Hospital Chicago-Naperville-Elgin, IL-IN

Franciscan Health Crown Point

Listed in its price file as “FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CROWN POINT”.

Franciscan Health Crown Point in Crown Point, IN publishes cash prices for 434 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Indiana median for 326 of 428 procedures and above it for 95. By typical cash price it ranks #23 of 85 Indiana hospitals and #30 of 63 hospitals in the Chicago, IL area, cheapest first. Select a procedure to compare it with other hospitals nearby.

12750 SAINT FRANCIS DR, CROWN POINT, IN 46307 Collected Sep 27, 2026 Source price file Check a bill from this hospital (219) 757-6100

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 150126 · CMS hospital register NPI 1336205798

Financial assistance

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

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

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

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

Scans and imaging

ProcedureCash priceList priceInsurers payvs IndianaOff list
Abdominal CT scan without and with contrast CPT 74170 CT Abd; W/WO Cont $996.91 $3,864.00 $3,864.00 22% below 74%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abd; W/WO Cont $996.91 $3,864.00 $3,864.00 — 74%
Abdominal X-ray, 2 views CPT 74019 X-Ray Exam Abdomen 2 Views $167.70 $650.00 $650.00 38% below 74%
Abdominal X-ray, 2 views inpatient CPT 74019 X-Ray Exam Abdomen 2 Views $167.70 $650.00 $650.00 — 74%
Ankle X-ray, complete, 3 or more views CPT 73610 Rad Exam Ankl; Compl 3 Vw Min $188.86 $732.00 $732.00–$1,464.00 4% below 74%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Rad Exam Ankl; Compl 3 Vw Min $188.86 $732.00 $732.00–$1,464.00 — 74%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Noninvasive Phys Study Uea/Lea Sngl/Bilat $391.64 $1,518.00 $1,518.00 — 74%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 Noninvasive Phys Study Uea/Lea Sngl/Bilat $391.64 $1,518.00 $1,518.00 — 74%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT Upper Extrmty; W/O Cont $712.08 $2,760.00 $2,760.00 11% below 74%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT Upper Extrmty; W/O Cont $712.08 $2,760.00 $2,760.00 — 74%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Rad Exam; Esophagus Sngl Contrast Study $267.03 $1,035.00 $1,035.00 43% below 74%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Rad Exam; Esophagus Sngl Contrast Study $267.03 $1,035.00 $1,035.00 — 74%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone Imaging; Whole Body $1,103.72 $4,278.00 $4,278.00 30% below 74%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone Imaging; Whole Body $1,103.72 $4,278.00 $4,278.00 — 74%
Breast ultrasound, complete, one breast CPT 76641 Ultrasound Breast Complete Unil Hcode $302.63 $1,173.00 $1,173.00 30% below 74%
Breast ultrasound, complete, one breast inpatient CPT 76641 Ultrasound Breast Complete Unil Hcode $302.63 $1,173.00 $1,173.00 — 74%
Breast ultrasound, limited (one breast or one area) CPT 76642 ED Bedside US Breast Limited $206.40 $800.00 $800.00–$1,600.00 36% below 74%
Breast ultrasound, limited (one breast or one area) CPT 76642 Ultrasound Breast Limited Hcode $206.40 $800.00 $800.00–$1,600.00 36% below 74%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Ultrasound Breast Limited Hcode $206.40 $800.00 $800.00–$1,600.00 — 74%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ED Bedside US Breast Limited $206.40 $800.00 $800.00–$1,600.00 — 74%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abd&Pelv W/O&W/Dye $996.91 $3,864.00 $3,864.00 47% below 74%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abd&Pelv W/O&W/Dye $996.91 $3,864.00 $3,864.00 — 74%
CT angiography (CTA) of the head CPT 70496 CT Angio Hd W/WO Cont $1,246.14 $4,830.00 $4,830.00 2% below 74%
CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Hd W/WO Cont $1,246.14 $4,830.00 $4,830.00 — 74%
CT angiography (CTA) of the neck CPT 70498 CT Angio Nk W/WO Cont $1,246.14 $4,830.00 $4,830.00 3% above 74%
CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Nk W/WO Cont $1,246.14 $4,830.00 $4,830.00 — 74%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest; W/WO Cont $1,246.14 $4,830.00 $4,830.00 2% below 74%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest; W/WO Cont $1,246.14 $4,830.00 $4,830.00 — 74%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd & Pelvis W/O Contrast $1,246.14 $4,830.00 $4,830.00 19% above 74%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd & Pelvis W/O Contrast $1,246.14 $4,830.00 $4,830.00 — 74%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd & Pelvis W/Contrast $1,424.16 $5,520.00 $5,520.00 6% below 74%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd & Pelvis W/Contrast $1,424.16 $5,520.00 $5,520.00 — 74%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT-Abd/Pelvis WO/W Contrast $1,601.92 $6,209.00 $6,209.00 7% below 74%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT-Abd/Pelvis WO/W Contrast $1,601.92 $6,209.00 $6,209.00 — 74%
CT scan of the abdomen with contrast CPT 74160 CT Abd; W/Cont $854.50 $3,312.00 $3,312.00 20% below 74%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abd; W/Cont $854.50 $3,312.00 $3,312.00 — 74%
CT scan of the abdomen without contrast CPT 74150 CT Abd; W/O Cont $712.08 $2,760.00 $2,760.00 16% below 74%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abd; W/O Cont $712.08 $2,760.00 $2,760.00 — 74%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial Area; W/O Cont $712.08 $2,760.00 $2,760.00 15% below 74%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial Area; W/O Cont $712.08 $2,760.00 $2,760.00 — 74%
CT scan of the head or brain, no contrast dye CPT 70450 CT Hd/Brain; W/O Cont $712.08 $2,760.00 $2,760.00 9% below 74%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Hd/Brain; W/O Cont $712.08 $2,760.00 $2,760.00 — 74%
CT scan of the head with contrast CPT 70460 CT Hd/Brain; W/Cont $854.50 $3,312.00 $3,312.00 1% below 74%
CT scan of the head with contrast inpatient CPT 70460 CT Hd/Brain; W/Cont $854.50 $3,312.00 $3,312.00 — 74%
CT scan of the head without and with contrast CPT 70470 CT Hd/Brain; W/WO Cont $996.91 $3,864.00 $3,864.00 4% below 74%
CT scan of the head without and with contrast inpatient CPT 70470 CT Hd/Brain; W/WO Cont $996.91 $3,864.00 $3,864.00 — 74%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumb Spin; W/O Cont $712.08 $2,760.00 $2,760.00 20% below 74%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumb Spin; W/O Cont $712.08 $2,760.00 $2,760.00 — 74%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Cerv Spin; W/O Cont $712.08 $2,760.00 $2,760.00 15% below 74%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Cerv Spin; W/O Cont $712.08 $2,760.00 $2,760.00 — 74%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelv; W/Cont $854.50 $3,312.00 $3,312.00 11% below 74%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelv; W/Cont $854.50 $3,312.00 $3,312.00 — 74%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CARotid DPLX SCAN; COMPL BILAT STUDY $569.41 $2,207.00 $2,207.00 — 74%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CARotid DPLX SCAN; COMPL BILAT STUDY $569.41 $2,207.00 $2,207.00 — 74%
Chest CT scan without and with contrast CPT 71270 CT Chest; W/WO Cont $996.91 $3,864.00 $3,864.00 6% below 74%
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest; W/WO Cont $996.91 $3,864.00 $3,864.00 — 74%
Chest X-ray, 2 views CPT 71046 X-Ray Exam Chest 2 Views $178.28 $691.00 $691.00 14% below 74%
Chest X-ray, 2 views inpatient CPT 71046 X-Ray Exam Chest 2 Views $178.28 $691.00 $691.00 — 74%
Chest X-ray, single view CPT 71045 Xray Exam Babyscan Chest 1 View $63.47 $246.00 $246.00 61% below 74%
Chest X-ray, single view CPT 71045 X-Ray Exam Chest 1 View $103.72 $402.00 $402.00 36% below 74%
Chest X-ray, single view inpatient CPT 71045 Xray Exam Babyscan Chest 1 View $63.47 $246.00 $246.00 — 74%
Chest X-ray, single view inpatient CPT 71045 X-Ray Exam Chest 1 View $103.72 $402.00 $402.00 — 74%
Collarbone (clavicle) X-ray, complete CPT 73000 Rad Exam; Clavicle Compl $164.09 $636.00 $636.00–$1,272.00 15% below 74%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 Rad Exam; Clavicle Compl $164.09 $636.00 $636.00–$1,272.00 — 74%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal W/Image; Compl $391.64 $1,518.00 $1,518.00 24% below 74%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal W/Image; Compl $391.64 $1,518.00 $1,518.00 — 74%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA Bone Density Study; Axial Skeleton $284.57 $1,103.00 $1,103.00 2% below 74%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA Bone Density Study; Axial Skeleton $284.57 $1,103.00 $1,103.00 — 74%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA Bn Density Study; Appendicular Skeleton $53.66 $208.00 $208.00 63% below 74%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA Bn Density Study; Appendicular Skeleton $53.66 $208.00 $208.00 — 74%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg Uterus Detailed; 1st Gestation $227.04 $880.00 $880.00 60% below 74%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Preg Uterus Detailed; 1st Gestation $227.04 $880.00 $880.00 — 74%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest; W/O Cont $712.08 $2,760.00 $2,760.00 15% below 74%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest; W/O Cont $712.08 $2,760.00 $2,760.00 — 74%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest; W/Cont $854.50 $3,312.00 $3,312.00 7% below 74%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest; W/Cont $854.50 $3,312.00 $3,312.00 — 74%
Diagnostic mammogram, both breasts both sides CPT 77066 Dx Mammo Incl Cad Bi $170.80 $662.00 $662.00 — 74%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Dx Mammo Incl Cad Bi $170.80 $662.00 $662.00 — 74%
Diagnostic mammogram, one breast CPT 77065 Dx Mammo Incl Cad Uni $124.87 $484.00 $484.00 44% below 74%
Diagnostic mammogram, one breast inpatient CPT 77065 Dx Mammo Incl Cad Uni $124.87 $484.00 $484.00 — 74%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Dplx Scan of Lea or Graft; Compl Bilat Study $534.06 $2,070.00 $2,070.00 — 74%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Dplx Scan of Lea or Graft; Compl Bilat Study $534.06 $2,070.00 $2,070.00 — 74%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Dplx Scan Ext Veins; Compl Bilat Study $534.06 $2,070.00 $2,070.00 — 74%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Dplx Scan Ext Veins; Compl Bilat Study $534.06 $2,070.00 $2,070.00 — 74%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Tte W/Doppler and Color Flow $818.63 $3,173.00 $3,173.00 50% below 74%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo Tte W/Doppler and Color Flow $818.63 $3,173.00 $3,173.00 — 74%
Elbow X-ray, 2 views CPT 73070 Rad Exam Elbow; 2 Vw $117.65 $456.00 $456.00–$912.00 29% below 74%
Elbow X-ray, 2 views inpatient CPT 73070 Rad Exam Elbow; 2 Vw $117.65 $456.00 $456.00–$912.00 — 74%
Elbow X-ray, complete, 3 or more views CPT 73080 Rad Exam Elbow; Complete 3 Vw Min $203.56 $789.00 $789.00–$1,578.00 20% below 74%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 Rad Exam Elbow; Complete 3 Vw Min $203.56 $789.00 $789.00–$1,578.00 — 74%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbitsellapost/Mid/Inner Ear; W/O Cont $712.08 $2,760.00 $2,760.00 12% below 74%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbitsellapost/Mid/Inner Ear; W/O Cont $712.08 $2,760.00 $2,760.00 — 74%
Facial bones X-ray, complete, 3 or more views CPT 70150 Rad Exam Facial Bns; Compl 3 Vw Min $210.27 $815.00 $815.00 23% below 74%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Rad Exam Facial Bns; Compl 3 Vw Min $210.27 $815.00 $815.00 — 74%
Forearm X-ray (radius and ulna), 2 views CPT 73090 Rad Exam; Fa 2 Vw $160.22 $621.00 $621.00–$1,242.00 14% below 74%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 Rad Exam; Fa 2 Vw $160.22 $621.00 $621.00–$1,242.00 — 74%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary System Imaging $960.79 $3,724.00 $3,724.00 27% below 74%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepatobiliary System Imaging $960.79 $3,724.00 $3,724.00 — 74%
Hand X-ray, 2 views CPT 73120 Rad Exam Hnd; 2 Vw $124.87 $484.00 $484.00–$968.00 27% below 74%
Hand X-ray, 2 views inpatient CPT 73120 Rad Exam Hnd; 2 Vw $124.87 $484.00 $484.00–$968.00 — 74%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Rad Exam; Calcaneus 2 Vw Min $146.54 $568.00 $568.00–$1,136.00 32% below 74%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Rad Exam; Calcaneus 2 Vw Min $146.54 $568.00 $568.00–$1,136.00 — 74%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Home Sleep Test/Type 3 Porta $427.25 $1,656.00 $1,656.00 4% above 74%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Home Sleep Test/Type 3 Porta $427.25 $1,656.00 $1,656.00 — 74%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Pss W 4/> P W Cpap/Bipap $2,064.26 $8,001.00 $8,001.00 38% below 74%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Pss W 4/> P W Cpap/Bipap $2,064.26 $8,001.00 $8,001.00 — 74%
Knee X-ray, 3 views CPT 73562 Rad Exam Knee; 3 Vw $188.86 $732.00 $732.00–$1,464.00 18% below 74%
Knee X-ray, 3 views inpatient CPT 73562 Rad Exam Knee; 3 Vw $188.86 $732.00 $732.00–$1,464.00 — 74%
Knee X-ray, complete, 4 or more views CPT 73564 Rad Exam Knee; Compl 4 Vw Min $195.56 $758.00 $758.00–$1,516.00 25% below 74%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 Rad Exam Knee; Compl 4 Vw Min $195.56 $758.00 $758.00–$1,516.00 — 74%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT Lower Extrmty; W/O Cont $712.08 $2,760.00 $2,760.00 9% below 74%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT Lower Extrmty; W/O Cont $712.08 $2,760.00 $2,760.00 — 74%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Bedside US Echo Exam of Abdomen Limited $331.27 $1,284.00 $1,284.00 27% below 74%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abd W/Image; Ltd $331.27 $1,284.00 $1,284.00 27% below 74%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abd W/Image; Ltd $331.27 $1,284.00 $1,284.00 — 74%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Bedside US Echo Exam of Abdomen Limited $331.27 $1,284.00 $1,284.00 — 74%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Xtr Non-Vasc Lmtd $206.40 $800.00 $800.00–$1,600.00 32% below 74%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Bedside US Lmtd Jt/Nonvasc Xtr Strux $206.40 $800.00 $800.00–$1,600.00 32% below 74%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Xtr Non-Vasc Lmtd $206.40 $800.00 $800.00–$1,600.00 — 74%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Bedside US Lmtd Jt/Nonvasc Xtr Strux $206.40 $800.00 $800.00–$1,600.00 — 74%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Rad Exam; Tibia and Fibula 2 Vw $157.38 $610.00 $610.00–$1,220.00 21% below 74%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Rad Exam; Tibia and Fibula 2 Vw $157.38 $610.00 $610.00–$1,220.00 — 74%
MR angiography (MRA) of the head without contrast CPT 70544 Mra Head; W/O Contrast $1,246.14 $4,830.00 $4,830.00 16% above 74%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Mra Head; W/O Contrast $1,246.14 $4,830.00 $4,830.00 — 74%
MRI of both breasts, without and then with contrast dye CPT 77049 MRI Breast WO/With Contrast W/Cad Bil $402.22 $1,559.00 $1,559.00–$3,118.00 45% below 74%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI Breast WO/With Contrast W/Cad Bil $402.22 $1,559.00 $1,559.00–$3,118.00 — 74%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Lower Extremity Jnt; W/O Contrast $1,246.14 $4,830.00 $4,830.00 21% above 74%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Lower Extremity Jnt; W/O Contrast $1,246.14 $4,830.00 $4,830.00 — 74%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Lower Extremity Jnt; W&W/O Contrast $1,601.92 $6,209.00 $6,209.00 11% above 74%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Lower Extremity Jnt; W&W/O Contrast $1,601.92 $6,209.00 $6,209.00 — 74%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen; W/O Contrast $1,246.14 $4,830.00 $4,830.00 17% above 74%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen; W/O Contrast $1,246.14 $4,830.00 $4,830.00 — 74%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen; W&W/O Contrast $1,601.92 $6,209.00 $6,209.00 1% above 74%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen; W&W/O Contrast $1,601.92 $6,209.00 $6,209.00 — 74%
MRI of the brain, no contrast dye CPT 70551 MRI Brain; W/O Contrast $1,246.14 $4,830.00 $4,830.00 20% above 74%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain; W/O Contrast $1,246.14 $4,830.00 $4,830.00 — 74%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain; W&W/O Contrast $1,601.92 $6,209.00 $6,209.00 16% above 74%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain; W&W/O Contrast $1,601.92 $6,209.00 $6,209.00 — 74%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar; W/O Contrast $1,246.14 $4,830.00 $4,830.00 20% above 74%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar; W/O Contrast $1,246.14 $4,830.00 $4,830.00 — 74%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar; W&W/O Contrast $1,601.92 $6,209.00 $6,209.00 9% above 74%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar; W&W/O Contrast $1,601.92 $6,209.00 $6,209.00 — 74%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic; W/O Contrast $1,246.14 $4,830.00 $4,830.00 22% above 74%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic; W/O Contrast $1,246.14 $4,830.00 $4,830.00 — 74%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical; W&W/O Contrast $1,601.92 $6,209.00 $6,209.00 9% above 74%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical; W&W/O Contrast $1,601.92 $6,209.00 $6,209.00 — 74%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical; W/O Contrast $1,246.14 $4,830.00 $4,830.00 20% above 74%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical; W/O Contrast $1,246.14 $4,830.00 $4,830.00 — 74%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis; W&W/O Contrast $1,601.92 $6,209.00 $6,209.00 10% above 74%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis; W&W/O Contrast $1,601.92 $6,209.00 $6,209.00 — 74%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis; W/O Contrast $1,246.14 $4,830.00 $4,830.00 16% above 74%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis; W/O Contrast $1,246.14 $4,830.00 $4,830.00 — 74%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Upper Extremity Jnt; W/O Contrast $1,246.14 $4,830.00 $4,830.00 17% above 74%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Upper Extremity Jnt; W/O Contrast $1,246.14 $4,830.00 $4,830.00 — 74%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Rad Exam Cerv Spine; 4 Vw Min $277.87 $1,077.00 $1,077.00 20% below 74%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Rad Exam Cerv Spine; 4 Vw Min $277.87 $1,077.00 $1,077.00 — 74%
Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tiss Nk; W/Cont $854.50 $3,312.00 $3,312.00 13% below 74%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Soft Tiss Nk; W/Cont $854.50 $3,312.00 $3,312.00 — 74%
Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tiss Nk; W/O Cont $712.08 $2,760.00 $2,760.00 15% below 74%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tiss Nk; W/O Cont $712.08 $2,760.00 $2,760.00 — 74%
Neck soft tissue X-ray CPT 70360 Rad Exam; Neck Soft Tiss $142.67 $553.00 $553.00 17% below 74%
Neck soft tissue X-ray inpatient CPT 70360 Rad Exam; Neck Soft Tiss $142.67 $553.00 $553.00 — 74%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial W/Spect; Multiple Studies $2,135.72 $8,278.00 $8,278.00 43% below 74%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Myocardial W/Spect; Multiple Studies $2,135.72 $8,278.00 $8,278.00 — 74%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet W/CT; Skull Base to Mid-Thigh $2,883.41 $11,176.00 $11,176.00 29% below 74%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Pet W/CT; Skull Base to Mid-Thigh $2,883.41 $11,176.00 $11,176.00 — 74%
Pelvic CT scan without contrast CPT 72192 CT Pelv W/O Cont $712.08 $2,760.00 $2,760.00 15% below 74%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelv W/O Cont $712.08 $2,760.00 $2,760.00 — 74%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Exam Pelvic Limited $249.23 $966.00 $966.00 25% below 74%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Bedside US Exam Pelvic Limited $249.23 $966.00 $966.00 25% below 74%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Bedside US Exam Pelvic Limited $249.23 $966.00 $966.00 — 74%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Exam Pelvic Limited $249.23 $966.00 $966.00 — 74%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelv; Compl $338.24 $1,311.00 $1,311.00 27% below 74%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelv; Compl $338.24 $1,311.00 $1,311.00 — 74%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uterus >14wk; 1st Gest $323.79 $1,255.00 $1,255.00 41% below 74%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ED US Preg Uterus >14wk; 1st Gest $323.79 $1,255.00 $1,255.00 41% below 74%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Uterus >14wk; 1st Gest $323.79 $1,255.00 $1,255.00 — 74%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ED US Preg Uterus >14wk; 1st Gest $323.79 $1,255.00 $1,255.00 — 74%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ED US Preg Uter <14wk; 1st Gest $284.57 $1,103.00 $1,103.00 44% below 74%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg Uter <14wk; 1st Gest $306.76 $1,189.00 $1,189.00 39% below 74%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ED US Preg Uter <14wk; 1st Gest $284.57 $1,103.00 $1,103.00 — 74%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg Uter <14wk; 1st Gest $306.76 $1,189.00 $1,189.00 — 74%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Bedside US Preg Uterus Limited 1+ Fetus(S) $345.46 $1,339.00 $1,339.00 11% below 74%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Uter Ltd $355.78 $1,379.00 $1,379.00 8% below 74%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Bedside US Preg Uterus Limited 1+ Fetus(S) $345.46 $1,339.00 $1,339.00 — 74%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Uter Ltd $355.78 $1,379.00 $1,379.00 — 74%
Rib X-ray, one side, 2 views CPT 71100 Rad Exam Ribs Unilatl; 2 Vw $199.69 $774.00 $774.00 2% below 74%
Rib X-ray, one side, 2 views inpatient CPT 71100 Rad Exam Ribs Unilatl; 2 Vw $199.69 $774.00 $774.00 — 74%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Rad Exam Ribs Unilat; W/Pa Cxr 3 Vw Min $174.92 $678.00 $678.00 28% below 74%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Rad Exam Ribs Unilat; W/Pa Cxr 3 Vw Min $174.92 $678.00 $678.00 — 74%
Screening mammogram, both breasts both sides CPT 77067 Scr Mammo Bi Incl Cad $114.55 $444.00 $444.00 — 74%
Screening mammogram, both breasts inpatient both sides CPT 77067 Scr Mammo Bi Incl Cad $114.55 $444.00 $444.00 — 74%
Shoulder X-ray, complete, 2 or more views CPT 73030 Rad Exam Shldr; Compl 2 Vw Min $199.69 $774.00 $774.00–$1,548.00 4% below 74%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Rad Exam Shldr; Compl 2 Vw Min $199.69 $774.00 $774.00–$1,548.00 — 74%
Sinus X-ray, complete, 3 or more views CPT 70220 Rad Exam Sinuses Compl 3 Vw Min $206.40 $800.00 $800.00 27% below 74%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Rad Exam Sinuses Compl 3 Vw Min $206.40 $800.00 $800.00 — 74%
Skull X-ray, fewer than 4 views CPT 70250 Rad Exam Skull; <4 Vw $157.38 $610.00 $610.00 32% below 74%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Rad Exam Skull; <4 Vw $157.38 $610.00 $610.00 — 74%
Sleep study in a lab (polysomnography) CPT 95810 Pss W 4/> Param W Tech $1,886.75 $7,313.00 $7,313.00 32% below 74%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Pss W 4/> Param W Tech $1,886.75 $7,313.00 $7,313.00 — 74%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Stress Tte Complete $890.36 $3,451.00 $3,451.00 50% below 74%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Stress Tte Complete $890.36 $3,451.00 $3,451.00 — 74%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Swallowing Function W/Video Contrast Study $203.56 $789.00 $789.00 45% below 74%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Swallowing Function W/Video Contrast Study $203.56 $789.00 $789.00 — 74%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-Ray Exam of Femur 2/> Views $195.56 $758.00 $758.00–$1,516.00 2% below 74%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-Ray Exam of Femur 2/> Views $195.56 $758.00 $758.00–$1,516.00 — 74%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Thor Spin; W/O Cont $712.08 $2,760.00 $2,760.00 18% below 74%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Thor Spin; W/O Cont $712.08 $2,760.00 $2,760.00 — 74%
Toe X-ray, 2 or more views CPT 73660 Rad Exam; Toe(S) 2 Vw Min $128.23 $497.00 $497.00 13% below 74%
Toe X-ray, 2 or more views inpatient CPT 73660 Rad Exam; Toe(S) 2 Vw Min $128.23 $497.00 $497.00 — 74%
Transvaginal pelvic ultrasound CPT 76830 US Transvag $292.31 $1,133.00 $1,133.00 28% below 74%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvag $292.31 $1,133.00 $1,133.00 — 74%
Transvaginal ultrasound during pregnancy CPT 76817 US Preg Uter Transvag $188.86 $732.00 $732.00 49% below 74%
Transvaginal ultrasound during pregnancy CPT 76817 ED Bedside US Preg Uterus Transvaginal $210.27 $815.00 $815.00 43% below 74%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Uter Transvag $188.86 $732.00 $732.00 — 74%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 ED Bedside US Preg Uterus Transvaginal $210.27 $815.00 $815.00 — 74%
Ultrasound of the abdomen, complete CPT 76700 ED Ultrasound, Abdominal;Complete $345.46 $1,339.00 $1,339.00 34% below 74%
Ultrasound of the abdomen, complete CPT 76700 US Abd W/Image Doc; Compl $355.78 $1,379.00 $1,379.00 32% below 74%
Ultrasound of the abdomen, complete inpatient CPT 76700 ED Ultrasound, Abdominal;Complete $345.46 $1,339.00 $1,339.00 — 74%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abd W/Image Doc; Compl $355.78 $1,379.00 $1,379.00 — 74%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum and Contents $317.34 $1,230.00 $1,230.00 26% below 74%
Ultrasound of the scrotum and testicles CPT 76870 HC US Scrotum $317.34 $1,230.00 $1,230.00 26% below 74%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum and Contents $317.34 $1,230.00 $1,230.00 — 74%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US Scrotum $317.34 $1,230.00 $1,230.00 — 74%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Sft Tissue Head/Neck W/Image $331.27 $1,284.00 $1,284.00 22% below 74%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Bedside US Exam of Head and Neck $331.27 $1,284.00 $1,284.00 22% below 74%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Sft Tissue Head/Neck W/Image $331.27 $1,284.00 $1,284.00 — 74%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Bedside US Exam of Head and Neck $331.27 $1,284.00 $1,284.00 — 74%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Rad Exam Upper GI Sngl Contrast Study $277.87 $1,077.00 $1,077.00 47% below 74%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Rad Exam Upper GI Sngl Contrast Study $277.87 $1,077.00 $1,077.00 — 74%
Upper arm X-ray (humerus), 2 views CPT 73060 Rad Exam; Humerus 2 Vw Min $153.25 $594.00 $594.00–$1,188.00 21% below 74%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Rad Exam; Humerus 2 Vw Min $153.25 $594.00 $594.00–$1,188.00 — 74%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplx Scan of Ext Veins; Unilat or Ltd Study $427.25 $1,656.00 $1,656.00 34% below 74%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Bedside Duplx Scan of Ext Veins; Unilat or Ltd $427.25 $1,656.00 $1,656.00 34% below 74%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Bedside Duplx Scan of Ext Veins; Unilat or Ltd $427.25 $1,656.00 $1,656.00 — 74%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplx Scan of Ext Veins; Unilat or Ltd Study $427.25 $1,656.00 $1,656.00 — 74%
Wrist X-ray, 2 views CPT 73100 Rad Exam Wrist; 2 Vw $153.25 $594.00 $594.00–$1,188.00 3% below 74%
Wrist X-ray, 2 views inpatient CPT 73100 Rad Exam Wrist; 2 Vw $153.25 $594.00 $594.00–$1,188.00 — 74%
Wrist X-ray, complete, 3 or more views CPT 73110 Rad Exam Wrist; Compl 3 Vw Min $174.92 $678.00 $678.00–$1,356.00 31% below 74%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Rad Exam Wrist; Compl 3 Vw Min $174.92 $678.00 $678.00–$1,356.00 — 74%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-Ray Exam Hip Uni, W/Pelvis When Performed, 2-3 V $213.88 $829.00 $829.00 20% below 74%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-Ray Exam Hip Uni, W/Pelvis When Performed, 2-3 V $213.88 $829.00 $829.00 — 74%
X-ray of the abdomen, 1 view CPT 74018 Xray Exam Babyscan Abdomen 1 View $63.47 $246.00 $246.00 72% below 74%
X-ray of the abdomen, 1 view CPT 74018 X-Ray Exam Abdomen 1 View $149.64 $580.00 $580.00 33% below 74%
X-ray of the abdomen, 1 view inpatient CPT 74018 Xray Exam Babyscan Abdomen 1 View $63.47 $246.00 $246.00 — 74%
X-ray of the abdomen, 1 view inpatient CPT 74018 X-Ray Exam Abdomen 1 View $149.64 $580.00 $580.00 — 74%
X-ray of the ankle, 2 views CPT 73600 Rad Exam Ankl; 2 Vw $142.67 $553.00 $553.00–$1,106.00 11% below 74%
X-ray of the ankle, 2 views inpatient CPT 73600 Rad Exam Ankl; 2 Vw $142.67 $553.00 $553.00–$1,106.00 — 74%
X-ray of the finger(s), 2 or more views CPT 73140 Rad Exam Fngr(S); 2 Vw Min $132.10 $512.00 $512.00–$1,024.00 16% below 74%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Rad Exam Fngr(S); 2 Vw Min $132.10 $512.00 $512.00–$1,024.00 — 74%
X-ray of the foot, 2 views CPT 73620 Rad Exam Ft; 2 Vw $139.06 $539.00 $539.00–$1,078.00 15% below 74%
X-ray of the foot, 2 views inpatient CPT 73620 Rad Exam Ft; 2 Vw $139.06 $539.00 $539.00–$1,078.00 — 74%
X-ray of the foot, complete, 3 or more views CPT 73630 Rad Exam Ft; Compl 3 Vw Min $181.37 $703.00 $703.00–$1,406.00 10% below 74%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Rad Exam Ft; Compl 3 Vw Min $181.37 $703.00 $703.00–$1,406.00 — 74%
X-ray of the hand, 3 or more views CPT 73130 Rad Exam Hnd; 3 Vw Min $174.92 $678.00 $678.00–$1,356.00 13% below 74%
X-ray of the hand, 3 or more views inpatient CPT 73130 Rad Exam Hnd; 3 Vw Min $174.92 $678.00 $678.00–$1,356.00 — 74%
X-ray of the knee, 1 or 2 views CPT 73560 Rad Exam Knee; 1/2 Vw $146.54 $568.00 $568.00–$1,136.00 30% below 74%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Rad Exam Knee; 1/2 Vw $146.54 $568.00 $568.00–$1,136.00 — 74%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Rad Exam Spine Lumbosacral;2/3 Vw $256.71 $995.00 $995.00 2% above 74%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Rad Exam Spine Lumbosacral;2/3 Vw $256.71 $995.00 $995.00 — 74%
X-ray of the lower back, 4 or more views CPT 72110 Rad Exam Spine Lumbosacral; 4vw Min $342.37 $1,327.00 $1,327.00 1% below 74%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Rad Exam Spine Lumbosacral; 4vw Min $342.37 $1,327.00 $1,327.00 — 74%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Rad Exam Spine; Thor 2 Vw $135.45 $525.00 $525.00 43% below 74%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Rad Exam Spine; Thor 2 Vw $135.45 $525.00 $525.00 — 74%
X-ray of the nasal bones, 3 or more views CPT 70160 Rad Exam Nasal Bns; Compl 3 Vw Min $135.45 $525.00 $525.00 34% below 74%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Rad Exam Nasal Bns; Compl 3 Vw Min $135.45 $525.00 $525.00 — 74%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Rad Exam Cerv Spine; 2/3 Vw $178.28 $691.00 $691.00 29% below 74%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Rad Exam Cerv Spine; 2/3 Vw $178.28 $691.00 $691.00 — 74%
X-ray of the pelvis, 1 or 2 views CPT 72170 Rad Exam Pel; 1/2 Vw $149.64 $580.00 $580.00 24% below 74%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Rad Exam Pel; 1/2 Vw $149.64 $580.00 $580.00 — 74%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Rad Exam Sacrum/Coccyx 2 Vw Min $185.50 $719.00 $719.00 15% below 74%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Rad Exam Sacrum/Coccyx 2 Vw Min $185.50 $719.00 $719.00 — 74%

Lab tests

ProcedureCash priceList priceInsurers payvs IndianaOff list
ACTH blood test CPT 82024 Adrenocorticotropic Hormone $206.40 $800.00 $800.00 21% below 74%
ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone $206.40 $800.00 $800.00 — 74%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase; Alanine Amino $35.86 $139.00 $139.00 28% above 74%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Transferase; Alanine Amino $35.86 $139.00 $139.00 — 74%
AST (aspartate aminotransferase) enzyme test CPT 84450 Ast or Sgot $35.86 $139.00 $139.00 24% above 74%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Ast or Sgot $35.86 $139.00 $139.00 — 74%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel $317.34 $1,230.00 $1,230.00 at median 74%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel $317.34 $1,230.00 $1,230.00 — 74%
Albumin blood test CPT 82040 Assay of Serum Albumin 062 $25.54 $99.00 $99.00 11% above 74%
Albumin blood test inpatient CPT 82040 Assay of Serum Albumin 062 $25.54 $99.00 $99.00 — 74%
Aldosterone blood test CPT 82088 Aldosterone 071 $110.42 $428.00 $428.00 47% below 74%
Aldosterone blood test inpatient CPT 82088 Aldosterone 071 $110.42 $428.00 $428.00 — 74%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase $35.86 $139.00 $139.00 10% above 74%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase $35.86 $139.00 $139.00 — 74%
Allergy blood test, specific IgE, per allergen CPT 86003 Allerg Sp Ige; Quan or Semiquan 493 $13.93 $54.00 $54.00 27% below 74%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allerg Sp Ige; Quan or Semiquan 493 $13.93 $54.00 $54.00 — 74%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha-Fetoprotein; Serum 075 $78.95 $306.00 $306.00 23% below 74%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha-Fetoprotein; Serum 075 $78.95 $306.00 $306.00 — 74%
Ammonia blood test CPT 82140 Ammonia $68.11 $264.00 $264.00 43% below 74%
Ammonia blood test inpatient CPT 82140 Ammonia $68.11 $264.00 $264.00 — 74%
Amylase blood test CPT 82150 Amylase 088 $64.24 $249.00 $249.00 27% above 74%
Amylase blood test CPT 82150 Amylase 087 $64.24 $249.00 $249.00 27% above 74%
Amylase blood test inpatient CPT 82150 Amylase 088 $64.24 $249.00 $249.00 — 74%
Amylase blood test inpatient CPT 82150 Amylase 087 $64.24 $249.00 $249.00 — 74%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibody $146.54 $568.00 $568.00 177% above 74%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibody $146.54 $568.00 $568.00 — 74%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab (Ana); $93.14 $361.00 $361.00 55% above 74%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab (Ana); $93.14 $361.00 $361.00 — 74%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic Peptide $60.89 $236.00 $236.00 64% below 74%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Natriuretic Peptide $60.89 $236.00 $236.00 — 74%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bacterial Culture - Othr Source 671 $60.89 $236.00 $236.00 35% below 74%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bacterial Culture - Othr Source 671 $60.89 $236.00 $236.00 — 74%
Basic metabolic panel (blood test) CPT 80048 Bmp (Calcium Total) $85.66 $332.00 $332.00 6% above 74%
Basic metabolic panel (blood test) inpatient CPT 80048 Bmp (Calcium Total) $85.66 $332.00 $332.00 — 74%
Bilirubin blood test, total CPT 82247 Bilirubin Total 102 $18.06 $70.00 $70.00 46% below 74%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total 102 $18.06 $70.00 $70.00 — 74%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Tissue Exam by Pathologist 009 $85.66 $332.00 $332.00 67% below 74%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Tissue Exam by Pathologist 009 $85.66 $332.00 $332.00 — 74%
Blood culture for bacteria CPT 87040 Aerob Bacterial Bld Culture $71.47 $277.00 $277.00 45% below 74%
Blood culture for bacteria inpatient CPT 87040 Aerob Bacterial Bld Culture $71.47 $277.00 $277.00 — 74%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture $9.29 $36.00 $36.00 45% below 74%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture $9.29 $36.00 $36.00 — 74%
Blood glucose (sugar) test CPT 82947 Glucose; Quan Bld 196 $35.86 $139.00 $139.00 33% above 74%
Blood glucose (sugar) test CPT 82947 Glucose; Quan Bld Nicu $35.86 $139.00 $139.00 33% above 74%
Blood glucose (sugar) test CPT 82947 Glucose; Quan Bld 1262 $35.86 $139.00 $139.00 33% above 74%
Blood glucose (sugar) test one side CPT 82947 Glucose; Quan Blood-Rt $35.86 $139.00 $139.00 33% above 74%
Blood glucose (sugar) test inpatient CPT 82947 Glucose; Quan Bld 196 $35.86 $139.00 $139.00 — 74%
Blood glucose (sugar) test inpatient CPT 82947 Glucose; Quan Bld 1262 $35.86 $139.00 $139.00 — 74%
Blood glucose (sugar) test inpatient CPT 82947 Glucose; Quan Bld Nicu $35.86 $139.00 $139.00 — 74%
Blood glucose (sugar) test inpatient one side CPT 82947 Glucose; Quan Blood-Rt $35.86 $139.00 $139.00 — 74%
Blood lead test CPT 83655 Lead 246 $18.06 $70.00 $70.00 75% below 74%
Blood lead test inpatient CPT 83655 Lead 246 $18.06 $70.00 $70.00 — 74%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg; Qual $68.11 $264.00 $264.00 11% below 74%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Hcg; Qual $68.11 $264.00 $264.00 — 74%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bld Typing; Abo 641 $46.44 $180.00 $180.00 10% below 74%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bld Typing; Abo $53.66 $208.00 $208.00 4% above 74%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bld Typing; Abo 641 $46.44 $180.00 $180.00 — 74%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bld Typing; Abo $53.66 $208.00 $208.00 — 74%
Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen; Quan 414 $35.86 $139.00 $139.00 49% above 74%
Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen; Quan 413 $35.86 $139.00 $139.00 49% above 74%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen; Quan 413 $35.86 $139.00 $139.00 — 74%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen; Quan 414 $35.86 $139.00 $139.00 — 74%
C-peptide blood test CPT 84681 C-Peptide $68.11 $264.00 $264.00 49% below 74%
C-peptide blood test inpatient CPT 84681 C-Peptide $68.11 $264.00 $264.00 — 74%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein $57.28 $222.00 $222.00 18% below 74%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein $57.28 $222.00 $222.00 — 74%
C. difficile toxin gene test (stool PCR) CPT 87493 C Diff Amplified Probe $85.66 $332.00 $332.00 37% below 74%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C Diff Amplified Probe $85.66 $332.00 $332.00 — 74%
CA 19-9 blood test (tumor marker) CPT 86301 Ia Quant; Ca 19-9 $78.95 $306.00 $306.00 46% below 74%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Ia Quant; Ca 19-9 $78.95 $306.00 $306.00 — 74%
CA-125 blood test (ovarian cancer marker) CPT 86304 Ia Quant; Ca 125 $128.23 $497.00 $497.00 22% below 74%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Ia Quant; Ca 125 $128.23 $497.00 $497.00 — 74%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-Cov-2 Covid-19 Amp Prb $32.77 $127.00 $127.00 69% below 74%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 Ncov Any Technique $92.62 $359.00 $359.00 13% below 74%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 Ncov Dx Panel $92.62 $359.00 $359.00 13% below 74%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Sars-Cov-2 Covid-19 Amp Prb $32.77 $127.00 $127.00 — 74%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 2019 Ncov Any Technique $92.62 $359.00 $359.00 — 74%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 2019 Ncov Dx Panel $92.62 $359.00 $359.00 — 74%
Calcium blood test, total CPT 82310 Calcium; Total $32.25 $125.00 $125.00 19% above 74%
Calcium blood test, total inpatient CPT 82310 Calcium; Total $32.25 $125.00 $125.00 — 74%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen 121 $110.42 $428.00 $428.00 11% below 74%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen 121 $110.42 $428.00 $428.00 — 74%
Chickenpox (varicella) immunity blood test CPT 86787 Ab; Varicella-Zoster 620 $78.95 $306.00 $306.00 22% below 74%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Ab; Varicella-Zoster 620 $78.95 $306.00 $306.00 — 74%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia T Amplif Na Probe 750 $93.14 $361.00 $361.00 9% below 74%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia T Amplif Na Probe 750 $93.14 $361.00 $361.00 — 74%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel $117.65 $456.00 $456.00 7% above 74%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel $117.65 $456.00 $456.00 — 74%
Complete blood count (CBC) with differential CPT 85025 Compl Cbc W Plt W Autom Diff $49.79 $193.00 $193.00 24% above 74%
Complete blood count (CBC) with differential inpatient CPT 85025 Compl Cbc W Plt W Autom Diff $49.79 $193.00 $193.00 — 74%
Complete blood count (CBC), no differential CPT 85027 Compl Autom Cbc W Plt $39.47 $153.00 $153.00 30% above 74%
Complete blood count (CBC), no differential CPT 85027 Compl Autom Cbc W Plt Nicu $39.47 $153.00 $153.00 30% above 74%
Complete blood count (CBC), no differential inpatient CPT 85027 Compl Autom Cbc W Plt Nicu $39.47 $153.00 $153.00 — 74%
Complete blood count (CBC), no differential inpatient CPT 85027 Compl Autom Cbc W Plt $39.47 $153.00 $153.00 — 74%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehen Metabolic Panel 004 $132.10 $512.00 $512.00 29% above 74%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehen Metabolic Panel 004 $132.10 $512.00 $512.00 — 74%
Cortisol blood test, total CPT 82533 Cortisol; Total $96.49 $374.00 $374.00 1% above 74%
Cortisol blood test, total inpatient CPT 82533 Cortisol; Total $96.49 $374.00 $374.00 — 74%
Creatine kinase (CK) blood test, total CPT 82550 Cpk Total 150 $49.79 $193.00 $193.00 28% above 74%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Cpk Total 150 $49.79 $193.00 $193.00 — 74%
Creatinine blood test CPT 82565 Creatinine; Bld 155 $39.47 $153.00 $153.00 37% above 74%
Creatinine blood test CPT 82565 Creatinine;Bld $39.47 $153.00 $153.00 37% above 74%
Creatinine blood test CPT 82565 Creatinine; Bld-Nicu $39.47 $153.00 $153.00 37% above 74%
Creatinine blood test inpatient CPT 82565 Creatinine; Bld 155 $39.47 $153.00 $153.00 — 74%
Creatinine blood test inpatient CPT 82565 Creatinine; Bld-Nicu $39.47 $153.00 $153.00 — 74%
Creatinine blood test inpatient CPT 82565 Creatinine;Bld $39.47 $153.00 $153.00 — 74%
Cytomegalovirus (CMV) antibody test CPT 86644 Ab; Cmv 578 $71.47 $277.00 $277.00 8% below 74%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Ab; Cmv 578 $71.47 $277.00 $277.00 — 74%
D-dimer blood test (blood clot marker) CPT 85379 POCT D-Dimer - Quantitative $114.55 $444.00 $444.00 6% below 74%
D-dimer blood test (blood clot marker) inpatient CPT 85379 POCT D-Dimer - Quantitative $114.55 $444.00 $444.00 — 74%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-Sulfate $128.23 $497.00 $497.00 16% below 74%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone-Sulfate $128.23 $497.00 $497.00 — 74%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Class List A $93.14 $361.00 $361.00 18% below 74%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Class List A $93.14 $361.00 $361.00 — 74%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel $78.95 $306.00 $306.00 23% above 74%
Electrolyte panel (sodium, potassium, chloride, CO2) one side CPT 80051 Electrolyte Panel-Rt $78.95 $306.00 $306.00 23% above 74%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel $78.95 $306.00 $306.00 — 74%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient one side CPT 80051 Electrolyte Panel-Rt $78.95 $306.00 $306.00 — 74%
Epstein-Barr virus (EBV) antibody test CPT 86665 Ab; Eb Vca $78.95 $306.00 $306.00 7% below 74%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Ab; Eb Vca $78.95 $306.00 $306.00 — 74%
Estradiol blood test CPT 82670 Estradiol $114.55 $444.00 $444.00 13% below 74%
Estradiol blood test inpatient CPT 82670 Estradiol $114.55 $444.00 $444.00 — 74%
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; Fsh $139.06 $539.00 $539.00 9% above 74%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Gonadotropin; Fsh $139.06 $539.00 $539.00 — 74%
Fecal calprotectin (stool inflammation test) CPT 83993 Assay for Calprotectin Fecal $85.66 $332.00 $332.00 52% below 74%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Assay for Calprotectin Fecal $85.66 $332.00 $332.00 — 74%
Ferritin blood test (iron stores) CPT 82728 Ferritin $85.66 $332.00 $332.00 10% above 74%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin $85.66 $332.00 $332.00 — 74%
Fibrinogen blood test CPT 85384 Fibrinogen; Activity $74.82 $290.00 $290.00 18% above 74%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen; Activity $74.82 $290.00 $290.00 — 74%
Folate (folic acid) blood test CPT 82746 Folic Acid; Serum $71.47 $277.00 $277.00 7% below 74%
Folate (folic acid) blood test inpatient CPT 82746 Folic Acid; Serum $71.47 $277.00 $277.00 — 74%
Free T3 thyroid hormone test CPT 84481 T3; Free $195.56 $758.00 $758.00 31% above 74%
Free T3 thyroid hormone test inpatient CPT 84481 T3; Free $195.56 $758.00 $758.00 — 74%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free Thyroxine 395 $78.95 $306.00 $306.00 3% below 74%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free Thyroxine 395 $78.95 $306.00 $306.00 — 74%
Free testosterone test CPT 84402 Testosterone; Free $132.10 $512.00 $512.00 58% above 74%
Free testosterone test inpatient CPT 84402 Testosterone; Free $132.10 $512.00 $512.00 — 74%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Glutamyltransferase Gamma $35.86 $139.00 $139.00 6% above 74%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Glutamyltransferase Gamma $35.86 $139.00 $139.00 — 74%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel $235.30 $912.00 $912.00 23% below 74%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel $235.30 $912.00 $912.00 — 74%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose; Post Glucose Dose 199 $32.25 $125.00 $125.00 22% below 74%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose; Post Glucose Dose 199 $32.25 $125.00 $125.00 — 74%
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance Test (Gtt) $106.81 $414.00 $414.00 46% above 74%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance Test (Gtt) $106.81 $414.00 $414.00 — 74%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Amplif Na Probe 768 $82.30 $319.00 $319.00 17% below 74%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Amplif Na Probe 768 $82.30 $319.00 $319.00 — 74%
H. pylori antibody blood test CPT 86677 Ab; Helicobacter Pylori $99.85 $387.00 $387.00 at median 74%
H. pylori antibody blood test inpatient CPT 86677 Ab; Helicobacter Pylori $99.85 $387.00 $387.00 — 74%
H. pylori stool antigen test CPT 87338 Hpylori Stool Eia $64.24 $249.00 $249.00 50% below 74%
H. pylori stool antigen test inpatient CPT 87338 Hpylori Stool Eia $64.24 $249.00 $249.00 — 74%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Na Quan $82.30 $319.00 $319.00 78% below 74%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 Na Quan $82.30 $319.00 $319.00 — 74%
HIV-1 and HIV-2 antibody test CPT 86703 Ab; Hiv-1 & Hiv-2 Sgl Assay 596 $82.30 $319.00 $319.00 16% above 74%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Ab; Hiv-1 & Hiv-2 Sgl Assay 596 $82.30 $319.00 $319.00 — 74%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab $46.44 $180.00 $180.00 22% below 74%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab $46.44 $180.00 $180.00 — 74%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High-Risk Types $46.44 $180.00 $180.00 55% below 74%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Hpv High-Risk Types $46.44 $180.00 $180.00 — 74%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Glycosylated Hemoglobin Test $74.82 $290.00 $290.00 11% above 74%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Glycosylated Hemoglobin Test $74.82 $290.00 $290.00 — 74%
Hemoglobin blood test CPT 85018 Hemoglobin $18.06 $70.00 $70.00 3% below 74%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin $18.06 $70.00 $70.00 — 74%
Hepatitis B core antibody test (total) CPT 86704 Ab; Hbcab - Total 598 $59.60 $231.00 $231.00 12% below 74%
Hepatitis B core antibody test (total) CPT 86704 Ab; Hbcab - Total 599 $71.47 $277.00 $277.00 5% above 74%
Hepatitis B core antibody test (total) inpatient CPT 86704 Ab; Hbcab - Total 598 $59.60 $231.00 $231.00 — 74%
Hepatitis B core antibody test (total) inpatient CPT 86704 Ab; Hbcab - Total 599 $71.47 $277.00 $277.00 — 74%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Ab: Hbsab $74.82 $290.00 $290.00 14% above 74%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Ab: Hbsab $74.82 $290.00 $290.00 — 74%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag Eia 741 $78.95 $306.00 $306.00 29% above 74%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag Eia 869 $78.95 $306.00 $306.00 29% above 74%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag Eia 741 $78.95 $306.00 $306.00 — 74%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag Eia 869 $78.95 $306.00 $306.00 — 74%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab 625 $124.87 $484.00 $484.00 23% above 74%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Ab 625 $124.87 $484.00 $484.00 — 74%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hep-C Na Quan 831 $85.66 $332.00 $332.00 61% below 74%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hep-C Na Quan 831 $85.66 $332.00 $332.00 — 74%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Test $60.89 $236.00 $236.00 18% above 74%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Test $60.89 $236.00 $236.00 — 74%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2 $60.89 $236.00 $236.00 16% below 74%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Type 2 $60.89 $236.00 $236.00 — 74%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein Hs $71.47 $277.00 $277.00 3% below 74%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein Hs $71.47 $277.00 $277.00 — 74%
Homocysteine blood test CPT 83090 Assay of Homocystine $170.80 $662.00 $662.00 32% above 74%
Homocysteine blood test inpatient CPT 83090 Assay of Homocystine $170.80 $662.00 $662.00 — 74%
Insulin blood test CPT 83525 Insulin; Total $71.47 $277.00 $277.00 6% below 74%
Insulin blood test inpatient CPT 83525 Insulin; Total $71.47 $277.00 $277.00 — 74%
Iron blood test (serum iron) CPT 83540 IRON $49.79 $193.00 $193.00 4% above 74%
Iron blood test (serum iron) inpatient CPT 83540 IRON $49.79 $193.00 $193.00 — 74%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity $35.86 $139.00 $139.00 20% below 74%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity $35.86 $139.00 $139.00 — 74%
Kidney function blood test panel CPT 80069 Renal Function Panel $60.89 $236.00 $236.00 42% below 74%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel $60.89 $236.00 $236.00 — 74%
LH (luteinizing hormone) test CPT 83002 Gonadotropin; Luteinizing Hormone $142.67 $553.00 $553.00 1% above 74%
LH (luteinizing hormone) test inpatient CPT 83002 Gonadotropin; Luteinizing Hormone $142.67 $553.00 $553.00 — 74%
Lactate (lactic acid) blood test CPT 83605 Lactate $60.89 $236.00 $236.00 32% below 74%
Lactate (lactic acid) blood test CPT 83605 POCT Lactate Level $60.89 $236.00 $236.00 32% below 74%
Lactate (lactic acid) blood test CPT 83605 Lactate-Or $60.89 $236.00 $236.00 32% below 74%
Lactate (lactic acid) blood test CPT 83605 HC Lactate 1423 $60.89 $236.00 $236.00 32% below 74%
Lactate (lactic acid) blood test one side CPT 83605 Lactate - Rt $60.89 $236.00 $236.00 32% below 74%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactate 1423 $60.89 $236.00 $236.00 — 74%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactate $60.89 $236.00 $236.00 — 74%
Lactate (lactic acid) blood test inpatient CPT 83605 POCT Lactate Level $60.89 $236.00 $236.00 — 74%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactate-Or $60.89 $236.00 $236.00 — 74%
Lactate (lactic acid) blood test inpatient one side CPT 83605 Lactate - Rt $60.89 $236.00 $236.00 — 74%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase 244 $32.25 $125.00 $125.00 24% below 74%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase 244 $32.25 $125.00 $125.00 — 74%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase 249 $64.24 $249.00 $249.00 28% below 74%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase 249 $64.24 $249.00 $249.00 — 74%
Liver function blood test panel CPT 80076 Hepatic Function Panel $121.26 $470.00 $470.00 15% above 74%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel $121.26 $470.00 $470.00 — 74%
Lyme disease antibody test CPT 86618 Ab; Lyme's Disease $106.81 $414.00 $414.00 17% below 74%
Lyme disease antibody test inpatient CPT 86618 Ab; Lyme's Disease $106.81 $414.00 $414.00 — 74%
Magnesium blood test CPT 83735 Magnesium 256 $35.86 $139.00 $139.00 22% below 74%
Magnesium blood test inpatient CPT 83735 Magnesium 256 $35.86 $139.00 $139.00 — 74%
Measles (rubeola) antibody test CPT 86765 Ab; Rubeola $89.01 $345.00 $345.00 9% above 74%
Measles (rubeola) antibody test inpatient CPT 86765 Ab; Rubeola $89.01 $345.00 $345.00 — 74%
Mono test (heterophile antibody, Monospot) CPT 86308 Qual Heterophile Ab $57.28 $222.00 $222.00 31% below 74%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Qual Heterophile Ab $57.28 $222.00 $222.00 — 74%
Mumps immunity blood test CPT 86735 Ab; Mumps $106.81 $414.00 $414.00 39% above 74%
Mumps immunity blood test inpatient CPT 86735 Ab; Mumps $106.81 $414.00 $414.00 — 74%
Obstetric blood test panel CPT 80055 Obstetric Panel $157.38 $610.00 $610.00 53% below 74%
Obstetric blood test panel inpatient CPT 80055 Obstetric Panel $157.38 $610.00 $610.00 — 74%
PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate Specific Antigen (Psa); Free $78.95 $306.00 $306.00 13% above 74%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Prostate Specific Antigen (Psa); Free $78.95 $306.00 $306.00 — 74%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen (Psa); Total $78.95 $306.00 $306.00 2% below 74%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen (Psa); Total $78.95 $306.00 $306.00 — 74%
Pap test (liquid-based, automated screening with review) CPT 88175 Atl Scrn Cytopath W Rvw by Tech $71.47 $277.00 $277.00 9% below 74%
Pap test (liquid-based, automated screening with review) CPT 88175 Cytopath C/V Auto Fluid Redo 791 $71.47 $277.00 $277.00 9% below 74%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Atl Scrn Cytopath W Rvw by Tech $71.47 $277.00 $277.00 — 74%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopath C/V Auto Fluid Redo 791 $71.47 $277.00 $277.00 — 74%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cp Cerv/Vag; Atl; Manual Scrn $60.89 $236.00 $236.00 13% below 74%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cp Cerv/Vag; Atl; Manual Scrn $60.89 $236.00 $236.00 — 74%
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone 339 $170.80 $662.00 $662.00 13% below 74%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone 339 $170.80 $662.00 $662.00 — 74%
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt; Plasma or Whole Bld 489 $32.25 $125.00 $125.00 36% below 74%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt; Plasma or Whole Bld 489 $32.25 $125.00 $125.00 — 74%
Phosphorus (phosphate) blood test CPT 84100 Phosphate 345 $25.54 $99.00 $99.00 14% below 74%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphate 345 $25.54 $99.00 $99.00 — 74%
Potassium blood test CPT 84132 Assay of Serum Potassium 934 $28.64 $111.00 $111.00 at median 74%
Potassium blood test CPT 84132 Assay of Serum Potassium-ER $28.64 $111.00 $111.00 at median 74%
Potassium blood test CPT 84132 Assay of Serum Potassium 1257 $28.64 $111.00 $111.00 at median 74%
Potassium blood test CPT 84132 Assay of Serum Potassium-Nicu $28.64 $111.00 $111.00 at median 74%
Potassium blood test CPT 84132 Assay of Serum Potassium $28.64 $111.00 $111.00 at median 74%
Potassium blood test CPT 84132 Assay of Serum Potassium-Oh $81.79 $317.00 $317.00 187% above 74%
Potassium blood test inpatient CPT 84132 Assay of Serum Potassium 1257 $28.64 $111.00 $111.00 — 74%
Potassium blood test inpatient CPT 84132 Assay of Serum Potassium-Nicu $28.64 $111.00 $111.00 — 74%
Potassium blood test inpatient CPT 84132 Assay of Serum Potassium-ER $28.64 $111.00 $111.00 — 74%
Potassium blood test inpatient CPT 84132 Assay of Serum Potassium $28.64 $111.00 $111.00 — 74%
Potassium blood test inpatient CPT 84132 Assay of Serum Potassium 934 $28.64 $111.00 $111.00 — 74%
Potassium blood test inpatient CPT 84132 Assay of Serum Potassium-Oh $81.79 $317.00 $317.00 — 74%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Fetal Chrmoml Aneuploidy $640.61 $2,483.00 $2,483.00 24% below 74%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Fetal Chrmoml Aneuploidy $640.61 $2,483.00 $2,483.00 — 74%
Progesterone blood test CPT 84144 Progesterone Assay $128.23 $497.00 $497.00 7% below 74%
Progesterone blood test inpatient CPT 84144 Progesterone Assay $128.23 $497.00 $497.00 — 74%
Prolactin blood test CPT 84146 Prolactin Assay $157.38 $610.00 $610.00 57% above 74%
Prolactin blood test inpatient CPT 84146 Prolactin Assay $157.38 $610.00 $610.00 — 74%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time; 482 $3.61 $14.00 $14.00 86% below 74%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time; 482 $3.61 $14.00 $14.00 — 74%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Test Prsmv Dir Opt Obs $111.20 $431.00 $431.00 2% above 74%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug Test Prsmv Dir Opt Obs $111.20 $431.00 $431.00 — 74%
Rapid flu test (influenza antigen) CPT 87804 Infect Agent Detect; Influenza $43.34 $168.00 $168.00 20% below 74%
Rapid flu test (influenza antigen) inpatient CPT 87804 Infect Agent Detect; Influenza $43.34 $168.00 $168.00 — 74%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infect Agent Detect; Strep $43.34 $168.00 $168.00 45% below 74%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Infect Agent Detect; Strep $43.34 $168.00 $168.00 — 74%
Renin blood test CPT 84244 Renin $96.49 $374.00 $374.00 13% below 74%
Renin blood test inpatient CPT 84244 Renin $96.49 $374.00 $374.00 — 74%
Rh blood typing CPT 86901 Bld Typing; Rh D 643 $28.64 $111.00 $111.00 27% below 74%
Rh blood typing inpatient CPT 86901 Bld Typing; Rh D 643 $28.64 $111.00 $111.00 — 74%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quant $46.44 $180.00 $180.00 10% below 74%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quant $46.44 $180.00 $180.00 — 74%
Rubella antibody test (immunity check) CPT 86762 Ab; Rubella 613 $35.86 $139.00 $139.00 48% below 74%
Rubella antibody test (immunity check) inpatient CPT 86762 Ab; Rubella 613 $35.86 $139.00 $139.00 — 74%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Autom Erythrocyte Sed Rate $32.25 $125.00 $125.00 17% below 74%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Autom Erythrocyte Sed Rate $32.25 $125.00 $125.00 — 74%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Anal Vol/Count/Mot $96.49 $374.00 $374.00 15% below 74%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen Anal Vol/Count/Mot $96.49 $374.00 $374.00 — 74%
Sodium blood test CPT 84295 Assay of Serum Sodium-Nicu $21.16 $82.00 $82.00 42% below 74%
Sodium blood test CPT 84295 Assay of Serum Sodium $21.16 $82.00 $82.00 42% below 74%
Sodium blood test CPT 84295 Sodium; Whole Bld 1260 $21.16 $82.00 $82.00 42% below 74%
Sodium blood test CPT 84295 Sodium; Whole Bld $21.16 $82.00 $82.00 42% below 74%
Sodium blood test inpatient CPT 84295 Sodium; Whole Bld 1260 $21.16 $82.00 $82.00 — 74%
Sodium blood test inpatient CPT 84295 Assay of Serum Sodium $21.16 $82.00 $82.00 — 74%
Sodium blood test inpatient CPT 84295 Assay of Serum Sodium-Nicu $21.16 $82.00 $82.00 — 74%
Sodium blood test inpatient CPT 84295 Sodium; Whole Bld $21.16 $82.00 $82.00 — 74%
Stool ova and parasites exam CPT 87177 Ova and Parasite Dir Smr W ID $49.79 $193.00 $193.00 1% above 74%
Stool ova and parasites exam inpatient CPT 87177 Ova and Parasite Dir Smr W ID $49.79 $193.00 $193.00 — 74%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Blood Occult; Qual Consecutive Specimens $21.16 $82.00 $82.00 42% below 74%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Blood Occult; Qual Consecutive Specimens $21.16 $82.00 $82.00 — 74%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Immunochemical Fecal Occult Blood $32.25 $125.00 $125.00 40% below 74%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Immunochemical Fecal Occult Blood $32.25 $125.00 $125.00 — 74%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum 618 $43.34 $168.00 $168.00 41% below 74%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema Pallidum 618 $43.34 $168.00 $168.00 — 74%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Test Non-Trep Qual 562 $43.34 $168.00 $168.00 6% above 74%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis Test Non-Trep Qual 562 $43.34 $168.00 $168.00 — 74%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB Test Cell Immun Measure $71.47 $277.00 $277.00 57% below 74%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB Test Cell Immun Measure $71.47 $277.00 $277.00 — 74%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone; Total $142.67 $553.00 $553.00 23% above 74%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone; Total $142.67 $553.00 $553.00 — 74%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Ab Ea 552 $57.28 $222.00 $222.00 38% below 74%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Ab Ea 552 $57.28 $222.00 $222.00 — 74%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone $99.85 $387.00 $387.00 22% above 74%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone $99.85 $387.00 $387.00 — 74%
Total IgE blood test CPT 82785 Assay of Ige 185 $57.28 $222.00 $222.00 24% below 74%
Total IgE blood test inpatient CPT 82785 Assay of Ige 185 $57.28 $222.00 $222.00 — 74%
Total cholesterol blood test CPT 82465 Cholesterol Serum or Whole Bld Total 133 $28.64 $111.00 $111.00 9% below 74%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Serum or Whole Bld Total 133 $28.64 $111.00 $111.00 — 74%
Total thyroxine (T4) blood test CPT 84436 Thyroxine; Total 392 $82.30 $319.00 $319.00 73% above 74%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine; Total 392 $82.30 $319.00 $319.00 — 74%
Total triiodothyronine (T3) blood test CPT 84480 T3; Total $71.47 $277.00 $277.00 41% below 74%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3; Total $71.47 $277.00 $277.00 — 74%
Transferrin blood test CPT 84466 Transferrin $68.11 $264.00 $264.00 18% below 74%
Transferrin blood test inpatient CPT 84466 Transferrin $68.11 $264.00 $264.00 — 74%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Amplif $85.66 $332.00 $332.00 10% below 74%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis Amplif $85.66 $332.00 $332.00 — 74%
Triglycerides blood test CPT 84478 Triglycerides 404 $28.64 $111.00 $111.00 20% below 74%
Triglycerides blood test inpatient CPT 84478 Triglycerides 404 $28.64 $111.00 $111.00 — 74%
Troponin test, quantitative CPT 84484 Troponin Quan 411 $78.95 $306.00 $306.00 36% below 74%
Troponin test, quantitative inpatient CPT 84484 Troponin Quan 411 $78.95 $306.00 $306.00 — 74%
Uric acid blood test CPT 84550 Uric Acid; Bld 417 $35.86 $139.00 $139.00 25% below 74%
Uric acid blood test inpatient CPT 84550 Uric Acid; Bld 417 $35.86 $139.00 $139.00 — 74%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Auto W/Scope $35.86 $139.00 $139.00 17% below 74%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Auto W/Scope $35.86 $139.00 $139.00 — 74%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis; Non-Auto W/Micro $25.54 $99.00 $99.00 4% below 74%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis; Non-Auto W/Micro $25.54 $99.00 $99.00 — 74%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis; Auto WO/Micro 052 $21.16 $82.00 $82.00 14% below 74%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis; Auto WO/Micro 052 $21.16 $82.00 $82.00 — 74%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis; Non-Auto WO/Micro Express Care $28.64 $111.00 $111.00 79% above 74%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis; Non-Auto WO/Micro $28.64 $111.00 $111.00 79% above 74%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis; Non-Auto WO/Micro $28.64 $111.00 $111.00 — 74%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis; Non-Auto WO/Micro Express Care $28.64 $111.00 $111.00 — 74%
Urine culture for bacteria, with colony count CPT 87086 Bact Culture - Urine; Quan Count $46.44 $180.00 $180.00 5% above 74%
Urine culture for bacteria, with colony count inpatient CPT 87086 Bact Culture - Urine; Quan Count $46.44 $180.00 $180.00 — 74%
Urine microalbumin (albumin) test CPT 82043 Microalbumin; Urine Quan $78.95 $306.00 $306.00 128% above 74%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin; Urine Quan $78.95 $306.00 $306.00 — 74%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test $53.66 $208.00 $208.00 2% below 74%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test-OP Surg $53.66 $208.00 $208.00 2% below 74%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test-OP Surg $53.66 $208.00 $208.00 — 74%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test $53.66 $208.00 $208.00 — 74%
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vit B-12) $78.95 $306.00 $306.00 4% above 74%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Cyanocobalamin (Vit B-12) $78.95 $306.00 $306.00 — 74%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D; 25 Hydroxy $99.85 $387.00 $387.00 20% below 74%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D; 25 Hydroxy $99.85 $387.00 $387.00 — 74%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vit D1 25-Dihydroxy $185.50 $719.00 $719.00 5% above 74%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vit D1 25-Dihydroxy $185.50 $719.00 $719.00 — 74%
Zinc blood test CPT 84630 ZINC $57.28 $222.00 $222.00 23% below 74%
Zinc blood test inpatient CPT 84630 ZINC $57.28 $222.00 $222.00 — 74%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg; Quan 429 $103.72 $402.00 $402.00 31% above 74%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg; Quan 430 $106.81 $414.00 $414.00 35% above 74%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg; Quan 429 $103.72 $402.00 $402.00 — 74%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg; Quan 430 $106.81 $414.00 $414.00 — 74%

Surgery and procedures

ProcedureCash priceList priceInsurers payvs IndianaOff list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 Adenoidectomy Primary <Age 12 $3,466.42 $13,435.74 $13,435.74 26% below 74%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 Arthrd Ant Interbody Decompress Cervical Belw C2 $15,009.94 $58,178.05 $58,178.05 45% below 74%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Arthrs Aided Ant Cruciate Ligm Rpr/Agmntj/Rcnstj $15,457.64 $59,913.34 $59,913.34 22% below 74%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 Surgical Arthroscopy Shoulder W/Rotator Cuff Rpr $13,786.04 $53,434.26 $53,434.26 19% below 74%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Bx Breast 1st Lesion Strtctc Hcode $2,135.72 $8,278.00 $8,278.00 15% below 74%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Bx Breast 1st Lesion Strtctc Hcode $2,135.72 $8,278.00 $8,278.00 — 74%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Corrj Hlx Vlgs Bncty Sesmdc Dstl Metar Osteot $11,738.69 $45,498.80 $45,498.80 25% above 74%
Cardiac catheterization with coronary angiogram CPT 93458 L Hrt Artery/Ventricle Angio $7,118.22 $27,590.00 $27,590.00 28% below 74%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 L Hrt Artery/Ventricle Angio $7,118.22 $27,590.00 $27,590.00 — 74%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion; Ext $676.22 $2,621.00 $2,621.00 54% below 74%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion; Ext $676.22 $2,621.00 $2,621.00 — 74%
Carpal tunnel release, open surgery CPT 64721 Neuroplasty &/Transpos Median Nrv Carpal Tunne $3,150.57 $12,211.51 $12,211.51–$15,550.53 33% below 74%
Cataract surgery with lens implant CPT 66984 Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp $3,968.44 $15,381.54 $15,381.54 25% below 74%
Catheter ablation for atrial fibrillation CPT 93656 Comp Ep Eval Tx Atrial Fib Pulm Vein Isol $16,016.38 $62,079.00 $62,079.00 42% below 74%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Comp Ep Eval Tx Atrial Fib Pulm Vein Isol $16,016.38 $62,079.00 $62,079.00 — 74%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circumcision Age >28 Days $3,649.85 $14,146.69 $14,146.69 29% below 74%
Colonoscopy with polyp removal CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq $2,233.84 $8,658.31 $8,658.31 29% below 74%
Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy Single/Multiple $2,153.96 $8,348.69 $8,348.69–$9,422.19 29% below 74%
Colonoscopy, diagnostic CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd $1,783.81 $6,914.00 $5,947.00–$6,914.00 12% below 74%
Complex cataract surgery with lens implant CPT 66982 Xcapsl Ctrc Rmvl Insj Io Lens Prosth Cplx WO Ecp $4,362.39 $16,908.48 $16,908.48 27% below 74%
Cystoscopy with ureteral stent placement CPT 52332 Cysto W/Insert Ureteral Stent $5,273.72 $20,440.77 $16,201.20–$20,440.77 24% below 74%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystourethroscopy $3,184.93 $12,344.70 $12,344.70 17% above 74%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Tympanostomy General Anesthesia $2,539.47 $9,842.89 $9,215.81–$9,842.89 58% below 74%
Earwax removal with instruments, one ear one side CPT 69210 Removal Impacted Cerumen Instrumentation Unilat $4,724.80 $18,313.19 $8,592.85–$18,313.19 2837% above 74%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 Nasal/Sinus Endoscopy W/Maxillary Antrostomy $8,675.82 $33,627.21 $33,627.21–$41,821.53 at median 74%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 Nsl/Sinus Ndsc Max Antrost W/Rmvl Tiss Max Sinus $7,469.94 $28,953.25 $28,953.25–$51,772.47 21% below 74%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Njx Interlaminar Crv/Thrc W/Image Guidance Hcode $1,495.11 $5,795.00 $5,795.00 35% above 74%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn $2,444.49 $9,474.78 $9,474.78 121% above 74%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Njx Interlaminar Crv/Thrc W/Image Guidance Hcode $1,495.11 $5,795.00 $5,795.00 — 74%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Injection Facet Lumbar/Sacral; Single Lvl Hcode $534.06 $2,070.00 $2,070.00–$4,140.00 56% below 74%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level $1,978.10 $7,667.05 $7,667.05–$11,173.25 64% above 74%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Injection Facet Lumbar/Sacral; Single Lvl Hcode $534.06 $2,070.00 $2,070.00–$4,140.00 — 74%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Rpr Aa Hernia 1st 3-10 Cm Reducible $17,445.04 $67,616.42 $67,616.42 7% below 74%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Rpr Aa Hernia 1st < 3 Cm Reducible $8,946.84 $34,677.66 $20,602.35–$34,677.66 at median 74%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa if Pfrmd $1,773.01 $6,872.15 $6,872.15 21% below 74%
Gallbladder removal, laparoscopic CPT 47562 Laparoscopy Surg Cholecystectomy $14,433.72 $55,944.66 $55,944.66 9% below 74%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Laps Surg Cholecystectomy W/Cholangiography $14,789.74 $57,324.58 $57,324.58 12% below 74%
Hammertoe correction surgery CPT 28285 Correction Hammertoe $9,192.35 $35,629.25 $35,629.25 26% below 74%
Hemorrhoidectomy (internal and external), one area CPT 46255 Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group $4,884.46 $18,932.00 $18,932.00 14% below 74%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Hysterosalpingography Cath $153.25 $594.00 $594.00 47% below 74%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Hysterosalpingography Cath $153.25 $594.00 $594.00 — 74%
Hysteroscopy with endometrial ablation CPT 58563 Hysteroscopy Endometrial Ablation $5,968.92 $23,135.35 $23,135.35 28% below 74%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscopy Bx Endometrium&/Polypc W/WO D&C $5,695.53 $22,075.70 $22,075.70 20% below 74%
IUD insertion (the device itself billed separately) CPT 58300 Insertion Intrauterine Device Iud $3,429.90 $13,294.20 $13,294.20 44% below 74%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D Absc; Smpl or Sgl Hcode $174.92 $678.00 $678.00 65% below 74%
Incision and drainage of a simple or single skin abscess CPT 10060 Incision and Drainage of Abscess; Smpl or Sgl $3,216.14 $12,465.67 $12,465.67 535% above 74%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D Absc; Smpl or Sgl Hcode $174.92 $678.00 $678.00 — 74%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible $5,840.88 $22,639.07 $22,639.07–$69,271.80 33% below 74%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection 1 Tendon Sheath/Ligament Aponeurosis $4,399.59 $17,052.66 $17,052.66 655% above 74%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis; Maj Jt Hcode $427.25 $1,656.00 $1,656.00 3% below 74%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis; Maj Jt Hcode $2,177.14 $8,438.52 $8,438.52 395% above 74%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis; Maj Jt Hcode $427.25 $1,656.00 $1,656.00 — 74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/Inj Interm Jnt/Bursa Hcode $274.51 $1,064.00 $1,064.00 41% below 74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drain/Inj Interm Jnt/Bursa Hcode $274.51 $1,064.00 $1,064.00 — 74%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Drain/Inject Sm Jnt/Bursa Hcode $235.30 $912.00 $912.00 21% below 74%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US $2,743.38 $10,633.25 $10,633.25 818% above 74%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Drain/Inject Sm Jnt/Bursa Hcode $235.30 $912.00 $912.00 — 74%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Arthroscopy Kne Surg Meniscus Rpr Medial/Lateral $13,263.39 $51,408.48 $51,408.48 at median 74%
Knee arthroscopy with meniscus trim CPT 29881 Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg $5,622.74 $21,793.55 $21,793.55–$21,937.72 31% below 74%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Arthrs Knee Surg Meniscectomy Med&Lat W/Shaving $5,723.17 $22,182.82 $22,182.82 28% below 74%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Laparoscopic Appendectomy $9,807.49 $38,013.52 $38,013.52 31% below 74%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 Laps Surg Esopg/Gstr Fundoplasty $18,304.68 $70,948.36 $70,948.36 20% below 74%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 Laparoscopy W Total Hysterectomy Uterus 250 Gm/< $20,728.67 $80,343.69 $80,343.69 8% below 74%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Laps Total Hysterect 250 Gm/< W/Rmvl Tube/Ovary $20,847.21 $80,803.13 $80,803.13 9% below 74%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Laparoscopy Surg Rpr Initial Inguinal Hernia $16,005.99 $62,038.74 $62,038.74–$73,859.06 5% below 74%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Laps Surg Rpr Recurrent Inguinal Hernia $16,153.66 $62,611.08 $62,611.08 1% above 74%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Laparoscopy W/Rmvl Adnexal Structures $9,816.23 $38,047.39 $38,047.39–$82,955.95 40% below 74%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Repair Intermediate S/a/T/E 2.5 Cm/< $2,983.76 $11,564.97 $11,564.97 312% above 74%
Left heart catheterization, diagnostic one side CPT 93452 Left Hrt Cath W/Ventrclgrphy $4,271.45 $16,556.00 $16,556.00 45% below 74%
Left heart catheterization, diagnostic inpatient one side CPT 93452 Left Hrt Cath W/Ventrclgrphy $4,271.45 $16,556.00 $16,556.00 — 74%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx Interlaminar Lmbr/Sac W/Image Guidance Hcode $1,316.83 $5,104.00 $5,104.00–$10,208.00 at median 74%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx Interlaminar Lmbr/Sac W/Image Guidance Hcode $2,413.36 $9,354.12 $9,228.87–$9,354.12 83% above 74%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx Interlaminar Lmbr/Sac W/Image Guidance Hcode $1,316.83 $5,104.00 $5,104.00–$10,208.00 — 74%
Lower-back epidural injection, without imaging guidance CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn $16,979.08 $65,810.38 $65,810.38 1079% above 74%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection Transforaminal; Lumbar Single Lvl Hcode $960.79 $3,724.00 $3,724.00–$7,448.00 43% below 74%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level $2,238.73 $8,677.25 $8,677.25–$8,702.70 32% above 74%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Injection Transforaminal; Lumbar Single Lvl Hcode $960.79 $3,724.00 $3,724.00–$7,448.00 — 74%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Laminotomy Dcmprn Nrv Root 1 Ntrspc Lumbar $10,960.15 $42,481.21 $42,481.21 21% below 74%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 Arthrodesis Combined Tq 1ntrspc Lumbar $36,236.69 $140,452.30 $140,452.30 48% below 74%
Lumbar laminectomy (spinal decompression), one level CPT 63047 Lam Facetectomy & Foramotomy 1 Vrt Sgm Lumbar $16,088.06 $62,356.81 $25,160.40–$62,356.81 11% above 74%
Lumpectomy (partial mastectomy) CPT 19301 Mastectomy Partial $7,634.25 $29,590.13 $29,590.13–$52,398.89 3% below 74%
Mastectomy (total removal of the breast) CPT 19303 Mastectomy Simple Complete $8,656.60 $33,552.72 $33,552.72–$38,132.94 51% below 74%
Miscarriage treatment with D&C, first trimester CPT 59820 Tx Missed Abortion First Trimester Surgical $3,693.63 $14,316.40 $14,316.40 14% below 74%
Occipital nerve block (injection for headaches) CPT 64405 Inject Anesthesia; Greater Occipital Nerve Hcode $427.25 $1,656.00 $1,656.00 29% below 74%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Inject Anesthesia; Greater Occipital Nerve Hcode $427.25 $1,656.00 $1,656.00 — 74%
Pacemaker implant (dual chamber) CPT 33208 Insrt Heart Pm Atrial & Vent $9,966.02 $38,628.00 $38,628.00 18% below 74%
Pacemaker implant (dual chamber) inpatient CPT 33208 Insrt Heart Pm Atrial & Vent $9,966.02 $38,628.00 $38,628.00 — 74%
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis W/Imaging $782.77 $3,034.00 $3,034.00 44% below 74%
Paracentesis with imaging guidance inpatient CPT 49083 Abd Paracentesis W/Imaging $782.77 $3,034.00 $3,034.00 — 74%
Partial knee replacement (one compartment) CPT 27446 Arthrp Knee Condyle&Plateau Medial/Lat Cmprt $16,388.16 $63,520.00 $63,520.00 34% below 74%
Prostate biopsy CPT 55700 Biopsy Prostate; Needle/Punch $4,017.40 $15,571.30 $15,571.30 14% above 74%
Prostate removal (prostatectomy), laparoscopic CPT 55866 Laps Surg Prst8ect Rpbic Rad W/Nerve Sparing $25,917.41 $100,455.09 $100,455.09 15% below 74%
Removal of a breast lump, open surgery CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion $3,930.82 $15,235.75 $15,235.75–$25,527.71 29% below 74%
Removal of a foreign object under the skin, simple CPT 10120 Foreign Body Removal; Simple $222.65 $863.00 $863.00 64% below 74%
Removal of a foreign object under the skin, simple CPT 10120 Incision & Removal FB Sq;Simple $306.76 $1,189.00 $1,189.00 50% below 74%
Removal of a foreign object under the skin, simple CPT 10120 Foreign Body Removal; Simple $4,628.01 $17,938.01 $17,938.01 652% above 74%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Foreign Body Removal; Simple $222.65 $863.00 $863.00 — 74%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision & Removal FB Sq;Simple $306.76 $1,189.00 $1,189.00 — 74%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 Total Thyroid Lobectomy Uni W/WO Isthmusectomy $8,084.35 $31,334.68 $31,334.68 18% below 74%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colon ca scrn not hi rsk ind $1,785.40 $6,920.15 $6,865.15–$6,920.15 9% below 74%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colorectal scrn; hi risk ind $1,791.28 $6,942.95 $6,865.15–$6,942.95 at median 74%
Septoplasty to straighten the nasal septum CPT 30520 Septoplasty/Submucous Resecj W/WO Cartilage Grf $5,694.45 $22,071.53 $13,863.62–$22,071.53 43% below 74%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy Xtrcorp Shock Wave $4,355.68 $16,882.50 $15,994.95–$16,882.50 65% below 74%
Short arm splint (forearm and hand) CPT 29125 Apply Forearm Splint; Static Ot $74.82 $290.00 $290.00–$580.00 60% below 74%
Short arm splint (forearm and hand) inpatient CPT 29125 Apply Forearm Splint; Static Ot $74.82 $290.00 $290.00–$580.00 — 74%
Short leg splint (calf to foot) CPT 29515 Application Short Leg Splint Calf to Foot $4,630.17 $17,946.40 $17,946.40 1764% above 74%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 Surgical Arthroscopy Shoulder Dstl Claviculc $11,080.60 $42,948.06 $42,948.06 23% below 74%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls $12,970.58 $50,273.55 $50,273.55 16% below 74%
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Skin Single Lesion $4,590.83 $17,793.93 $17,793.93 905% above 74%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Lumbar Puncture Diagnostic HCODE $1,032.52 $4,002.00 $4,002.00 1% above 74%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Lumbar Puncture Diagnostic HCODE $2,315.29 $8,974.00 $8,974.00 125% above 74%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Lumbar Puncture Diagnostic HCODE $1,032.52 $4,002.00 $4,002.00 — 74%
TURP (transurethral resection of the prostate) CPT 52601 Trurl Electrosurg Rescj Prostate Bleed Complete $5,306.29 $20,567.02 $20,567.02 67% below 74%
Thoracentesis with imaging guidance CPT 32555 Aspirate Pleura W/ Imaging Hcode $747.68 $2,898.00 $2,898.00–$5,796.00 32% below 74%
Thoracentesis with imaging guidance inpatient CPT 32555 Aspirate Pleura W/ Imaging Hcode $747.68 $2,898.00 $2,898.00–$5,796.00 — 74%
Tonsil and adenoid removal, age 12 or older CPT 42821 Tonsillectomy & Adenoidectomy Age 12/> $4,266.14 $16,535.44 $16,535.44 37% below 74%
Tonsil and adenoid removal, child under 12 CPT 42820 Tonsillectomy & Adenoidectomy <Age 12 $4,032.90 $15,631.39 $15,631.39 35% below 74%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Tonsillectomy Primary/Secondary Age 12/> $4,016.24 $15,566.84 $15,566.84 30% below 74%
Total hip replacement CPT 27130 Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft $17,656.44 $68,435.83 $68,435.83–$124,983.41 40% below 74%
Total knee replacement CPT 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments $17,997.01 $69,755.85 $69,755.85–$97,582.96 32% below 74%
Total shoulder replacement CPT 23472 Arthroplasty Glenohumeral Joint Total Shoulder $18,814.85 $72,925.76 $72,925.76 46% below 74%
Total thyroid removal (thyroidectomy) CPT 60240 Thyroidectomy Total/Complete $9,401.63 $36,440.42 $36,035.77–$36,440.42 36% below 74%
Trigger finger release surgery CPT 26055 Tendon Sheath Incision $3,135.72 $12,153.94 $12,153.94 25% below 74%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx Breast 1st Lesion US Imag Hcode $1,530.71 $5,933.00 $5,933.00 33% below 74%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Bx Breast 1st Lesion US Imag Hcode $1,530.71 $5,933.00 $5,933.00 — 74%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Egd Balloon Dilation Esophagus <30 Mm Diam $2,415.48 $9,362.33 $9,362.33 25% below 74%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd Transoral Biopsy Single/Multiple $2,121.45 $8,222.69 $8,222.69–$9,904.43 31% below 74%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Esophagogastroduodenoscopy Submucosal Injection $2,999.36 $11,625.41 $11,625.41 21% below 74%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd Removal Tumor Polyp/Other Lesion Snare Tech $2,661.06 $10,314.17 $10,314.17 34% below 74%
Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic $1,650.92 $6,398.90 $6,398.90 31% below 74%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 Cysto W/Ureteroscopy W/Lithotripsy $4,394.75 $17,033.90 $17,033.90 56% below 74%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 Cysto/Uretero W/Lithotripsy &Indwell Stent Insrt $7,979.90 $30,929.84 $30,929.84–$37,234.38 50% below 74%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Subq Tissue 20 Sq Cm or Less Hcode $229.36 $889.00 $889.00 71% below 74%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Subq Tissue 20 Sq Cm or Less Hcode $7,392.04 $28,651.30 $28,651.30 849% above 74%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Subq Tissue 20 Sq Cm or Less Hcode $229.36 $889.00 $889.00 — 74%

Doctor visits and therapy

ProcedureCash priceList priceInsurers payvs IndianaOff list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 2 Hours $292.31 $1,133.00 $1,133.00 68% below 74%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 4 Hours $391.64 $1,518.00 $1,518.00 56% below 74%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 6 Hours $498.46 $1,932.00 $1,932.00 45% below 74%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood or Blood Components $604.24 $2,342.00 $2,342.00 33% below 74%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 8 Hours $640.61 $2,483.00 $2,483.00 29% below 74%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 10 Hours $640.61 $2,483.00 $2,483.00 29% below 74%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood 12 Hours $747.68 $2,898.00 $2,898.00 17% below 74%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood 2 Hours $292.31 $1,133.00 $1,133.00 — 74%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood 4 Hours $391.64 $1,518.00 $1,518.00 — 74%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood 6 Hours $498.46 $1,932.00 $1,932.00 — 74%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood or Blood Components $604.24 $2,342.00 $2,342.00 — 74%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood 10 Hours $640.61 $2,483.00 $2,483.00 — 74%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood 8 Hours $640.61 $2,483.00 $2,483.00 — 74%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood 12 Hours $747.68 $2,898.00 $2,898.00 — 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment; E-Z Pap $44.12 $171.00 $171.00 61% below 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 E-Z Pap Treatment; Subseq $44.12 $171.00 $171.00 61% below 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi/Dpi Treatment; Subseq $68.11 $264.00 $264.00 40% below 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pep Treatment; Subseq $68.11 $264.00 $264.00 40% below 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment;Subseq $68.11 $264.00 $264.00 40% below 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment; Aerosol $68.11 $264.00 $264.00 40% below 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment; Mdi/Dpi $68.11 $264.00 $264.00 40% below 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment; Nebulizer $68.11 $264.00 $264.00 40% below 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment; Pep $68.11 $264.00 $264.00 40% below 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Treatment; Subseq $68.11 $264.00 $264.00 40% below 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 E-Z Pap Treatment; Subseq $44.12 $171.00 $171.00 — 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment; E-Z Pap $44.12 $171.00 $171.00 — 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Mdi/Dpi Treatment; Subseq $68.11 $264.00 $264.00 — 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Pep Treatment; Subseq $68.11 $264.00 $264.00 — 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment;Subseq $68.11 $264.00 $264.00 — 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment; Aerosol $68.11 $264.00 $264.00 — 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Treatment; Subseq $68.11 $264.00 $264.00 — 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment; Mdi/Dpi $68.11 $264.00 $264.00 — 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment; Nebulizer $68.11 $264.00 $264.00 — 74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment; Pep $68.11 $264.00 $264.00 — 74%
Chemotherapy IV infusion, first hour CPT 96413 Chemo Admin IV Inf Up to 1 Hr Sgl or Init Subs $295.15 $1,144.00 $1,144.00 56% below 74%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Admin IV Inf Up to 1 Hr Sgl or Init Subs $295.15 $1,144.00 $1,144.00 — 74%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Comprehensive Audio Evaluation $181.37 $703.00 $703.00 6% below 74%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 Comprehensive Audio Evaluation $181.37 $703.00 $703.00 — 74%
Critical care, first 30 to 74 minutes CPT 99291 Emergency Visit Level 6 $1,424.16 $5,520.00 $5,520.00 33% below 74%
Critical care, first 30 to 74 minutes CPT 99291 Emerg Visit Lvl 7 Tta Consult/Eval $2,669.53 $10,347.00 $10,347.00 25% above 74%
Critical care, first 30 to 74 minutes CPT 99291 Emerg Visit Lvl 8 $3,559.37 $13,796.00 $13,796.00 67% above 74%
Critical care, first 30 to 74 minutes CPT 99291 Emerg Visit Lvl 9 Tta Full Alert $4,271.45 $16,556.00 $16,556.00 100% above 74%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Emergency Visit Level 6 $1,424.16 $5,520.00 $5,520.00 — 74%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Emerg Visit Lvl 7 Tta Consult/Eval $2,669.53 $10,347.00 $10,347.00 — 74%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Emerg Visit Lvl 8 $3,559.37 $13,796.00 $13,796.00 — 74%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Emerg Visit Lvl 9 Tta Full Alert $4,271.45 $16,556.00 $16,556.00 — 74%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg; Incl Record Awake / Drowsy $391.64 $1,518.00 $1,518.00 43% below 74%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Eeg; Incl Record Awake / Drowsy $391.64 $1,518.00 $1,518.00 — 74%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg/12 Lds; Tracing Only $124.87 $484.00 $484.00 38% below 74%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg/12 Lds; Tracing Only $124.87 $484.00 $484.00 — 74%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Visit Level 1 $106.81 $414.00 $414.00 51% below 74%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 OB Emergency Visit Level 1 $106.81 $414.00 $414.00 51% below 74%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Visit Level 1 $106.81 $414.00 $414.00 — 74%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 OB Emergency Visit Level 1 $106.81 $414.00 $414.00 — 74%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Visit Level 2 $213.88 $829.00 $829.00 49% below 74%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 OB Emergency Visit Level 2 $213.88 $829.00 $829.00 49% below 74%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 OB Emergency Visit Level 2 $213.88 $829.00 $829.00 — 74%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Visit Level 2 $213.88 $829.00 $829.00 — 74%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Visit Level 3 $498.46 $1,932.00 $1,932.00 36% below 74%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 OB Emergency Visit Level 3 $498.46 $1,932.00 $1,932.00 36% below 74%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 OB Emergency Visit Level 3 $498.46 $1,932.00 $1,932.00 — 74%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Visit Level 3 $498.46 $1,932.00 $1,932.00 — 74%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 OB Emergency Visit Level 4 $712.08 $2,760.00 $2,760.00 40% below 74%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Visit Level 4 $712.08 $2,760.00 $2,760.00 40% below 74%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Visit Level 4 $712.08 $2,760.00 $2,760.00 — 74%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 OB Emergency Visit Level 4 $712.08 $2,760.00 $2,760.00 — 74%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 OB Emergency Visit Level 5 $1,067.86 $4,139.00 $4,139.00 39% below 74%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Visit Level 5 $1,067.86 $4,139.00 $4,139.00 39% below 74%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 OB Emergency Visit Level 5 $1,067.86 $4,139.00 $4,139.00 — 74%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Visit Level 5 $1,067.86 $4,139.00 $4,139.00 — 74%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardio Stress Test; Tracing Only $355.78 $1,379.00 $1,379.00 55% below 74%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardio Stress Test; Tracing Only $355.78 $1,379.00 $1,379.00 — 74%
Family therapy with the patient, 50 minutes CPT 90847 Family Therapy W Pt $181.37 $703.00 $703.00 8% below 74%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Therapy W Pt $181.37 $703.00 $703.00 — 74%
Group psychotherapy session CPT 90853 Group Therapy Not Multi-Family $292.31 $1,133.00 $1,133.00 21% above 74%
Group psychotherapy session inpatient CPT 90853 Group Therapy Not Multi-Family $292.31 $1,133.00 $1,133.00 — 74%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Inf Hydration; Init 31-60 Min $249.23 $966.00 $966.00 37% below 74%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Inf Hydration; Init 31-60 Min $249.23 $966.00 $966.00 — 74%
IV infusion of a medicine, first hour CPT 96365 IV Inf Tx/Dx/Proph; Init Up to 1 Hr $249.23 $966.00 $966.00 38% below 74%
IV infusion of a medicine, first hour inpatient CPT 96365 IV Inf Tx/Dx/Proph; Init Up to 1 Hr $249.23 $966.00 $966.00 — 74%
IV push of a medicine, first drug CPT 96374 Inj Tx/Dx/Proph; IV push sngl init $106.81 $414.00 $414.00 46% below 74%
IV push of a medicine, first drug inpatient CPT 96374 Inj Tx/Dx/Proph; IV push sngl init $106.81 $414.00 $414.00 — 74%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj Sc/Im $21.16 $82.00 $82.00 80% below 74%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Tx/Dx/Proph; Im $46.44 $180.00 $180.00 56% below 74%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Tx/Dx/Proph; Im Sq $53.66 $208.00 $208.00 49% below 74%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj Sc/Im $21.16 $82.00 $82.00 — 74%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inj Tx/Dx/Proph; Im $46.44 $180.00 $180.00 — 74%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inj Tx/Dx/Proph; Im Sq $53.66 $208.00 $208.00 — 74%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psych Diagnostic Eval $110.42 $428.00 $428.00 57% below 74%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Rehab Psych Diagnostic $110.42 $428.00 $428.00 57% below 74%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Rehab Psych Diagnostic $110.42 $428.00 $428.00 — 74%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psych Diagnostic Eval $110.42 $428.00 $428.00 — 74%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Motor&/Sens 7-8 Nrv Cndj Tst $1,067.86 $4,139.00 $4,139.00 24% above 74%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Motor&/Sens 7-8 Nrv Cndj Tst $1,067.86 $4,139.00 $4,139.00 — 74%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Ea 15 Min Pt $35.86 $139.00 $139.00 51% below 74%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Ea 15 Min Ot $35.86 $139.00 $139.00 51% below 74%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reeducation Ea 15 Min Pt $35.86 $139.00 $139.00 — 74%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reeducation Ea 15 Min Ot $35.86 $139.00 $139.00 — 74%
New patient office visit, about 30 minutes CPT 99203 OP Visit E&M of New Patient;Level 3 $93.14 $361.00 $361.00 46% below 74%
New patient office visit, about 30 minutes CPT 99203 OP Visit E&M of New Patient; Level 3 $93.14 $361.00 $361.00 46% below 74%
New patient office visit, about 30 minutes inpatient CPT 99203 OP Visit E&M of New Patient; Level 3 $93.14 $361.00 $361.00 — 74%
New patient office visit, about 30 minutes inpatient CPT 99203 OP Visit E&M of New Patient;Level 3 $93.14 $361.00 $361.00 — 74%
New patient office visit, about 45 minutes CPT 99204 OP Visit E&M of New Patient; Level 4 $114.55 $444.00 $444.00 43% below 74%
New patient office visit, about 45 minutes CPT 99204 OP Visit E&M of New Patient;Level 4 $117.65 $456.00 $456.00 42% below 74%
New patient office visit, about 45 minutes inpatient CPT 99204 OP Visit E&M of New Patient; Level 4 $114.55 $444.00 $444.00 — 74%
New patient office visit, about 45 minutes inpatient CPT 99204 OP Visit E&M of New Patient;Level 4 $117.65 $456.00 $456.00 — 74%
New patient office visit, about 60 minutes CPT 99205 OP Visit E&M of New Patient;Level 5 $167.70 $650.00 $650.00 36% below 74%
New patient office visit, about 60 minutes CPT 99205 OP Visit E&M of New Patient; Level 5 $167.70 $650.00 $650.00 36% below 74%
New patient office visit, about 60 minutes inpatient CPT 99205 OP Visit E&M of New Patient;Level 5 $167.70 $650.00 $650.00 — 74%
New patient office visit, about 60 minutes inpatient CPT 99205 OP Visit E&M of New Patient; Level 5 $167.70 $650.00 $650.00 — 74%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP Visit E&M of New Patient; Level 2 $71.47 $277.00 $277.00 47% below 74%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP Visit E&M of New Patient;Level 2 $71.47 $277.00 $277.00 47% below 74%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OP Visit E&M of New Patient;Level 2 $71.47 $277.00 $277.00 — 74%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OP Visit E&M of New Patient; Level 2 $71.47 $277.00 $277.00 — 74%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Mnt; Init Assmnt Ea 15 Min $16.51 $64.00 $64.00 52% below 74%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Medical Nutrition Indiv In $32.25 $125.00 $125.00 6% below 74%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Mnt; Init Assmnt Ea 15 Min $16.51 $64.00 $64.00 — 74%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Medical Nutrition Indiv In $32.25 $125.00 $125.00 — 74%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Low Complex 30 Min $106.81 $414.00 $414.00 33% below 74%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Ot Eval Low Complex 30 Min $106.81 $414.00 $414.00 — 74%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval High Complex 45 Min $106.81 $414.00 $414.00 54% below 74%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Eval High Complex 45 Min $106.81 $414.00 $414.00 — 74%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Low Complex 20 Min $71.47 $277.00 $277.00 49% below 74%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pt Eval Low Complex 20 Min $71.47 $277.00 $277.00 — 74%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Mod Complex 30 Min $89.01 $345.00 $345.00 51% below 74%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Eval Mod Complex 30 Min $89.01 $345.00 $345.00 — 74%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy 1/> Regions Ea 15 Mins Ot $32.25 $125.00 $125.00 61% below 74%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy 1/> Regions Ea 15 Mins Pt $32.25 $125.00 $125.00 61% below 74%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy 1/> Regions Ea 15 Mins Ot $32.25 $125.00 $125.00 — 74%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy 1/> Regions Ea 15 Mins Pt $32.25 $125.00 $125.00 — 74%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercises Ea 15 Min Pt $32.25 $125.00 $125.00 56% below 74%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercises Ea 15 Min Ot $32.25 $125.00 $125.00 56% below 74%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercises Ea 15 Min Ot $32.25 $125.00 $125.00 — 74%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercises Ea 15 Min Pt $32.25 $125.00 $125.00 — 74%
Psychiatric evaluation with medical services CPT 90792 Psych Diag Eval W/Med Srvcs $181.37 $703.00 $703.00 2% below 74%
Psychiatric evaluation with medical services inpatient CPT 90792 Psych Diag Eval W/Med Srvcs $181.37 $703.00 $703.00 — 74%
Psychotherapy session, 30 minutes CPT 90832 Rehab Psytx Pt 30 $78.95 $306.00 $306.00 20% below 74%
Psychotherapy session, 30 minutes inpatient CPT 90832 Rehab Psytx Pt 30 $78.95 $306.00 $306.00 — 74%
Psychotherapy session, 60 minutes CPT 90837 Psytx Pt 60 Mins $153.25 $594.00 $594.00 35% below 74%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psytx Pt 60 Mins $153.25 $594.00 $594.00 — 74%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Behav Chng Smoking Greater Than 3 Min Up to 10 Min $21.16 $82.00 $82.00 29% below 74%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Behav Chng Smoking Greater Than 3 Min Up to 10 Min $21.16 $82.00 $82.00 — 74%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP Visit E&M of Established Patient; Level 5 $167.70 $650.00 $650.00 12% above 74%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP Visit E&M of Established Patient;Level 5 $167.70 $650.00 $650.00 12% above 74%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP Visit E&M of Established Patient; Level 5 $167.70 $650.00 $650.00 — 74%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP Visit E&M of Established Patient;Level 5 $167.70 $650.00 $650.00 — 74%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP Visit E&M of Established Patient;Level 3 $93.14 $361.00 $361.00 at median 74%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP Visit E&M of Established Patient; Level 3 $93.14 $361.00 $361.00 at median 74%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP Visit E&M of Established Patient; Level 3 $93.14 $361.00 $361.00 — 74%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP Visit E&M of Established Patient;Level 3 $93.14 $361.00 $361.00 — 74%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP Visit E&M of Established Patient;Level 4 $114.55 $444.00 $444.00 7% above 74%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP Visit E&M of Established Patient; Level 4 $114.55 $444.00 $444.00 7% above 74%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP Visit E&M of Established Patient;Level 4 $114.55 $444.00 $444.00 — 74%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP Visit E&M of Established Patient; Level 4 $114.55 $444.00 $444.00 — 74%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP Visit E&M of Established Patient; Level 2 $71.47 $277.00 $277.00 34% above 74%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP Visit E&M of Established Patient;Level 2 $71.47 $277.00 $277.00 34% above 74%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP Visit E&M of Established Patient; Level 2 $71.47 $277.00 $277.00 — 74%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP Visit E&M of Established Patient;Level 2 $71.47 $277.00 $277.00 — 74%
Speech and language evaluation CPT 92523 Speech Sound Lang Comprehen $193.24 $749.00 $749.00 5% below 74%
Speech and language evaluation inpatient CPT 92523 Speech Sound Lang Comprehen $193.24 $749.00 $749.00 — 74%
Speech therapy session, individual CPT 92507 Speech/Hearing Therapy Indiv $96.49 $374.00 $374.00 31% below 74%
Speech therapy session, individual CPT 92507 Speech/Hearing Therapy, Individual $133.13 $516.00 $516.00 5% below 74%
Speech therapy session, individual inpatient CPT 92507 Speech/Hearing Therapy Indiv $96.49 $374.00 $374.00 — 74%
Speech therapy session, individual inpatient CPT 92507 Speech/Hearing Therapy, Individual $133.13 $516.00 $516.00 — 74%
Spirometry (breathing test) CPT 94010 Spirometry $142.67 $553.00 $553.00 46% below 74%
Spirometry (breathing test) inpatient CPT 94010 Spirometry $142.67 $553.00 $553.00 — 74%
Spirometry before and after a bronchodilator CPT 94060 Bronchospasm - Pre & Post Bd $231.68 $898.00 $898.00 59% below 74%
Spirometry before and after a bronchodilator inpatient CPT 94060 Bronchospasm - Pre & Post Bd $231.68 $898.00 $898.00 — 74%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Ea 15 Min Pt $35.86 $139.00 $139.00 45% below 74%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Ea 15 Min Ot $35.86 $139.00 $139.00 45% below 74%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Ea 15 Min Ot $35.86 $139.00 $139.00 — 74%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Ea 15 Min Pt $35.86 $139.00 $139.00 — 74%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic 073 $46.44 $180.00 $180.00 78% below 74%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic $60.89 $236.00 $236.00 71% below 74%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic 073 $46.44 $180.00 $180.00 — 74%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic $60.89 $236.00 $236.00 — 74%

Vaccines

ProcedureCash priceList priceInsurers payvs IndianaOff list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP $455.91 $1,767.10 $1,767.10 11% above 74%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP $455.91 $1,767.10 $1,767.10 — 74%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP $70.56 $273.50 $273.50 10% below 74%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP $70.56 $273.50 $273.50 — 74%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLU VACCINE TV2025(9 YR UP)RCMB(PF)135 MCG(45 MCGX3)/0.5 ML IM SYRINGE $19.35 $75.00 $75.00 49% below 74%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLU VACCINE TV2025(9 YR UP)RCMB(PF)135 MCG(45 MCGX3)/0.5 ML IM SYRINGE $19.35 $75.00 $75.00 — 74%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE $9.03 $35.00 $35.00 78% below 74%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE $9.03 $35.00 $35.00 — 74%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE $86.25 $334.30 $334.30 13% above 74%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE $86.25 $334.30 $334.30 — 74%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPH B POLYSAC CONJ-MENING (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLN $85.85 $332.75 $332.75 32% above 74%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPH B POLYSAC CONJ-MENING (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLN $85.85 $332.75 $332.75 — 74%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN $36.65 $142.05 $142.05 25% below 74%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN $36.65 $142.05 $142.05 — 74%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT $233.88 $906.50 $906.50 10% below 74%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT $233.88 $906.50 $906.50 — 74%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION $273.43 $1,059.80 $1,059.80 13% below 74%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION $273.43 $1,059.80 $1,059.80 — 74%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE $537.56 $2,083.55 $2,083.55 39% above 74%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE $537.56 $2,083.55 $2,083.55 — 74%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE $69.66 $270.00 $270.00 86% below 74%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 PNEUMOCOCCAL 15-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE $69.66 $270.00 $270.00 — 74%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE $79.98 $310.00 $310.00 87% below 74%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE $79.98 $310.00 $310.00 — 74%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PNEUMOCOCCAL 21-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE $79.98 $310.00 $310.00 80% below 74%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 PNEUMOCOCCAL 21-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE $79.98 $310.00 $310.00 — 74%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE $1,022.52 $3,963.25 $3,963.25 10% below 74%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE $1,022.52 $3,963.25 $3,963.25 — 74%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP $1,017.19 $3,942.60 $3,942.60 25% above 74%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP $1,017.19 $3,942.60 $3,942.60 — 74%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE $94.81 $367.50 $367.50 18% below 74%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE $94.81 $367.50 $367.50 — 74%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE $117.94 $457.15 $457.15 4% below 74%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP $117.94 $457.15 $457.15 4% below 74%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE $142.73 $553.20 $553.20 16% above 74%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP $117.94 $457.15 $457.15 — 74%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE $117.94 $457.15 $457.15 — 74%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE $142.73 $553.20 $553.20 — 74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin; 1 Vac $11.09 $43.00 $43.00 83% below 74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin; 1 Vac $11.09 $43.00 $43.00 — 74%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin; Ea Add Vac $7.48 $29.00 $29.00 81% below 74%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin; Ea Add Vac $7.48 $29.00 $29.00 — 74%
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://images.franciscanhealth.org/pdfs/enterprise/price_transparency/352074283_franciscan-health-crown-point_standardcharges.zip