00–$59,724.83 144% above 50%
Coronary stent placement, one artery inpatient CPT 92928 HC INSERTION NON-DES W/WO ANGIOPLAST SINGLE MAJOR ARTERY/BRANCHES 1 LESION 1+ CORONARY SEGMENTS $31,434.12 $62,868.24 $39,858.46–$59,724.83 — 50%
Cystoscopy with ureteral stent placement CPT 52332 HC CYSTOURETHROSCOPY W/ INSERTION URETERAL STENT $12,674.97 $25,349.94 $3,365.00–$24,082.44 27% above 50%
Cystoscopy with ureteral stent placement inpatient CPT 52332 HC CYSTOURETHROSCOPY W/ INSERTION URETERAL STENT $12,674.97 $25,349.94 $16,071.86–$24,082.44 — 50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY $1,226.48 $2,452.96 $588.71–$2,330.31 39% below 50%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY $1,226.48 $2,452.96 $1,555.18–$2,330.31 — 50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCTION PREMALIGNANT LESION FIRST LESION $350.51 $701.01 $168.24–$665.96 73% above 50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUCTION PREMALIGNANT LESION FIRST LESION $350.51 $701.01 $444.44–$665.96 — 50%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC TYMPANOSTOMY W/ LOCAL ANESTHESIA $1,871.50 $3,743.00 $898.32–$3,555.85 41% above 50%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 HC TYMPANOSTOMY W/ LOCAL ANESTHESIA $1,871.50 $3,743.00 $2,373.06–$3,555.85 — 50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNILATERAL $218.30 $436.59 $104.78–$414.76 41% above 50%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNILATERAL $218.30 $436.59 $276.80–$414.76 — 50%
Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN UNILATERAL $218.30 $436.59 $104.78–$414.76 41% above 50%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN UNILATERAL $218.30 $436.59 $276.80–$414.76 — 50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC INJECTION EPIDURAL OR SUBARACHNOID CERVICAL OR THORACIC FOR PAIN MGMT W/ IMAGING GUIDANCE $2,990.81 $5,981.62 $1,435.59–$5,682.54 34% above 50%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC INJECTION EPIDURAL OR SUBARACHNOID CERVICAL OR THORACIC FOR PAIN MGMT W/ IMAGING GUIDANCE $2,990.81 $5,981.62 $3,792.35–$5,682.54 — 50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJECTION PARAVERTEBRAL FACET JOINT W/ IMG GUID LUMBAR OR SACRAL SINGLE LEVEL FOR PAIN MGMT $4,998.95 $9,997.90 $1,480.00–$9,498.01 129% above 50%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJECTION PARAVERTEBRAL FACET JOINT W/ IMG GUID LUMBAR OR SACRAL SINGLE LEVEL FOR PAIN MGMT $4,998.95 $9,997.90 $6,338.67–$9,498.01 — 50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC $2,171.79 $4,343.58 $1,042.46–$4,126.40 15% below 50%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC $2,171.79 $4,343.58 $2,753.83–$4,126.40 — 50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC HYSTEROSALPINGOGRAPHY OR SALINE INFUSION SONOHYSTEROGRAOPHY $631.89 $1,263.78 $303.31–$1,200.59 66% above 50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC HYSTEROSALPINGOGRAPHY OR SALINE INFUSION SONOHYSTEROGRAOPHY $631.89 $1,263.78 $801.24–$1,200.59 — 50%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSCESS SIMPLE $365.11 $730.22 $175.25–$693.71 6% below 50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D ABSCESS SIMPLE $365.11 $730.22 $462.96–$693.71 — 50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECTION TENDON SHEATH LIGAMENT APONEUROSIS $1,084.83 $2,169.66 $520.72–$2,061.18 220% above 50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECTION TENDON SHEATH LIGAMENT APONEUROSIS $1,084.83 $2,169.66 $1,375.56–$2,061.18 — 50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS JOINT/BURSA MAJOR W/O ULTRASOUND GUIDANCE $1,521.45 $3,042.90 $627.20–$2,890.76 119% above 50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS JOINT/BURSA MAJOR W/O ULTRASOUND GUIDANCE $1,521.45 $3,042.90 $1,929.20–$2,890.76 — 50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT $2,180.04 $4,360.07 $271.86–$4,142.07 399% above 50%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT $2,180.04 $4,360.07 $2,764.28–$4,142.07 — 50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS JOINT/BURSA INTERMEDIATE W/O ULTRASOUND GUIDANCE $1,458.06 $2,916.11 $627.20–$2,770.30 134% above 50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS JOINT/BURSA INTERMEDIATE W/O ULTRASOUND GUIDANCE $1,458.06 $2,916.11 $1,848.81–$2,770.30 — 50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE $1,331.27 $2,662.54 $627.20–$2,529.41 170% above 50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ARTHROCENTESIS JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE $1,331.27 $2,662.54 $1,688.05–$2,529.41 — 50%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJECTION EPIDURAL OR SUBARACHNOID LUMBAR OR SACRAL (CAUDAL) FOR PAIN MGMT W/ IMAGING GUIDANCE $2,335.99 $4,671.98 $1,121.28–$4,438.38 15% above 50%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJECTION EPIDURAL OR SUBARACHNOID LUMBAR OR SACRAL (CAUDAL) FOR PAIN MGMT W/ IMAGING GUIDANCE $2,335.99 $4,671.98 $2,962.04–$4,438.38 — 50%
Lower-back epidural injection, without imaging guidance CPT 62322 HC INJECTION EPIDURAL OR SUBARACHNOID LUMBAR OR SACRAL (CAUDAL) FOR PAIN MGMT W/O IMAGING GUIDANCE $1,635.91 $3,271.82 $785.24–$3,108.23 at median 50%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INJECTION EPIDURAL OR SUBARACHNOID LUMBAR OR SACRAL (CAUDAL) FOR PAIN MGMT W/O IMAGING GUIDANCE $1,635.91 $3,271.82 $2,074.33–$3,108.23 — 50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJECTION(S) TRANSFORAMINAL LUMBAR SACRAL SINGLE LEVEL $5,549.32 $11,098.63 $1,807.26–$10,543.70 169% above 50%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJECTION(S) TRANSFORAMINAL LUMBAR SACRAL SINGLE LEVEL $5,549.32 $11,098.63 $7,036.53–$10,543.70 — 50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC BEN LESION TRUNK/EXTREMITIES <0.5 CM $1,292.85 $2,585.70 $620.57–$2,456.42 6% below 50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC BEN LESION TRUNK/EXTREMITIES <0.5 CM $1,292.85 $2,585.70 $1,639.33–$2,456.42 — 50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC BEN LESION FACE & MUC MEMB <0.5 CM $1,292.85 $2,585.70 $620.57–$2,456.42 6% below 50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXC BEN LESION FACE & MUC MEMB <0.5 CM $1,292.85 $2,585.70 $1,639.33–$2,456.42 — 50%
Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PLATE SINGLE $365.11 $730.22 $175.25–$693.71 11% above 50%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION NAIL PLATE SINGLE $365.11 $730.22 $462.96–$693.71 — 50%
Occipital nerve block (injection for headaches) CPT 64405 HC INJECTION NERVE GREATER OCCIPITAL FOR PAIN MGMT $1,084.83 $2,169.66 $520.72–$2,061.18 15% above 50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJECTION NERVE GREATER OCCIPITAL FOR PAIN MGMT $1,084.83 $2,169.66 $1,375.56–$2,061.18 — 50%
Pacemaker implant (dual chamber) CPT 33208 HC INSERT/REPLACE PM W/ TRANSVENOUS ELECTRODE ATRIAL & VENTRICLE $18,695.02 $37,390.04 $7,200.00–$35,520.54 24% above 50%
Pacemaker implant (dual chamber) inpatient CPT 33208 HC INSERT/REPLACE PM W/ TRANSVENOUS ELECTRODE ATRIAL & VENTRICLE $18,695.02 $37,390.04 $23,705.29–$35,520.54 — 50%
Paracentesis with imaging guidance CPT 49083 HC ABDOMINAL PARACENTESIS W/ IMAGING GUIDANCE $1,722.77 $3,445.53 $826.93–$3,273.25 1% below 50%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOMINAL PARACENTESIS W/ IMAGING GUIDANCE $1,722.77 $3,445.53 $2,184.47–$3,273.25 — 50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DESTRUCTION BY NEUROLYTIC AGENT (RFA) LUMBAR/SACRAL PARAVERT JOINT NERVE SINGLE JOINT $7,176.44 $14,352.87 $3,365.00–$13,635.23 118% above 50%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DESTRUCTION BY NEUROLYTIC AGENT (RFA) LUMBAR/SACRAL PARAVERT JOINT NERVE SINGLE JOINT $7,176.44 $14,352.87 $9,099.72–$13,635.23 — 50%
Removal of a foreign object under the skin, simple CPT 10120 HC REMOVAL FB SUBCUTANEOUS SIMPLE $726.81 $1,453.62 $348.87–$1,380.94 7% above 50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVAL FB SUBCUTANEOUS SIMPLE $726.81 $1,453.62 $921.60–$1,380.94 — 50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC COLONOSCOPY SCREENING $2,990.28 $5,980.55 $1,435.33–$5,681.52 15% above 50%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC COLONOSCOPY SCREENING $2,990.28 $5,980.55 $3,791.67–$5,681.52 — 50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC COLONOSCOPY SCREENING HIGH RISK $2,990.28 $5,980.55 $1,435.33–$5,681.52 15% above 50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC COLONOSCOPY SCREENING HIGH RISK $2,990.28 $5,980.55 $3,791.67–$5,681.52 — 50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC REP SIMP SC/NE/AX/GEN/TR/EXT <2.5 CM $456.87 $913.73 $219.30–$868.04 38% above 50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC REP SIMP SC/NE/AX/GEN/TR/EXT <2.5 CM $456.87 $913.73 $579.30–$868.04 — 50%
Skin biopsy, punch, one lesion CPT 11104 HC BX SKIN PUNCH FIRST LESION $734.14 $1,468.28 $352.39–$1,394.87 64% above 50%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC BX SKIN PUNCH FIRST LESION $734.14 $1,468.28 $930.89–$1,394.87 — 50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC $1,272.51 $2,545.01 $610.80–$2,417.76 17% above 50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC $1,272.51 $2,545.01 $1,613.54–$2,417.76 — 50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC REP SIMP SC/NE/AX/GEN/TR/EXT 2.6-7.5 CM $365.11 $730.22 $175.25–$693.71 4% above 50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC REP SIMP SC/NE/AX/GEN/TR/EXT 2.6-7.5 CM $365.11 $730.22 $462.96–$693.71 — 50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC BX SKIN TANGENTIAL FIRST LESION $385.15 $770.30 $184.87–$830.64 27% above 50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC BX SKIN TANGENTIAL FIRST LESION $385.15 $770.30 $488.37–$731.79 — 50%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS W/ IMAGING GUIDANCE $2,405.39 $4,810.77 $1,154.58–$4,570.23 30% above 50%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS W/ IMAGING GUIDANCE $2,405.39 $4,810.77 $3,050.03–$4,570.23 — 50%
Trigger point injections, 1 or 2 muscles CPT 20552 HC TRIGGER POINT INJECTION 1-2 MUSCLES $542.42 $1,084.83 $260.36–$1,030.59 22% below 50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC TRIGGER POINT INJECTION 1-2 MUSCLES $542.42 $1,084.83 $687.78–$1,030.59 — 50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BREAST BX W/ LOCALIZATION DEVICE & IMAGING OF SPECIMEN FIRST LESION W/ US GUIDANCE $3,503.04 $7,006.07 $1,681.46–$6,655.77 5% above 50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BREAST BX W/ LOCALIZATION DEVICE & IMAGING OF SPECIMEN FIRST LESION W/ US GUIDANCE $3,503.04 $7,006.07 $4,441.85–$6,655.77 — 50%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC EGD FLEXIBLE TRANSORAL W/ BALLOON DILATION ESOPHAGUS <30MM $3,485.72 $6,971.44 $1,673.15–$6,622.87 2% below 50%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC EGD FLEXIBLE TRANSORAL W/ BALLOON DILATION ESOPHAGUS <30MM $3,485.72 $6,971.44 $4,419.89–$6,622.87 — 50%
Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD FLEXIBLE TRANSORAL W/ BX $2,883.30 $5,766.60 $1,383.98–$5,478.27 3% above 50%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD FLEXIBLE TRANSORAL W/ BX $2,883.30 $5,766.60 $3,656.02–$5,478.27 — 50%
Upper endoscopy (EGD) with injection into the lining CPT 43236 HC EGD FLEXIBLE TRANSORAL W/ SUBMUCOSAL INJECTION $2,835.23 $5,670.46 $1,360.91–$5,386.94 1% above 50%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC EGD FLEXIBLE TRANSORAL W/ SUBMUCOSAL INJECTION $2,835.23 $5,670.46 $3,595.07–$5,386.94 — 50%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC EGD FLEXIBLE TRANSORAL W/ REMOVAL TUMOR POLYP LESION BY SNARE $3,485.72 $6,971.44 $1,673.15–$6,622.87 4% above 50%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC EGD FLEXIBLE TRANSORAL W/ REMOVAL TUMOR POLYP LESION BY SNARE $3,485.72 $6,971.44 $4,419.89–$6,622.87 — 50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC EGD FLEXIBLE TRANSORAL W/ DILATION ESOPHAGUS OVER GUIDE WIRE $2,668.16 $5,336.32 $1,280.72–$5,069.50 5% below 50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC EGD FLEXIBLE TRANSORAL W/ DILATION ESOPHAGUS OVER GUIDE WIRE $2,668.16 $5,336.32 $3,383.23–$5,069.50 — 50%
Upper endoscopy (EGD), diagnostic CPT 43235 HC EGD FLEXIBLE TRANSORAL DIAGNOSTIC $2,594.85 $5,189.70 $1,245.53–$4,930.22 at median 50%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC EGD FLEXIBLE TRANSORAL DIAGNOSTIC $2,594.85 $5,189.70 $3,290.27–$4,930.22 — 50%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HC EGD FLEXIBLE TRANSORAL W/ DRAINAGE PSEUDOCYST $10,111.32 $20,222.63 $3,365.00–$19,211.50 121% above 50%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 HC EGD FLEXIBLE TRANSORAL W/ DRAINAGE PSEUDOCYST $10,111.32 $20,222.63 $12,821.15–$19,211.50 — 50%
Vein ablation, radiofrequency, first vein CPT 36475 HC ABLATION THERAPY EXTREMITY PERCU RADIOFREQUENCY 1ST VEIN W/RAD & SI $5,783.53 $11,567.06 $2,776.09–$10,988.71 11% below 50%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC ABLATION THERAPY EXTREMITY PERCU RADIOFREQUENCY 1ST VEIN W/RAD & SI $5,783.53 $11,567.06 $7,333.52–$10,988.71 — 50%
Wart removal, up to 14 warts CPT 17110 HC DESTRUCTION LESIONS BENIGN UP TO 14 LESIONS $365.11 $730.22 $175.25–$693.71 16% above 50%
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCTION LESIONS BENIGN UP TO 14 LESIONS $365.11 $730.22 $462.96–$693.71 — 50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDEMENT SUBQ TISSUE 1ST 20 SQ CM $848.62 $1,697.24 $407.34–$1,612.38 9% above 50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDEMENT SUBQ TISSUE 1ST 20 SQ CM $848.62 $1,697.24 $1,076.05–$1,612.38 — 50%

Doctor visits and therapy

ProcedureCash priceList priceInsurers payvs OhioOff list
Blood transfusion (giving blood or blood components) CPT 36430 HC TRANSFUSION BLOOD OR BLOOD COMPONENTS $803.32 $1,606.64 $385.59–$1,526.31 28% below 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC TRANSFUSION BLOOD OR BLOOD COMPONENTS $803.32 $1,606.64 $1,018.61–$1,526.31 — 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC METERED DOSE INHALER - SELF ADMINISTERED MEDS $113.32 $226.63 $54.39–$447.44 36% below 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC IPPB TX $113.32 $226.63 $54.39–$447.44 36% below 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC HELIOX TX ACUTE AIRWAY OBSTRUCTION $113.32 $226.63 $54.39–$447.44 36% below 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AEROSOL OR NEBULIZER TREATMENT $355.94 $711.87 $170.85–$676.28 101% above 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC METERED DOSE INHALER TREATMENT $355.94 $711.87 $170.85–$676.28 101% above 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC IPV TX $355.94 $711.87 $170.85–$676.28 101% above 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC IPPB TX $113.32 $226.63 $143.68–$215.30 — 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC HELIOX TX ACUTE AIRWAY OBSTRUCTION $113.32 $226.63 $143.68–$215.30 — 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC METERED DOSE INHALER - SELF ADMINISTERED MEDS $113.32 $226.63 $143.68–$215.30 — 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC METERED DOSE INHALER TREATMENT $355.94 $711.87 $451.33–$676.28 — 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AEROSOL OR NEBULIZER TREATMENT $355.94 $711.87 $451.33–$676.28 — 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC IPV TX $355.94 $711.87 $451.33–$676.28 — 50%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO ADMIN IV INITIAL UP TO 1 HOUR $609.49 $1,218.97 $292.55–$1,158.02 20% below 50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO ADMIN IV INITIAL UP TO 1 HOUR $609.49 $1,218.97 $772.83–$1,158.02 — 50%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC AUDIOMETRY THRESHOLD EVAL W/ SPEECH RECOGNITION $281.07 $562.14 $134.91–$534.03 7% above 50%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC AUDIOMETRY THRESHOLD EVAL W/ SPEECH RECOGNITION $281.07 $562.14 $356.40–$534.03 — 50%
Critical care, first 30 to 74 minutes CPT 99291 HC EMERGENCY ROOM CRITICAL CARE $1,548.30 $3,096.60 $743.18–$2,941.77 47% below 50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC EMERGENCY ROOM CRITICAL CARE $1,548.30 $3,096.60 $1,963.24–$2,941.77 — 50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE & DROWSY $806.63 $1,613.25 $387.18–$1,532.59 16% below 50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE & DROWSY $806.63 $1,613.25 $1,022.80–$1,532.59 — 50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG 12-LEAD $161.53 $323.05 $77.53–$306.90 13% below 50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG 12-LEAD $161.53 $323.05 $204.81–$306.90 — 50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY ROOM LEVEL 1 $178.39 $356.78 $85.63–$970.00 43% below 50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMERGENCY ROOM LEVEL 1 $178.39 $356.78 $226.20–$338.94 — 50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY ROOM LEVEL 2 $290.99 $581.97 $139.67–$970.00 43% below 50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY ROOM LEVEL 2 $290.99 $581.97 $368.97–$552.87 — 50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY ROOM LEVEL 3 $570.84 $1,141.67 $274.00–$1,084.59 33% below 50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMERGENCY ROOM LEVEL 3 $570.84 $1,141.67 $723.82–$1,084.59 — 50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY ROOM LEVEL 4 $930.73 $1,861.45 $446.75–$1,768.38 30% below 50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMERGENCY ROOM LEVEL 4 $930.73 $1,861.45 $1,180.16–$1,768.38 — 50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY ROOM LEVEL 5 $1,126.57 $2,253.14 $540.75–$2,140.48 36% below 50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMERGENCY ROOM LEVEL 5 $1,126.57 $2,253.14 $1,428.49–$2,140.48 — 50%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC STRESS TEST W/ CONTINUOUS EKG MONITORING $851.14 $1,702.27 $408.54–$1,617.16 5% below 50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC STRESS TEST W/ CONTINUOUS EKG MONITORING $851.14 $1,702.27 $1,079.24–$1,617.16 — 50%
Family therapy with the patient, 50 minutes CPT 90847 HC PSYCHOTHERAPY FAMILY W/ PATIENT 50 MINUTES $281.18 $562.35 $134.96–$534.23 5% below 50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PSYCHOTHERAPY FAMILY W/ PATIENT 50 MINUTES $281.18 $562.35 $356.53–$534.23 — 50%
Family therapy without the patient, 50 minutes CPT 90846 HC PSYCHOTHERAPY FAMILY W/O PATIENT 50 MINUTES $196.88 $393.75 $94.50–$374.06 36% below 50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC PSYCHOTHERAPY FAMILY W/O PATIENT 50 MINUTES $196.88 $393.75 $249.64–$374.06 — 50%
Group psychotherapy session CPT 90853 HC CCH PSYCHOTHERAPY GROUP $190.55 $381.09 $91.46–$362.04 10% above 50%
Group psychotherapy session inpatient CPT 90853 HC CCH PSYCHOTHERAPY GROUP $190.55 $381.09 $241.61–$362.04 — 50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRATION INITIAL HOUR $413.44 $826.88 $198.45–$785.54 1% below 50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC HYDRATION INITIAL HOUR $413.44 $826.88 $524.24–$785.54 — 50%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION NON-CHEMO INITIAL HOUR $421.71 $843.41 $202.42–$801.24 3% below 50%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION NON-CHEMO INITIAL HOUR $421.71 $843.41 $534.72–$801.24 — 50%
IV push of a medicine, first drug CPT 96374 HC IV PUSH NON-CHEMO INITIAL $387.15 $774.29 $185.83–$735.58 57% above 50%
IV push of a medicine, first drug inpatient CPT 96374 HC IV PUSH NON-CHEMO INITIAL $387.15 $774.29 $490.90–$735.58 — 50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION IM OR SQ $130.78 $261.56 $62.77–$248.48 8% below 50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION IM OR SQ $130.78 $261.56 $165.83–$248.48 — 50%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS BY RECT $121.14 $242.28 $58.15–$230.17 13% above 50%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS BY OT $121.14 $242.28 $58.15–$230.17 13% above 50%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS $121.14 $242.28 $58.15–$230.17 13% above 50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS BY RECT $121.14 $242.28 $153.61–$230.17 — 50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS BY OT $121.14 $242.28 $153.61–$230.17 — 50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS $121.14 $242.28 $153.61–$230.17 — 50%
New patient office visit, about 30 minutes CPT 99203 HC CLINIC VISIT NEW PT LEVEL 3 $94.82 $189.63 $45.51–$225.00 14% below 50%
New patient office visit, about 30 minutes inpatient CPT 99203 HC CLINIC VISIT NEW PT LEVEL 3 $94.82 $189.63 $120.23–$180.15 — 50%
New patient office visit, about 45 minutes CPT 99204 HC CLINIC VISIT NEW PT LEVEL 4 $115.21 $230.42 $55.30–$340.50 5% below 50%
New patient office visit, about 45 minutes inpatient CPT 99204 HC CLINIC VISIT NEW PT LEVEL 4 $115.21 $230.42 $146.09–$218.90 — 50%
New patient office visit, about 60 minutes CPT 99205 HC CLINIC VISIT NEW PT LEVEL 5 $129.00 $257.99 $61.92–$455.04 25% below 50%
New patient office visit, about 60 minutes inpatient CPT 99205 HC CLINIC VISIT NEW PT LEVEL 5 $129.00 $257.99 $163.57–$245.09 — 50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC CLINIC VISIT NEW PT LEVEL 2 $69.46 $138.92 $33.34–$143.08 29% below 50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC CLINIC VISIT NEW PT LEVEL 2 $69.46 $138.92 $88.08–$131.97 — 50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC CCH MEDICAL NUTRITION THERAPY INDIVIDUAL INITIAL ASSESSMENT & INTERVENTION EACH 15 MINS $93.12 $186.24 $44.70–$176.93 43% above 50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC CCH MEDICAL NUTRITION THERAPY INDIVIDUAL INITIAL ASSESSMENT & INTERVENTION EACH 15 MINS $93.12 $186.24 $118.08–$176.93 — 50%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION LOW COMPLEXITY $234.28 $468.56 $112.45–$445.13 10% below 50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION LOW COMPLEXITY $234.28 $468.56 $297.07–$445.13 — 50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION HIGH COMPLEXITY $261.85 $523.69 $125.69–$497.51 13% below 50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION HIGH COMPLEXITY $261.85 $523.69 $332.02–$497.51 — 50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION LOW COMPLEXITY $220.50 $441.00 $105.84–$418.95 16% below 50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION LOW COMPLEXITY $220.50 $441.00 $279.59–$418.95 — 50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION MODERATE COMPLEXITY $234.28 $468.56 $112.45–$445.13 16% below 50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION MODERATE COMPLEXITY $234.28 $468.56 $297.07–$445.13 — 50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TECHNIQUES EACH 15 MINS BY OT $107.32 $214.64 $51.51–$203.91 2% below 50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TECHNIQUES EACH 15 MINS $107.32 $214.64 $51.51–$203.91 2% below 50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TECHNIQUES EACH 15 MINS BY OT $107.32 $214.64 $136.08–$203.91 — 50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TECHNIQUES EACH 15 MINS $107.32 $214.64 $136.08–$203.91 — 50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS BY OT $111.58 $223.15 $53.56–$211.99 5% below 50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS $111.58 $223.15 $53.56–$211.99 5% below 50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS BY RECT $111.58 $223.15 $53.56–$211.99 5% below 50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS BY OT $111.58 $223.15 $141.48–$211.99 — 50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS BY RECT $111.58 $223.15 $141.48–$211.99 — 50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS $111.58 $223.15 $141.48–$211.99 — 50%
Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W/ PT 30 MINUTES $281.18 $562.35 $134.96–$534.23 52% above 50%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W/ PT 30 MINUTES $281.18 $562.35 $356.53–$534.23 — 50%
Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY W/ PT 45 MINUTES $281.18 $562.35 $134.96–$534.23 5% above 50%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY W/ PT 45 MINUTES $281.18 $562.35 $356.53–$534.23 — 50%
Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY W/ PT 60 MINUTES $281.18 $562.35 $134.96–$534.23 10% below 50%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY W/ PT 60 MINUTES $281.18 $562.35 $356.53–$534.23 — 50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC CCH SMOKING & TOBACCO USE CESSATION COUNSELING 3-10 MINS $54.74 $109.48 $26.28–$104.01 25% above 50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC CCH SMOKING & TOBACCO USE CESSATION COUNSELING 3-10 MINS $54.74 $109.48 $69.41–$104.01 — 50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC CLINIC VISIT ESTABLISHED PT LEVEL 5 $106.95 $213.89 $51.33–$368.90 37% below 50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC CLINIC VISIT ESTABLISHED PT LEVEL 5 $106.95 $213.89 $135.61–$203.20 — 50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC CLINIC VISIT ESTABLISHED PT LEVEL 3 $68.91 $137.81 $33.07–$181.94 40% below 50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC CLINIC VISIT ESTABLISHED PT LEVEL 3 $68.91 $137.81 $87.37–$130.92 — 50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC CLINIC VISIT ESTABLISHED PT LEVEL 4 $86.55 $173.09 $41.54–$259.66 37% below 50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC CLINIC VISIT ESTABLISHED PT LEVEL 4 $86.55 $173.09 $109.74–$164.44 — 50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC CLINIC VISIT ESTABLISHED PT LEVEL 2 $51.98 $103.95 $24.95–$113.02 47% below 50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC CLINIC VISIT ESTABLISHED PT LEVEL 2 $51.98 $103.95 $65.90–$98.75 — 50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 HC CCH OFFICE/OUTPATIENT CONSULTATION NEW/EST PT 30 MINUTES $71.67 $143.33 $34.40–$216.70 28% below 50%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 HC CCH OFFICE/OUTPATIENT CONSULTATION NEW/EST PT 30 MINUTES $71.67 $143.33 $90.87–$136.16 — 50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC CCH OFFICE/OUTPATIENT CONSULTATION NEW/EST PT 40 MINUTES $104.74 $209.48 $50.28–$310.68 21% below 50%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 HC CCH OFFICE/OUTPATIENT CONSULTATION NEW/EST PT 40 MINUTES $104.74 $209.48 $132.81–$199.01 — 50%
Speech and language evaluation CPT 92523 HC SPEECH EVALUATION SOUND PRODUCTION W/ LANGUAGE COMPREHENSION AND EXPRESSION $502.60 $1,005.20 $241.25–$954.94 52% above 50%
Speech and language evaluation inpatient CPT 92523 HC SPEECH EVALUATION SOUND PRODUCTION W/ LANGUAGE COMPREHENSION AND EXPRESSION $502.60 $1,005.20 $637.30–$954.94 — 50%
Speech therapy session, individual CPT 92507 HC SPEECH THERAPY INDIVIDUAL $218.89 $437.78 $105.07–$415.89 at median 50%
Speech therapy session, individual inpatient CPT 92507 HC SPEECH THERAPY INDIVIDUAL $218.89 $437.78 $277.55–$415.89 — 50%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY VITAL CAPACITY W/ OR W/O MAXIMAL VOLUNTARY VENTILATION $365.37 $730.73 $175.38–$694.19 15% above 50%
Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY VITAL CAPACITY W/ OR W/O MAXIMAL VOLUNTARY VENTILATION $365.37 $730.73 $463.28–$694.19 — 50%
Spirometry before and after a bronchodilator CPT 94060 HC BRONCHODILATION RESPONSE PRE & POST BRONCHODILATOR ADMIN $572.20 $1,144.40 $274.66–$1,087.18 at median 50%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC BRONCHODILATION RESPONSE PRE & POST BRONCHODILATOR ADMIN $572.20 $1,144.40 $725.55–$1,087.18 — 50%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUTIC ACTIVITIES DIRECT EACH 15 MINS $122.20 $244.40 $58.66–$232.18 1% above 50%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUTIC ACTIVITIES DIRECT- EACH 15 MINUTES BY OT $122.20 $244.40 $58.66–$232.18 1% above 50%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPUETIC ACTIVITIES INDIVIDUAL EACH 15 MINS $122.20 $244.40 $58.66–$232.18 1% above 50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUTIC ACTIVITIES DIRECT EACH 15 MINS $122.20 $244.40 $154.95–$232.18 — 50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPUETIC ACTIVITIES INDIVIDUAL EACH 15 MINS $122.20 $244.40 $154.95–$232.18 — 50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUTIC ACTIVITIES DIRECT- EACH 15 MINUTES BY OT $122.20 $244.40 $154.95–$232.18 — 50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERAPEUTIC $236.86 $473.71 $113.69–$450.02 at median 50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY THERAPEUTIC $236.86 $473.71 $300.33–$450.02 — 50%
Visual field test, extended CPT 92083 HC EXAMINATION VISUAL FIELD EXTENDED $236.86 $473.71 $113.69–$450.02 54% above 50%
Visual field test, extended inpatient CPT 92083 HC EXAMINATION VISUAL FIELD EXTENDED $236.86 $473.71 $300.33–$450.02 — 50%

Vaccines

ProcedureCash priceList priceInsurers payvs OhioOff list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY $37.50 $74.99 $0.01–$196.32 50% below 50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 HC Cch Iiv Adjuvant Vaccine Im $37.50 $75.00 $0.01–$196.32 50% below 50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY $37.50 $74.99 $47.54–$71.24 — 50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 HC Cch Iiv Adjuvant Vaccine Im $37.50 $75.00 $47.55–$71.25 — 50%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC Sars-Cov-2 (Covid-19) Vaccine Omicron 50mg $85.00 $170.00 $40.80–$364.80 59% below 50%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 MRNA VAC 12Y+ MODERNA 50 MCG/0.5ML IM SUSY $85.08 $170.16 $40.84–$364.80 59% below 50%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 HC Sars-Cov-2 (Covid-19) Vaccine Omicron 50mg $85.00 $170.00 $107.78–$161.50 — 50%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 MRNA VAC 12Y+ MODERNA 50 MCG/0.5ML IM SUSY $85.08 $170.16 $107.88–$161.65 — 50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC Cch Varicella Virus Vaccine $125.00 $250.00 $60.00–$444.20 64% below 50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR $893.91 $1,787.81 $173.59–$1,698.42 157% above 50%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC Cch Varicella Virus Vaccine $125.00 $250.00 $158.50–$237.50 — 50%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR $893.91 $1,787.81 $1,133.47–$1,698.42 — 50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC Cch Dtap Ipv Vaccine 4-6 Yrs Im $50.00 $100.00 $24.00–$157.23 61% below 50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 HC Cch Dtap Ipv Vaccine 4-6 Yrs Im $50.00 $100.00 $63.40–$95.00 — 50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC Cch Dtap Vaccine < 7 Yrs Im $25.00 $50.00 $12.00–$73.83 61% below 50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP $195.22 $390.43 $29.33–$370.91 201% above 50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC Cch Dtap Vaccine < 7 Yrs Im $25.00 $50.00 $31.70–$47.50 — 50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP $195.22 $390.43 $247.53–$370.91 — 50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC Cch Dtap Hep B Ipv Vaccine Im $77.50 $155.00 $37.20–$233.38 59% below 50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HC Cch Dtap Hep B Ipv Vaccine Im $77.50 $155.00 $98.27–$147.25 — 50%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC Cch Dtap Hib IP Vaccine Im $100.00 $200.00 $48.00–$288.85 37% below 50%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 HC Cch Dtap Hib IP Vaccine Im $100.00 $200.00 $126.80–$190.00 — 50%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 HC Cch Riv3 Vaccine Preservative Free Im $50.00 $100.00 $0.01–$196.32 73% below 50%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 HC Cch Riv3 Vaccine Preservative Free Im $50.00 $100.00 $63.40–$95.00 — 50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC Iiv3 Vaccine Preservative Free 0.5 Ml Im $11.00 $22.00 $0.01–$46.44 76% below 50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC Iiv3 Vaccine Preservative Free 0.5 Ml Im $11.00 $22.00 $13.95–$20.90 — 50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC Hpv Vaccine Nonavalent 2 or 3 Dose Im $200.00 $400.00 $96.00–$732.90 61% below 50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSY $1,531.66 $3,063.32 $291.62–$2,910.15 195% above 50%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC Hpv Vaccine Nonavalent 2 or 3 Dose Im $200.00 $400.00 $253.60–$380.00 — 50%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSY $1,531.66 $3,063.32 $1,942.14–$2,910.15 — 50%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HC Im Adult Hepa-Hepb $87.50 $175.00 $42.00–$308.93 71% below 50%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HC Im Adult Hepa-Hepb $87.50 $175.00 $110.95–$166.25 — 50%
Hepatitis A vaccine, adult dose CPT 90632 HC Im Adult Hep-a Vaccine $62.50 $125.00 $30.00–$175.20 68% below 50%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 50 UNIT/ML IM SUSP $389.29 $778.57 $76.13–$739.64 100% above 50%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSY $416.44 $832.88 $76.13–$791.24 114% above 50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC Im Adult Hep-a Vaccine $62.50 $125.00 $79.25–$118.75 — 50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 50 UNIT/ML IM SUSP $389.29 $778.57 $493.61–$739.64 — 50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSY $416.44 $832.88 $528.05–$791.24 — 50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC Cch Hep a Vaccine Ped/Adol 2 Dose Im $31.50 $63.00 $15.12–$96.05 65% below 50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACCINE 25 UNIT/0.5ML IM SUSP $256.75 $513.49 $37.81–$487.82 186% above 50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACCINE 720 EL U/0.5ML IM SUSY $258.62 $517.23 $37.81–$491.37 188% above 50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC Cch Hep a Vaccine Ped/Adol 2 Dose Im $31.50 $63.00 $39.94–$59.85 — 50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VACCINE 25 UNIT/0.5ML IM SUSP $256.75 $513.49 $325.55–$487.82 — 50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VACCINE 720 EL U/0.5ML IM SUSY $258.62 $517.23 $327.92–$491.37 — 50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC Hepatitis B Vaccine 3 Dose Im $60.00 $120.00 $28.80–$175.95 61% below 50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC RECOMBINANT 10 MCG/ML IJ SUSP $306.91 $613.82 $76.36–$583.13 97% above 50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSY $349.09 $698.17 $76.36–$663.26 124% above 50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC Hepatitis B Vaccine 3 Dose Im $60.00 $120.00 $76.08–$114.00 — 50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC RECOMBINANT 10 MCG/ML IJ SUSP $306.91 $613.82 $389.16–$583.13 — 50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSY $349.09 $698.17 $442.64–$663.26 — 50%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HC Hepb Vaccine Adult 2 Dose Im $139.50 $279.00 $66.96–$400.70 36% below 50%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VAC RECOMB ADJ 20 MCG/0.5ML IM SOSY $768.69 $1,537.38 $165.01–$1,460.51 251% above 50%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HC Hepb Vaccine Adult 2 Dose Im $139.50 $279.00 $176.89–$265.05 — 50%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VAC RECOMB ADJ 20 MCG/0.5ML IM SOSY $768.69 $1,537.38 $974.70–$1,460.51 — 50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC Hepb Vaccine Pediatric/Adolescent 3 Dose Im $60.00 $120.00 $28.80–$114.00 1% below 50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC RECOMBINANT 5 MCG/0.5ML IJ SUSP $187.68 $375.36 $32.43–$356.59 211% above 50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC RECOMBINANT 5 MCG/0.5ML IJ SUSY $187.68 $375.36 $32.43–$356.59 211% above 50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML IJ SUSY $193.10 $386.20 $32.43–$366.89 220% above 50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC Hepb Vaccine Pediatric/Adolescent 3 Dose Im $60.00 $120.00 $76.08–$114.00 — 50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC RECOMBINANT 5 MCG/0.5ML IJ SUSP $187.68 $375.36 $237.98–$356.59 — 50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC RECOMBINANT 5 MCG/0.5ML IJ SUSY $187.68 $375.36 $237.98–$356.59 — 50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML IJ SUSY $193.10 $386.20 $244.85–$366.89 — 50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HC Cch Hib Vaccine Prp-Omp Vaccine 3 Dose Im $22.00 $44.00 $10.56–$76.33 69% below 50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HC Cch Hib Vaccine Prp-Omp Vaccine 3 Dose Im $22.00 $44.00 $27.90–$41.80 — 50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC Cch Hemophilus Influenza B Vaccine (Hib) Prp-T Im $25.50 $51.00 $12.24–$48.45 17% below 50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSAC CONJ VAC 10 MCG IJ SOLR $86.38 $172.76 $13.02–$164.12 183% above 50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSAC CONJ VAC IM SOLR $88.80 $177.59 $13.02–$168.71 191% above 50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HC Cch Hemophilus Influenza B Vaccine (Hib) Prp-T Im $25.50 $51.00 $32.33–$48.45 — 50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSAC CONJ VAC 10 MCG IJ SOLR $86.38 $172.76 $109.53–$164.12 — 50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSAC CONJ VAC IM SOLR $88.80 $177.59 $112.59–$168.71 — 50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC Influenza Vaccine Quadrivalent Split Virus Prsrv Free High Dose Im $50.00 $100.00 $24.00–$196.32 55% below 50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HC Influenza Vaccine Quadrivalent Split Virus Prsrv Free High Dose Im $50.00 $100.00 $63.40–$95.00 — 50%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 HC Cch Japanese Encephalitis Vacc Inactivated Im $215.50 $431.00 $103.44–$733.38 84% below 50%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 HC Cch Japanese Encephalitis Vacc Inactivated Im $215.50 $431.00 $273.25–$409.45 — 50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC Cch Mmr Vaccine $75.00 $150.00 $36.00–$233.58 64% below 50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR $454.50 $908.99 $94.73–$863.54 118% above 50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC Cch Mmr Vaccine $75.00 $150.00 $95.10–$142.50 — 50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR $454.50 $908.99 $576.30–$863.54 — 50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC Cch Live Mmr Vaccine Sq $187.50 $375.00 $90.00–$687.60 63% below 50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR $1,344.04 $2,688.08 $284.67–$2,553.68 163% above 50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 HC Cch Live Mmr Vaccine Sq $187.50 $375.00 $237.75–$356.25 — 50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR $1,344.04 $2,688.08 $1,704.24–$2,553.68 — 50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC Cch Meningococcal Conjugate Vaccine Im $125.00 $250.00 $60.00–$378.33 61% below 50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A C Y&W-135 OLIG IM SOLN $822.17 $1,644.33 $156.44–$1,562.11 159% above 50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A C Y&W-135 OLIG IM SOLR $822.17 $1,644.34 $156.44–$1,562.12 159% above 50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC Cch Meningococcal Conjugate Vaccine Im $125.00 $250.00 $158.50–$237.50 — 50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A C Y&W-135 OLIG IM SOLN $822.17 $1,644.33 $1,042.51–$1,562.11 — 50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A C Y&W-135 OLIG IM SOLR $822.17 $1,644.34 $1,042.51–$1,562.12 — 50%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 HC Cch Meningococcal Conjugate Acwy-Tt Vaccine Im $89.00 $178.00 $42.72–$397.75 78% below 50%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 HC Cch Meningococcal Conjugate Acwy-Tt Vaccine Im $89.00 $178.00 $112.85–$169.10 — 50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC Cch Menb Recombinant Prot Vaccine Im $175.00 $350.00 $84.00–$538.55 68% below 50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY $1,169.51 $2,339.02 $218.41–$2,222.07 111% above 50%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 HC Cch Menb Recombinant Prot Vaccine Im $175.00 $350.00 $221.90–$332.50 — 50%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY $1,169.51 $2,339.02 $1,482.94–$2,222.07 — 50%
Meningococcal B vaccine (Trumenba) CPT 90621 HC Cch Menb Recombinant Lipoprotein Vaccine Im $120.00 $240.00 $57.60–$457.93 69% below 50%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 HC Cch Menb Recombinant Lipoprotein Vaccine Im $120.00 $240.00 $152.16–$228.00 — 50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC Cch Pneumococcal Vaccine 13 Valent Im $180.00 $360.00 $86.40–$644.98 59% below 50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 HC Cch Pneumococcal Vaccine 13 Valent Im $180.00 $360.00 $228.24–$342.00 — 50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC Pneumococcal Vaccine 20 Valent Im $181.00 $362.00 $86.88–$721.65 73% below 50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HC Pneumococcal Vaccine 20 Valent Im $181.00 $362.00 $229.51–$343.90 — 50%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 HC Cch Pneumococcal Conjugate Vaccine 21 Valent (Pcv21) Im $267.50 $535.00 $128.40–$688.50 18% below 50%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 HC Cch Pneumococcal Conjugate Vaccine 21 Valent (Pcv21) Im $267.50 $535.00 $339.19–$508.25 — 50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOSY $29.50 $59.00 $14.16–$333.68 89% below 50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC Pneumococcal Vaccine 23 Valent >2 Yrs Sq/Im $75.00 $150.00 $36.00–$333.68 73% below 50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOSY $29.50 $59.00 $37.41–$56.05 — 50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC Pneumococcal Vaccine 23 Valent >2 Yrs Sq/Im $75.00 $150.00 $95.10–$142.50 — 50%
Polio vaccine, inactivated (IPV) CPT 90713 HC Cch Poliovirus Ipv Sc/Im $30.00 $60.00 $14.40–$103.33 51% below 50%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE INACTIVATED IJ SUSP $270.40 $540.79 $44.11–$513.75 340% above 50%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC Cch Poliovirus Ipv Sc/Im $30.00 $60.00 $38.04–$57.00 — 50%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE INACTIVATED IJ SUSP $270.40 $540.79 $342.86–$513.75 — 50%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 HC Cch Rsv Vaccine Monoclonal Antibody 1ml Im $333.50 $667.00 $160.08–$1,262.25 68% below 50%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 HC Cch Rsv Vaccine Monoclonal Antibody 1ml Im $333.50 $667.00 $422.88–$633.65 — 50%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 HC Cch Rsv Vaccine Monoclonal Antibody .5ml Im $333.50 $667.00 $160.08–$1,262.25 75% below 50%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5ML IM SOSY $357.04 $714.07 $171.38–$1,262.25 74% below 50%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 HC Cch Rsv Vaccine Monoclonal Antibody .5ml Im $333.50 $667.00 $422.88–$633.65 — 50%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5ML IM SOSY $357.04 $714.07 $452.72–$678.37 — 50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 HC Rsv Vaccine Pref Bivalent Im $184.00 $368.00 $0.01–$752.25 74% below 50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV PRE-FUSION F A&B VAC RCMB 120 MCG/0.5ML IM SOLR $191.44 $382.88 $0.01–$752.25 73% below 50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 HC Rsv Vaccine Pref Bivalent Im $184.00 $368.00 $233.31–$349.60 — 50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV PRE-FUSION F A&B VAC RCMB 120 MCG/0.5ML IM SOLR $191.44 $382.88 $242.75–$363.74 — 50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 HC Cch Rsv Vaccine Im $1,279.00 $2,558.00 $613.92–$2,430.10 261% above 50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSVPREF3 VAC RECOMB ADJUVANTED 120 MCG/0.5ML IM SUSR $1,426.36 $2,852.72 $684.65–$2,710.08 302% above 50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 HC Cch Rsv Vaccine Im $1,279.00 $2,558.00 $1,621.77–$2,430.10 — 50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSVPREF3 VAC RECOMB ADJUVANTED 120 MCG/0.5ML IM SUSR $1,426.36 $2,852.72 $1,808.62–$2,710.08 — 50%
Rabies vaccine, one dose CPT 90675 HC Cch Rabies Vaccine Im $300.00 $600.00 $144.00–$821.38 68% below 50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC IM SUSR $2,023.54 $4,047.07 $385.41–$3,844.72 112% above 50%
Rabies vaccine, one dose inpatient CPT 90675 HC Cch Rabies Vaccine Im $300.00 $600.00 $380.40–$570.00 — 50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC IM SUSR $2,023.54 $4,047.07 $2,565.84–$3,844.72 — 50%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 HC Cch Rotovirus Vaccine Attenuated 2 Dose Live Oral $71.50 $143.00 $34.32–$343.23 73% below 50%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN $178.11 $356.22 $85.49–$343.23 32% below 50%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 HC Cch Rotovirus Vaccine Attenuated 2 Dose Live Oral $71.50 $143.00 $90.66–$135.85 — 50%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN $178.11 $356.22 $225.84–$338.41 — 50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC Cch Rotovirus Vaccine Pentavalent 3 Dose Live Oral $75.00 $150.00 $36.00–$244.38 45% below 50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC Cch Rotovirus Vaccine Pentavalent 3 Dose Live Oral $75.00 $150.00 $95.10–$142.50 — 50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC Shingrix 50mcg $150.00 $300.00 $72.00–$467.70 70% below 50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR $1,092.71 $2,185.42 $186.15–$2,076.15 117% above 50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSY $1,129.86 $2,259.71 $186.15–$2,146.72 124% above 50%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HC Shingrix 50mcg $150.00 $300.00 $190.20–$285.00 — 50%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR $1,092.71 $2,185.42 $1,385.56–$2,076.15 — 50%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSY $1,129.86 $2,259.71 $1,432.66–$2,146.72 — 50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC Cch Td Vaccine No Prsrv >/=7 Im $30.00 $60.00 $14.40–$71.63 67% below 50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LF/0.5ML IM SUSP $270.40 $540.79 $30.14–$513.75 201% above 50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC Cch Td Vaccine No Prsrv >/=7 Im $30.00 $60.00 $38.04–$57.00 — 50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LF/0.5ML IM SUSP $270.40 $540.79 $342.86–$513.75 — 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC Tdap Vaccine >7 Im $50.00 $100.00 $24.00–$96.68 55% below 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2-15.5 LF-MCG/0.5 IM SUSP $270.40 $540.79 $40.69–$513.75 145% above 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY $270.40 $540.79 $40.69–$513.75 145% above 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC Tdap Vaccine >7 Im $50.00 $100.00 $63.40–$95.00 — 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY $270.40 $540.79 $342.86–$513.75 — 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2-15.5 LF-MCG/0.5 IM SUSP $270.40 $540.79 $342.86–$513.75 — 50%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 HC Cch Typhoid Vaccine Im $66.00 $132.00 $31.68–$214.98 77% below 50%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI POLYSACCHARIDE VACC 25 MCG/0.5ML IM SOSY $752.41 $1,504.82 $91.48–$1,429.58 162% above 50%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 HC Cch Typhoid Vaccine Im $66.00 $132.00 $83.69–$125.40 — 50%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VI POLYSACCHARIDE VACC 25 MCG/0.5ML IM SOSY $752.41 $1,504.82 $954.06–$1,429.58 — 50%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 HC Cch Typhoid Vaccine Oral $28.00 $56.00 $13.44–$272.00 44% below 50%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 TYPHOID VACCINE PO CAP DR $34.43 $68.85 $16.52–$272.00 31% below 50%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 HC Cch Typhoid Vaccine Oral $28.00 $56.00 $35.50–$53.20 — 50%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 TYPHOID VACCINE PO CAP DR $34.43 $68.85 $43.65–$65.41 — 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC VACCINE ADMINISTRATION INITIAL $130.78 $261.56 $62.77–$248.48 242% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC VACCINE ADMINISTRATION INITIAL $130.78 $261.56 $165.83–$248.48 — 50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC VACCINE ADMINISTRATION EACH ADDITIONAL $28.74 $57.47 $13.79–$54.60 17% below 50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC VACCINE ADMINISTRATION EACH ADDITIONAL $28.74 $57.47 $36.44–$54.60 — 50%
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/10271/311072406_pike-health-services-inc_standardcharges.csv