Southern NH Medical Center
Southern NH Medical Center in Nashua, NH publishes cash prices for 311 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the New Hampshire median for 259 of 304 procedures and above it for 33. By typical cash price it ranks #2 of 15 New Hampshire hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
8 Prospect Street, Nashua, NH 03060 Collected Sep 27, 2026 Source price file (603) 577-2000
Acute care hospital Emergency department CMS star rating 2 of 5 CCN 300020 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs New Hampshire | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE MIN 3 VIEWS | $239.76 | $648.00 | — | at median | 63% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE MIN 3 VIEWS | $239.76 | $648.00 | — | — | 63% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC NON INVASIVE LIMITED BILAT EXTREMITY ARTERIES | $288.23 | $779.00 | — | — | 63% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC NON INVASIVE LIMITED BILAT EXTREMITY ARTERIES | $288.23 | $779.00 | — | — | 63% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR ESOPHAGUS | $406.63 | $1,099.00 | — | 35% below | 63% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC XR ESOPHAGUS | $406.63 | $1,099.00 | — | — | 63% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE/JOINT IMAGING WHOLE BODY | $1,312.02 | $3,546.00 | — | 44% below | 63% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE/JOINT IMAGING WHOLE BODY | $1,312.02 | $3,546.00 | — | — | 63% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST UNILAT COMPLETE | $296.74 | $802.00 | — | 20% below | 63% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US BREAST UNILAT COMPLETE | $296.74 | $802.00 | — | — | 63% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED | $296.74 | $802.00 | — | 9% below | 63% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED | $296.74 | $802.00 | — | — | 63% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA CHEST WITH CONTRAST | $735.56 | $1,988.00 | — | 63% below | 63% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CTA CHEST WITH CONTRAST | $735.56 | $1,988.00 | — | — | 63% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CTA HEART W/3D IMAGE | $997.89 | $2,697.00 | — | 92% below | 63% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CTA HEART W/3D IMAGE | $997.89 | $2,697.00 | — | — | 63% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT CALCIUM SCORING SELF PAY | $37.00 | $100.00 | — | 86% below | 63% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT CALCIUM SCORING | $252.34 | $682.00 | — | 4% below | 63% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT CALCIUM SCORING SELF PAY | $37.00 | $100.00 | — | — | 63% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT CALCIUM SCORING | $252.34 | $682.00 | — | — | 63% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABDOMEN & PELVIS WO CONTRAST | $1,192.51 | $3,223.00 | — | 48% below | 63% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABDOMEN & PELVIS WO CONTRAST | $1,192.51 | $3,223.00 | — | — | 63% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS WITH CONTRAST | $1,699.04 | $4,592.00 | — | 33% below | 63% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS WITH CONTRAST | $1,699.04 | $4,592.00 | — | — | 63% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS WO&W CONTRAST | $1,789.32 | $4,836.00 | — | 41% below | 63% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN & PELVIS WO&W CONTRAST | $1,789.32 | $4,836.00 | — | — | 63% |
| CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN WITH CONTRAST | $801.79 | $2,167.00 | — | 52% below | 63% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN WITH CONTRAST | $801.79 | $2,167.00 | — | — | 63% |
| CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST | $708.18 | $1,914.00 | — | 48% below | 63% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST | $708.18 | $1,914.00 | — | — | 63% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST | $508.01 | $1,373.00 | — | 70% below | 63% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST | $508.01 | $1,373.00 | — | — | 63% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD WO CONTRAST | $650.46 | $1,758.00 | — | 51% below | 63% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD WO CONTRAST | $650.46 | $1,758.00 | — | — | 63% |
| CT scan of the head with contrast CPT 70460 HC CT HEAD WITH CONTRAST | $708.18 | $1,914.00 | — | 56% below | 63% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD WITH CONTRAST | $708.18 | $1,914.00 | — | — | 63% |
| CT scan of the head without and with contrast CPT 70470 HC CT HEAD WO&W CONTRAST | $765.53 | $2,069.00 | — | 63% below | 63% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD WO&W CONTRAST | $765.53 | $2,069.00 | — | — | 63% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT SPINE LUMBAR WO CONTRAST | $653.42 | $1,766.00 | — | 69% below | 63% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT SPINE LUMBAR WO CONTRAST | $653.42 | $1,766.00 | — | — | 63% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT SPINE CERVICAL WO CONTRAST | $644.54 | $1,742.00 | — | 68% below | 63% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT SPINE CERVICAL WO CONTRAST | $644.54 | $1,742.00 | — | — | 63% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS WITH CONTRAST | $1,076.33 | $2,909.00 | — | 35% below | 63% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS WITH CONTRAST | $1,076.33 | $2,909.00 | — | — | 63% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HC USV DUPLEX EXTRACRANIAL ARTERIES COMPLETE | $801.05 | $2,165.00 | — | 79% below | 63% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 HC USV DUPLEX EXTRACRANIAL ARTERIES COMPLETE | $801.05 | $2,165.00 | — | — | 63% |
| Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS | $183.15 | $495.00 | — | 45% below | 63% |
| Chest X-ray, 2 views inpatient CPT 71046 HC XR CHEST 2 VIEWS | $183.15 | $495.00 | — | — | 63% |
| Chest X-ray, single view CPT 71045 HC XR CHEST 1 VIEW | $117.66 | $318.00 | — | 52% below | 63% |
| Chest X-ray, single view inpatient CPT 71045 HC XR CHEST 1 VIEW | $117.66 | $318.00 | — | — | 63% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE (76770) | $727.79 | $1,967.00 | — | 9% above | 63% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE (76770) | $727.79 | $1,967.00 | — | — | 63% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC XR BONE DENSITY HIP/PELVIS/SPINE | $300.44 | $812.00 | — | 32% below | 63% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC XR BONE DENSITY HIP/PELVIS/SPINE | $300.44 | $812.00 | — | — | 63% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC XR BONE DENSITY WRIST/HEEL | $255.30 | $690.00 | — | 34% below | 63% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC XR BONE DENSITY WRIST/HEEL | $255.30 | $690.00 | — | — | 63% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST WO CONTRAST DIAGNOSTIC | $603.47 | $1,631.00 | — | 62% below | 63% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT CHEST WO CONTRAST DIAGNOSTIC | $603.47 | $1,631.00 | — | — | 63% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT CHEST WITH CONTRAST DIAGNOSTIC | $775.15 | $2,095.00 | — | 53% below | 63% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT CHEST WITH CONTRAST DIAGNOSTIC | $775.15 | $2,095.00 | — | — | 63% |
| Diagnostic mammogram, both breasts CPT 77066 HC BIL MAMMO DX INCL CAD | $347.43 | $939.00 | — | 31% below | 63% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 HC BIL MAMMO DX INCL CAD | $347.43 | $939.00 | — | — | 63% |
| Diagnostic mammogram, one breast one side CPT 77065 HC MAMMOGRAM DIAGNOSTIC UNILATERAL INCL CAD | $276.76 | $748.00 | — | 9% below | 63% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC MAMMOGRAM DIAGNOSTIC UNILATERAL INCL CAD | $276.76 | $748.00 | — | — | 63% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC USV DUPLEX LOWER EXTREMITY COMPLETE BILAT ARTERIAL | $655.64 | $1,772.00 | — | — | 63% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC USV DUPLEX LOWER EXTREMITY COMPLETE BILAT ARTERIAL | $655.64 | $1,772.00 | — | — | 63% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC USV DUPLEX EXTREMITY COMPLETE BILAT VENOUS | $655.64 | $1,772.00 | — | — | 63% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC USV DUPLEX EXTREMITY COMPLETE BILAT VENOUS | $655.64 | $1,772.00 | — | — | 63% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO REALTIME COMPL W/DOPPLER W/CONTR (M-MODE) | $1,295.00 | $3,500.00 | — | 19% below | 63% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO CARD REALTIME COMPL W/DOPPLER (M-MODE) | $1,295.00 | $3,500.00 | — | 19% below | 63% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO REALTIME COMPL W/DOPPLER W/CONTR (M-MODE) | $1,295.00 | $3,500.00 | — | — | 63% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO CARD REALTIME COMPL W/DOPPLER (M-MODE) | $1,295.00 | $3,500.00 | — | — | 63% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY IMAGING | $1,282.05 | $3,465.00 | — | 30% below | 63% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM HEPATOBILIARY IMAGING | $1,282.05 | $3,465.00 | — | — | 63% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC HOME SLEEP TEST W/PORTABLE MONITOR | $589.04 | $1,592.00 | — | 32% below | 63% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC HOME SLEEP TEST W/PORTABLE MONITOR | $589.04 | $1,592.00 | — | — | 63% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOM 6/> CPAP 4/>PARM | $2,829.76 | $7,648.00 | — | 58% below | 63% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOM 6/> CPAP 4/>PARM | $2,829.76 | $7,648.00 | — | — | 63% |
| Knee X-ray, 3 views CPT 73562 KNEE 3 VIEW | $211.27 | $571.00 | — | 15% below | 63% |
| Knee X-ray, 3 views inpatient CPT 73562 KNEE 3 VIEW | $211.27 | $571.00 | — | — | 63% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED | $508.01 | $1,373.00 | — | 2% below | 63% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED | $508.01 | $1,373.00 | — | — | 63% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LUNG CANCER SCR C- | $522.44 | $1,412.00 | — | 43% below | 63% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX LUNG CANCER SCR C- | $522.44 | $1,412.00 | — | — | 63% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI BREAST W & W/O CONTRAST CAD BI | $1,768.97 | $4,781.00 | — | — | 63% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MRI BREAST W & W/O CONTRAST CAD BI | $1,768.97 | $4,781.00 | — | — | 63% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 EXT LWR JT W/O CONT | $1,408.96 | $3,808.00 | — | 14% below | 63% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 EXT LWR JT W/O CONT | $1,408.96 | $3,808.00 | — | — | 63% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 EXT LWR JT WO/W CONT | $1,704.96 | $4,608.00 | — | 34% below | 63% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 EXT LWR JT WO/W CONT | $1,704.96 | $4,608.00 | — | — | 63% |
| MRI of the abdomen without contrast CPT 74181 HC MR ABDOMEN WO CONTRAST | $1,149.59 | $3,107.00 | — | 43% below | 63% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MR ABDOMEN WO CONTRAST | $1,149.59 | $3,107.00 | — | — | 63% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MR ABDOMEN WO&W CONTRAST | $1,648.72 | $4,456.00 | — | 58% below | 63% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MR ABDOMEN WO&W CONTRAST | $1,648.72 | $4,456.00 | — | — | 63% |
| MRI of the brain, no contrast dye CPT 70551 HC MR BRAIN WO CONTRAST | $1,335.70 | $3,610.00 | — | 42% below | 63% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MR BRAIN WO CONTRAST | $1,335.70 | $3,610.00 | — | — | 63% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MR BRAIN WO&W CONTRAST | $2,140.82 | $5,786.00 | — | 56% below | 63% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MR BRAIN WO&W CONTRAST | $2,140.82 | $5,786.00 | — | — | 63% |
| MRI of the lower back, no contrast dye CPT 72148 HC MR SPINE LUMBAR WO CONTRAST | $1,386.39 | $3,747.00 | — | 44% below | 63% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MR SPINE LUMBAR WO CONTRAST | $1,386.39 | $3,747.00 | — | — | 63% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MR SPINE LUMBAR WO&W CONTRAST | $1,677.21 | $4,533.00 | — | 65% below | 63% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MR SPINE LUMBAR WO&W CONTRAST | $1,677.21 | $4,533.00 | — | — | 63% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MR SPINE THORACIC WO CONTRAST | $772.93 | $2,089.00 | — | 62% below | 63% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MR SPINE THORACIC WO CONTRAST | $772.93 | $2,089.00 | — | — | 63% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MR SPINE CERVICAL WO&W CONTRAST | $1,058.20 | $2,860.00 | — | 75% below | 63% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MR SPINE CERVICAL WO&W CONTRAST | $1,058.20 | $2,860.00 | — | — | 63% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MR SPINE CERVICAL WO CONTRAST | $598.66 | $1,618.00 | — | 76% below | 63% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MR SPINE CERVICAL WO CONTRAST | $598.66 | $1,618.00 | — | — | 63% |
| MRI of the pelvis without and with contrast CPT 72197 HC MR PELVIS WO&W CONTRAST | $1,644.28 | $4,444.00 | — | 62% below | 63% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MR PELVIS WO&W CONTRAST | $1,644.28 | $4,444.00 | — | — | 63% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MR PELVIS WO CONTRAST | $1,149.96 | $3,108.00 | — | 42% below | 63% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MR PELVIS WO CONTRAST | $1,149.96 | $3,108.00 | — | — | 63% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 EXT-UPR JT W/O CONT | $867.65 | $2,345.00 | — | 50% below | 63% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 EXT-UPR JT W/O CONT | $867.65 | $2,345.00 | — | — | 63% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM MYOCARDIAL PERFUSION MULTI SPECT | $2,207.79 | $5,967.00 | — | 20% below | 63% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM MYOCARDIAL PERFUSION MULTI SPECT | $2,207.79 | $5,967.00 | — | — | 63% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET W/CT SKULL BASE TO MID THIGH | $3,764.38 | $10,174.00 | — | 3% below | 63% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET W/CT SKULL BASE TO MID THIGH | $3,764.38 | $10,174.00 | — | — | 63% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIS LIMITED | $374.44 | $1,012.00 | — | at median | 63% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIS LIMITED | $374.44 | $1,012.00 | — | — | 63% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIS COMPLETE | $374.44 | $1,012.00 | — | 41% below | 63% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIS COMPLETE | $374.44 | $1,012.00 | — | — | 63% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB 2ND/3RD TRIMESTER >14 WKS | $517.26 | $1,398.00 | — | 15% below | 63% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB 2ND/3RD TRIMESTER >14 WKS | $517.26 | $1,398.00 | — | — | 63% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US PREG UTRS <14 WKS 0 DAYS-SNGL/1ST GEST (76801) | $348.17 | $941.00 | — | 46% below | 63% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US PREG UTRS <14 WKS 0 DAYS-SNGL/1ST GEST (76801) | $348.17 | $941.00 | — | — | 63% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED | $333.37 | $901.00 | — | 20% below | 63% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED | $333.37 | $901.00 | — | — | 63% |
| Screening mammogram, both breasts both sides CPT 77067 HC BI MAMMOGRAM SCREENING BILAT | $314.50 | $850.00 | — | — | 63% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC BI MAMMOGRAM SCREENING BILAT | $314.50 | $850.00 | — | — | 63% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN 2 VIEWS | $233.84 | $632.00 | — | at median | 63% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER MIN 2 VIEWS | $233.84 | $632.00 | — | — | 63% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY 4+ ADD'L PARAM (6 OR OLDER) | $2,543.75 | $6,875.00 | — | 58% below | 63% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY 4+ ADD'L PARAM (6 OR OLDER) | $2,543.75 | $6,875.00 | — | — | 63% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC STRESS TTE COMPLETE W/CONT ECG W/CONTRAST | $1,591.37 | $4,301.00 | — | 5% below | 63% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC STRESS TTE COMPLETE W/CONT ECG | $1,591.37 | $4,301.00 | — | 5% below | 63% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC STRESS TTE COMPLETE W/CONT ECG | $1,591.37 | $4,301.00 | — | — | 63% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC STRESS TTE COMPLETE W/CONT ECG W/CONTRAST | $1,591.37 | $4,301.00 | — | — | 63% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR SWALLOWING WITH SPEECH EVAL | $324.49 | $877.00 | — | 46% below | 63% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC XR SWALLOWING WITH SPEECH EVAL | $324.49 | $877.00 | — | — | 63% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON-OB | $429.94 | $1,162.00 | — | 38% below | 63% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON-OB | $429.94 | $1,162.00 | — | — | 63% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL | $434.38 | $1,174.00 | — | 18% below | 63% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL | $434.38 | $1,174.00 | — | — | 63% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMPLETE | $579.79 | $1,567.00 | — | 37% below | 63% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN COMPLETE | $579.79 | $1,567.00 | — | — | 63% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM | $374.44 | $1,012.00 | — | 36% below | 63% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM | $374.44 | $1,012.00 | — | — | 63% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US SOFT TISSUE HEAD/NECK | $374.44 | $1,012.00 | — | 26% below | 63% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US SOFT TISSUE HEAD/NECK | $374.44 | $1,012.00 | — | — | 63% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC X-RAY XM UPR GI TRC 1 CONTRAST | $452.14 | $1,222.00 | — | 34% below | 63% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC X-RAY XM UPR GI TRC 1 CONTRAST | $452.14 | $1,222.00 | — | — | 63% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC USV DUPLEX EXTREMITY LIMITED/UNILAT VENOUS | $327.82 | $886.00 | — | 63% below | 63% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC USV DUPLEX EXTREMITY LIMITED/UNILAT VENOUS | $327.82 | $886.00 | — | — | 63% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST MIN 3 VIEWS | $246.42 | $666.00 | — | 4% below | 63% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST MIN 3 VIEWS | $246.42 | $666.00 | — | — | 63% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC XR HIP 2-3 VIEWS UNILATIERAL | $250.12 | $676.00 | — | 14% below | 63% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC XR HIP 2-3 VIEWS UNILATIERAL | $250.12 | $676.00 | — | — | 63% |
| X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW | $223.11 | $603.00 | — | 17% below | 63% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN 1 VIEW | $223.11 | $603.00 | — | — | 63% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE 2VIEW AP&LAT | $210.53 | $569.00 | — | 10% above | 63% |
| X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2VIEW AP&LAT | $210.53 | $569.00 | — | — | 63% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGER(S) 2+ VIEWS | $194.62 | $526.00 | — | 7% above | 63% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XR FINGER(S) 2+ VIEWS | $194.62 | $526.00 | — | — | 63% |
| X-ray of the foot, 2 views CPT 73620 FOOT 2 VIEWS | $156.14 | $422.00 | — | 6% below | 63% |
| X-ray of the foot, 2 views inpatient CPT 73620 FOOT 2 VIEWS | $156.14 | $422.00 | — | — | 63% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT MIN 3 VIEWS | $207.94 | $562.00 | — | at median | 63% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT MIN 3 VIEWS | $207.94 | $562.00 | — | — | 63% |
| X-ray of the hand, 3 or more views CPT 73130 HAND MIN 3 VIEWS PER SIDE | $361.86 | $978.00 | — | 42% above | 63% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND MIN 3 VIEWS PER SIDE | $361.86 | $978.00 | — | — | 63% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1/2 VIEWS | $189.44 | $512.00 | — | 8% below | 63% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 1/2 VIEWS | $189.44 | $512.00 | — | — | 63% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR SPINE LUMBAR 2-3 VIEWS | $277.87 | $751.00 | — | 18% below | 63% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC XR SPINE LUMBAR 2-3 VIEWS | $277.87 | $751.00 | — | — | 63% |
| X-ray of the lower back, 4 or more views CPT 72110 HC XR SPINE LUMBAR 4+ VIEWS | $286.75 | $775.00 | — | 25% below | 63% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC XR SPINE LUMBAR 4+ VIEWS | $286.75 | $775.00 | — | — | 63% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC SPINE THORACIC 2 VIEWS | $218.30 | $590.00 | — | 25% below | 63% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC SPINE THORACIC 2 VIEWS | $218.30 | $590.00 | — | — | 63% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC NASAL BONES 3+ VIEWS | $209.05 | $565.00 | — | 23% below | 63% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC NASAL BONES 3+ VIEWS | $209.05 | $565.00 | — | — | 63% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR SPINE CERVICAL 2-3 VIEWS | $213.12 | $576.00 | — | 24% below | 63% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC XR SPINE CERVICAL 2-3 VIEWS | $213.12 | $576.00 | — | — | 63% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1-2 VIEWS | $171.68 | $464.00 | — | 34% below | 63% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC XR PELVIS 1-2 VIEWS | $171.68 | $464.00 | — | — | 63% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC XR SACRUM/COCCYX 1-2 VIEWS | $205.72 | $556.00 | — | 30% below | 63% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC XR SACRUM/COCCYX 1-2 VIEWS | $205.72 | $556.00 | — | — | 63% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs New Hampshire | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO ALT SGPT | $24.42 | $66.00 | — | 65% below | 63% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO ALT SGPT | $24.42 | $66.00 | — | — | 63% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT | $31.08 | $84.00 | — | 54% below | 63% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT | $31.08 | $84.00 | — | — | 63% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC ACUTE HEPATITIS PANEL | $108.78 | $294.00 | — | 78% below | 63% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC ACUTE HEPATITIS PANEL | $108.78 | $294.00 | — | — | 63% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH | $28.49 | $77.00 | — | 11% below | 63% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH | $28.49 | $77.00 | — | — | 63% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY | $95.83 | $259.00 | — | 28% below | 63% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY | $95.83 | $259.00 | — | — | 63% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA | $76.22 | $206.00 | — | 37% below | 63% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA | $76.22 | $206.00 | — | — | 63% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE | $94.72 | $256.00 | — | 56% below | 63% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE | $94.72 | $256.00 | — | — | 63% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL | $36.26 | $98.00 | — | 48% below | 63% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL | $36.26 | $98.00 | — | — | 63% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM | $147.63 | $399.00 | — | 34% below | 63% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM PROSTATE ONLY | $159.10 | $430.00 | — | 28% below | 63% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM | $147.63 | $399.00 | — | — | 63% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM PROSTATE ONLY | $159.10 | $430.00 | — | — | 63% |
| Blood culture for bacteria CPT 87040 HC CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES | $148.74 | $402.00 | — | 6% below | 63% |
| Blood culture for bacteria inpatient CPT 87040 HC CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES | $148.74 | $402.00 | — | — | 63% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE | $10.36 | $28.00 | — | 48% below | 63% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC VENIPUNCTURE | $10.36 | $28.00 | — | — | 63% |
| Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP | $16.28 | $44.00 | — | 59% below | 63% |
| Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP | $16.28 | $44.00 | — | — | 63% |
| Blood lead test CPT 83655 HC ASSAY OF LEAD | $74.00 | $200.00 | — | 45% below | 63% |
| Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD | $74.00 | $200.00 | — | — | 63% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE | $33.67 | $91.00 | — | 66% below | 63% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE | $33.67 | $91.00 | — | — | 63% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO | $48.84 | $132.00 | — | 19% below | 63% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO | $48.84 | $132.00 | — | — | 63% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN | $54.76 | $148.00 | — | 35% below | 63% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN | $54.76 | $148.00 | — | — | 63% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE | $100.64 | $272.00 | — | 52% below | 63% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE | $100.64 | $272.00 | — | — | 63% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9 | $132.83 | $359.00 | — | 37% below | 63% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9 | $132.83 | $359.00 | — | — | 63% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 | $105.82 | $286.00 | — | 54% below | 63% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 | $105.82 | $286.00 | — | — | 63% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV2 AMP PROBE | $157.25 | $425.00 | — | 1% above | 63% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV2 AMP PROBE | $157.25 | $425.00 | — | — | 63% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ | $123.58 | $334.00 | — | 30% below | 63% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ | $123.58 | $334.00 | — | — | 63% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $56.24 | $152.00 | — | 46% below | 63% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $56.24 | $152.00 | — | — | 63% |
| Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $40.70 | $110.00 | — | 14% below | 63% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $40.70 | $110.00 | — | — | 63% |
| Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED | $29.97 | $81.00 | — | 49% below | 63% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED | $29.97 | $81.00 | — | — | 63% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL | $45.14 | $122.00 | — | 54% below | 63% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL | $45.14 | $122.00 | — | — | 63% |
| D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE | $38.48 | $104.00 | — | 71% below | 63% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE | $38.48 | $104.00 | — | — | 63% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE | $91.76 | $248.00 | — | 39% below | 63% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE | $91.76 | $248.00 | — | — | 63% |
| Estradiol blood test CPT 82670 HC ESTRADIOL TOTAL | $107.67 | $291.00 | — | 33% below | 63% |
| Estradiol blood test inpatient CPT 82670 HC ESTRADIOL TOTAL | $107.67 | $291.00 | — | — | 63% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE | $65.12 | $176.00 | — | 51% below | 63% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE | $65.12 | $176.00 | — | — | 63% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY OF CALPROTECTIN FECAL | $222.74 | $602.00 | — | 10% below | 63% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY OF CALPROTECTIN FECAL | $222.74 | $602.00 | — | — | 63% |
| Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN | $64.01 | $173.00 | — | 32% below | 63% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN | $64.01 | $173.00 | — | — | 63% |
| Folate (folic acid) blood test CPT 82746 HC ASSAY OF FOLIC ACID SERUM | $49.58 | $134.00 | — | 46% below | 63% |
| Folate (folic acid) blood test inpatient CPT 82746 HC ASSAY OF FOLIC ACID SERUM | $49.58 | $134.00 | — | — | 63% |
| Free T3 thyroid hormone test CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE | $93.24 | $252.00 | — | 56% below | 63% |
| Free T3 thyroid hormone test inpatient CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE | $93.24 | $252.00 | — | — | 63% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE | $48.10 | $130.00 | — | 58% below | 63% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE | $48.10 | $130.00 | — | — | 63% |
| Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE | $112.48 | $304.00 | — | 45% below | 63% |
| Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE | $112.48 | $304.00 | — | — | 63% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE | $26.27 | $71.00 | — | 49% below | 63% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE | $26.27 | $71.00 | — | — | 63% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS | $54.39 | $147.00 | — | 66% below | 63% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS | $54.39 | $147.00 | — | — | 63% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ | $123.58 | $334.00 | — | 37% below | 63% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ | $123.58 | $334.00 | — | — | 63% |
| H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL | $84.73 | $229.00 | — | 34% below | 63% |
| H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL | $84.73 | $229.00 | — | — | 63% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION | $364.82 | $986.00 | — | 32% below | 63% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION | $364.82 | $986.00 | — | — | 63% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE | $119.14 | $322.00 | — | at median | 63% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE | $119.14 | $322.00 | — | — | 63% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES | $211.27 | $571.00 | — | 8% above | 63% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES | $211.27 | $571.00 | — | — | 63% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C | $42.18 | $114.00 | — | 47% below | 63% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C | $42.18 | $114.00 | — | — | 63% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB | $62.53 | $169.00 | — | 49% below | 63% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB | $62.53 | $169.00 | — | — | 63% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN | $71.41 | $193.00 | — | 31% below | 63% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN | $71.41 | $193.00 | — | — | 63% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY | $86.21 | $233.00 | — | 47% below | 63% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY | $86.21 | $233.00 | — | — | 63% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION | $276.02 | $746.00 | — | 48% below | 63% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION | $276.02 | $746.00 | — | — | 63% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 | $63.27 | $171.00 | — | 57% below | 63% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 | $63.27 | $171.00 | — | — | 63% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 | $66.23 | $179.00 | — | 61% below | 63% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 | $66.23 | $179.00 | — | — | 63% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY | $92.87 | $251.00 | — | 10% below | 63% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY | $92.87 | $251.00 | — | — | 63% |
| Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTEINE | $97.31 | $263.00 | — | 43% below | 63% |
| Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTEINE | $97.31 | $263.00 | — | — | 63% |
| Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL | $72.15 | $195.00 | — | 50% below | 63% |
| Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL | $72.15 | $195.00 | — | — | 63% |
| Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON | $32.93 | $89.00 | — | 59% below | 63% |
| Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON | $32.93 | $89.00 | — | — | 63% |
| Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY | $38.48 | $104.00 | — | 25% below | 63% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY | $38.48 | $104.00 | — | — | 63% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $45.14 | $122.00 | — | 59% below | 63% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL | $45.14 | $122.00 | — | — | 63% |
| LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE | $65.12 | $176.00 | — | 60% below | 63% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE | $65.12 | $176.00 | — | — | 63% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE | $42.92 | $116.00 | — | 43% below | 63% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE | $42.92 | $116.00 | — | — | 63% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL | $39.22 | $106.00 | — | 59% below | 63% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL | $39.22 | $106.00 | — | — | 63% |
| Lyme disease antibody test CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE | $42.55 | $115.00 | — | 63% below | 63% |
| Lyme disease antibody test CPT 86618 LVL II | $48.84 | $132.00 | — | 57% below | 63% |
| Lyme disease antibody test inpatient CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE | $42.55 | $115.00 | — | — | 63% |
| Lyme disease antibody test inpatient CPT 86618 LVL II | $48.84 | $132.00 | — | — | 63% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM | $37.37 | $101.00 | — | 28% below | 63% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM | $37.37 | $101.00 | — | — | 63% |
| Measles (rubeola) antibody test CPT 86765 HC ANTIBODY RUBEOLA | $60.68 | $164.00 | — | 55% below | 63% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC ANTIBODY RUBEOLA | $60.68 | $164.00 | — | — | 63% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES SCREEN | $48.47 | $131.00 | — | 24% below | 63% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES SCREEN | $48.47 | $131.00 | — | — | 63% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $66.60 | $180.00 | — | 63% below | 63% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $66.60 | $180.00 | — | — | 63% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $69.56 | $188.00 | — | 35% below | 63% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $69.56 | $188.00 | — | — | 63% |
| Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS | $92.87 | $251.00 | — | 10% below | 63% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS | $92.87 | $251.00 | — | — | 63% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN | $89.91 | $243.00 | — | 11% below | 63% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN | $89.91 | $243.00 | — | — | 63% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE | $130.24 | $352.00 | — | 44% below | 63% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE | $130.24 | $352.00 | — | — | 63% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $43.66 | $118.00 | — | 37% below | 63% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $43.66 | $118.00 | — | — | 63% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHRMOML ANEUPLOIDY ANALYSIS PANEL | $3,121.69 | $8,437.00 | — | 36% above | 63% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHRMOML ANEUPLOIDY ANALYSIS PANEL | $3,121.69 | $8,437.00 | — | — | 63% |
| Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE | $82.88 | $224.00 | — | 59% below | 63% |
| Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE | $82.88 | $224.00 | — | — | 63% |
| Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN | $83.62 | $226.00 | — | 65% below | 63% |
| Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN | $83.62 | $226.00 | — | — | 63% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $35.52 | $96.00 | — | 30% below | 63% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $35.52 | $96.00 | — | — | 63% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE | $56.61 | $153.00 | — | 102% above | 63% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE | $56.61 | $153.00 | — | — | 63% |
| Rapid flu test (influenza antigen) CPT 87804 HC IAADIADOO INFLUENZA | $76.22 | $206.00 | — | 42% below | 63% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 HC IAADIADOO INFLUENZA | $76.22 | $206.00 | — | — | 63% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC IAADIADOO STREPTOCOCCUS GROUP A | $74.74 | $202.00 | — | 3% below | 63% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC IAADIADOO STREPTOCOCCUS GROUP A | $74.74 | $202.00 | — | — | 63% |
| Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE | $54.39 | $147.00 | — | 24% below | 63% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE | $54.39 | $147.00 | — | — | 63% |
| Rubella antibody test (immunity check) CPT 86762 HC ANTIBODY RUBELLA | $66.97 | $181.00 | — | 23% below | 63% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC ANTIBODY RUBELLA | $66.97 | $181.00 | — | — | 63% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC SEDIMENTATION RATE RBC AUTOMATED | $22.57 | $61.00 | — | 38% below | 63% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC SEDIMENTATION RATE RBC AUTOMATED | $22.57 | $61.00 | — | — | 63% |
| Stool ova and parasites exam CPT 87177 HC OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID | $68.82 | $186.00 | — | 38% below | 63% |
| Stool ova and parasites exam inpatient CPT 87177 HC OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID | $68.82 | $186.00 | — | — | 63% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER | $18.50 | $50.00 | — | 62% below | 63% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER | $18.50 | $50.00 | — | — | 63% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 | $42.18 | $114.00 | — | 76% below | 63% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 | $42.18 | $114.00 | — | — | 63% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL | $29.23 | $79.00 | — | 33% below | 63% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL | $29.23 | $79.00 | — | — | 63% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON II | $81.77 | $221.00 | — | 62% below | 63% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON | $165.39 | $447.00 | — | 24% below | 63% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON II | $81.77 | $221.00 | — | — | 63% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON | $165.39 | $447.00 | — | — | 63% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL | $112.48 | $304.00 | — | 52% below | 63% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL | $112.48 | $304.00 | — | — | 63% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODIES EACH | $132.46 | $358.00 | — | 9% below | 63% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODIES EACH | $132.46 | $358.00 | — | — | 63% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH | $59.94 | $162.00 | — | 51% below | 63% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH | $59.94 | $162.00 | — | — | 63% |
| Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH | $146.15 | $395.00 | — | 37% below | 63% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH | $146.15 | $395.00 | — | — | 63% |
| Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID | $26.27 | $71.00 | — | 57% below | 63% |
| Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID | $26.27 | $71.00 | — | — | 63% |
| Urinalysis without microscope exam, automated CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $20.72 | $56.00 | — | 19% below | 63% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $20.72 | $56.00 | — | — | 63% |
| Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $17.02 | $46.00 | — | 10% below | 63% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $17.02 | $46.00 | — | — | 63% |
| Urine culture for bacteria, with colony count CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE | $42.55 | $115.00 | — | 51% below | 63% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE | $42.55 | $115.00 | — | — | 63% |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS | $34.78 | $94.00 | — | 22% below | 63% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS | $34.78 | $94.00 | — | — | 63% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC CYANOCOBALAMIN VITAMIN B-12 | $64.01 | $173.00 | — | 36% below | 63% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC CYANOCOBALAMIN VITAMIN B-12 | $64.01 | $173.00 | — | — | 63% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED | $87.32 | $236.00 | — | 49% below | 63% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED | $87.32 | $236.00 | — | — | 63% |
| Zinc blood test CPT 84630 HC ASSAY OF ZINC | $88.06 | $238.00 | — | 24% below | 63% |
| Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC | $88.06 | $238.00 | — | — | 63% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE | $70.30 | $190.00 | — | 62% below | 63% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LEVEL 2 | $70.30 | $190.00 | — | 62% below | 63% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE | $70.30 | $190.00 | — | — | 63% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LEVEL 2 | $70.30 | $190.00 | — | — | 63% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs New Hampshire | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST WITH STEREO GUIDANCE 1ST LESION | $2,750.58 | $7,434.00 | — | 6% below | 63% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST WITH STEREO GUIDANCE 1ST LESION | $2,750.58 | $7,434.00 | — | — | 63% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC PROF CLSD TX,METRSAL FX W/O MANIP EA | $141.34 | $382.00 | — | 38% below | 63% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CLSD TX,METRSAL FX W/O MANIP EA | $337.07 | $911.00 | — | 47% above | 63% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC PROF CLSD TX,METRSAL FX W/O MANIP EA | $141.34 | $382.00 | — | — | 63% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CLSD TX,METRSAL FX W/O MANIP EA | $337.07 | $911.00 | — | — | 63% |
| Cardiac catheterization with coronary angiogram CPT 93458 HC CORONARY ANGIO WITH LHC | $5,965.88 | $16,124.00 | — | 27% below | 63% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC CORONARY ANGIO WITH LHC | $5,965.88 | $16,124.00 | — | — | 63% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC PROF. CARDIOVERSION 92960 | $118.77 | $321.00 | — | 88% below | 63% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION EXTERNAL W/CS | $1,204.35 | $3,255.00 | — | 21% above | 63% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC PROF. CARDIOVERSION 92960 | $118.77 | $321.00 | — | — | 63% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION EXTERNAL W/CS | $1,204.35 | $3,255.00 | — | — | 63% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION CLMP/DEV OTH PLASTIBEL (54150) | $422.54 | $1,142.00 | — | 3% below | 63% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION CLMP/DEV OTH PLASTIBEL (54150) | $422.54 | $1,142.00 | — | — | 63% |
| Circumcision, surgical, older than a newborn CPT 54160 HC CIRCUM SURG NON-CLAMP<28DAYS (54160) | $422.54 | $1,142.00 | — | 11% below | 63% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 HC CIRCUM SURG NON-CLAMP<28DAYS (54160) | $422.54 | $1,142.00 | — | — | 63% |
| Colonoscopy with polyp removal CPT 45385 HC COLONOSCOPY W/RMVL TMR/POLYP/LSN SNARE W/CS | $1,512.19 | $4,087.00 | — | at median | 63% |
| Colonoscopy with polyp removal inpatient CPT 45385 HC COLONOSCOPY W/RMVL TMR/POLYP/LSN SNARE W/CS | $1,512.19 | $4,087.00 | — | — | 63% |
| Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY W/BIOPSY SNGL/MULTI W/CS | $1,512.19 | $4,087.00 | — | at median | 63% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY W/BIOPSY SNGL/MULTI W/CS | $1,512.19 | $4,087.00 | — | — | 63% |
| Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY DIAG INCL SPEC COLLECT BRUSH/WASHING W/CS | $1,254.67 | $3,391.00 | — | 2% below | 63% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY DIAG INCL SPEC COLLECT BRUSH/WASHING W/CS | $1,254.67 | $3,391.00 | — | — | 63% |
| Coronary stent placement, one artery CPT 92928 HC CORONARY TX DE STENT | $5,384.24 | $14,552.00 | — | 38% below | 63% |
| Coronary stent placement, one artery inpatient CPT 92928 HC CORONARY TX DE STENT | $5,384.24 | $14,552.00 | — | — | 63% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC MOD CYSTOURETHROSCOPY DX(DIST) | $278.61 | $753.00 | — | 72% below | 63% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC MOD CYSTOURETHROSCOPY DX(DIST) | $278.61 | $753.00 | — | — | 63% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 HC D&C - LDRP | $3,277.83 | $8,859.00 | — | 77% above | 63% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC D&C - LDRP | $3,277.83 | $8,859.00 | — | — | 63% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC PROF. REMOVE IMPACTED EAR WAX UNI 69209 | $16.28 | $44.00 | — | 82% below | 63% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMPACT CERUMEN W/IRRIGATION | $55.13 | $149.00 | — | 39% below | 63% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC PROF. REMOVE IMPACTED EAR WAX UNI 69209 | $16.28 | $44.00 | — | — | 63% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM IMPACT CERUMEN W/IRRIGATION | $55.13 | $149.00 | — | — | 63% |
| Earwax removal with instruments, one ear CPT 69210 HC PROF. REMOVE IMPACT CERUMEN, 1/BTH 69210 | $58.46 | $158.00 | — | 26% below | 63% |
| Earwax removal with instruments, one ear one side CPT 69210 HC REMVL IMPACTED CERUMEN REQ INSTRUMENTATION UNILAT | $55.13 | $149.00 | — | 30% below | 63% |
| Earwax removal with instruments, one ear inpatient CPT 69210 HC PROF. REMOVE IMPACT CERUMEN, 1/BTH 69210 | $58.46 | $158.00 | — | — | 63% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMVL IMPACTED CERUMEN REQ INSTRUMENTATION UNILAT | $55.13 | $149.00 | — | — | 63% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ED PROF BIOPSY OF UTERUS LINING | $75.11 | $203.00 | — | 62% below | 63% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC BIOPSY OF UTERUS LINING | $481.00 | $1,300.00 | — | 142% above | 63% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ED PROF BIOPSY OF UTERUS LINING | $75.11 | $203.00 | — | — | 63% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC BIOPSY OF UTERUS LINING | $481.00 | $1,300.00 | — | — | 63% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX INTERLAMINAR CRV/THRC W/IMG GDN | $1,074.85 | $2,905.00 | — | 8% below | 63% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC NJX INTERLAMINAR CRV/THRC W/IMG GDN | $1,074.85 | $2,905.00 | — | — | 63% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ DX/THERA AGENT JT LUMB/SACR SNGL W/FLUORO OR CT | $1,955.45 | $5,285.00 | — | 38% above | 63% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ DX/THERA AGENT JT LUMB/SACR SNGL W/FLUORO OR CT | $1,955.45 | $5,285.00 | — | — | 63% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC SIGMOIDOSCOPY DIAG INCL SPEC COLLECT BRUSH/WASHING | $499.50 | $1,350.00 | — | 17% below | 63% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC SIGMOIDOSCOPY DIAG INCL SPEC COLLECT BRUSH/WASHING | $499.50 | $1,350.00 | — | — | 63% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC INJECTION,HYSTEROSALPING | $198.32 | $536.00 | — | 39% below | 63% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC INJECTION,HYSTEROSALPING | $198.32 | $536.00 | — | — | 63% |
| IUD insertion (the device itself billed separately) CPT 58300 HC INSERTION IUD | $604.58 | $1,634.00 | — | 33% above | 63% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERTION IUD | $604.58 | $1,634.00 | — | — | 63% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC PROF. I&D ABSCESS SIMPLE 10060 | $152.81 | $413.00 | — | 28% below | 63% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSCESS SIMPLE/SINGLE | $264.18 | $714.00 | — | 24% above | 63% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D SOFT TISSUE SIMPLE/SINGLE | $459.17 | $1,241.00 | — | 115% above | 63% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC PROF. I&D ABSCESS SIMPLE 10060 | $152.81 | $413.00 | — | — | 63% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D ABSCESS SIMPLE/SINGLE | $264.18 | $714.00 | — | — | 63% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D SOFT TISSUE SIMPLE/SINGLE | $459.17 | $1,241.00 | — | — | 63% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ(S) TENDON SHEATH/LIGAMENT | $553.89 | $1,497.00 | — | 88% above | 63% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJ(S) TENDON SHEATH/LIGAMENT | $553.89 | $1,497.00 | — | — | 63% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PROF. ARTHROCNTSIS/ASP MAJ JNT BUR 20610 | $96.57 | $261.00 | — | 72% below | 63% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ASP/INJ MAJOR JOINT/BURSA WO US GUIDANCE | $370.74 | $1,002.00 | — | 6% above | 63% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC PROF. ARTHROCNTSIS/ASP MAJ JNT BUR 20610 | $96.57 | $261.00 | — | — | 63% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ASP/INJ MAJOR JOINT/BURSA WO US GUIDANCE | $370.74 | $1,002.00 | — | — | 63% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC PROF. ARTHROCNTSIS/ASPIR INTRM JNT 20605 | $81.03 | $219.00 | — | 71% below | 63% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ASP/INJ INTERMEDIATE JOINT/BURSA WO US GUIDANCE | $370.74 | $1,002.00 | — | 31% above | 63% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INTERMEDIATE JOINT/BURSA WO US GUIDANCE | $581.64 | $1,572.00 | — | 105% above | 63% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC PROF. ARTHROCNTSIS/ASPIR INTRM JNT 20605 | $81.03 | $219.00 | — | — | 63% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ASP/INJ INTERMEDIATE JOINT/BURSA WO US GUIDANCE | $370.74 | $1,002.00 | — | — | 63% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ INTERMEDIATE JOINT/BURSA WO US GUIDANCE | $581.64 | $1,572.00 | — | — | 63% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC PROF. ARTHROCNTSIS/ASPIR SMALL JNT 20600 | $77.70 | $210.00 | — | 71% below | 63% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ SML JT/BURSA | $327.82 | $886.00 | — | 24% above | 63% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ASP/INJ SMALL JOINT/BURSA WO US GUIDANCE | $327.82 | $886.00 | — | 24% above | 63% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC PROF. ARTHROCNTSIS/ASPIR SMALL JNT 20600 | $77.70 | $210.00 | — | — | 63% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ASP/INJ SMALL JOINT/BURSA WO US GUIDANCE | $327.82 | $886.00 | — | — | 63% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ SML JT/BURSA | $327.82 | $886.00 | — | — | 63% |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 HC LDRP HYSTERECTOMY | $2,727.27 | $7,371.00 | — | — | 63% |
| Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 HC LDRP HYSTERECTOMY | $2,727.27 | $7,371.00 | — | — | 63% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 HC LDRP HYSTERECTOMY | $2,727.27 | $7,371.00 | — | — | 63% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 HC LDRP HYSTERECTOMY | $2,727.27 | $7,371.00 | — | — | 63% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC PROF. LAC LAYER CLOSURE<2.5 CM 12031 | $197.21 | $533.00 | — | 30% below | 63% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC REPR INTERM WOUND < 2.5CM SCL TRK EXT | $470.27 | $1,271.00 | — | 68% above | 63% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC REPR INTERM WND SCLP TRNK EXT 2.5 CM/LESS | $471.01 | $1,273.00 | — | 68% above | 63% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC PROF. LAC LAYER CLOSURE<2.5 CM 12031 | $197.21 | $533.00 | — | — | 63% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC REPR INTERM WOUND < 2.5CM SCL TRK EXT | $470.27 | $1,271.00 | — | — | 63% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC REPR INTERM WND SCLP TRNK EXT 2.5 CM/LESS | $471.01 | $1,273.00 | — | — | 63% |
| Left heart catheterization, diagnostic CPT 93452 HC LHC | $2,553.37 | $6,901.00 | — | 4% below | 63% |
| Left heart catheterization, diagnostic inpatient CPT 93452 HC LHC | $2,553.37 | $6,901.00 | — | — | 63% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC NJX INTERLAMINAR LMBR/SAC W/IMG GDN | $1,074.85 | $2,905.00 | — | 6% above | 63% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC NJX INTERLAMINAR LMBR/SAC W/IMG GDN | $1,074.85 | $2,905.00 | — | — | 63% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX INTERLAMINAR LMBR/SAC | $540.57 | $1,461.00 | — | 39% below | 63% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX INTERLAMINAR LMBR/SAC | $540.57 | $1,461.00 | — | — | 63% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ SNGL MVR RT L/S TRANSFRM INCL FLUORO | $1,944.72 | $5,256.00 | — | 67% above | 63% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ SNGL MVR RT L/S TRANSFRM INCL FLUORO | $1,944.72 | $5,256.00 | — | — | 63% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC SKN LSN B9+MARG.5CM/< | $405.15 | $1,095.00 | — | 30% above | 63% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC SKN LSN B9+MARG.5CM/< | $405.15 | $1,095.00 | — | — | 63% |
| Nail removal (partial or complete), one nail CPT 11730 HC PROF. AVULSN NAIL PLT PRT/TOT SMPL 11730 | $131.35 | $355.00 | — | 14% below | 63% |
| Nail removal (partial or complete), one nail CPT 11730 HC NAILPLATE AVULDSION | $264.18 | $714.00 | — | 72% above | 63% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC PROF. AVULSN NAIL PLT PRT/TOT SMPL 11730 | $131.35 | $355.00 | — | — | 63% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC NAILPLATE AVULDSION | $264.18 | $714.00 | — | — | 63% |
| Occipital nerve block (injection for headaches) CPT 64405 HC OCCIPITAL NERVE BLOCK | $597.55 | $1,615.00 | — | 53% above | 63% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC OCCIPITAL NERVE BLOCK | $597.55 | $1,615.00 | — | — | 63% |
| Pacemaker implant (dual chamber) CPT 33208 HC INSERT NEW/REPLACE PPM RA & RV | $5,595.88 | $15,124.00 | — | at median | 63% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 HC INSERT NEW/REPLACE PPM RA & RV | $5,595.88 | $15,124.00 | — | — | 63% |
| Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING ED | $1,230.25 | $3,325.00 | — | 9% above | 63% |
| Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING IR | $1,375.29 | $3,717.00 | — | 22% above | 63% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABD PARACENTESIS W/IMAGING ED | $1,230.25 | $3,325.00 | — | — | 63% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABD PARACENTESIS W/IMAGING IR | $1,375.29 | $3,717.00 | — | — | 63% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC PROF. EXCISE NAIL FOR PERM REMOVAL 11750 | $179.45 | $485.00 | — | 67% below | 63% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC EXC NAIL MATRIX PART/COMP PERM RMVL | $470.27 | $1,271.00 | — | 13% below | 63% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC PROF. EXCISE NAIL FOR PERM REMOVAL 11750 | $179.45 | $485.00 | — | — | 63% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC EXC NAIL MATRIX PART/COMP PERM RMVL | $470.27 | $1,271.00 | — | — | 63% |
| Removal of a foreign object under the skin, simple CPT 10120 HC PROF. REMVL FB,SUBCUTANEOUS SIMPLE 10120 | $109.52 | $296.00 | — | 60% below | 63% |
| Removal of a foreign object under the skin, simple CPT 10120 HC REMOVAL FB SUBCUTANEOUS | $470.27 | $1,271.00 | — | 71% above | 63% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC PROF. REMVL FB,SUBCUTANEOUS SIMPLE 10120 | $109.52 | $296.00 | — | — | 63% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVAL FB SUBCUTANEOUS | $470.27 | $1,271.00 | — | — | 63% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC SCREENING COLONOSCOPY LOW RISK | $1,406.74 | $3,802.00 | — | 3% below | 63% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC SCREENING COLONOSCOPY LOW RISK | $1,406.74 | $3,802.00 | — | — | 63% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC SCREENING COLONOSCOPY HIGH RISK | $1,406.74 | $3,802.00 | — | 6% below | 63% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC SCREENING COLONOSCOPY HIGH RISK | $1,406.74 | $3,802.00 | — | — | 63% |
| Short arm splint (forearm and hand) CPT 29125 HC PROF. APP.SHRT ARM SP 29125 | $70.30 | $190.00 | — | 53% below | 63% |
| Short arm splint (forearm and hand) CPT 29125 HC SHORT ARM SPLINT | $178.71 | $483.00 | — | 21% above | 63% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC PROF. APP.SHRT ARM SP 29125 | $70.30 | $190.00 | — | — | 63% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC SHORT ARM SPLINT | $178.71 | $483.00 | — | — | 63% |
| Short leg cast (below the knee) CPT 29405 HC APPL,SHORT LEG CAST | $113.96 | $308.00 | — | 52% below | 63% |
| Short leg cast (below the knee) CPT 29405 HC PROF. APP.SHRT.LEG CA 29405 | $140.60 | $380.00 | — | 41% below | 63% |
| Short leg cast (below the knee) inpatient CPT 29405 HC APPL,SHORT LEG CAST | $113.96 | $308.00 | — | — | 63% |
| Short leg cast (below the knee) inpatient CPT 29405 HC PROF. APP.SHRT.LEG CA 29405 | $140.60 | $380.00 | — | — | 63% |
| Short leg splint (calf to foot) CPT 29515 HC PROF. APP.SHRT LG.SPL 29515 | $82.14 | $222.00 | — | 33% below | 63% |
| Short leg splint (calf to foot) CPT 29515 HC SPLINT-SHORT LEG | $201.65 | $545.00 | — | 65% above | 63% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC PROF. APP.SHRT LG.SPL 29515 | $82.14 | $222.00 | — | — | 63% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC SPLINT-SHORT LEG | $201.65 | $545.00 | — | — | 63% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC PROF. LAC REPAIR SIMPLE<2.5 CM -12001 | $161.32 | $436.00 | — | 11% below | 63% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC 2.5CM SCALP,NECK,TRNK,EXT SM | $271.21 | $733.00 | — | 49% above | 63% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC PROF. LAC REPAIR SIMPLE<2.5 CM -12001 | $161.32 | $436.00 | — | — | 63% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC 2.5CM SCALP,NECK,TRNK,EXT SM | $271.21 | $733.00 | — | — | 63% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC LUMBAR PUNCTURE DX | $849.89 | $2,297.00 | — | 43% above | 63% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC LUMBAR PUNCTURE DX | $849.89 | $2,297.00 | — | — | 63% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC PROF. LAC REPAIR SIMPLE 2.6-7.5 CM 12002 | $202.76 | $548.00 | — | 8% above | 63% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC SIM-2.6-7.5CMSCL,NK,TRUNK,EX | $344.10 | $930.00 | — | 83% above | 63% |
| 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 PROF. LAC REPAIR SIMPLE 2.6-7.5 CM 12002 | $202.76 | $548.00 | — | — | 63% |
| 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 SIM-2.6-7.5CMSCL,NK,TRUNK,EX | $344.10 | $930.00 | — | — | 63% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC PROF. LAC REPAIR SIMPLE<2.5 CM 12011 | $201.65 | $545.00 | — | 17% above | 63% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC SIM-O-2.5CM FACE,EAR,NSE,LIP | $264.18 | $714.00 | — | 54% above | 63% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC PROF. LAC REPAIR SIMPLE<2.5 CM 12011 | $201.65 | $545.00 | — | — | 63% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC SIM-O-2.5CM FACE,EAR,NSE,LIP | $264.18 | $714.00 | — | — | 63% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS WITH GUIDANCE | $1,106.67 | $2,991.00 | — | 2% above | 63% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS WITH GUIDANCE | $1,106.67 | $2,991.00 | — | — | 63% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC PROF INJ TRIGGER PT 1-2 MUSCLES | $44.40 | $120.00 | — | 84% below | 63% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ TRIGGER PT 1-2 MUSCL | $370.74 | $1,002.00 | — | 34% above | 63% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ SNGL/MULT TRIG PTS 1 / 2 MUSCLES | $553.89 | $1,497.00 | — | 101% above | 63% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC PROF INJ TRIGGER PT 1-2 MUSCLES | $44.40 | $120.00 | — | — | 63% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ TRIGGER PT 1-2 MUSCL | $370.74 | $1,002.00 | — | — | 63% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ SNGL/MULT TRIG PTS 1 / 2 MUSCLES | $553.89 | $1,497.00 | — | — | 63% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST WITH US GUIDANCE 1ST LESION | $1,492.58 | $4,034.00 | — | 36% below | 63% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST WITH US GUIDANCE 1ST LESION | $1,492.58 | $4,034.00 | — | — | 63% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC EGD/DIL BALLOON W/CS | $1,488.51 | $4,023.00 | — | 8% above | 63% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC EGD/DIL BALLOON W/CS | $1,488.51 | $4,023.00 | — | — | 63% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD/BIOPSY/SNGL/MULTI W/CS | $1,299.81 | $3,513.00 | — | 4% above | 63% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD/BIOPSY/SNGL/MULTI W/CS | $1,299.81 | $3,513.00 | — | — | 63% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 HC EGD W/INJ ANY SUBSTANCE W/CS | $1,299.81 | $3,513.00 | — | 3% below | 63% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC EGD W/INJ ANY SUBSTANCE W/CS | $1,299.81 | $3,513.00 | — | — | 63% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC EGD/POLYPECTOMY W/CS | $1,723.46 | $4,658.00 | — | at median | 63% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC EGD/POLYPECTOMY W/CS | $1,723.46 | $4,658.00 | — | — | 63% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC EGD/DIL OVER WIRE ESOPH W/CS | $1,299.81 | $3,513.00 | — | 7% below | 63% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC EGD/DIL OVER WIRE ESOPH W/CS | $1,299.81 | $3,513.00 | — | — | 63% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC EGD W/CS | $1,299.81 | $3,513.00 | — | at median | 63% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC EGD W/CS | $1,299.81 | $3,513.00 | — | — | 63% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HC EGD W/TRANSMURAL DRAIN CYST | $4,043.73 | $10,929.00 | — | 110% above | 63% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 HC EGD W/TRANSMURAL DRAIN CYST | $4,043.73 | $10,929.00 | — | — | 63% |
| Vein ablation, radiofrequency, first vein one side CPT 36475 HC ENDOVENOUS ABLATION 1 VEIN RAD RT | $4,890.66 | $13,218.00 | — | 55% above | 63% |
| Vein ablation, radiofrequency, first vein inpatient one side CPT 36475 HC ENDOVENOUS ABLATION 1 VEIN RAD RT | $4,890.66 | $13,218.00 | — | — | 63% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SUBCUT TISSUE 1ST 20 SQCM/LESS | $1,069.67 | $2,891.00 | — | 226% above | 63% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDE SUBCUT TISSUE 1ST 20 SQCM/LESS | $1,069.67 | $2,891.00 | — | — | 63% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs New Hampshire | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SNH PACU | $757.02 | $2,046.00 | — | 26% below | 63% |
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION | $757.02 | $2,046.00 | — | 26% below | 63% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION | $757.02 | $2,046.00 | — | — | 63% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION SNH PACU | $757.02 | $2,046.00 | — | — | 63% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TX | $271.58 | $734.00 | — | 12% above | 63% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AIRWAY INHALATION TX | $271.58 | $734.00 | — | — | 63% |
| Chemotherapy IV infusion, first hour CPT 96413 HC BIO/CHEM/COMPLEX IV INFUSED 1ST HR | $524.66 | $1,418.00 | — | 2% below | 63% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC BIO/CHEM/COMPLEX IV INFUSED 1ST HR | $524.66 | $1,418.00 | — | — | 63% |
| Critical care, first 30 to 74 minutes CPT 99291 HC PROF. CRITICAL CARE, FIRST HOUR 99291 | $331.89 | $897.00 | — | 84% below | 63% |
| Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE 1ST HOUR | $1,736.04 | $4,692.00 | — | 17% below | 63% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC PROF. CRITICAL CARE, FIRST HOUR 99291 | $331.89 | $897.00 | — | — | 63% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE 1ST HOUR | $1,736.04 | $4,692.00 | — | — | 63% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG REGULAR AWAKE & DROWSY | $587.19 | $1,587.00 | — | 46% below | 63% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG REGULAR AWAKE & DROWSY | $587.19 | $1,587.00 | — | — | 63% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG | $113.59 | $307.00 | — | 35% below | 63% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG | $113.59 | $307.00 | — | — | 63% |
| Electroconvulsive therapy (ECT), one session CPT 90870 HC ECT SINGLE | $714.47 | $1,931.00 | — | 72% below | 63% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HC ECT SINGLE | $714.47 | $1,931.00 | — | — | 63% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC PROF EMERGENCY CARE DR. LVL 1 | $56.98 | $154.00 | — | 71% below | 63% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC E/R LEVEL 1/ REMVL SUT ELSEWHERE | $182.04 | $492.00 | — | 7% below | 63% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC PROF EMERGENCY CARE DR. LVL 1 | $56.98 | $154.00 | — | — | 63% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC E/R LEVEL 1/ REMVL SUT ELSEWHERE | $182.04 | $492.00 | — | — | 63% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC PROF EMERGENCY CARE DR. LVL 2 | $87.69 | $237.00 | — | 69% below | 63% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC E/R LEVEL 2 | $289.34 | $782.00 | — | 1% above | 63% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC PROF EMERGENCY CARE DR. LVL 2 | $87.69 | $237.00 | — | — | 63% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC E/R LEVEL 2 | $289.34 | $782.00 | — | — | 63% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC PROF EMERGENCY CARE DR. LVL 3 | $128.39 | $347.00 | — | 76% below | 63% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC E/R LEVEL 3 | $532.06 | $1,438.00 | — | at median | 63% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC PROF EMERGENCY CARE DR. LVL 3 | $128.39 | $347.00 | — | — | 63% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC E/R LEVEL 3 | $532.06 | $1,438.00 | — | — | 63% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC PROF EMERGENCY CARE DR. LVL 4 | $200.54 | $542.00 | — | 79% below | 63% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC E/R LEVEL 4 | $946.83 | $2,559.00 | — | at median | 63% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC PROF EMERGENCY CARE DR. LVL 4 | $200.54 | $542.00 | — | — | 63% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC E/R LEVEL 4 | $946.83 | $2,559.00 | — | — | 63% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC PROF EMERGENCY CARE DR. LVL 5 | $239.39 | $647.00 | — | 82% below | 63% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC E/R LEVEL 5 | $1,308.69 | $3,537.00 | — | 1% above | 63% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC PROF EMERGENCY CARE DR. LVL 5 | $239.39 | $647.00 | — | — | 63% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC E/R LEVEL 5 | $1,308.69 | $3,537.00 | — | — | 63% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC ECG STRESS | $767.75 | $2,075.00 | — | 17% below | 63% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC ECG STRESS | $767.75 | $2,075.00 | — | — | 63% |
| Group psychotherapy session CPT 90853 PHP, GROUP PSYCHOTHERAPY | $94.72 | $256.00 | — | 81% below | 63% |
| Group psychotherapy session inpatient CPT 90853 PHP, GROUP PSYCHOTHERAPY | $94.72 | $256.00 | — | — | 63% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV HYDRATION INITIAL UP TO 1HR | $269.73 | $729.00 | — | 28% below | 63% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV HYDRATION INITIAL UP TO 1HR | $269.73 | $729.00 | — | — | 63% |
| IV infusion of a medicine, first hour CPT 96365 HC PROF. BHU - IV INF INIT UP TO 1 HR BY PROVIDER | $79.55 | $215.00 | — | 76% below | 63% |
| IV infusion of a medicine, first hour CPT 96365 HC IV DRUG INF INITIAL UP TO 1 HR TX RM | $298.22 | $806.00 | — | 10% below | 63% |
| IV infusion of a medicine, first hour CPT 96365 HC IV DRUG INF INITIAL UP TO 1 HR | $298.22 | $806.00 | — | 10% below | 63% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC PROF. BHU - IV INF INIT UP TO 1 HR BY PROVIDER | $79.55 | $215.00 | — | — | 63% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV DRUG INF INITIAL UP TO 1 HR | $298.22 | $806.00 | — | — | 63% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV DRUG INF INITIAL UP TO 1 HR TX RM | $298.22 | $806.00 | — | — | 63% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC PROF. BHU - INJ-SUBQ/IM BY PROVIDER | $18.50 | $50.00 | — | 74% below | 63% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THER/PROPH/DIAG INJ SC/IM | $91.39 | $247.00 | — | 27% above | 63% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ DRUG/ANTIB SC/IM ADMIN | $91.39 | $247.00 | — | 27% above | 63% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ DRUG/ANTIB SC/IM ADMIN TX RM | $91.39 | $247.00 | — | 27% above | 63% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC PROF. BHU - INJ-SUBQ/IM BY PROVIDER | $18.50 | $50.00 | — | — | 63% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ DRUG/ANTIB SC/IM ADMIN TX RM | $91.39 | $247.00 | — | — | 63% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THER/PROPH/DIAG INJ SC/IM | $91.39 | $247.00 | — | — | 63% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ DRUG/ANTIB SC/IM ADMIN | $91.39 | $247.00 | — | — | 63% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCH DIAGNOSTIC EVALUATION | $257.52 | $696.00 | — | at median | 63% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCH DIAGNOSTIC EVALUATION | $257.52 | $696.00 | — | — | 63% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC TELEHEALTH OT NM RE-EDUC MVT-BAL/PST-UNIT | $61.05 | $165.00 | — | 29% below | 63% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC PT NM RE-EDUC MVT-BAL/PST-UNIT | $61.05 | $165.00 | — | 29% below | 63% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC OT NM RE-EDUC MVT-BAL/PST-UNIT | $61.05 | $165.00 | — | 29% below | 63% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC OT NM RE-EDUC MVT-BAL/PST-UNIT | $61.05 | $165.00 | — | — | 63% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC TELEHEALTH OT NM RE-EDUC MVT-BAL/PST-UNIT | $61.05 | $165.00 | — | — | 63% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT NM RE-EDUC MVT-BAL/PST-UNIT | $61.05 | $165.00 | — | — | 63% |
| New patient office visit, about 30 minutes CPT 99203 HC PROF. BHU TELEMED NEW PT,DETAILED,LOW 30-44 MINS | $59.57 | $161.00 | — | 63% below | 63% |
| New patient office visit, about 30 minutes CPT 99203 HC PROF. BHU NEW PT,DETAILED,LOW 30-44 MINS | $59.57 | $161.00 | — | 63% below | 63% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC PROF. BHU TELEMED NEW PT,DETAILED,LOW 30-44 MINS | $59.57 | $161.00 | — | — | 63% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC PROF. BHU NEW PT,DETAILED,LOW 30-44 MINS | $59.57 | $161.00 | — | — | 63% |
| New patient office visit, about 45 minutes CPT 99204 HC PROF. BHU NEW PT,COMPREH,MOD-HIGH 45-59 MINS | $95.09 | $257.00 | — | 55% below | 63% |
| New patient office visit, about 45 minutes CPT 99204 HC PROF. BHU TELEMED NEW PT,COMPREH,MOD-HIGH 45-59 MINS | $95.09 | $257.00 | — | 55% below | 63% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC PROF. BHU NEW PT,COMPREH,MOD-HIGH 45-59 MINS | $95.09 | $257.00 | — | — | 63% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC PROF. BHU TELEMED NEW PT,COMPREH,MOD-HIGH 45-59 MINS | $95.09 | $257.00 | — | — | 63% |
| New patient office visit, about 60 minutes CPT 99205 HC PROF. BHU TELEMED NEW PT,COMPREHEN,HIGH 60-74 MINS | $145.41 | $393.00 | — | 47% below | 63% |
| New patient office visit, about 60 minutes CPT 99205 HC PROF. BHU NEW PT,COMPREHEN,HIGH 60-74 MINS | $145.41 | $393.00 | — | 47% below | 63% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC PROF. BHU TELEMED NEW PT,COMPREHEN,HIGH 60-74 MINS | $145.41 | $393.00 | — | — | 63% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC PROF. BHU NEW PT,COMPREHEN,HIGH 60-74 MINS | $145.41 | $393.00 | — | — | 63% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC PROF. BHU NEW PT,EXPANDED,LOW-MOD 15-29 MINS | $35.15 | $95.00 | — | 70% below | 63% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC PROF. BHU TELEMED NEW PT,EXPANDED,LOW-MOD 15-29 MINS | $35.15 | $95.00 | — | 70% below | 63% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC PROF. BHU TELEMED NEW PT,EXPANDED,LOW-MOD 15-29 MINS | $35.15 | $95.00 | — | — | 63% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC PROF. BHU NEW PT,EXPANDED,LOW-MOD 15-29 MINS | $35.15 | $95.00 | — | — | 63% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC TELEHEALTH INITIAL NUTR 15 MI-UNIT | $68.82 | $186.00 | — | 3% below | 63% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC INITIAL NUTR 15 MI-UNIT | $68.82 | $186.00 | — | 3% below | 63% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC TELEHEALTH INITIAL NUTR 15 MI-UNIT | $68.82 | $186.00 | — | — | 63% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC INITIAL NUTR 15 MI-UNIT | $68.82 | $186.00 | — | — | 63% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEX 30 MIN | $168.35 | $455.00 | — | 42% below | 63% |
| Occupational therapy evaluation, low complexity CPT 97165 HC TELEHEALTH OT EVAL LOW COMPLEX 30 MIN | $168.35 | $455.00 | — | 42% below | 63% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEX 30 MIN | $168.35 | $455.00 | — | — | 63% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC TELEHEALTH OT EVAL LOW COMPLEX 30 MIN | $168.35 | $455.00 | — | — | 63% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC TELEHEALTH PT EVAL HIGH COMPLEX 45 MIN | $183.15 | $495.00 | — | 37% below | 63% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEX 45 MIN | $183.15 | $495.00 | — | 37% below | 63% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC TELEHEALTH PT EVAL HIGH COMPLEX 45 MIN | $183.15 | $495.00 | — | — | 63% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEX 45 MIN | $183.15 | $495.00 | — | — | 63% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC TELEHEALTH PT EVAL LOW COMPLEX 20 MIN | $179.08 | $484.00 | — | 35% below | 63% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEX 20 MIN | $179.08 | $484.00 | — | 35% below | 63% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEX 20 MIN | $179.08 | $484.00 | — | — | 63% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC TELEHEALTH PT EVAL LOW COMPLEX 20 MIN | $179.08 | $484.00 | — | — | 63% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC TELEHEALTH PT EVAL MOD COMPLEX 30 MIN | $181.30 | $490.00 | — | 36% below | 63% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MOD COMPLEX 30 MIN | $181.30 | $490.00 | — | 36% below | 63% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL MOD COMPLEX 30 MIN | $181.30 | $490.00 | — | — | 63% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC TELEHEALTH PT EVAL MOD COMPLEX 30 MIN | $181.30 | $490.00 | — | — | 63% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT MANUAL THERAPY TECHNIQUE-UNIT | $55.50 | $150.00 | — | 36% below | 63% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THERAPY TECHNIQUE-UNIT | $55.50 | $150.00 | — | 36% below | 63% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC OT MANUAL THERAPY TECHNIQUE-UNIT | $55.50 | $150.00 | — | — | 63% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MANUAL THERAPY TECHNIQUE-UNIT | $55.50 | $150.00 | — | — | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THER EX UNIT | $60.31 | $163.00 | — | 27% below | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC TELEHEALTH OT THER EX UNIT | $60.31 | $163.00 | — | 27% below | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC TELEHEALTH PT THER EX UNIT | $60.31 | $163.00 | — | 27% below | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THER EX UNIT | $60.31 | $163.00 | — | 27% below | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THER EX UNIT | $60.31 | $163.00 | — | — | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC TELEHEALTH OT THER EX UNIT | $60.31 | $163.00 | — | — | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC TELEHEALTH PT THER EX UNIT | $60.31 | $163.00 | — | — | 63% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THER EX UNIT | $60.31 | $163.00 | — | — | 63% |
| Psychiatric evaluation with medical services CPT 90792 HC PROF. BHU PSYCHIATRIC DIAGNOSTIC EVAL 90792 | $169.83 | $459.00 | — | at median | 63% |
| Psychiatric evaluation with medical services inpatient CPT 90792 HC PROF. BHU PSYCHIATRIC DIAGNOSTIC EVAL 90792 | $169.83 | $459.00 | — | — | 63% |
| Psychotherapy session, 30 minutes CPT 90832 HC PROF. BHU PSYCHOTHERAPY 20-30 MINS 90832 | $78.44 | $212.00 | — | 80% below | 63% |
| Psychotherapy session, 30 minutes CPT 90832 HC PROF. BHU TELEMED PSYCHOTHERAPY 20-30 MINS 90832 | $78.44 | $212.00 | — | 80% below | 63% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PROF. BHU TELEMED PSYCHOTHERAPY 20-30 MINS 90832 | $78.44 | $212.00 | — | — | 63% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PROF. BHU PSYCHOTHERAPY 20-30 MINS 90832 | $78.44 | $212.00 | — | — | 63% |
| Psychotherapy session, 45 minutes CPT 90834 HC PROF. BHU TELEMED PSYCHOTHERAPY 45-50 MINS 90834 | $106.56 | $288.00 | — | 26% below | 63% |
| Psychotherapy session, 45 minutes CPT 90834 HC PROF. BHU PSYCHOTHERAPY 45-50 MINS 90834 | $106.56 | $288.00 | — | 26% below | 63% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PROF. BHU PSYCHOTHERAPY 45-50 MINS 90834 | $106.56 | $288.00 | — | — | 63% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PROF. BHU TELEMED PSYCHOTHERAPY 45-50 MINS 90834 | $106.56 | $288.00 | — | — | 63% |
| Psychotherapy session, 60 minutes CPT 90837 HC PROF. BHU TELEMED PSYCHOTHERAPY 75-80 MINS 90837 | $145.78 | $394.00 | — | 86% below | 63% |
| Psychotherapy session, 60 minutes CPT 90837 HC PROF. BHU PSYCHOTHERAPY 75-80 MINS 90837 | $145.78 | $394.00 | — | 86% below | 63% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PROF. BHU PSYCHOTHERAPY 75-80 MINS 90837 | $145.78 | $394.00 | — | — | 63% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PROF. BHU TELEMED PSYCHOTHERAPY 75-80 MINS 90837 | $145.78 | $394.00 | — | — | 63% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC SMOKING CESSATION ASYMPTOMATIC INTERMEDIATE 3-10MIN | $25.53 | $69.00 | — | 27% below | 63% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC SMOKING CESSATION ASYMPTOMATIC INTERMEDIATE 3-10MIN | $25.53 | $69.00 | — | — | 63% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OFFICE/OUTPATIENT VISIT EST LEVEL 5 40-54 MIS | $92.50 | $250.00 | — | 55% below | 63% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC PROF. BHU TELEMED E/M EST PT LVL 5 40-54 MINS | $145.41 | $393.00 | — | 29% below | 63% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OFFICE/OUTPATIENT VISIT EST LEVEL 5 40-54 MIS | $92.50 | $250.00 | — | — | 63% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC PROF. BHU TELEMED E/M EST PT LVL 5 40-54 MINS | $145.41 | $393.00 | — | — | 63% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PROF. BHU TELEMED E/M EST PT LVL 3 20-29 MINS | $59.57 | $161.00 | — | 41% below | 63% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE/OUTPATIENT VISIT EST LEVEL 3 | $92.50 | $250.00 | — | 9% below | 63% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC FACILITY CLINIC ASSESS/MGMT SERVICES | $92.50 | $250.00 | — | 9% below | 63% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC FACILITY ASSESSMENT L&D | $203.50 | $550.00 | — | 101% above | 63% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC PROF. BHU TELEMED E/M EST PT LVL 3 20-29 MINS | $59.57 | $161.00 | — | — | 63% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OFFICE/OUTPATIENT VISIT EST LEVEL 3 | $92.50 | $250.00 | — | — | 63% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC FACILITY CLINIC ASSESS/MGMT SERVICES | $92.50 | $250.00 | — | — | 63% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC FACILITY ASSESSMENT L&D | $203.50 | $550.00 | — | — | 63% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC LEVEL II EVAL - ESTABLISHED PATIENT 30-39 MINS | $92.50 | $250.00 | — | 37% below | 63% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE/OUTPATIENT VISIT EST LEVEL 4 | $92.50 | $250.00 | — | 37% below | 63% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PROF. BHU TELEMED E/M EST PT LVL 4 30-39 MINS | $95.09 | $257.00 | — | 36% below | 63% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OFFICE/OUTPATIENT VISIT EST LEVEL 4 | $92.50 | $250.00 | — | — | 63% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC LEVEL II EVAL - ESTABLISHED PATIENT 30-39 MINS | $92.50 | $250.00 | — | — | 63% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC PROF. BHU TELEMED E/M EST PT LVL 4 30-39 MINS | $95.09 | $257.00 | — | — | 63% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC PROF. BHU TELEMED E/M EST PT LVL 2 10-19 MINS | $35.15 | $95.00 | — | 57% below | 63% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFICE/OUTPATIENT VISIT EST LEVEL 2 | $92.50 | $250.00 | — | 14% above | 63% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC PROF. BHU TELEMED E/M EST PT LVL 2 10-19 MINS | $35.15 | $95.00 | — | — | 63% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OFFICE/OUTPATIENT VISIT EST LEVEL 2 | $92.50 | $250.00 | — | — | 63% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC PROF. BHU OP/OBV/ED CONSULT III 30 MINS | $140.60 | $380.00 | — | 153% above | 63% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 HC PROF. BHU OP/OBV/ED CONSULT III 30 MINS | $140.60 | $380.00 | — | — | 63% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC PROF. BHU OP/OBV/ED CONSULT IV 40 MINS | $207.20 | $560.00 | — | 157% above | 63% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 HC PROF. BHU OP/OBV/ED CONSULT IV 40 MINS | $207.20 | $560.00 | — | — | 63% |
| Speech and language evaluation CPT 92523 HC TELEHEALTH EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $249.01 | $673.00 | — | 52% below | 63% |
| Speech and language evaluation CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $249.01 | $673.00 | — | 52% below | 63% |
| Speech and language evaluation inpatient CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $249.01 | $673.00 | — | — | 63% |
| Speech and language evaluation inpatient CPT 92523 HC TELEHEALTH EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $249.01 | $673.00 | — | — | 63% |
| Speech therapy session, individual CPT 92507 HC TX SPEECH LANG VOICE COMM & AUDITORY PROC IND | $237.17 | $641.00 | — | 38% below | 63% |
| Speech therapy session, individual CPT 92507 HC TELEHEALTH TX SPEECH LANG VOICE COMM & AUDITORY PROC IND | $237.17 | $641.00 | — | 38% below | 63% |
| Speech therapy session, individual inpatient CPT 92507 HC TELEHEALTH TX SPEECH LANG VOICE COMM & AUDITORY PROC IND | $237.17 | $641.00 | — | — | 63% |
| Speech therapy session, individual inpatient CPT 92507 HC TX SPEECH LANG VOICE COMM & AUDITORY PROC IND | $237.17 | $641.00 | — | — | 63% |
| Spirometry (breathing test) CPT 94010 HC BREATHING CAPACITY TEST | $158.36 | $428.00 | — | 22% below | 63% |
| Spirometry (breathing test) inpatient CPT 94010 HC BREATHING CAPACITY TEST | $158.36 | $428.00 | — | — | 63% |
| Spirometry before and after a bronchodilator CPT 94060 HC PFT/SPIROMETRY W/BRONCH | $328.56 | $888.00 | — | 3% below | 63% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC PFT/SPIROMETRY W/BRONCH | $328.56 | $888.00 | — | — | 63% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC TELEHEALTH PT DYNAMIC ACT/FUNCT PERF-UNIT | $64.75 | $175.00 | — | 18% below | 63% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT DYNAMIC ACT/FUNCT PERF-UNIT | $64.75 | $175.00 | — | 18% below | 63% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC TELEHEALTH OT DYNAMIC ACT/FUNCT PERF-UNIT | $64.75 | $175.00 | — | 18% below | 63% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT DYNAMIC ACT/FUNCT PERF-UNIT | $64.75 | $175.00 | — | 18% below | 63% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC OT DYNAMIC ACT/FUNCT PERF-UNIT | $64.75 | $175.00 | — | — | 63% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT DYNAMIC ACT/FUNCT PERF-UNIT | $64.75 | $175.00 | — | — | 63% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC TELEHEALTH PT DYNAMIC ACT/FUNCT PERF-UNIT | $64.75 | $175.00 | — | — | 63% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC TELEHEALTH OT DYNAMIC ACT/FUNCT PERF-UNIT | $64.75 | $175.00 | — | — | 63% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPEUTIC PHLEBOTOMY | $345.58 | $934.00 | — | 19% below | 63% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPEUTIC PHLEBOTOMY | $345.58 | $934.00 | — | — | 63% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs New Hampshire | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY | $67.05 | $181.23 | — | 1% below | 63% |
| 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 | $67.05 | $181.23 | — | — | 63% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC PFIZER COVID VACCINE 12 YRS AND OLDER | $103.60 | $280.00 | — | 12% below | 63% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 MRNA VAC-TRIS(PFIZER) 30 MCG/0.3ML IM SUSY | $142.46 | $385.02 | — | 21% above | 63% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC PFIZER COVID VACCINE 12 YRS AND OLDER | $103.60 | $280.00 | — | — | 63% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 MRNA VAC-TRIS(PFIZER) 30 MCG/0.3ML IM SUSY | $142.46 | $385.02 | — | — | 63% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HEPATITIS A-HEP B RECOMB VAC 720-20 ELU-MCG/ML IM SUSY | $129.91 | $351.10 | — | 30% below | 63% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HEPATITIS A-HEP B RECOMB VAC 720-20 ELU-MCG/ML IM SUSY | $129.91 | $351.10 | — | — | 63% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSY | $356.60 | $963.78 | — | 28% above | 63% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSY | $356.60 | $963.78 | — | — | 63% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSP | $70.69 | $191.06 | — | 4% below | 63% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSP | $70.69 | $191.06 | — | — | 63% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSP (W) | $59.42 | $160.59 | — | 25% below | 63% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSY | $59.42 | $160.59 | — | 25% below | 63% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSP (W) | $59.42 | $160.59 | — | — | 63% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSY | $59.42 | $160.59 | — | — | 63% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR | $92.64 | $250.38 | — | 15% below | 63% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR | $92.64 | $250.38 | — | — | 63% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING ACY&W-135 DIPHTH CONJ IM SOLN | $133.43 | $360.62 | — | 10% above | 63% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A C Y&W-135 OLIG IM SOLR | $139.21 | $376.24 | — | 15% above | 63% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING ACY&W-135 DIPHTH CONJ IM SOLN | $133.43 | $360.62 | — | — | 63% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A C Y&W-135 OLIG IM SOLR | $139.21 | $376.24 | — | — | 63% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY | $210.81 | $569.76 | — | 35% above | 63% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY | $210.81 | $569.76 | — | — | 63% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY | $304.53 | $823.07 | — | 54% below | 63% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY | $304.53 | $823.07 | — | — | 63% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOSY | $145.19 | $392.40 | — | 35% below | 63% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOSY | $145.19 | $392.40 | — | — | 63% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 HC ABRYSVO RSV VACCINE | $214.23 | $579.00 | — | 1% below | 63% |
| 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 | $317.70 | $858.64 | — | 46% above | 63% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 HC ABRYSVO RSV VACCINE | $214.23 | $579.00 | — | — | 63% |
| 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 | $317.70 | $858.64 | — | — | 63% |
| Rabies vaccine, one dose CPT 90675 RABIES VIRUS VACCINE, HDC IM SUSR | $403.05 | $1,089.34 | — | 29% below | 63% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC IM SUSR | $430.88 | $1,164.55 | — | 24% below | 63% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VIRUS VACCINE, HDC IM SUSR | $403.05 | $1,089.34 | — | — | 63% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC IM SUSR | $430.88 | $1,164.55 | — | — | 63% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR | $233.14 | $630.11 | — | 29% above | 63% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR | $233.14 | $630.11 | — | — | 63% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ | $46.05 | $124.47 | — | 25% below | 63% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 2-2 LF/0.5ML IM SUSP | $58.73 | $158.74 | — | 4% below | 63% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ | $46.05 | $124.47 | — | — | 63% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 2-2 LF/0.5ML IM SUSP | $58.73 | $158.74 | — | — | 63% |
| 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 SUSP | $44.09 | $119.17 | — | 16% below | 63% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERSTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP (W) | $48.17 | $130.19 | — | 9% below | 63% |
| 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 | $48.17 | $130.19 | — | 9% below | 63% |
| 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 SUSP | $44.09 | $119.17 | — | — | 63% |
| 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 | $48.17 | $130.19 | — | — | 63% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERSTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP (W) | $48.17 | $130.19 | — | — | 63% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMINISTRATION VACCINE SINGLE INJECTION | $8.14 | $22.00 | — | 86% below | 63% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN IMMUN VAC/TOX | $8.14 | $22.00 | — | 86% below | 63% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN IMMUN VAC/TOX | $8.14 | $22.00 | — | — | 63% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMINISTRATION VACCINE SINGLE INJECTION | $8.14 | $22.00 | — | — | 63% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC ADMIN IMMUN ADD'L VAC/TOX | $8.14 | $22.00 | — | 82% below | 63% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC ADMINISTRATION VACCINE EA ADDL INJECTION | $8.14 | $22.00 | — | 82% below | 63% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC INJ IMMUN ADD'L VAC/TOX | $28.49 | $77.00 | — | 38% below | 63% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC ADMIN IMMUN ADD'L VAC/TOX | $8.14 | $22.00 | — | — | 63% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC ADMINISTRATION VACCINE EA ADDL INJECTION | $8.14 | $22.00 | — | — | 63% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC INJ IMMUN ADD'L VAC/TOX | $28.49 | $77.00 | — | — | 63% |
Source file: https://hospitalpricedisclosure.com/Download.aspx?pxi=06hFExK19Svl3QLOl*_*Dgkw*-*&f=iFd*_*cEPwhQHJy3lVvHy9uQ*-*