Fairview Maple Grove Surgery Center
Fairview Maple Grove Surgery Center in Maple Grove, MN publishes cash prices for 111 common procedures listed here, from its own machine-readable price file updated May 18, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Minnesota median for 88 of 110 procedures and above it for 16. Select a procedure to compare it with other hospitals nearby.
14500 99th Ave N, Maple Grove, MN 55369-4742 Collected Sep 22, 2026 Source price file Check a bill from this hospital
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Minnesota | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 HC REMOVAL ADENOIDS,PRIMARY,<12 Y/O | $1,470.07 | $3,666.00 | $765.00–$3,913.50 | 61% above | 60% |
| Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 HC REMOVAL ADENOIDS,PRIMARY,<12 Y/O | $1,470.07 | $3,666.00 | — | — | 60% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 HC ARTHROSCOPY AIDED ANT CRUCIATE REPAIR | $3,167.10 | $7,898.00 | $1,685.00–$10,760.22 | at median | 60% |
| Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 HC ARTHROSCOPY AIDED ANT CRUCIATE REPAIR | $3,167.10 | $7,898.00 | — | — | 60% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 HC SHOULDER ARTHROSCOPY,SURG,W/ROTAT CUFF REPAIR | $2,472.97 | $6,167.00 | $1,685.00–$8,620.53 | 32% below | 60% |
| Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 HC SHOULDER ARTHROSCOPY,SURG,W/ROTAT CUFF REPAIR | $2,472.97 | $6,167.00 | — | — | 60% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC NASAL/SINUS ENDOSCOPY,W/DILAT MAXILLARY SINUS OSTIUM | $4,076.37 | $10,165.50 | $945.00–$9,148.95 | 57% above | 60% |
| Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 HC NASAL/SINUS ENDOSCOPY,W/DILAT MAXILLARY SINUS OSTIUM | $4,076.37 | $10,165.50 | — | — | 60% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HC CORRECT HALLUX VALGUS W/BUNION, W/DISTAL METATARSAL OSTEOTOMY | $1,739.14 | $4,337.00 | $945.00–$4,277.00 | 21% below | 60% |
| Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 HC CORRECT HALLUX VALGUS W/BUNION, W/DISTAL METATARSAL OSTEOTOMY | $1,739.14 | $4,337.00 | — | — | 60% |
| Carpal tunnel release, open surgery CPT 64721 HC REVISE MEDIAN N/CARPAL TUNNEL SURG | $1,470.07 | $3,666.00 | $765.00–$3,616.00 | 25% below | 60% |
| Carpal tunnel release, open surgery inpatient CPT 64721 HC REVISE MEDIAN N/CARPAL TUNNEL SURG | $1,470.07 | $3,666.00 | — | — | 60% |
| Cataract surgery with lens implant CPT 66984 HC REMV CATARACT EXTRACAP,INSERT LENS | $1,470.07 | $3,666.00 | $765.00–$3,616.00 | 55% below | 60% |
| Cataract surgery with lens implant inpatient CPT 66984 HC REMV CATARACT EXTRACAP,INSERT LENS | $1,470.07 | $3,666.00 | — | — | 60% |
| Cervical biopsy CPT 57500 HC BIOPSY/EXCIS CERVICAL LESION W/WO FULGURATION | $663.26 | $1,654.00 | $102.10–$1,630.00 | 7% below | 60% |
| Cervical biopsy inpatient CPT 57500 HC BIOPSY/EXCIS CERVICAL LESION W/WO FULGURATION | $663.26 | $1,654.00 | — | — | 60% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC CIRCUMCISION SURGICAL NON-DEV >28 DAYS AGE | $1,470.07 | $3,666.00 | $765.00–$3,616.00 | 4% below | 60% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 HC CIRCUMCISION SURGICAL NON-DEV >28 DAYS AGE | $1,470.07 | $3,666.00 | — | — | 60% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION CLAMP/DEVICE | $1,470.07 | $3,666.00 | $765.00–$3,616.00 | 503% above | 60% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION CLAMP/DEVICE | $1,470.07 | $3,666.00 | — | — | 60% |
| Colonoscopy with polyp removal CPT 45385 HC COLONOSCOPY W SNARE REMOVAL TUMOR/POLYP/LESION | $841.76 | $2,099.13 | $561.32–$2,076.00 | 49% below | 60% |
| Colonoscopy with polyp removal inpatient CPT 45385 HC COLONOSCOPY W SNARE REMOVAL TUMOR/POLYP/LESION | $841.76 | $2,099.13 | — | — | 60% |
| Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY W BIOPSY | $844.11 | $2,105.00 | $561.32–$2,076.00 | 47% below | 60% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY W BIOPSY | $844.11 | $2,105.00 | — | — | 60% |
| Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY W/WO BRUSH/WASH | $844.11 | $2,105.00 | $434.03–$2,076.00 | 37% below | 60% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY W/WO BRUSH/WASH | $844.11 | $2,105.00 | — | — | 60% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC COLP CERVIX/UPPER VAGINA W BX CERVIX/ENDOCERV CURETT | $275.49 | $687.00 | $76.90–$678.00 | 60% below | 60% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC COLP CERVIX/UPPER VAGINA W BX CERVIX/ENDOCERV CURETT | $275.49 | $687.00 | — | — | 60% |
| Complex cataract surgery with lens implant CPT 66982 HC REMV CATARACT EXTRACAP,INSERT LENS,COMP | $1,470.07 | $3,666.00 | $765.00–$3,616.00 | 46% below | 60% |
| Complex cataract surgery with lens implant inpatient CPT 66982 HC REMV CATARACT EXTRACAP,INSERT LENS,COMP | $1,470.07 | $3,666.00 | — | — | 60% |
| Cystoscopy with ureteral stent placement CPT 52332 HC CYSTOSCOPY,INSERT URETERAL STENT | $1,470.07 | $3,666.00 | $765.00–$4,161.96 | 60% below | 60% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 HC CYSTOSCOPY,INSERT URETERAL STENT | $1,470.07 | $3,666.00 | — | — | 60% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY | $704.56 | $1,757.00 | $317.76–$1,811.96 | 15% below | 60% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY | $704.56 | $1,757.00 | — | — | 60% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 HC DILATION/CURETTAGE DIAG/THER NON OB | $1,470.07 | $3,666.00 | $765.00–$3,892.47 | 13% below | 60% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC DILATION/CURETTAGE DIAG/THER NON OB | $1,470.07 | $3,666.00 | — | — | 60% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 HC CREATE EARDRUM OPENING,GEN ANESTH | $844.11 | $2,105.00 | $665.07–$2,076.00 | 54% below | 60% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 HC CREATE EARDRUM OPENING,GEN ANESTH | $844.11 | $2,105.00 | — | — | 60% |
| Earwax removal with instruments, one ear CPT 69210 HC REMOVE IMPACTED CERUMEN | $413.24 | $1,030.50 | $28.28–$927.45 | 235% above | 60% |
| Earwax removal with instruments, one ear inpatient CPT 69210 HC REMOVE IMPACTED CERUMEN | $413.24 | $1,030.50 | — | — | 60% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ENDOMETRIAL BIOPSY W/O CERVICAL DILATION | $275.49 | $687.00 | $52.36–$678.00 | 11% above | 60% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ENDOMETRIAL BIOPSY W/O CERVICAL DILATION | $275.49 | $687.00 | — | — | 60% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 HC NASAL SCOPY,REMV TOTL ETHMOID | $2,608.71 | $6,505.50 | $945.00–$8,353.52 | 33% below | 60% |
| Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 HC NASAL SCOPY,REMV TOTL ETHMOID | $2,608.71 | $6,505.50 | — | — | 60% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 HC NASAL SCOPY,EXPLOR FRONTAL SINUS | $1,925.77 | $4,802.40 | $917.72–$8,353.52 | 70% below | 60% |
| Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 HC NASAL SCOPY,EXPLOR FRONTAL SINUS | $1,925.77 | $4,802.40 | — | — | 60% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 HC NASAL SCOPY,OPEN MAXILL SINUS | $1,470.07 | $3,666.00 | $765.00–$4,449.14 | at median | 60% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 HC NASAL SCOPY,OPEN MAXILL SINUS | $1,470.07 | $3,666.00 | — | — | 60% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 HC NASAL/SINUS SCOPE W REMOVAL TISSUE MAX SINUS | $1,620.85 | $4,042.00 | $765.00–$8,353.52 | 69% below | 60% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 HC NASAL/SINUS SCOPE W REMOVAL TISSUE MAX SINUS | $1,620.85 | $4,042.00 | — | — | 60% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC INJ EPIDURAL CERVICAL/THORACIC, W IMAGING | $663.26 | $1,654.00 | $329.68–$1,630.00 | 45% below | 60% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC INJ EPIDURAL CERVICAL/THORACIC, W IMAGING | $663.26 | $1,654.00 | — | — | 60% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC FACET/MEDIAL BRANCH INJ LUMB/SACR 1ST W FLUORO | $663.26 | $1,654.00 | $423.83–$1,630.00 | 52% below | 60% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC FACET/MEDIAL BRANCH INJ LUMB/SACR 1ST W FLUORO | $663.26 | $1,654.00 | — | — | 60% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 HC INITIAL REPAIR AA HERNIA 3-10 CM REDUCIBLE | $1,739.14 | $4,337.00 | $945.00–$7,529.67 | at median | 60% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 HC INITIAL REPAIR AA HERNIA 3-10 CM REDUCIBLE | $1,739.14 | $4,337.00 | — | — | 60% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 HC INITIAL REPAIR AA HERNIA < 3 CM REDUCIBLE | $1,739.14 | $4,337.00 | $945.00–$4,277.00 | 33% below | 60% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 HC INITIAL REPAIR AA HERNIA < 3 CM REDUCIBLE | $1,739.14 | $4,337.00 | — | — | 60% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC FLEX SIGMOIDOSCOPY W/WO COLL SPEC BY BRUSH/WASH | $663.26 | $1,654.00 | $150.53–$1,630.00 | 30% below | 60% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC FLEX SIGMOIDOSCOPY W/WO COLL SPEC BY BRUSH/WASH | $663.26 | $1,654.00 | — | — | 60% |
| Gallbladder removal, laparoscopic CPT 47562 HC LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY | $2,472.97 | $6,167.00 | $1,685.00–$7,040.48 | 42% below | 60% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 HC LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY | $2,472.97 | $6,167.00 | — | — | 60% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC LAP,CHOLECYSTECTOMY/GRAPH | $2,472.97 | $6,167.00 | $1,685.00–$7,040.48 | 43% below | 60% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 HC LAP,CHOLECYSTECTOMY/GRAPH | $2,472.97 | $6,167.00 | — | — | 60% |
| Hammertoe correction surgery CPT 28285 HC REPAIR OF HAMMERTOE, ONE | $1,470.07 | $3,666.00 | $765.00–$3,915.36 | 37% below | 60% |
| Hammertoe correction surgery inpatient CPT 28285 HC REPAIR OF HAMMERTOE, ONE | $1,470.07 | $3,666.00 | — | — | 60% |
| Hysteroscopy with endometrial ablation CPT 58563 HC HYSTEROSCOPY, SURGICAL; W/ ENDOMETRIAL ABLATION, ANY METHOD | $1,739.14 | $4,337.00 | $945.00–$5,956.94 | 54% below | 60% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HC HYSTEROSCOPY, SURGICAL; W/ ENDOMETRIAL ABLATION, ANY METHOD | $1,739.14 | $4,337.00 | — | — | 60% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC HYSTEROSCOPY W ENDOMETRIAL BX/POLYPECTOMY W/WO D&C | $1,476.67 | $3,682.44 | $765.00–$3,892.47 | 39% below | 60% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HC HYSTEROSCOPY W ENDOMETRIAL BX/POLYPECTOMY W/WO D&C | $1,476.67 | $3,682.44 | — | — | 60% |
| IUD insertion (the device itself billed separately) CPT 58300 HC INSERTION INTRAUTERINE DEVICE | $74.26 | $185.17 | $92.59–$678.00 | 76% below | 60% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERTION INTRAUTERINE DEVICE | $74.26 | $185.17 | — | — | 60% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC REPAIR ING HERNIA,5+Y/O,REDUCIBL | $1,739.14 | $4,337.00 | $945.00–$4,277.00 | 39% below | 60% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC REPAIR ING HERNIA,5+Y/O,REDUCIBL | $1,739.14 | $4,337.00 | — | — | 60% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECT TENDON SHEATH/LIGAMENT | $275.49 | $687.00 | $29.45–$678.00 | 25% below | 60% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECT TENDON SHEATH/LIGAMENT | $275.49 | $687.00 | — | — | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC DRAIN/INJ MAJOR JOINT/BURSA W/O US | $275.49 | $687.00 | $34.03–$678.00 | 24% below | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC DRAIN/INJ MAJOR JOINT/BURSA W/O US | $275.49 | $687.00 | — | — | 60% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT | $275.49 | $687.00 | $61.37–$678.00 | 1% above | 60% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT | $275.49 | $687.00 | — | — | 60% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJ INTER JOINT/BURSA W/O US | $413.24 | $1,030.50 | $29.13–$927.45 | 35% above | 60% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJ INTER JOINT/BURSA W/O US | $413.24 | $1,030.50 | — | — | 60% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJ SMALL JOINT/BURSA W/O US | $275.49 | $687.00 | $28.79–$678.00 | 15% below | 60% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJ SMALL JOINT/BURSA W/O US | $275.49 | $687.00 | — | — | 60% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 HC KNEE ARTHROSCOPY, MED/LAT MENISCUS REPAIR | $1,739.14 | $4,337.00 | $945.00–$4,277.00 | 43% below | 60% |
| Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 HC KNEE ARTHROSCOPY, MED/LAT MENISCUS REPAIR | $1,739.14 | $4,337.00 | — | — | 60% |
| Knee arthroscopy with meniscus trim CPT 29881 HC KNEE ARTHROSCOPY, MED/LAT MENISECTOMY | $1,739.14 | $4,337.00 | $945.00–$4,277.00 | 29% below | 60% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 HC KNEE ARTHROSCOPY, MED/LAT MENISECTOMY | $1,739.14 | $4,337.00 | — | — | 60% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 HC KNEE ARTHROSCOPY, SINGLE MENISECTOMY | $1,739.14 | $4,337.00 | $945.00–$4,277.00 | 29% below | 60% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 HC KNEE ARTHROSCOPY, SINGLE MENISECTOMY | $1,739.14 | $4,337.00 | — | — | 60% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 HC KNEE ARTHROSCOPY, SHAVE ARTICULAR CARTILAGE | $1,739.14 | $4,337.00 | $945.00–$4,277.00 | 29% below | 60% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 HC KNEE ARTHROSCOPY, SHAVE ARTICULAR CARTILAGE | $1,739.14 | $4,337.00 | — | — | 60% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 HC LAPAROSCOPY, SURGICAL; W/ REMOVAL, ADNEXAL STRUCTURES | $3,888.34 | $9,696.60 | $1,685.00–$8,726.94 | 1% above | 60% |
| Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 HC LAPAROSCOPY, SURGICAL; W/ REMOVAL, ADNEXAL STRUCTURES | $3,888.34 | $9,696.60 | — | — | 60% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC REPAIR INTERMED, WOUND TRUNK/ARM/LEG <=2.5 CM | $275.49 | $687.00 | $182.60–$678.00 | 39% below | 60% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC REPAIR INTERMED, WOUND TRUNK/ARM/LEG <=2.5 CM | $275.49 | $687.00 | — | — | 60% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ EPIDURAL LUMBAR/SACRAL, W IMAGING | $652.58 | $1,627.36 | $329.68–$1,630.00 | 45% below | 60% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ EPIDURAL LUMBAR/SACRAL, W IMAGING | $652.58 | $1,627.36 | — | — | 60% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ TRANSFORAMIN EPIDURAL, LUMB/SACR SINGLE | $663.26 | $1,654.00 | $423.83–$1,630.00 | 49% below | 60% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ TRANSFORAMIN EPIDURAL, LUMB/SACR SINGLE | $663.26 | $1,654.00 | — | — | 60% |
| Lumpectomy (partial mastectomy) CPT 19301 HC MASTECTOMY, PARTIAL | $1,474.72 | $3,677.59 | $765.00–$4,620.90 | 13% below | 60% |
| Lumpectomy (partial mastectomy) inpatient CPT 19301 HC MASTECTOMY, PARTIAL | $1,474.72 | $3,677.59 | — | — | 60% |
| Miscarriage treatment with D&C, first trimester CPT 59820 HC TREATMENT MISSED ABORTION SURG, 1ST TRIMESTER | $1,470.07 | $3,666.00 | $765.00–$3,892.47 | 14% below | 60% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC TREATMENT MISSED ABORTION SURG, 1ST TRIMESTER | $1,470.07 | $3,666.00 | — | — | 60% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC BENIGN SKIN LESION FACE/EARS <=0.5 CM | $663.26 | $1,654.00 | $101.44–$1,630.00 | 11% above | 60% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXC BENIGN SKIN LESION FACE/EARS <=0.5 CM | $663.26 | $1,654.00 | — | — | 60% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DESTRUCT PARVERTEB FACET SINGL LUMBAR/SACRAL | $1,434.98 | $3,578.50 | $496.60–$3,616.00 | 33% below | 60% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DESTRUCT PARVERTEB FACET SINGL LUMBAR/SACRAL | $1,434.98 | $3,578.50 | — | — | 60% |
| Removal of a breast lump, open surgery CPT 19120 HC EXCISION BREAST LESION, OPEN >=1 | $1,470.07 | $3,666.00 | $765.00–$4,620.90 | 27% below | 60% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC EXCISION BREAST LESION, OPEN >=1 | $1,470.07 | $3,666.00 | — | — | 60% |
| Removal of a foreign object under the skin, simple CPT 10120 HC REMOVE FOREIGN BODY SIMPLE | $275.49 | $687.00 | $104.06–$678.00 | 32% below | 60% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVE FOREIGN BODY SIMPLE | $275.49 | $687.00 | — | — | 60% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC COLOREC CANC SCRN,SCOPY NOT HI RISK | $663.26 | $1,654.00 | $434.03–$1,630.00 | 58% below | 60% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC COLOREC CANC SCRN,SCOPY NOT HI RISK | $663.26 | $1,654.00 | — | — | 60% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC COLOREC CANC SCRN,COLONOSCPY HI RISK | $663.26 | $1,654.00 | $434.03–$1,630.00 | 56% below | 60% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC COLOREC CANC SCRN,COLONOSCPY HI RISK | $663.26 | $1,654.00 | — | — | 60% |
| Septoplasty to straighten the nasal septum CPT 30520 HC REPAIR OF NASAL SEPTUM | $1,469.75 | $3,665.21 | $765.00–$3,913.50 | 39% below | 60% |
| Septoplasty to straighten the nasal septum inpatient CPT 30520 HC REPAIR OF NASAL SEPTUM | $1,469.75 | $3,665.21 | — | — | 60% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC FRAGMENTING OF KIDNEY STONE | $2,472.97 | $6,167.00 | $1,641.92–$10,171.00 | 46% below | 60% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 HC FRAGMENTING OF KIDNEY STONE | $2,472.97 | $6,167.00 | — | — | 60% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 HC SHOULDER ARTHROSCOPY,DIS CLAVICULECTOMY | $2,472.97 | $6,167.00 | $1,544.64–$6,082.00 | 7% above | 60% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 HC SHOULDER ARTHROSCOPY,DIS CLAVICULECTOMY | $2,472.97 | $6,167.00 | — | — | 60% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HC SHOULDER ARTHROSCOPY,PART ACROMIOPLASTY | $1,091.13 | $2,721.00 | $220.00–$2,806.12 | 29% below | 60% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 HC SHOULDER ARTHROSCOPY,PART ACROMIOPLASTY | $1,091.13 | $2,721.00 | — | — | 60% |
| Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY OF SKIN, FIRST LESION | $275.49 | $687.00 | $90.32–$678.00 | 8% below | 60% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY OF SKIN, FIRST LESION | $275.49 | $687.00 | — | — | 60% |
| Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS, FIRST 15 | $275.49 | $687.00 | $94.60–$678.00 | 29% above | 60% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVAL OF SKIN TAGS, FIRST 15 | $275.49 | $687.00 | — | — | 60% |
| TURP (transurethral resection of the prostate) CPT 52601 HC TRANSURETHRAL ELEC-SURG PROSTATECTOM | $2,129.31 | $5,310.00 | $1,080.00–$6,134.54 | 42% below | 60% |
| TURP (transurethral resection of the prostate) inpatient CPT 52601 HC TRANSURETHRAL ELEC-SURG PROSTATECTOM | $2,129.31 | $5,310.00 | — | — | 60% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BIOPSY OF SKIN, FIRST LESION | $275.49 | $687.00 | $73.31–$678.00 | 9% above | 60% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BIOPSY OF SKIN, FIRST LESION | $275.49 | $687.00 | — | — | 60% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 HC REMOVE TONSILS/ADENOIDS,12+ Y/O | $1,468.00 | $3,660.84 | $765.00–$3,913.50 | 15% below | 60% |
| Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 HC REMOVE TONSILS/ADENOIDS,12+ Y/O | $1,468.00 | $3,660.84 | — | — | 60% |
| Tonsil and adenoid removal, child under 12 CPT 42820 HC REMOVE TONSILS/ADENOIDS,<12 Y/O | $1,966.20 | $4,903.23 | $765.00–$7,138.58 | 133% above | 60% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 HC REMOVE TONSILS/ADENOIDS,<12 Y/O | $1,966.20 | $4,903.23 | — | — | 60% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 HC REMOVAL OF TONSILS,12+ Y/O | $1,469.54 | $3,664.66 | $765.00–$3,913.50 | at median | 60% |
| Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 HC REMOVAL OF TONSILS,12+ Y/O | $1,469.54 | $3,664.66 | — | — | 60% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 HC REMOVAL OF TONSILS,<12 Y/O | $1,944.45 | $4,849.00 | $765.00–$7,138.58 | 180% above | 60% |
| Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 HC REMOVAL OF TONSILS,<12 Y/O | $1,944.45 | $4,849.00 | — | — | 60% |
| Trigger finger release surgery CPT 26055 HC INCISION TENDON SHEATH FINGER | $844.11 | $2,105.00 | $667.00–$2,076.00 | 32% below | 60% |
| Trigger finger release surgery inpatient CPT 26055 HC INCISION TENDON SHEATH FINGER | $844.11 | $2,105.00 | — | — | 60% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJECTION SNGL/MULT TRIGGER POINT, 1 OR 2 MUSCLES | $275.49 | $687.00 | $27.49–$678.00 | 14% below | 60% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJECTION SNGL/MULT TRIGGER POINT, 1 OR 2 MUSCLES | $275.49 | $687.00 | — | — | 60% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 HC LAP,TUBAL CAUTERY | $2,522.66 | $6,290.92 | $1,685.00–$7,040.48 | 224% above | 60% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 HC LAP,TUBAL CAUTERY | $2,522.66 | $6,290.92 | — | — | 60% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC UGI ENDOSCOPY W ESOPHAGEAL DILATION BALLOON <30MM | $844.11 | $2,105.00 | $595.71–$2,289.15 | 55% below | 60% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC UGI ENDOSCOPY W ESOPHAGEAL DILATION BALLOON <30MM | $844.11 | $2,105.00 | — | — | 60% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC UGI ENDOSCOPY DIAG W BIOPSY | $843.14 | $2,102.58 | $446.34–$2,076.00 | 40% below | 60% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC UGI ENDOSCOPY DIAG W BIOPSY | $843.14 | $2,102.58 | — | — | 60% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 HC UGI ENDOSCOPY DIAG W SUBMUCOSAL INJECTION | $844.11 | $2,105.00 | $446.34–$2,076.00 | 45% below | 60% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC UGI ENDOSCOPY DIAG W SUBMUCOSAL INJECTION | $844.11 | $2,105.00 | — | — | 60% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC UGI ENDOSCOPY W SNARE TUMOR/POLYP/LESION | $844.11 | $2,105.00 | $595.71–$2,289.15 | 53% below | 60% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC UGI ENDOSCOPY W SNARE TUMOR/POLYP/LESION | $844.11 | $2,105.00 | — | — | 60% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC UGI ENDOSCOPY DIAG W OR W/O BRUSH/WASH | $844.11 | $2,105.00 | $446.34–$2,076.00 | 30% below | 60% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC UGI ENDOSCOPY DIAG W OR W/O BRUSH/WASH | $844.11 | $2,105.00 | — | — | 60% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 HC CYSTOURETHROSCOPY W/ URETEROSCOPY &/OR PYELOSCOPY; W/ LITHOTRIPSY | $2,128.91 | $5,309.00 | $2,420.02–$10,171.00 | 50% below | 60% |
| Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 HC CYSTOURETHROSCOPY W/ URETEROSCOPY &/OR PYELOSCOPY; W/ LITHOTRIPSY | $2,128.91 | $5,309.00 | — | — | 60% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 HC CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT | $2,128.91 | $5,309.00 | $1,080.00–$6,134.54 | 62% below | 60% |
| Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 HC CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT | $2,128.91 | $5,309.00 | — | — | 60% |
| Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 HC VASECTOMY UNILAT/BILAT W POSTOP SEMEN | $1,470.07 | $3,666.00 | $765.00–$3,616.00 | — | 60% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 HC VASECTOMY UNILAT/BILAT W POSTOP SEMEN | $1,470.07 | $3,666.00 | — | — | 60% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR | $3,203.99 | $7,990.00 | $1,685.00–$11,065.17 | 7% above | 60% |
| Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 HC OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR | $3,203.99 | $7,990.00 | — | — | 60% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Minnesota | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 MRNA VAC-TRIS(PFIZER) 30 MCG/0.3ML IM SUSP | $23.06 | $57.51 | $28.75–$296.40 | 87% below | 60% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 MRNA VAC-TRIS(PFIZER) 30 MCG/0.3ML IM SUSY | $46.12 | $115.00 | $57.50–$296.40 | 73% below | 60% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 MRNA VAC-TRIS(PFIZER) 30 MCG/0.3ML IM SUSP | $23.06 | $57.51 | — | — | 60% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 MRNA VAC-TRIS(PFIZER) 30 MCG/0.3ML IM SUSY | $46.12 | $115.00 | — | — | 60% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR | $141.56 | $353.00 | $118.52–$340.12 | 28% below | 60% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR | $141.56 | $353.00 | — | — | 60% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTH-ACELL PERTUSSIS-TETANUS 15-23-5 LF-MCG/0.5 IM SUSP | $21.66 | $54.00 | $20.50–$48.60 | 59% below | 60% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP | $21.66 | $54.00 | $20.50–$48.60 | 59% below | 60% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHTH-ACELL PERTUSSIS-TETANUS 15-23-5 LF-MCG/0.5 IM SUSP | $21.66 | $54.00 | — | — | 60% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP | $21.66 | $54.00 | — | — | 60% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEPATITIS B RECOMB-IPV IM SUSY | $23.93 | $59.65 | $29.83–$190.90 | 72% below | 60% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP-HEPATITIS B RECOMB-IPV IM SUSY | $23.93 | $59.65 | — | — | 60% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV-HIB VACCINE IM SUSR | $86.22 | $215.00 | $82.05–$193.50 | 14% below | 60% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP-IPV-HIB VACCINE IM SUSR | $86.22 | $215.00 | — | — | 60% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 INFLUENZA VAC RECOMB HA (PF) 0.5 ML IM SOSY (FLUBLOK) | $27.67 | $69.00 | $29.52–$172.80 | 34% below | 60% |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 INFLUENZA VAC RECOMB HA (PF) 0.5 ML IM SOSY (FLUBLOK) | $27.67 | $69.00 | — | — | 60% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A-HEP B RECOMB VAC 720-20 ELU-MCG/ML IM SUSY | $108.94 | $271.67 | $89.82–$244.50 | 25% below | 60% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A-HEP B RECOMB VAC 720-20 ELU-MCG/ML IM SUSY | $108.94 | $271.67 | — | — | 60% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSP | $56.95 | $142.00 | $51.00–$129.90 | 46% below | 60% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSP | $56.95 | $142.00 | — | — | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSY | $52.13 | $130.00 | $51.16–$139.85 | 54% below | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSP | $52.13 | $130.00 | $51.16–$139.85 | 54% below | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSP | $52.13 | $130.00 | — | — | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SUSY | $52.13 | $130.00 | — | — | 60% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC RECOMBINANT 5 MCG/0.5ML IJ SUSY | $21.66 | $54.00 | $21.73–$61.15 | 58% below | 60% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC RECOMBINANT 5 MCG/0.5ML IJ SUSY | $21.66 | $54.00 | — | — | 60% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VAC HIGH-DOSE QUAD 0.7 ML IM SUSY (FLUZONE HD) | $26.07 | $65.00 | $32.50–$172.80 | 60% below | 60% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VAC SPLIT HIGH-DOSE 0.5 ML IM SUSY | $27.67 | $69.00 | $34.50–$172.80 | 57% below | 60% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VAC HIGH-DOSE QUAD 0.7 ML IM SUSY (FLUZONE HD) | $26.07 | $65.00 | — | — | 60% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VAC SPLIT HIGH-DOSE 0.5 ML IM SUSY | $27.67 | $69.00 | — | — | 60% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 JAPANESE ENCEPHALITIS VAC INAC IM SUSP | $223.36 | $557.00 | $201.15–$561.01 | at median | 60% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 JAPANESE ENCEPHALITIS VAC INAC IM SUSP | $223.36 | $557.00 | — | — | 60% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR | $27.14 | $67.67 | $33.84–$111.47 | 77% below | 60% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR | $27.14 | $67.67 | — | — | 60% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENING ACY&W-135 TETANUS CONJ IM SOLN | $103.46 | $258.00 | $115.64–$325.49 | 30% below | 60% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENING ACY&W-135 TETANUS CONJ IM SOLN | $103.46 | $258.00 | — | — | 60% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP | $93.43 | $232.99 | $116.49–$512.73 | 65% below | 60% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP | $93.43 | $232.99 | — | — | 60% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY | $129.79 | $323.65 | $161.82–$592.31 | 68% below | 60% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY | $129.79 | $323.65 | — | — | 60% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOSY | $98.25 | $245.00 | $97.01–$265.22 | 22% below | 60% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOLN | $98.25 | $245.00 | $97.01–$265.22 | 22% below | 60% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOSY | $98.25 | $245.00 | — | — | 60% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOLN | $98.25 | $245.00 | — | — | 60% |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE INACTIVATED IJ INJ | $18.25 | $45.50 | $22.75–$50.48 | 76% below | 60% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE INACTIVATED IJ INJ | $18.25 | $45.50 | — | — | 60% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP 200 MG (100 MG X 2 SYR) DOSE | $129.93 | $324.00 | $162.00–$1,014.28 | 79% below | 60% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB-ALIP 200 MG (100 MG X 2 SYR) DOSE | $129.93 | $324.00 | — | — | 60% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5ML IM SOSY | $216.54 | $540.00 | $270.00–$1,014.28 | 60% below | 60% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5ML IM SOSY | $216.54 | $540.00 | — | — | 60% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV PRE-FUSION F A&B VAC RCMB 120 MCG/0.5ML IM SOLR | $116.96 | $291.67 | $145.83–$575.42 | 47% below | 60% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV PRE-FUSION F A&B VAC RCMB 120 MCG/0.5ML IM SOLR | $116.96 | $291.67 | — | — | 60% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSVPREF3 VAC RECOMB ADJUVANTED 120 MCG/0.5ML IM SUSR | $124.31 | $310.00 | $155.00–$546.16 | 6% below | 60% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSVPREF3 VAC RECOMB ADJUVANTED 120 MCG/0.5ML IM SUSR | $124.31 | $310.00 | — | — | 60% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC IM SUSR | $268.67 | $670.00 | $258.19–$709.30 | 48% below | 60% |
| Rabies vaccine, one dose CPT 90675 RABIES VIRUS VACCINE, HDC IM SUSR | $268.67 | $670.00 | $258.19–$709.30 | 48% below | 60% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VIRUS VACCINE, HDC IM SUSR | $268.67 | $670.00 | — | — | 60% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC IM SUSR | $268.67 | $670.00 | — | — | 60% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR | $139.55 | $348.00 | $128.04–$386.20 | 37% below | 60% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR | $139.55 | $348.00 | — | — | 60% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ | $19.65 | $49.00 | $20.19–$65.79 | 69% below | 60% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 2-2 LF/0.5ML IM SUSP | $19.65 | $49.00 | $20.19–$65.79 | 69% below | 60% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 2-2 LF/0.5ML IM SUSP | $19.65 | $49.00 | — | — | 60% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ | $19.65 | $49.00 | — | — | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY | $32.22 | $80.33 | $27.26–$72.30 | 59% below | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DTAP-IPV-HIB-HEPATITIS B RECMB IM SUSY | $97.45 | $243.00 | $27.26–$218.70 | 24% above | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY | $32.22 | $80.33 | — | — | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DTAP-IPV-HIB-HEPATITIS B RECMB IM SUSY | $97.45 | $243.00 | — | — | 60% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI POLYSACCHARIDE VACC 25 MCG/0.5ML IM SOSY | $74.99 | $187.00 | $62.51–$168.30 | 46% below | 60% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VI POLYSACCHARIDE VACC 25 MCG/0.5ML IM SOSY | $74.99 | $187.00 | — | — | 60% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML IJ SUSY | $16.04 | $40.00 | $18.36–$36.00 | 37% below | 60% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR | $16.04 | $40.00 | $18.36–$36.00 | 37% below | 60% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INFLUENZA VAC RECOM HA QUAD PF 0.5 ML IM SOSY (FLUBLOK) | $16.04 | $40.00 | $18.36–$36.00 | 37% below | 60% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INFLUENZA VAC RECOM HA QUAD PF 0.5 ML IM SOSY (FLUBLOK) | $16.04 | $40.00 | — | — | 60% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR | $16.04 | $40.00 | — | — | 60% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML IJ SUSY | $16.04 | $40.00 | — | — | 60% |
| Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACCINE SC INJ | $164.75 | $410.83 | $205.42–$479.80 | at median | 60% |
| Yellow fever vaccine, live inpatient CPT 90717 YELLOW FEVER VACCINE SC INJ | $164.75 | $410.83 | — | — | 60% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.