Hospital Chillicothe, OH

Adena Regional Medical Center

Adena Regional Medical Center in Chillicothe, OH publishes cash prices for 315 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 222 of 308 procedures and above it for 80. By typical cash price it ranks #13 of 116 Ohio hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

272 Hospital Road, Chillicothe, OH 45601 Collected Sep 27, 2026 Source price file (740) 779-7500

Acute care hospital Emergency department CMS star rating 3 of 5 CCN 360159 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 HC RADIOLOGY EXAM ANKLE COMPLETE- MIN 3 VIEWS	$353.51	$707.02	$83.10–$671.67	11% 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	$320.85–$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	$127.04–$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	$440.75–$922.69	—	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC RADIOLOGY EXAM ESOPHAGUS INCL SCOUT NECK W/SINGLE-CONTRAST	$262.09	$524.17	$167.48–$837.69	39% 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	$237.87–$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	$381.72–$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	$1,201.94–$2,516.18	—	50%
Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST UNILATERAL COMPLETE	$638.83	$1,277.66	$99.82–$1,213.78	100% above	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US BREAST UNILATERAL COMPLETE	$638.83	$1,277.66	$579.80–$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	$83.10–$605.82	23% below	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC US BREAST UNILATERAL LIMITED	$318.85	$637.70	$289.39–$605.82	—	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	$167.48–$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	$1,088.11–$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	$333.12–$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	$1,787.33–$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	$83.10–$2,149.00	41% 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	$161.53–$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	$227.83–$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	$1,385.72–$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	$333.12–$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	$1,829.93–$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	$333.12–$4,541.88	14% 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	$2,169.59–$4,541.88	—	50%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/ CONTRAST	$1,008.12	$2,016.23	$167.48–$2,149.00	9% below	50%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W/ CONTRAST	$1,008.12	$2,016.23	$914.97–$1,915.42	—	50%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O CONTRAST	$764.32	$1,528.63	$99.82–$2,149.00	27% below	50%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O CONTRAST	$764.32	$1,528.63	$693.69–$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	$99.82–$2,149.00	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	$694.09–$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	$99.82–$2,149.00	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	$693.69–$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	$167.48–$2,149.00	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	$914.97–$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	$167.48–$2,270.94	10% 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	$1,084.79–$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	$99.82–$2,149.00	27% 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	$693.69–$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	$99.82–$2,149.00	26% 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	$693.69–$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	$167.48–$2,149.00	10% below	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/ CONTRAST	$1,008.12	$2,016.23	$914.97–$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	$227.83–$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	$535.77–$1,121.61	—	50%
Chest X-ray, 2 views CPT 71046 HC RADIOLOGY X-RAY CHEST 2 VIEWS	$173.44	$346.87	$83.10–$403.57	34% below	50%
Chest X-ray, 2 views inpatient CPT 71046 HC RADIOLOGY X-RAY CHEST 2 VIEWS	$173.44	$346.87	$157.41–$329.53	—	50%
Chest X-ray, single view CPT 71045 HC RADIOLOGY X-RAY CHEST SINGLE VIEW	$173.44	$346.87	$83.10–$403.57	19% below	50%
Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGY X-RAY CHEST SINGLE VIEW	$173.44	$346.87	$157.41–$329.53	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$371.92	$743.83	$99.82–$706.64	45% 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	$337.55–$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	$99.82–$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	$264.97–$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	$83.10–$403.57	39% 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	$139.85–$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	$99.82–$2,149.00	15% 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	$693.69–$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	$167.48–$2,149.00	10% 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	$914.97–$1,915.42	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMMOGRAM DIAGNOSTIC BILATERAL INCLUDING CAD	$374.90	$749.80	$146.43–$712.31	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC MAMMOGRAM DIAGNOSTIC BILATERAL INCLUDING CAD	$374.90	$749.80	$340.26–$712.31	—	50%
Diagnostic mammogram, one breast one side CPT 77065 HC MAMMOGRAM DIAGNOSTIC UNILATERAL INCLUDING CAD	$326.03	$652.05	$115.62–$619.45	1% below	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC MAMMOGRAM DIAGNOSTIC UNILATERAL INCLUDING CAD	$326.03	$652.05	$295.90–$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	$227.83–$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	$979.95–$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	$227.83–$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	$979.95–$2,051.46	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO COMPLETE W/ BUBBLE STUDY	$1,911.58	$3,823.16	$521.74–$3,632.00	13% above	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	$521.74–$3,632.00	13% above	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO COMPLETE W/ BUBBLE STUDY	$1,911.58	$3,823.16	$1,734.95–$3,632.00	—	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	$1,734.95–$3,632.00	—	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	$381.72–$1,841.58	35% 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	$879.69–$1,841.58	—	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	$206.17–$2,844.61	119% 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	$1,358.83–$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	$819.96–$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	$2,448.60–$5,125.97	—	50%
Knee X-ray, 3 views CPT 73562 HC RADIOLOGY EXAM KNEE 3 VIEWS	$353.51	$707.02	$83.10–$671.67	3% above	50%
Knee X-ray, 3 views inpatient CPT 73562 HC RADIOLOGY EXAM KNEE 3 VIEWS	$353.51	$707.02	$320.85–$671.67	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMINAL LIMITED	$409.20	$818.40	$99.82–$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	$371.39–$777.48	—	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	$99.82–$2,149.00	15% 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	$203.10–$425.17	—	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	$227.83–$4,020.40	46% 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	$1,920.48–$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	$333.12–$5,462.50	25% 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	$2,609.35–$5,462.50	—	50%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O CONTRAST	$1,158.63	$2,317.25	$227.83–$2,201.39	29% below	50%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN W/O CONTRAST	$1,158.63	$2,317.25	$1,051.57–$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	$333.12–$2,993.45	23% 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	$1,429.92–$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	$227.83–$2,203.67	17% below	50%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST	$1,159.83	$2,319.65	$1,052.66–$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	$333.12–$2,840.83	26% 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	$1,357.02–$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	$227.83–$2,174.08	13% 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	$1,038.52–$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	$333.12–$2,785.88	31% 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	$1,330.77–$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	$227.83–$2,195.71	19% 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	$1,048.85–$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	$333.12–$2,826.72	32% 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	$1,350.28–$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	$227.83–$2,186.82	15% 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	$1,044.61–$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	$333.12–$2,895.13	19% 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	$1,382.96–$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	$227.83–$2,171.89	18% below	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS W/O CONTRAST	$1,143.10	$2,286.20	$1,037.48–$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	$227.83–$2,078.83	13% 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	$993.02–$2,078.83	—	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	$1,236.19–$6,165.44	12% 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	$2,918.50–$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	$1,365.38–$6,918.35	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	$3,063.15–$6,412.50	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIC LIMITED	$249.78	$499.56	$99.82–$496.49	40% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIC LIMITED	$249.78	$499.56	$226.70–$474.58	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC COMPLETE	$409.20	$818.40	$99.82–$777.48	14% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC COMPLETE	$409.20	$818.40	$371.39–$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	$99.82–$496.49	66% 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	$161.10–$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	$99.82–$496.49	65% 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	$161.10–$337.25	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED 1 OR MORE FETUSES	$177.50	$355.00	$99.82–$496.49	63% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED 1 OR MORE FETUSES	$177.50	$355.00	$161.10–$337.25	—	50%
Screening mammogram, both breasts both sides CPT 77067 HC MAMMOGRAM SCREENING BILATERAL INCLUDING CAD	$143.75	$287.50	$117.58–$449.72	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC MAMMOGRAM SCREENING BILATERAL INCLUDING CAD	$143.75	$287.50	$130.47–$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	$83.10–$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	$320.85–$671.67	—	50%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY 4+ PARAMETERS AGE > 6 YRS	$2,697.88	$5,395.76	$819.96–$5,125.97	21% below	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY 4+ PARAMETERS AGE > 6 YRS	$2,697.88	$5,395.76	$2,448.60–$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	$521.74–$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	$1,064.30–$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	$167.48–$837.69	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	$282.75–$591.92	—	50%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL	$409.20	$818.40	$99.82–$777.48	24% below	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL	$409.20	$818.40	$371.39–$777.48	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL	$177.50	$355.00	$99.82–$496.49	63% below	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL	$177.50	$355.00	$161.10–$337.25	—	50%
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMINAL COMPLETE	$409.20	$818.40	$99.82–$777.48	28% below	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMINAL COMPLETE	$409.20	$818.40	$371.39–$777.48	—	50%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM	$409.20	$818.40	$99.82–$777.48	19% below	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM	$409.20	$818.40	$371.39–$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	$99.82–$777.48	26% 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	$371.39–$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	$167.48–$837.69	46% 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	$282.75–$591.92	—	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	$99.82–$1,300.59	6% 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	$621.27–$1,300.59	—	50%
Wrist X-ray, complete, 3 or more views CPT 73110 HC RADIOLOGY EXAM WRIST COMPLETE- MIN 3 VIEWS	$353.51	$707.02	$83.10–$671.67	6% 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	$320.85–$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	$83.10–$403.57	44% 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	$160.42–$335.83	—	50%
X-ray of the abdomen, 1 view CPT 74018 HC RADIOLOGY EXAM ABDOMEN SINGLE VIEW	$154.09	$308.18	$83.10–$403.57	38% below	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC RADIOLOGY EXAM ABDOMEN SINGLE VIEW	$154.09	$308.18	$139.85–$292.77	—	50%
X-ray of the ankle, 2 views CPT 73600 HC RADIOLOGY EXAM ANKLE 2 VIEWS	$154.09	$308.18	$83.10–$403.57	40% below	50%
X-ray of the ankle, 2 views inpatient CPT 73600 HC RADIOLOGY EXAM ANKLE 2 VIEWS	$154.09	$308.18	$139.85–$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	$83.10–$671.67	51% 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	$320.85–$671.67	—	50%
X-ray of the foot, 2 views CPT 73620 HC RADIOLOGY EXAM FOOT 2 VIEWS	$154.09	$308.18	$83.10–$403.57	32% below	50%
X-ray of the foot, 2 views inpatient CPT 73620 HC RADIOLOGY EXAM FOOT 2 VIEWS	$154.09	$308.18	$139.85–$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	$83.10–$671.67	13% 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	$320.85–$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	$83.10–$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	$320.85–$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	$83.10–$671.67	32% 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	$320.85–$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	$99.82–$496.49	37% 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	$168.90–$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	$99.82–$577.87	29% 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	$276.04–$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	$99.82–$496.49	35% 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	$168.90–$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	$83.10–$403.57	38% 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	$160.42–$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	$83.10–$403.57	40% 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	$160.42–$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	$99.82–$496.49	25% 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	$168.90–$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	$83.10–$403.57	38% 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	$160.42–$335.83	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SO TRANSFERASE ALANINE AMINO	$12.64	$25.27	$5.30–$38.57	54% below	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO	$12.64	$25.27	$5.30–$38.57	54% below	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SO TRANSFERASE ALANINE AMINO	$12.64	$25.27	$11.47–$24.01	—	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO	$12.64	$25.27	$11.47–$24.01	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC AST OR SGOT	$12.34	$24.68	$5.18–$37.68	51% below	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC AST OR SGOT	$12.34	$24.68	$11.20–$23.45	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC ACUTE HEPATITIS PANEL	$124.78	$249.55	$47.63–$346.56	42% below	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC ACUTE HEPATITIS PANEL	$124.78	$249.55	$113.25–$237.07	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 HC SO ALLERGEN SPECIFIC IGE- EA - A	$12.45	$24.89	$5.22–$37.99	47% below	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC SO ALLERGEN SPECIFIC IGE- EA - A	$12.45	$24.89	$11.30–$23.65	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCH SO CCP ANTIBODY	$30.86	$61.71	$12.95–$94.22	47% below	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP ANTIBODY	$30.86	$61.71	$12.95–$94.22	47% below	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP ANTIBODY	$30.86	$61.71	$28.00–$58.62	—	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCH SO CCP ANTIBODY	$30.86	$61.71	$28.00–$58.62	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC SO ANTINUCLEAR AB (ANA)	$28.83	$57.65	$12.09–$87.97	47% below	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC SO ANTINUCLEAR AB (ANA)	$28.83	$57.65	$26.16–$54.77	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC SO NATRIUERETIC PEPTIDE	$80.92	$161.84	$39.26–$285.66	43% below	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIUERETIC PEPTIDE	$80.92	$161.84	$39.26–$285.66	43% below	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC SO NATRIUERETIC PEPTIDE	$80.92	$161.84	$73.44–$153.75	—	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIUERETIC PEPTIDE	$80.92	$161.84	$73.44–$153.75	—	50%
Basic metabolic panel (blood test) CPT 80048 HC METABOLIC PANEL TOTAL CA	$20.11	$40.22	$8.46–$61.55	66% below	50%
Basic metabolic panel (blood test) inpatient CPT 80048 HC METABOLIC PANEL TOTAL CA	$20.11	$40.22	$18.25–$38.21	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURG PATH LEVEL IV EXCEPT PROSTATE NEEDLE BIOPSY	$97.75	$195.50	$49.76–$280.86	46% 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	$88.72–$185.73	—	50%
Blood culture for bacteria CPT 87040 HC AEROB BACTERIAL BLOOD CULTURE	$28.15	$56.30	$10.32–$75.09	70% below	50%
Blood culture for bacteria inpatient CPT 87040 HC AEROB BACTERIAL BLOOD CULTURE	$28.15	$56.30	$25.55–$53.49	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE	$15.91	$31.82	$6.75–$30.23	8% above	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC VENIPUNCTURE	$15.91	$31.82	$14.44–$30.23	—	50%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUAN BLOOD	$9.37	$18.73	$3.93–$28.61	55% below	50%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUAN BLOOD	$9.37	$18.73	$8.50–$17.79	—	50%
Blood lead test CPT 83655 HC SO LEAD - A	$28.86	$57.72	$12.11–$88.12	28% below	50%
Blood lead test inpatient CPT 83655 HC SO LEAD - A	$28.86	$57.72	$26.19–$54.83	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC HCG QUAL	$17.93	$35.85	$7.52–$54.71	63% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC HCG QUAL	$17.93	$35.85	$16.27–$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	$6.74–$428.59	363% 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	$204.73–$428.59	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN	$12.34	$24.68	$5.18–$37.68	72% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN	$12.34	$24.68	$11.20–$23.45	—	50%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFF AMPLIFIED PROBE	$95.63	$191.26	$37.27–$271.17	26% below	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFF AMPLIFIED PROBE	$95.63	$191.26	$86.79–$181.70	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 HC SO IA- QUANT CA 19-9	$34.08	$68.15	$20.81–$151.41	50% below	50%
CA 19-9 blood test (tumor marker) CPT 86301 HC IA QUANT CA 19-9	$36.42	$72.84	$20.81–$151.41	46% below	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC SO IA- QUANT CA 19-9	$34.08	$68.15	$30.93–$64.74	—	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IA QUANT CA 19-9	$36.42	$72.84	$33.05–$69.20	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC IA QUANT CA 125	$36.42	$72.84	$20.81–$151.41	61% below	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC CCH SO IA-QUANT CA 125	$193.82	$387.63	$20.81–$368.25	107% above	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IA QUANT CA 125	$36.42	$72.84	$33.05–$69.20	—	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC CCH SO IA-QUANT CA 125	$193.82	$387.63	$175.91–$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	$51.31–$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	$51.31–$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	$98.44–$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	$122.43–$256.30	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIF NA PROBE	$95.63	$191.26	$35.09–$255.32	4% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC SO CHLAMYDIA TRACHOMATIS AMPLIF NA PROBE	$95.63	$191.26	$35.09–$255.32	4% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIF NA PROBE	$95.63	$191.26	$86.79–$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	$86.79–$181.70	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC SO LIPID PANEL	$34.88	$69.76	$13.39–$97.44	33% below	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$34.88	$69.76	$13.39–$97.44	33% below	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL	$34.88	$69.76	$31.66–$66.27	—	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC SO LIPID PANEL	$34.88	$69.76	$31.66–$66.27	—	50%
Complete blood count (CBC) with differential CPT 85025 HC CBC EDIFF & PLATELET	$21.32	$42.63	$7.77–$56.54	39% below	50%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC EDIFF & PLATELET	$21.32	$42.63	$19.35–$40.50	—	50%
Complete blood count (CBC), no differential CPT 85027 HC CBC & PLATELET	$17.74	$35.47	$6.47–$47.07	45% below	50%
Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC & PLATELET	$17.74	$35.47	$16.10–$33.70	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL	$28.97	$57.93	$10.56–$76.85	52% below	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL	$28.97	$57.93	$26.29–$55.03	—	50%
D-dimer blood test (blood clot marker) CPT 85379 HC D-DIMER - QUAN	$27.92	$55.83	$10.18–$74.07	60% below	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D-DIMER - QUAN	$27.92	$55.83	$25.34–$53.04	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DHEA-S	$53.01	$106.02	$22.23–$161.75	46% below	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC CCH SO DHEA-S	$53.01	$106.02	$22.23–$161.75	46% below	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC CCH SO DHEA-S	$53.01	$106.02	$48.11–$100.72	—	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DHEA-S	$53.01	$106.02	$48.11–$100.72	—	50%
Estradiol blood test CPT 82670 HC SO ESTRADIOL	$65.63	$131.25	$27.94–$203.30	37% below	50%
Estradiol blood test CPT 82670 HC ESTRADIOL	$66.61	$133.21	$27.94–$203.30	36% below	50%
Estradiol blood test inpatient CPT 82670 HC SO ESTRADIOL	$65.63	$131.25	$59.56–$124.69	—	50%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL	$66.61	$133.21	$60.45–$126.55	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FSH	$44.30	$88.59	$18.58–$135.19	48% below	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FSH	$44.30	$88.59	$40.20–$84.16	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 HC SO CALPROTECTIN FECAL	$46.80	$93.60	$19.63–$142.83	69% below	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC SO CALPROTECTIN FECAL	$46.80	$93.60	$42.48–$88.92	—	50%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN	$32.50	$65.00	$13.63–$99.17	57% below	50%
Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN	$32.50	$65.00	$29.50–$61.75	—	50%
Folate (folic acid) blood test CPT 82746 HC FOLIC ACID SERUM	$35.06	$70.11	$14.70–$106.97	47% below	50%
Folate (folic acid) blood test inpatient CPT 82746 HC FOLIC ACID SERUM	$35.06	$70.11	$31.82–$66.60	—	50%
Free T3 thyroid hormone test CPT 84481 HC T3 FREE	$40.38	$80.75	$16.94–$123.26	41% below	50%
Free T3 thyroid hormone test inpatient CPT 84481 HC T3 FREE	$40.38	$80.75	$36.64–$76.71	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC FREE THYROXINE	$21.49	$42.98	$9.02–$65.64	47% below	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC FREE THYROXINE	$21.49	$42.98	$19.50–$40.83	—	50%
Free testosterone test CPT 84402 HC SO TESTOSTERONE FREE	$26.00	$52.00	$23.60–$185.32	72% below	50%
Free testosterone test inpatient CPT 84402 HC SO TESTOSTERONE FREE	$26.00	$52.00	$23.60–$49.40	—	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC CCH GENERAL HEALTH PANEL	$317.35	$634.70	$102.06–$602.97	43% 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	$288.03–$602.97	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$11.33	$22.65	$4.75–$34.56	61% below	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$11.33	$22.65	$10.28–$21.52	—	50%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST INCL 3 SPECIMENS	$23.31	$46.62	$12.87–$93.63	60% below	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST INCL 3 SPECIMENS	$23.31	$46.62	$21.16–$44.29	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC NEISSERIA AMPLIF NA PROBE	$95.63	$191.26	$35.09–$255.32	3% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC SO NEISSERIA AMPLIF NA PROBE	$95.63	$191.26	$35.09–$255.32	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	$86.79–$181.70	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC NEISSERIA AMPLIF NA PROBE	$95.63	$191.26	$86.79–$181.70	—	50%
H. pylori antibody blood test CPT 86677 HC SO AB HELICOBACTER PYLORI	$34.60	$69.20	$16.85–$122.61	49% below	50%
H. pylori antibody blood test inpatient CPT 86677 HC SO AB HELICOBACTER PYLORI	$34.60	$69.20	$31.40–$65.74	—	50%
H. pylori stool antigen test CPT 87338 HC SO HPYLORI STOOL- EIA	$39.20	$78.39	$14.38–$104.63	41% below	50%
H. pylori stool antigen test inpatient CPT 87338 HC SO HPYLORI STOOL- EIA	$39.20	$78.39	$35.57–$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	$85.10–$619.22	31% 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	$210.48–$440.63	—	50%
HIV-1 and HIV-2 antibody test CPT 86703 HC SO ANTI HIV 1\HIV 2	$32.68	$65.35	$13.71–$99.76	44% below	50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC SO ANTI HIV 1\HIV 2	$32.68	$65.35	$29.66–$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	$24.08–$175.22	at median	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	$24.08–$175.22	at median	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	$59.56–$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	$59.56–$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	$35.09–$255.32	62% 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	$38.91–$81.45	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HGB GLYCOSYLATED (A1C)	$23.14	$46.28	$9.71–$70.66	47% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HGB GLYCOSYLATED (A1C)	$23.14	$46.28	$21.00–$43.97	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF AB	$25.61	$51.21	$10.74–$78.15	47% below	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF AB	$25.61	$51.21	$23.24–$48.65	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC SO HEPATITIS B SURFACE AG- EIA	$25.38	$50.75	$10.33–$75.17	45% below	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE AG EIA	$25.38	$50.75	$10.33–$75.17	45% below	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC SO HEPATITIS B SURFACE AG- EIA	$25.38	$50.75	$23.03–$48.21	—	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEPATITIS B SURFACE AG EIA	$25.38	$50.75	$23.03–$48.21	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY	$31.42	$62.83	$14.27–$103.82	51% below	50%
Hepatitis C antibody blood test (screening) CPT 86803 HC SO HEPATITIS C ANTIBODY	$31.42	$62.83	$14.27–$103.82	51% below	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY	$31.42	$62.83	$28.51–$59.69	—	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC SO HEPATITIS C ANTIBODY	$31.42	$62.83	$28.51–$59.69	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC SO HEP-C REVERSE TRANSCRIPTION & NA QUAN	$116.74	$233.48	$42.84–$311.70	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	$105.95–$221.81	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 HC SO HERPES SIMPLEX- TYPE I	$34.95	$69.90	$13.19–$95.98	41% below	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC SO HERPES SIMPLEX- TYPE I	$34.95	$69.90	$31.72–$66.41	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 HC SO AB HSV II	$46.15	$92.30	$19.35–$140.79	30% below	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC SO AB HSV II	$46.15	$92.30	$41.89–$87.69	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC SO C-REACTIVE PROTEIN HS	$30.86	$61.71	$12.95–$94.22	48% below	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HS	$30.86	$61.71	$12.95–$94.22	48% below	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC SO C-REACTIVE PROTEIN HS	$30.86	$61.71	$28.00–$58.62	—	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HS	$30.86	$61.71	$28.00–$58.62	—	50%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE	$31.36	$62.72	$17.92–$130.39	60% below	50%
Homocysteine blood test CPT 83090 HC SO ASSAY OF HOMOCYSTINE	$40.22	$80.43	$17.92–$130.39	48% below	50%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTINE	$31.36	$62.72	$28.46–$59.58	—	50%
Homocysteine blood test inpatient CPT 83090 HC SO ASSAY OF HOMOCYSTINE	$40.22	$80.43	$36.50–$76.41	—	50%
Insulin blood test CPT 83525 HC SO INSULIN TOTAL	$27.25	$54.50	$11.43–$83.17	47% below	50%
Insulin blood test CPT 83525 HC INSULIN TOTAL	$27.25	$54.50	$11.43–$83.17	47% below	50%
Insulin blood test inpatient CPT 83525 HC SO INSULIN TOTAL	$27.25	$54.50	$24.73–$51.78	—	50%
Insulin blood test inpatient CPT 83525 HC INSULIN TOTAL	$27.25	$54.50	$24.73–$51.78	—	50%
Iron blood test (serum iron) CPT 83540 HC IRON	$15.44	$30.87	$6.47–$47.07	55% below	50%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON	$15.44	$30.87	$14.01–$29.33	—	50%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL	$23.81	$47.62	$8.68–$63.16	62% below	50%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL	$23.81	$47.62	$21.61–$45.24	—	50%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE	$44.14	$88.27	$18.52–$134.75	54% below	50%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE	$44.14	$88.27	$40.06–$83.86	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE	$16.42	$32.83	$6.89–$50.13	68% below	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE	$16.42	$32.83	$14.90–$31.19	—	50%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL	$17.33	$34.66	$8.17–$59.45	69% below	50%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL	$17.33	$34.66	$15.73–$32.93	—	50%
Lyme disease antibody test CPT 86618 HC SO AB LYME'S DISEASE	$40.60	$81.20	$17.03–$123.91	47% below	50%
Lyme disease antibody test CPT 86618 HC AB LYME'S DISEASE	$40.60	$81.20	$17.03–$123.91	47% below	50%
Lyme disease antibody test inpatient CPT 86618 HC SO AB LYME'S DISEASE	$40.60	$81.20	$36.85–$77.14	—	50%
Lyme disease antibody test inpatient CPT 86618 HC AB LYME'S DISEASE	$40.60	$81.20	$36.85–$77.14	—	50%
Magnesium blood test CPT 83735 HC MAGNESIUM	$13.76	$27.52	$6.70–$48.76	57% below	50%
Magnesium blood test CPT 83735 HC SO MAGNESIUM	$13.76	$27.51	$6.70–$48.76	57% below	50%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM	$13.76	$27.52	$12.49–$26.14	—	50%
Magnesium blood test inpatient CPT 83735 HC SO MAGNESIUM	$13.76	$27.51	$12.48–$26.13	—	50%
Measles (rubeola) antibody test CPT 86765 HC SO AB RUBEOLA	$30.72	$61.43	$12.88–$93.72	42% below	50%
Measles (rubeola) antibody test CPT 86765 HC AB RUBEOLA	$30.72	$61.43	$12.88–$93.72	42% below	50%
Measles (rubeola) antibody test inpatient CPT 86765 HC AB RUBEOLA	$30.72	$61.43	$27.88–$58.36	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 HC SO AB RUBEOLA	$30.72	$61.43	$27.88–$58.36	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 HC QUAL HETEROPHILE AB	$12.34	$24.68	$5.18–$37.68	76% below	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC QUAL HETEROPHILE AB	$12.34	$24.68	$11.20–$23.45	—	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC SO PSA FREE	$43.86	$87.71	$18.39–$133.82	46% below	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC SO PSA FREE	$43.86	$87.71	$39.80–$83.32	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL	$43.86	$87.71	$18.39–$133.82	43% below	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC SO PSA TOTAL	$43.86	$87.71	$18.39–$133.82	43% below	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC SO PSA TOTAL	$43.86	$87.71	$39.80–$83.32	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA TOTAL	$43.86	$87.71	$39.80–$83.32	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTOPATHOLOGY THIN LAYER AUTOMATED AND MANUAL	$69.00	$138.00	$26.61–$193.61	27% below	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	$26.61–$193.61	27% below	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTOPATHOLOGY THIN LAYER AUTOMATED AND MANUAL	$69.00	$138.00	$62.62–$131.10	—	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	$62.62–$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	$20.26–$147.41	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	$26.09–$54.63	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE	$98.41	$196.81	$41.28–$300.37	29% below	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE	$98.41	$196.81	$89.31–$186.97	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT PLASMA OR WHOLE BLOOD	$16.47	$32.94	$6.01–$43.72	53% below	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC CCH SO PTT PLASMA OR WHOLE BLOOD	$16.47	$32.94	$6.01–$43.72	53% below	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC CCH SO PTT PLASMA OR WHOLE BLOOD	$16.47	$32.94	$14.95–$31.29	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT PLASMA OR WHOLE BLOOD	$16.47	$32.94	$14.95–$31.29	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY ANALYSIS	$379.53	$759.05	$344.46–$5,523.01	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	$759.05–$5,523.01	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	$344.46–$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	$2,144.51–$4,489.39	—	50%
Progesterone blood test CPT 84144 HC PROGESTERONE	$45.68	$91.35	$20.86–$151.78	35% below	50%
Progesterone blood test inpatient CPT 84144 HC PROGESTERONE	$45.68	$91.35	$41.45–$86.78	—	50%
Prolactin blood test CPT 84146 HC PROLACTIN ASSAY	$46.20	$92.40	$19.38–$141.01	43% below	50%
Prolactin blood test inpatient CPT 84146 HC PROLACTIN ASSAY	$46.20	$92.40	$41.93–$87.78	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 HC CCH SO PROTHROMBIN TIME	$10.80	$21.59	$4.29–$31.21	54% below	50%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHOMBIN TIME	$10.80	$21.59	$4.29–$31.21	54% below	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHOMBIN TIME	$10.80	$21.59	$9.80–$20.51	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC CCH SO PROTHROMBIN TIME	$10.80	$21.59	$9.80–$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	$12.60–$91.68	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	$23.02–$48.18	—	50%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA IA W DIRECT OPTICAL	$32.68	$65.35	$16.55–$120.42	50% below	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA IA W DIRECT OPTICAL	$32.68	$65.35	$29.66–$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	$16.53–$120.29	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	$29.66–$62.08	—	50%
Rheumatoid factor (RF) test CPT 86431 HC SO QUAN RHEUM FACTOR	$13.53	$27.06	$5.67–$41.25	57% below	50%
Rheumatoid factor (RF) test CPT 86431 HC QUAN RHEUM FACTOR	$13.53	$27.06	$5.67–$41.25	57% below	50%
Rheumatoid factor (RF) test inpatient CPT 86431 HC QUAN RHEUM FACTOR	$13.53	$27.06	$12.28–$25.71	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 HC SO QUAN RHEUM FACTOR	$13.53	$27.06	$12.28–$25.71	—	50%
Rubella antibody test (immunity check) CPT 86762 HC SO RUBELLA ANTIBODY	$34.32	$68.64	$14.39–$104.71	at median	50%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY	$34.32	$68.64	$14.39–$104.71	at median	50%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY	$34.32	$68.64	$31.15–$65.21	—	50%
Rubella antibody test (immunity check) inpatient CPT 86762 HC SO RUBELLA ANTIBODY	$34.32	$68.64	$31.15–$65.21	—	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC AUTOM ERYTHROCTYE SED RATE	$7.41	$14.82	$2.70–$19.66	77% below	50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC AUTOM ERYTHROCTYE SED RATE	$7.41	$14.82	$6.73–$14.08	—	50%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC CCH SEMEN ANALYSIS VOLUME/COUNT/MOTILITY	$33.03	$66.06	$12.31–$89.57	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	$29.98–$62.76	—	50%
Stool ova and parasites exam CPT 87177 HC SO OVA & PARASITES DIR SMR W ID	$56.02	$112.03	$8.90–$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	$50.84–$106.43	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST	$10.19	$20.37	$4.27–$31.06	46% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SO SYPHILIS TEST	$10.19	$20.37	$4.27–$31.06	46% 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	$9.24–$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	$9.24–$19.35	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC SO TB TEST- CELL IMMUN MEASURE	$147.76	$295.51	$61.98–$450.97	33% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB TEST CELL IMMUN MEASURE	$147.76	$295.51	$61.98–$450.97	33% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC SO TB TEST- CELL IMMUN MEASURE	$147.76	$295.51	$134.10–$280.73	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB TEST CELL IMMUN MEASURE	$147.76	$295.51	$134.10–$280.73	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL	$48.57	$97.13	$25.81–$187.79	44% below	50%
Testosterone blood test, total (not free testosterone) CPT 84403 HC SO TESTOSTERONE TOTAL	$48.57	$97.13	$25.81–$187.79	44% below	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC SO TESTOSTERONE TOTAL	$48.57	$97.13	$44.08–$92.27	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL	$48.57	$97.13	$44.08–$92.27	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL AB EACH	$89.94	$179.87	$14.55–$170.88	53% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC CCH SO MICROSOMAL AB EACH	$89.94	$179.87	$14.55–$170.88	53% above	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL AB EACH	$89.94	$179.87	$81.63–$170.88	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC CCH SO MICROSOMAL AB EACH	$89.94	$179.87	$81.63–$170.88	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE	$40.06	$80.12	$16.80–$122.24	42% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC SO THYROID STIMULATING HORMONE	$40.06	$80.12	$16.80–$122.24	42% below	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC SO THYROID STIMULATING HORMONE	$40.06	$80.12	$36.36–$76.11	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE	$40.06	$80.12	$36.36–$76.11	—	50%
Trichomonas test (NAAT) CPT 87661 HC CCH TRICHOMONAS VAGINALIS AMPLIF	$45.73	$91.46	$35.09–$255.32	47% below	50%
Trichomonas test (NAAT) CPT 87661 HC SO TRICHOMONAS VAGINALIS AMPLIF - A	$45.73	$91.46	$35.09–$255.32	47% below	50%
Trichomonas test (NAAT) inpatient CPT 87661 HC CCH TRICHOMONAS VAGINALIS AMPLIF	$45.73	$91.46	$41.50–$86.89	—	50%
Trichomonas test (NAAT) inpatient CPT 87661 HC SO TRICHOMONAS VAGINALIS AMPLIF - A	$45.73	$91.46	$41.50–$86.89	—	50%
Uric acid blood test CPT 84550 HC URIC ACID BLOOD	$10.78	$21.56	$4.52–$32.88	68% below	50%
Uric acid blood test inpatient CPT 84550 HC URIC ACID BLOOD	$10.78	$21.56	$9.78–$20.48	—	50%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS TOTAL AUTOMATED W/ MICRO	$8.70	$17.39	$3.17–$23.07	67% below	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS TOTAL AUTOMATED W/ MICRO	$8.70	$17.39	$7.89–$16.52	—	50%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS TOTAL AUTOMATED W/O MICRO	$6.16	$12.32	$2.25–$16.38	73% below	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS TOTAL AUTOMATED W/O MICRO	$6.16	$12.32	$5.59–$11.70	—	50%
Urinalysis without microscope exam, manual CPT 81002 HC SO URINALYSIS TOTAL NON-AUTOMATED W/O MICRO	$6.33	$12.65	$3.48–$25.33	59% below	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC SO URINALYSIS TOTAL NON-AUTOMATED W/O MICRO	$6.33	$12.65	$5.74–$12.02	—	50%
Urine culture for bacteria, with colony count CPT 87086 HC BACT CULTURE - URINE QUAN COUNT	$14.13	$28.25	$8.07–$58.71	74% below	50%
Urine culture for bacteria, with colony count CPT 87086 HC CCH SO BACT CULTURE - URINE QUAN COUNT	$22.01	$44.01	$8.07–$58.71	60% below	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC BACT CULTURE - URINE QUAN COUNT	$14.13	$28.25	$12.82–$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	$19.97–$41.81	—	50%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY VISUAL COLOR	$17.33	$34.66	$8.61–$62.64	62% below	50%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY VISUAL COLOR	$17.33	$34.66	$15.73–$32.93	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12 LEVEL	$35.95	$71.89	$15.08–$109.73	50% below	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12 LEVEL	$35.95	$71.89	$32.62–$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	$29.60–$215.38	10% 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	$64.06–$134.10	—	50%
Zinc blood test CPT 84630 HC SO ZINC	$27.15	$54.29	$11.39–$82.88	36% below	50%
Zinc blood test inpatient CPT 84630 HC SO ZINC	$27.15	$54.29	$24.64–$51.58	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC SO HCG QUAN	$35.90	$71.79	$15.05–$109.51	47% below	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG QUAN	$35.90	$71.79	$15.05–$109.51	47% below	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG QUAN	$35.90	$71.79	$32.58–$68.20	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC SO HCG QUAN	$35.90	$71.79	$32.58–$68.20	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off 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	$1,577.02–$8,259.13	10% 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	$3,945.26–$8,259.13	—	50%
Cardiac catheterization with coronary angiogram CPT 93458 HC LHC W/ LV & CORONARY ANGIO	$12,523.50	$25,047.00	$3,095.54–$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	$11,366.33–$23,794.65	—	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE	$1,829.29	$3,658.57	$631.10–$3,475.64	11% below	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTIVE	$1,829.29	$3,658.57	$1,660.26–$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	$18,096.81–$68,633.26	32% 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	$18,096.81–$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	$1,995.99–$7,151.87	80% 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	$3,416.33–$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	$1,142.60–$8,015.00	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	$2,922.32–$6,117.69	—	50%
Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY FLEXIBLE W/ BX	$3,336.40	$6,672.80	$1,142.60–$8,015.00	at median	50%
Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY FLEXIBLE W/ BX	$3,336.40	$6,672.80	$3,028.12–$6,339.16	—	50%
Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY FLEXIBLE DIAGNOSTIC	$2,990.28	$5,980.55	$887.96–$5,681.52	9% above	50%
Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY FLEXIBLE DIAGNOSTIC	$2,990.28	$5,980.55	$2,713.97–$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	$11,022.89–$59,724.83	161% 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	$28,529.61–$59,724.83	—	50%
Cystoscopy with ureteral stent placement CPT 52332 HC CYSTOURETHROSCOPY W/ INSERTION URETERAL STENT	$12,674.97	$25,349.94	$3,365.80–$24,082.44	103% above	50%
Cystoscopy with ureteral stent placement inpatient CPT 52332 HC CYSTOURETHROSCOPY W/ INSERTION URETERAL STENT	$12,674.97	$25,349.94	$11,503.80–$24,082.44	—	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY	$1,226.48	$2,452.96	$665.81–$4,433.00	39% below	50%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY	$1,226.48	$2,452.96	$1,113.15–$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	$191.57–$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	$318.12–$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	$514.97–$3,555.85	170% 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	$1,698.57–$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	$56.33–$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	$198.12–$414.76	—	50%
Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN UNILATERAL	$218.30	$436.59	$56.33–$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	$198.12–$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	$674.01–$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	$2,714.46–$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	$844.53–$9,498.01	138% 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	$4,537.05–$9,498.01	—	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC	$2,171.79	$4,343.58	$887.96–$4,433.00	15% below	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC	$2,171.79	$4,343.58	$1,971.12–$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	$219.15–$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	$573.50–$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	$191.57–$693.71	4% below	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D ABSCESS SIMPLE	$365.11	$730.22	$331.37–$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	$293.09–$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	$984.59–$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	$293.09–$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	$1,380.87–$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	$127.04–$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	$1,978.60–$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	$293.09–$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	$1,323.33–$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	$293.09–$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	$1,208.26–$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	$674.01–$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	$2,120.14–$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	$844.53–$4,433.00	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	$1,484.75–$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	$844.53–$10,543.70	196% 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	$5,036.56–$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	$676.16–$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	$1,173.39–$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	$676.16–$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	$1,173.39–$2,456.42	—	50%
Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PLATE SINGLE	$365.11	$730.22	$191.57–$693.71	15% above	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION NAIL PLATE SINGLE	$365.11	$730.22	$331.37–$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	$293.09–$4,433.00	8% 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	$984.59–$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	$9,980.01–$35,520.54	47% above	50%
Pacemaker implant (dual chamber) inpatient CPT 33208 HC INSERT/REPLACE PM W/ TRANSVENOUS ELECTRODE ATRIAL & VENTRICLE	$18,695.02	$37,390.04	$16,967.60–$35,520.54	—	50%
Paracentesis with imaging guidance CPT 49083 HC ABDOMINAL PARACENTESIS W/ IMAGING GUIDANCE	$1,722.77	$3,445.53	$866.03–$4,433.00	at median	50%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOMINAL PARACENTESIS W/ IMAGING GUIDANCE	$1,722.77	$3,445.53	$1,563.58–$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	$1,864.55–$13,635.23	128% 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	$6,513.33–$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	$388.16–$4,433.00	12% above	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVAL FB SUBCUTANEOUS SIMPLE	$726.81	$1,453.62	$659.65–$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	$887.96–$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	$2,713.97–$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	$887.96–$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	$2,713.97–$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	$191.57–$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	$414.65–$868.04	—	50%
Skin biopsy, punch, one lesion CPT 11104 HC BX SKIN PUNCH FIRST LESION	$734.14	$1,468.28	$388.16–$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	$666.31–$1,394.87	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC	$1,272.51	$2,545.01	$674.01–$4,433.00	23% above	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC	$1,272.51	$2,545.01	$1,154.93–$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	$191.57–$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	$331.37–$693.71	—	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC BX SKIN TANGENTIAL FIRST LESION	$385.15	$770.30	$349.72–$1,067.43	28% above	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC BX SKIN TANGENTIAL FIRST LESION	$385.15	$770.30	$349.56–$731.79	—	50%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS W/ IMAGING GUIDANCE	$2,405.39	$4,810.77	$598.98–$4,570.23	32% above	50%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS W/ IMAGING GUIDANCE	$2,405.39	$4,810.77	$2,183.13–$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	$293.09–$1,030.59	26% below	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC TRIGGER POINT INJECTION 1-2 MUSCLES	$542.42	$1,084.83	$492.30–$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	$1,577.02–$8,015.00	10% 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	$3,179.35–$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	$1,832.26–$8,015.00	5% 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	$3,163.64–$6,622.87	—	50%
Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD FLEXIBLE TRANSORAL W/ BX	$2,883.30	$5,766.60	$866.03–$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	$2,616.88–$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	$866.03–$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	$2,573.25–$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	$1,832.26–$8,015.00	8% 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	$3,163.64–$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	$866.03–$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	$2,421.62–$5,069.50	—	50%
Upper endoscopy (EGD), diagnostic CPT 43235 HC EGD FLEXIBLE TRANSORAL DIAGNOSTIC	$2,594.85	$5,189.70	$866.03–$4,930.22	at median	50%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC EGD FLEXIBLE TRANSORAL DIAGNOSTIC	$2,594.85	$5,189.70	$2,355.09–$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	$5,796.75–$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	$9,177.03–$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	$3,014.90–$15,092.00	5% 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	$5,249.13–$10,988.71	—	50%
Wart removal, up to 14 warts CPT 17110 HC DESTRUCTION LESIONS BENIGN UP TO 14 LESIONS	$365.11	$730.22	$191.57–$693.71	35% above	50%
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCTION LESIONS BENIGN UP TO 14 LESIONS	$365.11	$730.22	$331.37–$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	$388.16–$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	$770.21–$1,612.38	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC TRANSFUSION BLOOD OR BLOOD COMPONENTS	$803.32	$1,606.64	$421.25–$1,526.31	31% below	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC TRANSFUSION BLOOD OR BLOOD COMPONENTS	$803.32	$1,606.64	$729.09–$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	$102.84–$574.99	37% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC HELIOX TX ACUTE AIRWAY OBSTRUCTION	$113.32	$226.63	$102.84–$574.99	37% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC IPPB TX	$113.32	$226.63	$102.84–$574.99	37% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC METERED DOSE INHALER TREATMENT	$355.94	$711.87	$209.09–$676.28	99% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AEROSOL OR NEBULIZER TREATMENT	$355.94	$711.87	$209.09–$676.28	99% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC IPV TX	$355.94	$711.87	$209.09–$676.28	99% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC HELIOX TX ACUTE AIRWAY OBSTRUCTION	$113.32	$226.63	$102.84–$215.30	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC IPPB TX	$113.32	$226.63	$102.84–$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	$102.84–$215.30	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC IPV TX	$355.94	$711.87	$323.05–$676.28	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AEROSOL OR NEBULIZER TREATMENT	$355.94	$711.87	$323.05–$676.28	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC METERED DOSE INHALER TREATMENT	$355.94	$711.87	$323.05–$676.28	—	50%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO ADMIN IV INITIAL UP TO 1 HOUR	$609.49	$1,218.97	$315.39–$1,158.02	18% below	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO ADMIN IV INITIAL UP TO 1 HOUR	$609.49	$1,218.97	$553.17–$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	$122.86–$534.03	at median	50%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC AUDIOMETRY THRESHOLD EVAL W/ SPEECH RECOGNITION	$281.07	$562.14	$255.10–$534.03	—	50%
Critical care, first 30 to 74 minutes CPT 99291 HC EMERGENCY ROOM CRITICAL CARE	$1,548.30	$3,096.60	$788.73–$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	$1,405.24–$2,941.77	—	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE & DROWSY	$806.63	$1,613.25	$206.17–$1,532.59	24% below	50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE & DROWSY	$806.63	$1,613.25	$732.09–$1,532.59	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG 12-LEAD	$161.53	$323.05	$56.33–$306.90	13% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG 12-LEAD	$161.53	$323.05	$146.60–$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	$80.52–$338.94	38% 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	$161.91–$338.94	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY ROOM LEVEL 2	$290.99	$581.97	$146.61–$552.87	43% below	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY ROOM LEVEL 2	$290.99	$581.97	$264.10–$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	$260.65–$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	$518.09–$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	$398.42–$3,251.00	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	$844.73–$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	$568.64–$7,143.00	28% 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	$1,022.47–$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	$206.17–$1,617.16	4% 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	$772.49–$1,617.16	—	50%
Family therapy with the patient, 50 minutes CPT 90847 HC PSYCHOTHERAPY FAMILY W/ PATIENT 50 MINUTES	$281.18	$562.35	$169.48–$534.23	1% below	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PSYCHOTHERAPY FAMILY W/ PATIENT 50 MINUTES	$281.18	$562.35	$255.19–$534.23	—	50%
Family therapy without the patient, 50 minutes CPT 90846 HC PSYCHOTHERAPY FAMILY W/O PATIENT 50 MINUTES	$196.88	$393.75	$169.48–$466.07	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	$178.68–$374.06	—	50%
Group psychotherapy session CPT 90853 HC CCH PSYCHOTHERAPY GROUP	$190.55	$381.09	$97.00–$362.04	15% above	50%
Group psychotherapy session inpatient CPT 90853 HC CCH PSYCHOTHERAPY GROUP	$190.55	$381.09	$172.94–$362.04	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRATION INITIAL HOUR	$413.44	$826.88	$203.10–$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	$375.24–$785.54	—	50%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION NON-CHEMO INITIAL HOUR	$421.71	$843.41	$203.10–$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	$382.74–$801.24	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION IM OR SQ	$130.78	$261.56	$68.75–$248.48	9% 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	$118.70–$248.48	—	50%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS	$121.14	$242.28	$31.37–$230.17	13% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS BY RECT	$121.14	$242.28	$31.37–$230.17	13% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS BY OT	$121.14	$242.28	$31.37–$230.17	13% above	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS	$121.14	$242.28	$109.95–$230.17	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS BY OT	$121.14	$242.28	$109.95–$230.17	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS BY RECT	$121.14	$242.28	$109.95–$230.17	—	50%
New patient office visit, about 30 minutes CPT 99203 HC CLINIC VISIT NEW PT LEVEL 3	$94.82	$189.63	$86.09–$309.37	5% below	50%
New patient office visit, about 30 minutes inpatient CPT 99203 HC CLINIC VISIT NEW PT LEVEL 3	$94.82	$189.63	$86.05–$180.15	—	50%
New patient office visit, about 45 minutes CPT 99204 HC CLINIC VISIT NEW PT LEVEL 4	$115.21	$230.42	$104.61–$468.17	14% below	50%
New patient office visit, about 45 minutes inpatient CPT 99204 HC CLINIC VISIT NEW PT LEVEL 4	$115.21	$230.42	$104.56–$218.90	—	50%
New patient office visit, about 60 minutes CPT 99205 HC CLINIC VISIT NEW PT LEVEL 5	$129.00	$257.99	$117.13–$625.69	28% below	50%
New patient office visit, about 60 minutes inpatient CPT 99205 HC CLINIC VISIT NEW PT LEVEL 5	$129.00	$257.99	$117.08–$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	$63.07–$196.73	23% 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	$63.04–$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	$35.12–$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	$84.52–$176.93	—	50%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION LOW COMPLEXITY	$234.28	$468.56	$96.30–$445.13	10% below	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION LOW COMPLEXITY	$234.28	$468.56	$212.63–$445.13	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION HIGH COMPLEXITY	$261.85	$523.69	$93.86–$497.51	12% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION HIGH COMPLEXITY	$261.85	$523.69	$237.65–$497.51	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION LOW COMPLEXITY	$220.50	$441.00	$93.86–$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	$200.13–$418.95	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION MODERATE COMPLEXITY	$234.28	$468.56	$93.86–$445.13	15% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION MODERATE COMPLEXITY	$234.28	$468.56	$212.63–$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	$26.59–$203.91	at median	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TECHNIQUES EACH 15 MINS	$107.32	$214.64	$26.59–$203.91	at median	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	$97.40–$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	$97.40–$203.91	—	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS BY RECT	$111.58	$223.15	$27.87–$211.99	at median	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS	$111.58	$223.15	$27.87–$211.99	at median	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS BY OT	$111.58	$223.15	$27.87–$211.99	at median	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	$101.27–$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	$101.27–$211.99	—	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	$101.27–$211.99	—	50%
Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W/ PT 30 MINUTES	$281.18	$562.35	$169.48–$534.23	55% above	50%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W/ PT 30 MINUTES	$281.18	$562.35	$255.19–$534.23	—	50%
Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY W/ PT 45 MINUTES	$281.18	$562.35	$169.48–$534.23	6% above	50%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY W/ PT 45 MINUTES	$281.18	$562.35	$255.19–$534.23	—	50%
Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY W/ PT 60 MINUTES	$281.18	$562.35	$169.48–$534.23	10% below	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY W/ PT 60 MINUTES	$281.18	$562.35	$255.19–$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	$35.78–$104.01	28% 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	$49.68–$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	$97.11–$507.25	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	$97.06–$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	$62.57–$250.18	36% 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	$62.54–$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	$78.58–$357.04	39% 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	$78.55–$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	$47.19–$155.39	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	$47.17–$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	$65.07–$297.96	50% 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	$65.04–$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	$95.10–$427.19	49% 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	$95.06–$199.01	—	50%
Speech and language evaluation CPT 92523 HC SPEECH EVALUATION SOUND PRODUCTION W/ LANGUAGE COMPREHENSION AND EXPRESSION	$502.60	$1,005.20	$217.95–$954.94	59% above	50%
Speech and language evaluation inpatient CPT 92523 HC SPEECH EVALUATION SOUND PRODUCTION W/ LANGUAGE COMPREHENSION AND EXPRESSION	$502.60	$1,005.20	$456.16–$954.94	—	50%
Speech therapy session, individual CPT 92507 HC SPEECH THERAPY INDIVIDUAL	$218.89	$437.78	$73.34–$415.89	5% below	50%
Speech therapy session, individual inpatient CPT 92507 HC SPEECH THERAPY INDIVIDUAL	$218.89	$437.78	$198.66–$415.89	—	50%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY VITAL CAPACITY W/ OR W/O MAXIMAL VOLUNTARY VENTILATION	$365.37	$730.73	$206.17–$694.19	26% above	50%
Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY VITAL CAPACITY W/ OR W/O MAXIMAL VOLUNTARY VENTILATION	$365.37	$730.73	$331.61–$694.19	—	50%
Spirometry before and after a bronchodilator CPT 94060 HC BRONCHODILATION RESPONSE PRE & POST BRONCHODILATOR ADMIN	$572.20	$1,144.40	$356.31–$1,087.18	1% above	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC BRONCHODILATION RESPONSE PRE & POST BRONCHODILATOR ADMIN	$572.20	$1,144.40	$519.33–$1,087.18	—	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUTIC ACTIVITIES DIRECT EACH 15 MINS	$122.20	$244.40	$33.33–$232.18	1% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPUETIC ACTIVITIES INDIVIDUAL EACH 15 MINS	$122.20	$244.40	$33.33–$232.18	1% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUTIC ACTIVITIES DIRECT- EACH 15 MINUTES BY OT	$122.20	$244.40	$33.33–$232.18	1% below	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPUETIC ACTIVITIES INDIVIDUAL EACH 15 MINS	$122.20	$244.40	$110.91–$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	$110.91–$232.18	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUTIC ACTIVITIES DIRECT EACH 15 MINS	$122.20	$244.40	$110.91–$232.18	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERAPEUTIC	$236.86	$473.71	$127.04–$450.02	6% below	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY THERAPEUTIC	$236.86	$473.71	$214.97–$450.02	—	50%
Visual field test, extended CPT 92083 HC EXAMINATION VISUAL FIELD EXTENDED	$236.86	$473.71	$127.04–$450.02	54% above	50%
Visual field test, extended inpatient CPT 92083 HC EXAMINATION VISUAL FIELD EXTENDED	$236.86	$473.71	$214.97–$450.02	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off 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	$0.02–$269.94	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	$0.02–$269.94	50% below	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	$34.04–$71.25	—	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	$34.03–$71.24	—	50%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC Sars-Cov-2 (Covid-19) Vaccine Omicron 50mg	$85.00	$170.00	$77.15–$444.54	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	$77.22–$444.54	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	$77.15–$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	$77.22–$161.65	—	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC Cch Varicella Virus Vaccine	$125.00	$250.00	$113.45–$466.69	65% below	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR	$893.91	$1,787.81	$341.26–$1,698.42	148% above	50%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC Cch Varicella Virus Vaccine	$125.00	$250.00	$113.45–$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	$811.31–$1,698.42	—	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	$0.02–$63.86	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	$9.98–$20.90	—	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC Hpv Vaccine Nonavalent 2 or 3 Dose Im	$200.00	$400.00	$181.52–$784.00	61% below	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSY	$1,531.66	$3,063.32	$573.29–$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	$181.52–$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	$1,390.13–$2,910.15	—	50%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HC Im Adult Hepa-Hepb	$87.50	$175.00	$79.42–$340.68	71% below	50%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HC Im Adult Hepa-Hepb	$87.50	$175.00	$79.42–$166.25	—	50%
Hepatitis A vaccine, adult dose CPT 90632 HC Im Adult Hep-a Vaccine	$62.50	$125.00	$56.73–$214.73	68% below	50%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 50 UNIT/ML IM SUSP	$389.29	$778.57	$149.67–$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	$149.67–$791.24	114% above	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC Im Adult Hep-a Vaccine	$62.50	$125.00	$56.73–$118.75	—	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 50 UNIT/ML IM SUSP	$389.29	$778.57	$353.32–$739.64	—	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSY	$416.44	$832.88	$377.96–$791.24	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC Hepatitis B Vaccine 3 Dose Im	$60.00	$120.00	$54.46–$206.65	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	$75.15–$583.13	98% 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	$75.15–$663.26	125% above	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC Hepatitis B Vaccine 3 Dose Im	$60.00	$120.00	$54.46–$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	$278.55–$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	$316.83–$663.26	—	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	$45.38–$269.94	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	$45.38–$95.00	—	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC Cch Mmr Vaccine	$75.00	$150.00	$68.07–$254.68	64% below	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR	$454.50	$908.99	$186.23–$863.54	118% above	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC Cch Mmr Vaccine	$75.00	$150.00	$68.07–$142.50	—	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR	$454.50	$908.99	$412.50–$863.54	—	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC Cch Meningococcal Conjugate Vaccine Im	$125.00	$250.00	$113.45–$420.57	61% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A C Y&W-135 OLIG IM SOLN	$822.17	$1,644.33	$307.54–$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	$307.54–$1,562.12	159% above	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC Cch Meningococcal Conjugate Vaccine Im	$125.00	$250.00	$113.45–$237.50	—	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A C Y&W-135 OLIG IM SOLN	$822.17	$1,644.33	$746.20–$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	$746.20–$1,562.12	—	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC Cch Menb Recombinant Prot Vaccine Im	$175.00	$350.00	$158.83–$591.70	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	$429.37–$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	$158.83–$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	$1,061.45–$2,222.07	—	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC Pneumococcal Vaccine 20 Valent Im	$181.00	$362.00	$164.28–$827.61	73% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HC Pneumococcal Vaccine 20 Valent Im	$181.00	$362.00	$164.28–$343.90	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOSY	$29.50	$59.00	$26.77–$389.33	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	$68.07–$389.33	72% 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	$26.77–$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	$68.07–$142.50	—	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	$302.68–$1,386.00	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	$324.04–$1,386.00	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	$302.68–$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	$324.04–$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	$0.02–$826.00	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	$0.02–$826.00	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	$167.00–$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	$173.75–$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	$714.00–$2,430.10	274% 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	$714.00–$2,710.08	317% 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	$1,160.82–$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	$1,294.56–$2,710.08	—	50%
Rabies vaccine, one dose CPT 90675 HC Cch Rabies Vaccine Im	$300.00	$600.00	$272.28–$1,061.30	69% below	50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC IM SUSR	$2,023.54	$4,047.07	$315.22–$3,844.72	112% above	50%
Rabies vaccine, one dose inpatient CPT 90675 HC Cch Rabies Vaccine Im	$300.00	$600.00	$272.28–$570.00	—	50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC IM SUSR	$2,023.54	$4,047.07	$1,836.56–$3,844.72	—	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC Shingrix 50mcg	$150.00	$300.00	$136.14–$513.55	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	$365.96–$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	$365.96–$2,146.72	124% above	50%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HC Shingrix 50mcg	$150.00	$300.00	$136.14–$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	$991.74–$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	$1,025.46–$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	$27.23–$81.03	66% 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	$59.25–$513.75	203% 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	$27.23–$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	$245.41–$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	$45.38–$129.03	55% below	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	$79.99–$513.75	145% above	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	$79.99–$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	$45.38–$95.00	—	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	$245.41–$513.75	—	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	$245.41–$513.75	—	50%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 HC Cch Typhoid Vaccine Im	$66.00	$132.00	$59.90–$245.93	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	$179.83–$1,429.58	162% above	50%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 HC Cch Typhoid Vaccine Im	$66.00	$132.00	$59.90–$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	$682.89–$1,429.58	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC VACCINE ADMINISTRATION INITIAL	$130.78	$261.56	$68.75–$248.48	226% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC VACCINE ADMINISTRATION INITIAL	$130.78	$261.56	$118.70–$248.48	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC VACCINE ADMINISTRATION EACH ADDITIONAL	$28.74	$57.47	$15.11–$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	$26.08–$54.60	—	50%

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/10272/314379443_adena-health-system_standardcharges.csv