Hospital Kansas City, MO-KS

Bates County Memorial Hospital

Bates County Memorial Hospital in Butler, MO publishes cash prices for 314 common procedures listed here, from its own machine-readable price file updated Apr 20, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Missouri median for 184 of 310 procedures and below it for 124. By typical cash price it ranks #46 of 60 Missouri hospitals and #7 of 17 hospitals in the Kansas City, MO area, cheapest first. Click a procedure to compare it with other hospitals nearby.

615 W Nursery St, Butler, MO 64730 Collected Sep 27, 2026 Source price file (660) 200-7000

Acute care hospital Emergency department CMS star rating 3 of 5 CCN 260034 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 5 actions for a hospital named Bates County Memorial Hospital in Butler, MO:

Nov 12, 2024 Warning notice
Nov 26, 2024 Case closed
Feb 4, 2026 Warning notice
May 11, 2026 Corrective action plan requested
May 15, 2026 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 DX ANKLE COMPLETE BILAT	$989.56	$1,413.65	$87.17–$1,201.60	—	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 DX ANKLE COMPLETE RIGHT	$660.22	$943.16	$87.17–$801.69	120% above	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 DX ANKLE COMPLETE LEFT	$660.22	$943.16	$87.17–$801.69	120% above	30%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 DX ANKLE COMPLETE BILAT	$989.56	$1,413.65	$1,201.60	—	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 DX ANKLE COMPLETE LEFT	$660.22	$943.16	$801.69	—	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 DX ANKLE COMPLETE RIGHT	$660.22	$943.16	$801.69	—	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ABI	$473.96	$677.08	$79.07–$575.52	39% above	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ABI	$473.96	$677.08	$575.52	—	30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RADIOLOGIC EXAMINATION, ESOPHAGUS, INCLUDING SCOUT CHEST RADIOGRAPH(S) AND DELAYED IMAGE(S), WHEN PERFORMED; SINGLE-CONTRAST (EG, BARIUM) STUDY	$58.24	$83.20	$21.82–$84.06	87% below	30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 DX BARIUM SWALLOW	$644.31	$920.44	$175.68–$782.37	48% above	30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RADIOLOGIC EXAMINATION, ESOPHAGUS, INCLUDING SCOUT CHEST RADIOGRAPH(S) AND DELAYED IMAGE(S), WHEN PERFORMED; SINGLE-CONTRAST (EG, BARIUM) STUDY	$58.24	$83.20	$21.82–$84.06	—	30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 DX BARIUM SWALLOW	$644.31	$920.44	$782.37	—	30%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY	$1,635.39	$2,336.26	$400.42–$1,985.82	10% above	30%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE WHOLE BODY	$1,635.39	$2,336.26	$1,985.82	—	30%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST BILATERAL COMPLETE	$865.39	$1,236.27	$104.71–$1,050.83	—	30%
Breast ultrasound, complete, one breast CPT 76641 US BCMH BREAST	$533.78	$762.53	$104.71–$648.15	40% above	30%
Breast ultrasound, complete, one breast one side CPT 76641 US, BREAST, UNILATERAL, REAL TIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE	$70.80	$101.14	$26.45–$89.83	81% below	30%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILATERAL COMPLETE	$533.78	$762.53	$104.71–$648.15	40% above	30%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BREAST BILATERAL COMPLETE	$865.39	$1,236.27	$1,050.83	—	30%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BCMH BREAST	$533.78	$762.53	$648.15	—	30%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US, BREAST, UNILATERAL, REAL TIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE	$70.80	$101.14	$26.45–$89.83	—	30%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST UNILATERAL COMPLETE	$533.78	$762.53	$648.15	—	30%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST POST MA	$533.78	$762.53	$87.17–$648.15	80% above	30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US, BREAST, UNILATERAL, REAL TIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; LIMITED	$65.96	$94.22	$24.65–$80.09	78% below	30%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST POST MA	$533.78	$762.53	$648.15	—	30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US, BREAST, UNILATERAL, REAL TIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; LIMITED	$65.96	$94.22	$24.65–$80.09	—	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST	$2,286.44	$3,266.33	$175.68–$2,776.38	18% above	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHEST PE PROTOCOL	$2,807.10	$4,010.14	$175.68–$3,408.62	45% above	30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST	$2,286.44	$3,266.33	$2,776.38	—	30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT CHEST PE PROTOCOL	$2,807.10	$4,010.14	$3,408.62	—	30%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CHEST-CALCIUM SCORING-CASH ONLY	$47.60	$68.00	$57.80–$87.17	44% below	30%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CHEST-CALCIUM SCORING-CASH ONLY	$47.60	$68.00	$57.80	—	30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS WO	$3,141.74	$4,488.20	$238.99–$3,814.97	48% above	30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS WO	$3,141.74	$4,488.20	$3,814.97	—	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ENTEROGRAPHY	$2,166.15	$3,094.50	$349.44–$2,630.33	9% below	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W	$3,407.57	$4,867.95	$349.44–$4,137.76	44% above	30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ENTEROGRAPHY	$2,166.15	$3,094.50	$2,630.33	—	30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W	$3,407.57	$4,867.95	$4,137.76	—	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS WO/W	$3,557.11	$5,081.58	$349.44–$4,319.34	22% above	30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS WO/W	$3,557.11	$5,081.58	$4,319.34	—	30%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W	$2,847.53	$4,067.90	$175.68–$3,457.72	82% above	30%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W	$2,847.53	$4,067.90	$3,457.72	—	30%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO	$2,202.46	$3,146.37	$104.71–$2,674.41	104% above	30%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO	$2,202.46	$3,146.37	$2,674.41	—	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES WO	$1,769.24	$2,527.48	$104.71–$2,148.36	64% above	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES LIMITED	$2,008.64	$2,869.48	$104.71–$2,439.06	86% above	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES	$2,008.64	$2,869.48	$104.71–$2,439.06	86% above	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES WO	$1,769.24	$2,527.48	$2,148.36	—	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES	$2,008.64	$2,869.48	$2,439.06	—	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES LIMITED	$2,008.64	$2,869.48	$2,439.06	—	30%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN WO	$1,931.42	$2,759.16	$104.71–$2,345.29	53% above	30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN WO	$1,931.42	$2,759.16	$2,345.29	—	30%
CT scan of the head with contrast CPT 70460 CT BRAIN W	$1,933.69	$2,762.41	$175.68–$2,348.05	34% above	30%
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN W	$1,933.69	$2,762.41	$2,348.05	—	30%
CT scan of the head without and with contrast CPT 70470 CT BRAIN WO/W	$2,464.43	$3,520.61	$175.68–$2,992.52	38% above	30%
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN WO/W	$2,464.43	$3,520.61	$2,992.52	—	30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR	$2,311.49	$3,302.12	$104.71–$2,806.80	68% above	30%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR	$2,311.49	$3,302.12	$2,806.80	—	30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL WO	$2,329.66	$3,328.08	$104.71–$2,828.87	44% above	30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL WO	$2,329.66	$3,328.08	$2,828.87	—	30%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W	$2,613.46	$3,733.51	$175.68–$3,173.48	60% above	30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W	$2,613.46	$3,733.51	$3,173.48	—	30%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DOPPLER	$1,189.44	$1,699.19	$186.35–$1,444.31	43% above	30%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DOPPLER	$1,189.44	$1,699.19	$1,444.31	—	30%
Chest X-ray, 2 views CPT 71046 DX CHEST DECUB 2 VIEWS	$443.01	$632.86	$87.17–$537.93	76% above	30%
Chest X-ray, 2 views CPT 71046 DX CHEST PA & LAT 2 VIEW	$526.20	$751.71	$87.17–$638.95	109% above	30%
Chest X-ray, 2 views inpatient CPT 71046 DX CHEST DECUB 2 VIEWS	$443.01	$632.86	$537.93	—	30%
Chest X-ray, 2 views inpatient CPT 71046 DX CHEST PA & LAT 2 VIEW	$526.20	$751.71	$638.95	—	30%
Chest X-ray, single view CPT 71045 DX PORTABLE CHEST	$440.65	$629.49	$87.17–$535.07	110% above	30%
Chest X-ray, single view CPT 71045 DX CHEST 1 VIEW	$440.65	$629.49	$87.17–$535.07	110% above	30%
Chest X-ray, single view inpatient CPT 71045 DX PORTABLE CHEST	$440.65	$629.49	$535.07	—	30%
Chest X-ray, single view inpatient CPT 71045 DX CHEST 1 VIEW	$440.65	$629.49	$535.07	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 ULTRASOUND, RETROPERITONEAL (EG, RENAL, AORTA, NODES), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE	$70.80	$101.14	$26.72–$95.39	87% below	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US ABDOMINAL AORTA	$955.49	$1,364.98	$104.71–$1,160.23	69% above	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL	$955.49	$1,364.98	$104.71–$1,160.23	69% above	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 ULTRASOUND, RETROPERITONEAL (EG, RENAL, AORTA, NODES), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE	$70.80	$101.14	$26.72–$95.39	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL	$955.49	$1,364.98	$1,160.23	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US ABDOMINAL AORTA	$955.49	$1,364.98	$1,160.23	—	30%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DX BONE DENSITOMETRY	$565.58	$807.96	$104.71–$686.77	65% above	30%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DX BONE DENSITOMETRY	$565.58	$807.96	$686.77	—	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO	$2,099.50	$2,999.28	$104.71–$2,549.39	63% above	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO	$2,099.50	$2,999.28	$2,549.39	—	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W	$2,440.96	$3,487.08	$175.68–$2,964.02	48% above	30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W	$2,440.96	$3,487.08	$2,964.02	—	30%
Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; BILATERAL	$95.26	$136.08	$40.09–$140.14	—	30%
Diagnostic mammogram, both breasts both sides CPT 77066 MG MAMMO DIAGNOSTIC BILAT WITH CAD	$439.14	$627.33	$140.14–$533.23	—	30%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; BILATERAL	$95.26	$136.08	$40.09–$140.14	—	30%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG MAMMO DIAGNOSTIC BILAT WITH CAD	$439.14	$627.33	$533.23	—	30%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL	$77.57	$110.81	$32.42–$110.68	67% below	30%
Diagnostic mammogram, one breast one side CPT 77065 MG MAMMO DIAGNOSTIC LEFT WITH CAD UNILATERAL	$359.64	$513.76	$110.68–$436.70	54% above	30%
Diagnostic mammogram, one breast one side CPT 77065 MG MAMMO DIAGNOSTIC RIGHT WITH CAD UNILATERAL	$359.64	$513.76	$110.68–$436.70	54% above	30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL	$77.57	$110.81	$32.42–$110.68	—	30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG MAMMO DIAGNOSTIC RIGHT WITH CAD UNILATERAL	$359.64	$513.76	$436.70	—	30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG MAMMO DIAGNOSTIC LEFT WITH CAD UNILATERAL	$359.64	$513.76	$436.70	—	30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ART DOP LOWER EXT BILAT	$1,437.78	$2,053.96	$184.92–$1,745.87	—	30%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ART DOP LOWER EXT BILAT	$1,437.78	$2,053.96	$1,745.87	—	30%
Duplex ultrasound of the leg veins, both legs CPT 93970 US VEN DOP UPPER/LOWER EXT BIL	$1,281.81	$1,831.15	$143.61–$1,556.48	59% above	30%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US VEN DOP UPPER/LOWER EXT BIL	$1,281.81	$1,831.15	$1,556.48	—	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO W DOPPLER INTERP & REPORT	$349.30	$499.00	$52.22–$424.15	77% below	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHOCARDIOGRAM	$2,245.63	$3,208.03	$170.04–$2,726.83	49% above	30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO W DOPPLER INTERP & REPORT	$349.30	$499.00	$52.22–$424.15	—	30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHOCARDIOGRAM	$2,245.63	$3,208.03	$2,726.83	—	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY WO CCK	$432.32	$617.59	$400.42–$524.95	69% below	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY	$1,907.19	$2,724.55	$400.42–$2,315.87	39% above	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY WO CCK	$432.32	$617.59	$524.95	—	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY	$1,907.19	$2,724.55	$2,315.87	—	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY FULL W/CPAP TITRAT	$3,927.86	$5,611.22	$567.70–$4,769.54	50% above	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY FULL W/CPAP TITRAT	$3,927.86	$5,611.22	$4,769.54	—	30%
Knee X-ray, 3 views both sides CPT 73562 DX KNEE 3 VIEW BILAT	$739.04	$1,055.77	$87.17–$897.40	—	30%
Knee X-ray, 3 views one side CPT 73562 DX KNEE 3 VIEW LEFT	$559.33	$799.04	$87.17–$679.18	107% above	30%
Knee X-ray, 3 views one side CPT 73562 DX KNEE 3 VIEW RIGHT	$607.97	$868.52	$87.17–$738.24	125% above	30%
Knee X-ray, 3 views inpatient both sides CPT 73562 DX KNEE 3 VIEW BILAT	$739.04	$1,055.77	$897.40	—	30%
Knee X-ray, 3 views inpatient one side CPT 73562 DX KNEE 3 VIEW LEFT	$559.33	$799.04	$679.18	—	30%
Knee X-ray, 3 views inpatient one side CPT 73562 DX KNEE 3 VIEW RIGHT	$607.97	$868.52	$738.24	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, FOLLOW-UP)	$55.04	$78.62	$21.56–$77.11	89% below	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PYLORIS	$652.64	$932.34	$104.71–$792.49	29% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS	$780.14	$1,114.48	$104.71–$947.31	55% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER	$854.67	$1,220.95	$104.71–$1,037.81	70% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN	$854.67	$1,220.95	$104.71–$1,037.81	70% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$928.99	$1,327.12	$104.71–$1,128.05	84% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER	$928.99	$1,327.12	$104.71–$1,128.05	84% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, FOLLOW-UP)	$55.04	$78.62	$21.56–$77.11	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PYLORIS	$652.64	$932.34	$792.49	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS	$780.14	$1,114.48	$947.31	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER	$854.67	$1,220.95	$1,037.81	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN	$854.67	$1,220.95	$1,037.81	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER	$928.99	$1,327.12	$1,128.05	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$928.99	$1,327.12	$1,128.05	—	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST-LUNG NODULE SCREENING PF	$103.42	$147.73	$39.07–$125.57	76% below	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST-NODULE SCREENING	$244.67	$349.52	$104.71–$297.09	44% below	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST-LUNG NODULE SCREENING PF	$103.42	$147.73	$39.07–$125.57	—	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST-NODULE SCREENING	$244.67	$349.52	$297.09	—	30%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI, BREAST, WITHOUT AND WITH CONTRAST MATERIAL(S), INCLUDING COMPUTER-AIDED DETECTION (CAD REAL-TIME LESION DETECTION, CHARACTERIZATION AND PHARMACOKINETIC ANALYSIS), WHEN PERFORMED; BILATERAL	$236.60	$338.00	$83.00–$304.02	—	30%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST BILAT WO/W	$3,967.18	$5,667.40	$303.73–$4,817.29	—	30%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI, BREAST, WITHOUT AND WITH CONTRAST MATERIAL(S), INCLUDING COMPUTER-AIDED DETECTION (CAD REAL-TIME LESION DETECTION, CHARACTERIZATION AND PHARMACOKINETIC ANALYSIS), WHEN PERFORMED; BILATERAL	$236.60	$338.00	$83.00–$304.02	—	30%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST BILAT WO/W	$3,967.18	$5,667.40	$4,817.29	—	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE WO LEFT	$2,635.75	$3,765.35	$238.99–$3,200.55	42% above	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE WO LEFT	$2,864.94	$4,092.77	$238.99–$3,478.85	54% above	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP WO RIGHT	$2,864.94	$4,092.77	$238.99–$3,478.85	54% above	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP WO LEFT	$2,864.94	$4,092.77	$238.99–$3,478.85	54% above	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE WO RIGHT	$2,864.94	$4,092.77	$238.99–$3,478.85	54% above	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE WO RIGHT	$2,864.94	$4,092.77	$238.99–$3,478.85	54% above	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE WO LEFT	$2,635.75	$3,765.35	$3,200.55	—	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE WO RIGHT	$2,864.94	$4,092.77	$3,478.85	—	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP WO LEFT	$2,864.94	$4,092.77	$3,478.85	—	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE WO LEFT	$2,864.94	$4,092.77	$3,478.85	—	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP WO RIGHT	$2,864.94	$4,092.77	$3,478.85	—	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE WO RIGHT	$2,864.94	$4,092.77	$3,478.85	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP W/WO LEFT	$3,427.04	$4,895.76	$349.44–$4,161.40	53% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE WO/W LEFT	$3,427.04	$4,895.76	$349.44–$4,161.40	53% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE WO/W LEFT	$3,427.04	$4,895.76	$349.44–$4,161.40	53% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE WO/W RIGHT	$3,427.04	$4,895.76	$349.44–$4,161.40	53% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE W/WO RIGHT	$3,427.04	$4,895.76	$349.44–$4,161.40	53% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP W/WO RIGHT	$3,427.04	$4,895.76	$349.44–$4,161.40	53% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP W/WO RIGHT	$3,427.04	$4,895.76	$4,161.40	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE WO/W LEFT	$3,427.04	$4,895.76	$4,161.40	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE WO/W RIGHT	$3,427.04	$4,895.76	$4,161.40	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE W/WO RIGHT	$3,427.04	$4,895.76	$4,161.40	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE WO/W LEFT	$3,427.04	$4,895.76	$4,161.40	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP W/WO LEFT	$3,427.04	$4,895.76	$4,161.40	—	30%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO	$2,635.75	$3,765.35	$238.99–$3,200.55	59% above	30%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO	$2,635.75	$3,765.35	$3,200.55	—	30%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO	$3,725.03	$5,321.47	$349.44–$4,523.25	54% above	30%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO	$3,725.03	$5,321.47	$4,523.25	—	30%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN/NECK-ANGIO	$2,635.75	$3,765.35	$238.99–$3,200.55	63% above	30%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN, VENOUS WO	$2,635.75	$3,765.35	$238.99–$3,200.55	63% above	30%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO	$2,864.94	$4,092.77	$238.99–$3,478.85	77% above	30%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN/NECK-ANGIO	$2,635.75	$3,765.35	$3,200.55	—	30%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN, VENOUS WO	$2,635.75	$3,765.35	$3,200.55	—	30%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO	$2,864.94	$4,092.77	$3,478.85	—	30%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO / W	$3,725.03	$5,321.47	$349.44–$4,523.25	46% above	30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO / W	$3,725.03	$5,321.47	$4,523.25	—	30%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR WO	$2,864.94	$4,092.77	$238.99–$3,478.85	54% above	30%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR WO	$2,864.94	$4,092.77	$3,478.85	—	30%
MRI of the lower back, without and then with contrast dye CPT 72158 MRA SPINAL CANAL WO/W	$3,427.04	$4,895.76	$349.44–$4,161.40	37% above	30%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR WO/W	$3,725.03	$5,321.47	$349.44–$4,523.25	49% above	30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRA SPINAL CANAL WO/W	$3,427.04	$4,895.76	$4,161.40	—	30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR WO/W	$3,725.03	$5,321.47	$4,523.25	—	30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC WO	$2,864.94	$4,092.77	$238.99–$3,478.85	63% above	30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC WO	$2,864.94	$4,092.77	$3,478.85	—	30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL WO/W	$3,725.03	$5,321.47	$349.44–$4,523.25	49% above	30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL WO/W	$3,725.03	$5,321.47	$4,523.25	—	30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL WO	$2,864.94	$4,092.77	$238.99–$3,478.85	45% above	30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL WO	$2,864.94	$4,092.77	$3,478.85	—	30%
MRI of the pelvis without and with contrast CPT 72197 MRI SACRUM/COCCYX WO/W	$3,036.06	$4,337.22	$349.44–$3,686.64	18% above	30%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/W	$3,725.03	$5,321.47	$349.44–$4,523.25	45% above	30%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI SACRUM/COCCYX WO/W	$3,036.06	$4,337.22	$3,686.64	—	30%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO/W	$3,725.03	$5,321.47	$4,523.25	—	30%
MRI of the pelvis, no contrast dye CPT 72195 MRI SACRUM/COCCYX WO	$2,418.12	$3,454.45	$238.99–$2,936.28	29% above	30%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO	$2,864.94	$4,092.77	$238.99–$3,478.85	52% above	30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI SACRUM/COCCYX WO	$2,418.12	$3,454.45	$2,936.28	—	30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO	$2,864.94	$4,092.77	$3,478.85	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST WO LEFT	$2,476.54	$3,537.91	$238.99–$3,007.22	33% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW WO LEFT	$2,476.54	$3,537.91	$238.99–$3,007.22	33% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW WO RIGHT	$2,476.54	$3,537.91	$238.99–$3,007.22	33% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST WO RIGHT	$2,575.61	$3,679.43	$238.99–$3,127.52	38% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER WO RIGHT	$2,864.94	$4,092.77	$238.99–$3,478.85	54% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER WO LEFT	$2,864.94	$4,092.77	$238.99–$3,478.85	54% above	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW WO LEFT	$2,476.54	$3,537.91	$3,007.22	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST WO LEFT	$2,476.54	$3,537.91	$3,007.22	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW WO RIGHT	$2,476.54	$3,537.91	$3,007.22	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST WO RIGHT	$2,575.61	$3,679.43	$3,127.52	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER WO LEFT	$2,864.94	$4,092.77	$3,478.85	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER WO RIGHT	$2,864.94	$4,092.77	$3,478.85	—	30%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYO PERF IMAGING	$4,175.52	$5,965.02	$1,296.74–$5,070.27	2% above	30%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYO PERF IMAGING	$4,175.52	$5,965.02	$5,070.27	—	30%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL TO MIDTHIGH	$3,382.85	$4,832.64	$1,432.26–$4,107.74	26% below	30%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT SKULL TO MIDTHIGH	$3,382.85	$4,832.64	$4,107.74	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, FOR FOLLICLES)	$47.69	$68.12	$17.75–$57.90	88% below	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS F/U OR LIMITED	$847.98	$1,211.39	$104.71–$1,029.68	110% above	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, FOR FOLLICLES)	$47.69	$68.12	$17.75–$57.90	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS F/U OR LIMITED	$847.98	$1,211.39	$1,029.68	—	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE	$66.07	$94.38	$25.16–$94.29	90% below	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS	$926.72	$1,323.88	$104.71–$1,125.30	43% above	30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE	$66.07	$94.38	$25.16–$94.29	—	30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS	$926.72	$1,323.88	$1,125.30	—	30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATERNAL EVALUATION, AFTER FIRST TRIMESTER (> OR = 14 WEEKS 0 DAYS), TRANSABDOMINAL APPROACH; SINGLE OR FIRST GESTATION	$95.77	$136.81	$35.99–$121.63	83% below	30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB > 14 WEEKS	$953.98	$1,362.82	$104.71–$1,158.40	68% above	30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATERNAL EVALUATION, AFTER FIRST TRIMESTER (> OR = 14 WEEKS 0 DAYS), TRANSABDOMINAL APPROACH; SINGLE OR FIRST GESTATION	$95.77	$136.81	$35.99–$121.63	—	30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB > 14 WEEKS	$953.98	$1,362.82	$1,158.40	—	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATERNAL EVALUATION, FIRST TRIMESTER (< 14 WEEKS 0 DAYS), TRANSABDOMINAL APPROACH; SINGLE OR FIRST GESTATION	$95.19	$135.98	$35.74–$115.58	81% below	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB COMPLETE < 14 WKS	$1,053.54	$1,505.05	$104.71–$1,279.29	106% above	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATERNAL EVALUATION, FIRST TRIMESTER (< 14 WEEKS 0 DAYS), TRANSABDOMINAL APPROACH; SINGLE OR FIRST GESTATION	$95.19	$135.98	$35.74–$115.58	—	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB COMPLETE < 14 WKS	$1,053.54	$1,505.05	$1,279.29	—	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, LIMITED	$62.61	$89.44	$23.62–$76.02	83% below	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED	$865.39	$1,236.27	$104.71–$1,050.83	141% above	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, LIMITED	$62.61	$89.44	$23.62–$76.02	—	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED	$865.39	$1,236.27	$1,050.83	—	30%
Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED	$73.42	$104.88	$30.42–$112.43	—	30%
Screening mammogram, both breasts CPT 77067 MG MAMMO SCREEN WITH CAD SPEC COUPON	$221.09	$315.83	$112.43–$268.46	34% above	30%
Screening mammogram, both breasts CPT 77067 MG MAMMO ROUTINE SCREENING WITH CAD	$349.79	$499.70	$112.43–$424.75	112% above	30%
Screening mammogram, both breasts one side CPT 77067 MG MAMMO SCREEN RIGHT WITH CAD	$321.81	$459.72	$112.43–$390.76	95% above	30%
Screening mammogram, both breasts one side CPT 77067 MG MAMMO SCREEN LEFT WITH CAD	$321.81	$459.72	$112.43–$390.76	95% above	30%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED	$73.42	$104.88	$30.42–$112.43	—	30%
Screening mammogram, both breasts inpatient CPT 77067 MG MAMMO SCREEN WITH CAD SPEC COUPON	$221.09	$315.83	$268.46	—	30%
Screening mammogram, both breasts inpatient CPT 77067 MG MAMMO ROUTINE SCREENING WITH CAD	$349.79	$499.70	$424.75	—	30%
Screening mammogram, both breasts inpatient one side CPT 77067 MG MAMMO SCREEN LEFT WITH CAD	$321.81	$459.72	$390.76	—	30%
Screening mammogram, both breasts inpatient one side CPT 77067 MG MAMMO SCREEN RIGHT WITH CAD	$321.81	$459.72	$390.76	—	30%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 DX SHOULDER COMPLETE BILAT	$921.42	$1,316.31	$87.17–$1,118.86	—	30%
Shoulder X-ray, complete, 2 or more views CPT 73030 DX SHOULDER POST OP	$564.90	$807.00	$87.17–$685.95	107% above	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 DX SHOULDER COMPLETE LEFT	$614.03	$877.18	$87.17–$745.60	125% above	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 DX SHOULDER COMPLETE RIGHT	$614.03	$877.18	$87.17–$745.60	125% above	30%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 DX SHOULDER COMPLETE BILAT	$921.42	$1,316.31	$1,118.86	—	30%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 DX SHOULDER POST OP	$564.90	$807.00	$685.95	—	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 DX SHOULDER COMPLETE RIGHT	$614.03	$877.18	$745.60	—	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 DX SHOULDER COMPLETE LEFT	$614.03	$877.18	$745.60	—	30%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY FULL	$3,717.49	$5,310.70	$509.03–$4,514.10	47% above	30%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STUDY FULL	$3,717.49	$5,310.70	$4,514.10	—	30%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE INTERP & REPORT	$329.00	$470.00	$62.75–$399.50	81% below	30%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 US STRESS ECHOCARDIOGRAPHY	$2,330.72	$3,329.60	$177.66–$2,830.16	33% above	30%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE INTERP & REPORT	$329.00	$470.00	$62.75–$399.50	—	30%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 US STRESS ECHOCARDIOGRAPHY	$2,330.72	$3,329.60	$2,830.16	—	30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 RADIOLOGIC EXAMINATION, SWALLOWING FUNCTION, WITH CINERADIOGRAPHY/VIDEORADIOGRAPHY, INCLUDING SCOUT NECK RADIOGRAPH(S) AND DELAYED IMAGE(S), WHEN PERFORMED, CONTRAST (EG, BARIUM) STUDY	$51.15	$73.06	$19.49–$106.20	88% below	30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 DX VIDEO SWALLOW	$720.02	$1,028.60	$175.68–$874.31	63% above	30%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RADIOLOGIC EXAMINATION, SWALLOWING FUNCTION, WITH CINERADIOGRAPHY/VIDEORADIOGRAPHY, INCLUDING SCOUT NECK RADIOGRAPH(S) AND DELAYED IMAGE(S), WHEN PERFORMED, CONTRAST (EG, BARIUM) STUDY	$51.15	$73.06	$19.49–$106.20	—	30%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 DX VIDEO SWALLOW	$720.02	$1,028.60	$874.31	—	30%
Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND, TRANSVAGINAL	$66.62	$95.16	$31.63–$104.66	89% below	30%
Transvaginal pelvic ultrasound CPT 76830 US PELVIS TRANSVAGINAL	$926.72	$1,323.88	$104.71–$1,125.30	60% above	30%
Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND, TRANSVAGINAL	$66.62	$95.16	$31.63–$104.66	—	30%
Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIS TRANSVAGINAL	$926.72	$1,323.88	$1,125.30	—	30%
Transvaginal ultrasound during pregnancy CPT 76817 ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, TRANSVAGINAL	$72.04	$102.91	$27.48–$87.47	85% below	30%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$887.35	$1,267.64	$104.71–$1,077.49	90% above	30%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, TRANSVAGINAL	$72.04	$102.91	$27.48–$87.47	—	30%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL	$887.35	$1,267.64	$1,077.49	—	30%
Ultrasound of the abdomen, complete CPT 76700 ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE	$77.57	$110.81	$29.30–$102.33	90% below	30%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$1,077.39	$1,539.12	$104.71–$1,308.25	37% above	30%
Ultrasound of the abdomen, complete inpatient CPT 76700 ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE	$77.57	$110.81	$29.30–$102.33	—	30%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$1,077.39	$1,539.12	$1,308.25	—	30%
Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND, SCROTUM AND CONTENTS	$61.88	$88.40	$29.07–$87.98	89% below	30%
Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR	$865.39	$1,236.27	$104.71–$1,050.83	49% above	30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 ULTRASOUND, SCROTUM AND CONTENTS	$61.88	$88.40	$29.07–$87.98	—	30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR	$865.39	$1,236.27	$1,050.83	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), REAL TIME WITH IMAGE DOCUMENTATION	$54.60	$78.00	$24.55–$96.58	90% below	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SP PAROTID GLAND BIOPSY	$818.45	$1,169.21	$104.71–$993.83	45% above	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$865.39	$1,236.27	$104.71–$1,050.83	53% above	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD & NECK	$889.62	$1,270.88	$104.71–$1,080.25	57% above	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), REAL TIME WITH IMAGE DOCUMENTATION	$54.60	$78.00	$24.55–$96.58	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SP PAROTID GLAND BIOPSY	$818.45	$1,169.21	$993.83	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$865.39	$1,236.27	$1,050.83	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD & NECK	$889.62	$1,270.88	$1,080.25	—	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RADIOLOGIC EXAMINATION, UPPER GASTROINTESTINAL TRACT, INCLUDING SCOUT ABDOMINAL RADIOGRAPH(S) AND DELAYED IMAGE(S), WHEN PERFORMED; SINGLE-CONTRAST (EG, BARIUM) STUDY	$77.54	$110.76	$29.03–$108.87	86% below	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 DX UPPER GI SCS	$651.97	$931.38	$175.68–$791.67	15% above	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RADIOLOGIC EXAMINATION, UPPER GASTROINTESTINAL TRACT, INCLUDING SCOUT ABDOMINAL RADIOGRAPH(S) AND DELAYED IMAGE(S), WHEN PERFORMED; SINGLE-CONTRAST (EG, BARIUM) STUDY	$77.54	$110.76	$29.03–$108.87	—	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 DX UPPER GI SCS	$651.97	$931.38	$791.67	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US VEN DOP UPPER/LOWER EXT UNI	$950.95	$1,358.49	$93.36–$1,154.72	69% above	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US VEN DOP UPPER/LOWER EXT UNI	$950.95	$1,358.49	$1,154.72	—	30%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 DX WRIST COMPLETE BILAT	$941.86	$1,345.51	$87.17–$1,143.68	—	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 DX WRIST COMPLETE LEFT	$629.17	$898.81	$87.17–$763.99	140% above	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 DX WRIST COMPLETE RIGHT	$629.17	$898.81	$87.17–$763.99	140% above	30%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 DX WRIST COMPLETE BILAT	$941.86	$1,345.51	$1,143.68	—	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 DX WRIST COMPLETE RIGHT	$629.17	$898.81	$763.99	—	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 DX WRIST COMPLETE LEFT	$629.17	$898.81	$763.99	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 DX HIP 2 VIEW RIGHT W AP PELVIS	$557.25	$796.06	$87.17–$676.65	134% above	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 DX HIP 2 VIEW LEFT W AP PELVIS	$557.25	$796.06	$87.17–$676.65	134% above	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 DX HIP 2 VIEW RIGHT W AP PELVIS	$557.25	$796.06	$676.65	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 DX HIP 2 VIEW LEFT W AP PELVIS	$557.25	$796.06	$676.65	—	30%
X-ray of the abdomen, 1 view CPT 74018 DX ABDOMEN 1 VIEW	$471.69	$673.84	$87.17–$572.76	116% above	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 DX ABDOMEN 1 VIEW	$471.69	$673.84	$572.76	—	30%
X-ray of the ankle, 2 views both sides CPT 73600 DX ANKLE 2 VIEW BILAT	$657.55	$939.35	$87.17–$798.45	—	30%
X-ray of the ankle, 2 views one side CPT 73600 DX ANKLE 2 VIEW RIGHT	$438.83	$626.89	$87.17–$532.86	131% above	30%
X-ray of the ankle, 2 views one side CPT 73600 DX ANKLE 2 VIEW LEFT	$476.99	$681.41	$87.17–$579.20	151% above	30%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 DX ANKLE 2 VIEW BILAT	$657.55	$939.35	$798.45	—	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 DX ANKLE 2 VIEW RIGHT	$438.83	$626.89	$532.86	—	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 DX ANKLE 2 VIEW LEFT	$476.99	$681.41	$579.20	—	30%
X-ray of the finger(s), 2 or more views both sides CPT 73140 DX FINGER COMPLETE BILAT	$506.39	$723.41	$87.17–$614.90	—	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 DX FINGER COMPLETE LEFT	$463.36	$661.94	$87.17–$562.65	126% above	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 DX FINGER COMPLETE RIGHT	$463.36	$661.94	$87.17–$562.65	126% above	30%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 DX FINGER COMPLETE BILAT	$506.39	$723.41	$614.90	—	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DX FINGER COMPLETE LEFT	$463.36	$661.94	$562.65	—	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DX FINGER COMPLETE RIGHT	$463.36	$661.94	$562.65	—	30%
X-ray of the foot, 2 views both sides CPT 73620 DX FOOT 2 VIEW BILAT	$650.58	$929.40	$87.17–$789.99	—	30%
X-ray of the foot, 2 views one side CPT 73620 DX FOOT 2 VIEW RIGHT	$434.65	$620.92	$87.17–$527.78	119% above	30%
X-ray of the foot, 2 views one side CPT 73620 DX FOOT 2 VIEW LEFT	$472.45	$674.92	$87.17–$573.68	138% above	30%
X-ray of the foot, 2 views inpatient both sides CPT 73620 DX FOOT 2 VIEW BILAT	$650.58	$929.40	$789.99	—	30%
X-ray of the foot, 2 views inpatient one side CPT 73620 DX FOOT 2 VIEW RIGHT	$434.65	$620.92	$527.78	—	30%
X-ray of the foot, 2 views inpatient one side CPT 73620 DX FOOT 2 VIEW LEFT	$472.45	$674.92	$573.68	—	30%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 DX FOOT COMPLETE BILAT	$989.56	$1,413.65	$87.17–$1,201.60	—	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 DX FOOT COMPLETE LEFT	$660.22	$943.16	$87.17–$801.69	141% above	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 DX FOOT COMPLETE RIGHT	$660.22	$943.16	$87.17–$801.69	141% above	30%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 DX FOOT COMPLETE BILAT	$989.56	$1,413.65	$1,201.60	—	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 DX FOOT COMPLETE LEFT	$660.22	$943.16	$801.69	—	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 DX FOOT COMPLETE RIGHT	$660.22	$943.16	$801.69	—	30%
X-ray of the hand, 3 or more views both sides CPT 73130 DX HAND COMPLETE BILAT	$847.71	$1,211.01	$87.17–$1,029.36	—	30%
X-ray of the hand, 3 or more views one side CPT 73130 DX HAND COMPLETE LEFT	$614.03	$877.18	$87.17–$745.60	144% above	30%
X-ray of the hand, 3 or more views one side CPT 73130 DX HAND COMPLETE RIGHT	$614.03	$877.18	$87.17–$745.60	144% above	30%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 DX HAND COMPLETE BILAT	$847.71	$1,211.01	$1,029.36	—	30%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 DX HAND COMPLETE LEFT	$614.03	$877.18	$745.60	—	30%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 DX HAND COMPLETE RIGHT	$614.03	$877.18	$745.60	—	30%
X-ray of the knee, 1 or 2 views both sides CPT 73560 DX KNEE 2 VIEW BILAT	$847.71	$1,211.01	$87.17–$1,029.36	—	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 DX KNEE 2 VIEW RIGHT	$564.90	$807.00	$87.17–$685.95	147% above	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 DX KNEE 2 VIEW LEFT	$614.03	$877.18	$87.17–$745.60	168% above	30%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 DX KNEE 2 VIEW BILAT	$847.71	$1,211.01	$1,029.36	—	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 DX KNEE 2 VIEW RIGHT	$564.90	$807.00	$685.95	—	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 DX KNEE 2 VIEW LEFT	$614.03	$877.18	$745.60	—	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 DX LUMBAR SPINE 2 VIEW	$560.73	$801.03	$104.71–$680.88	90% above	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 DX LUMBAR SPINE 3 VIEWS	$609.49	$870.69	$104.71–$740.09	107% above	30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 DX LUMBAR SPINE 2 VIEW	$560.73	$801.03	$680.88	—	30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 DX LUMBAR SPINE 3 VIEWS	$609.49	$870.69	$740.09	—	30%
X-ray of the lower back, 4 or more views CPT 72110 DX LUMBAR SPINE COMPLETE	$708.67	$1,012.38	$104.71–$860.52	66% above	30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 DX LUMBAR SPINE COMPLETE	$708.67	$1,012.38	$860.52	—	30%
X-ray of the nasal bones, 3 or more views CPT 70160 DX NASAL BONES	$605.70	$865.28	$87.17–$735.49	143% above	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 DX NASAL BONES	$605.70	$865.28	$735.49	—	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 DX CERVICAL SPINE 3 VIEW	$507.09	$724.41	$87.17–$615.75	69% above	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 DX CERVICAL SPINE 3 VIEW	$507.09	$724.41	$615.75	—	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 DX PELVIS	$474.72	$678.16	$104.71–$576.44	110% above	30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 DX PELVIS	$474.72	$678.16	$576.44	—	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 DX SACRUM & COCCYX	$507.09	$724.41	$87.17–$615.75	93% above	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 DX SACRUM & COCCYX	$507.09	$724.41	$615.75	—	30%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT	$109.03	$155.75	$5.30–$132.39	125% above	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT	$109.03	$155.75	$132.39	—	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$113.57	$162.24	$5.18–$137.90	144% above	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT	$113.57	$162.24	$137.90	—	30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PROFILE	$388.98	$555.68	$47.63–$472.33	65% above	30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PROFILE	$388.98	$555.68	$472.33	—	30%
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN IGE	$50.85	$72.64	$5.22–$61.74	130% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 STACHYBOTRYS ATRA	$50.85	$72.64	$5.22–$61.74	130% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS SHELLFISH	$60.60	$86.57	$5.22–$73.58	174% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 AUREOBASIDI PULLULANS IGE	$62.69	$89.55	$5.22–$76.12	184% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN	$69.66	$99.51	$5.22–$84.58	215% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALERNARIA ALTERNATA	$86.38	$123.39	$5.22–$104.88	291% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS EGG YOLK	$106.58	$152.25	$5.22–$129.41	382% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS BASIC FOODS	$110.76	$158.22	$5.22–$134.49	401% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLOYL V IGE	$110.76	$158.22	$5.22–$134.49	401% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLOYL G IGE	$110.76	$158.22	$5.22–$134.49	401% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS FOOD BERRIES	$120.38	$171.97	$5.22–$146.17	445% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FLAVUS IGE	$169.96	$242.80	$5.22–$206.38	669% above	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN IGE	$50.85	$72.64	$61.74	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STACHYBOTRYS ATRA	$50.85	$72.64	$61.74	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS SHELLFISH	$60.60	$86.57	$73.58	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AUREOBASIDI PULLULANS IGE	$62.69	$89.55	$76.12	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN	$69.66	$99.51	$84.58	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALERNARIA ALTERNATA	$86.38	$123.39	$104.88	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS EGG YOLK	$106.58	$152.25	$129.41	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLOYL G IGE	$110.76	$158.22	$134.49	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS BASIC FOODS	$110.76	$158.22	$134.49	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLOYL V IGE	$110.76	$158.22	$134.49	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS FOOD BERRIES	$120.38	$171.97	$146.17	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FLAVUS IGE	$169.96	$242.80	$206.38	—	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE ANTIBODIES	$119.63	$170.89	$12.95–$145.26	49% above	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE ANTIBODIES	$119.63	$170.89	$145.26	—	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA (SCREEN)	$142.34	$203.34	$12.09–$172.84	109% above	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA (SCREEN)	$142.34	$203.34	$172.84	—	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP (B-TYPE NATRIURETIC PEPTID	$372.66	$532.37	$39.26–$452.51	204% above	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PRO B TYPE BETA NATRIURETIC PEPTIDE	$405.07	$578.66	$39.26–$491.86	231% above	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP (B-TYPE NATRIURETIC PEPTID	$372.66	$532.37	$452.51	—	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT PRO B TYPE BETA NATRIURETIC PEPTIDE	$405.07	$578.66	$491.86	—	30%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$196.10	$280.13	$8.46–$238.11	58% above	30%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$196.10	$280.13	$238.11	—	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CYTOCELL BLOCK	$443.01	$632.86	$52.20–$537.93	117% above	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH IV	$481.53	$687.90	$52.20–$584.72	136% above	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CYTOCELL BLOCK	$443.01	$632.86	$537.93	—	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH IV	$481.53	$687.90	$584.72	—	30%
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$259.70	$370.99	$10.32–$315.34	133% above	30%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$259.70	$370.99	$315.34	—	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRAW FEE VENOUS	$36.35	$51.92	$9.34–$44.13	116% above	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DRAW FEE VENOUS	$36.35	$51.92	$44.13	—	30%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$72.69	$103.83	$3.93–$88.26	123% above	30%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$72.69	$103.83	$88.26	—	30%
Blood lead test CPT 83655 LEAD PEDIATRIC CAPILLARY	$78.75	$112.49	$12.11–$95.62	44% above	30%
Blood lead test CPT 83655 LEAD PEDIATRIC VENOUS	$87.07	$124.38	$12.11–$105.72	59% above	30%
Blood lead test CPT 83655 LEAD ADULT	$137.23	$196.03	$12.11–$166.63	151% above	30%
Blood lead test inpatient CPT 83655 LEAD PEDIATRIC CAPILLARY	$78.75	$112.49	$95.62	—	30%
Blood lead test inpatient CPT 83655 LEAD PEDIATRIC VENOUS	$87.07	$124.38	$105.72	—	30%
Blood lead test inpatient CPT 83655 LEAD ADULT	$137.23	$196.03	$166.63	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM	$118.12	$168.73	$7.52–$143.42	122% above	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST SERUM	$118.12	$168.73	$143.42	—	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPE ABO	$90.86	$129.79	$110.32–$133.26	26% above	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPE ABO	$90.86	$129.79	$110.32	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$84.05	$120.06	$5.18–$102.05	41% above	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$84.05	$120.06	$102.05	—	30%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE BY PCR	$190.80	$272.56	$37.27–$231.68	36% above	30%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE BY PCR	$190.80	$272.56	$231.68	—	30%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$233.95	$334.21	$20.81–$284.08	113% above	30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$233.95	$334.21	$284.08	—	30%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$283.17	$404.52	$20.81–$343.84	159% above	30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$283.17	$404.52	$343.84	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CORONAVIRUS NOVEL 2019	$75.60	$108.00	$51.31–$91.80	24% below	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CORONAVIRUS NAA BCMH	$97.52	$139.31	$51.31–$118.41	2% below	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CORONAVIRUS PCR LABCORP	$127.20	$181.71	$51.31–$154.45	27% above	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CORONAVIRUS NOVEL 2019	$75.60	$108.00	$91.80	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CORONAVIRUS NAA BCMH	$97.52	$139.31	$118.41	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CORONAVIRUS PCR LABCORP	$127.20	$181.71	$154.45	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA (PCR)	$82.53	$117.89	$35.09–$100.21	8% below	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AND GONOCOCCUS PCR	$94.90	$135.57	$35.09–$115.23	6% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA (PCR)	$82.53	$117.89	$100.21	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AND GONOCOCCUS PCR	$94.90	$135.57	$115.23	—	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$129.47	$184.95	$13.39–$157.21	26% above	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$129.47	$184.95	$157.21	—	30%
Complete blood count (CBC) with differential CPT 85025 CBC-POCHI	$106.58	$152.25	$7.77–$129.41	100% above	30%
Complete blood count (CBC) with differential CPT 85025 CBC WITH DIFF	$189.28	$270.40	$7.77–$229.84	255% above	30%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC-POCHI	$106.58	$152.25	$129.41	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH DIFF	$189.28	$270.40	$229.84	—	30%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM BILLING	$115.84	$165.48	$6.47–$140.66	136% above	30%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM BILLING	$115.84	$165.48	$140.66	—	30%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$249.10	$355.85	$10.56–$302.47	98% above	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$249.10	$355.85	$302.47	—	30%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER PLASA	$252.12	$360.17	$10.18–$306.14	101% above	30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER PLASA	$252.12	$360.17	$306.14	—	30%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA	$352.06	$502.94	$22.23–$427.50	158% above	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA	$352.06	$502.94	$427.50	—	30%
Estradiol blood test CPT 82670 ESTRADIOL	$343.74	$491.05	$27.94–$417.39	139% above	30%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$343.74	$491.05	$417.39	—	30%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMNULATING HORMONE	$159.34	$227.62	$18.58–$193.48	56% above	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMNULATING HORMONE	$159.34	$227.62	$193.48	—	30%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$248.83	$355.46	$19.63–$302.14	34% above	30%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$248.83	$355.46	$302.14	—	30%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$172.62	$246.60	$13.63–$209.61	106% above	30%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$172.62	$246.60	$209.61	—	30%
Folate (folic acid) blood test CPT 82746 FOLATE (SERUM)	$115.08	$164.40	$14.70–$139.74	51% above	30%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE (SERUM)	$115.08	$164.40	$139.74	—	30%
Free T3 thyroid hormone test CPT 84481 FREE T3	$266.51	$380.72	$16.94–$323.61	169% above	30%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$266.51	$380.72	$323.61	—	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T-4 FREE	$184.74	$263.91	$9.02–$224.32	149% above	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T-4 FREE	$184.74	$263.91	$224.32	—	30%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$500.46	$714.94	$25.47–$607.70	299% above	30%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$500.46	$714.94	$607.70	—	30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE	$64.09	$91.55	$4.75–$77.82	51% above	30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOSE DOSE	$64.09	$91.55	$77.82	—	30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 1 HR.	$194.35	$277.63	$12.87–$235.99	114% above	30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 4 HR.	$194.35	$277.63	$12.87–$235.99	114% above	30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 5 HR.	$194.35	$277.63	$12.87–$235.99	114% above	30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 2 HR.	$194.35	$277.63	$12.87–$235.99	114% above	30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 HR.	$211.24	$301.77	$12.87–$256.50	132% above	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 5 HR.	$194.35	$277.63	$235.99	—	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 2 HR.	$194.35	$277.63	$235.99	—	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 1 HR.	$194.35	$277.63	$235.99	—	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 4 HR.	$194.35	$277.63	$235.99	—	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 HR.	$211.24	$301.77	$256.50	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC NEISSERIA GONARRHEAE	$94.90	$135.57	$35.09–$115.23	17% above	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC NEISSERIA GONARRHEAE	$94.90	$135.57	$115.23	—	30%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI STOOL AG	$362.21	$517.44	$14.38–$439.82	202% above	30%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI STOOL AG	$362.21	$517.44	$439.82	—	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV TYPE 1 QUANTITATIVE	$694.29	$991.83	$85.10–$843.06	99% above	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV TYPE 1 QUANTITATIVE	$694.29	$991.83	$843.06	—	30%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/2 AG/AB	$134.01	$191.44	$13.71–$162.72	17% above	30%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1/2 AG/AB	$134.01	$191.44	$162.72	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV AG ABY COMBO	$149.76	$213.94	$24.08–$181.85	84% above	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV AG ABY COMBO	$149.76	$213.94	$181.85	—	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMAVIRUS DETECTION	$250.07	$357.23	$35.09–$303.65	126% above	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HUMAN PAPILLOMAVIRUS DETECTION	$250.07	$357.23	$303.65	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$73.29	$104.70	$9.71–$89.00	19% above	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$73.29	$104.70	$89.00	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$252.88	$361.25	$10.74–$307.06	267% above	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY	$252.88	$361.25	$307.06	—	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$149.16	$213.08	$10.33–$181.12	131% above	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$149.16	$213.08	$181.12	—	30%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$218.81	$312.58	$14.27–$265.69	158% above	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$218.81	$312.58	$265.69	—	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRUS PCR QUANT REFLEX GENOTYPE	$511.06	$730.08	$42.84–$620.57	72% above	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA BY PCR QUANT	$511.06	$730.08	$42.84–$620.57	72% above	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS RNA DIAGNOSIS	$511.06	$730.08	$42.84–$620.57	72% above	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRUS RNA DIAGNOSIS	$511.06	$730.08	$620.57	—	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA BY PCR QUANT	$511.06	$730.08	$620.57	—	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C VIRUS PCR QUANT REFLEX GENOTYPE	$511.06	$730.08	$620.57	—	30%
Herpes blood test, HSV-1 antibody CPT 86695 HSV I	$149.16	$213.08	$13.19–$181.12	126% above	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV I	$149.16	$213.08	$181.12	—	30%
Herpes blood test, HSV-2 antibody CPT 86696 HSV II	$389.92	$557.02	$19.35–$473.47	543% above	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV II	$389.92	$557.02	$473.47	—	30%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVE C=REACTIVE PROT	$248.34	$354.76	$12.95–$301.55	251% above	30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HIGH SENSITIVE C=REACTIVE PROT	$248.34	$354.76	$301.55	—	30%
Homocysteine blood test CPT 83090 HOMOCYSTINE	$445.79	$636.84	$17.92–$541.31	308% above	30%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE	$445.79	$636.84	$541.31	—	30%
Insulin blood test CPT 83525 INSULIN TOTAL BILLING	$80.32	$114.73	$11.43–$97.52	35% above	30%
Insulin blood test CPT 83525 INSULIN TOTAL	$183.23	$261.75	$11.43–$222.49	208% above	30%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL BILLING	$80.32	$114.73	$97.52	—	30%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$183.23	$261.75	$222.49	—	30%
Iron blood test (serum iron) CPT 83540 IRON	$96.16	$137.36	$6.47–$116.76	108% above	30%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$96.16	$137.36	$116.76	—	30%
Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING CAPACITY	$173.39	$247.69	$8.74–$210.54	157% above	30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING CAPACITY	$173.39	$247.69	$210.54	—	30%
Kidney function blood test panel CPT 80069 RENAL PANEL	$264.24	$377.48	$8.68–$320.86	148% above	30%
Kidney function blood test panel inpatient CPT 80069 RENAL PANEL	$264.24	$377.48	$320.86	—	30%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$173.27	$247.52	$18.52–$210.39	70% above	30%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$173.27	$247.52	$210.39	—	30%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$115.08	$164.40	$6.89–$139.74	83% above	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$115.08	$164.40	$139.74	—	30%
Liver function blood test panel CPT 80076 LIVER PROFILE	$330.11	$471.58	$8.17–$400.84	147% above	30%
Liver function blood test panel inpatient CPT 80076 LIVER PROFILE	$330.11	$471.58	$400.84	—	30%
Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL AB	$149.16	$213.08	$17.03–$181.12	63% above	30%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE TOTAL AB	$149.16	$213.08	$181.12	—	30%
Magnesium blood test CPT 83735 URINE MAGNESIUM	$70.42	$100.59	$6.70–$85.50	50% above	30%
Magnesium blood test CPT 83735 MAGNESIUM	$107.52	$153.59	$6.70–$130.55	129% above	30%
Magnesium blood test CPT 83735 MAGNESIUM RBC	$113.54	$162.20	$6.70–$137.87	142% above	30%
Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM	$70.42	$100.59	$85.50	—	30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$107.52	$153.59	$130.55	—	30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC	$113.54	$162.20	$137.87	—	30%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM	$168.84	$241.20	$12.88–$205.02	185% above	30%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG	$199.39	$284.84	$12.88–$242.11	237% above	30%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM	$168.84	$241.20	$205.02	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG	$199.39	$284.84	$242.11	—	30%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES	$21.70	$31.00	$5.18–$26.35	47% below	30%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES; SCREENING	$21.70	$31.00	$5.18–$26.35	47% below	30%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$115.84	$165.48	$5.18–$140.66	183% above	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES	$21.70	$31.00	$26.35	—	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES; SCREENING	$21.70	$31.00	$26.35	—	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$115.84	$165.48	$140.66	—	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA	$579.53	$827.90	$18.39–$703.72	658% above	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA	$579.53	$827.90	$703.72	—	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$80.11	$114.43	$18.39–$97.27	4% above	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRASENSITIVE	$90.86	$129.79	$18.39–$110.32	18% above	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$80.11	$114.43	$97.27	—	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRASENSITIVE	$90.86	$129.79	$110.32	—	30%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID LEVEL	$447.47	$639.23	$41.28–$543.35	162% above	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID LEVEL	$447.47	$639.23	$543.35	—	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT MIXING STUDIES	$91.95	$131.35	$6.01–$111.65	75% above	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT	$99.94	$142.77	$6.01–$121.35	90% above	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT MIXING STUDIES	$91.95	$131.35	$111.65	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT	$99.94	$142.77	$121.35	—	30%
Progesterone blood test CPT 84144 PROGESTERONE	$131.48	$187.82	$20.86–$159.65	19% above	30%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$131.48	$187.82	$159.65	—	30%
Prolactin blood test CPT 84146 PROLACTIN	$164.57	$235.09	$19.38–$199.83	34% above	30%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$164.57	$235.09	$199.83	—	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$21.70	$31.00	$4.29–$26.35	22% below	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME POC	$77.23	$110.32	$4.29–$93.77	176% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$77.23	$110.32	$4.29–$93.77	176% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PT MIXING STUDIES	$201.31	$287.58	$4.29–$244.44	619% above	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$21.70	$31.00	$26.35	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$77.23	$110.32	$93.77	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME POC	$77.23	$110.32	$93.77	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT MIXING STUDIES	$201.31	$287.58	$244.44	—	30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST BY OPTICAL OBSERVATION ANY # OF CLASSES	$31.50	$45.00	$12.60–$38.25	54% below	30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLAS	$56.79	$81.12	$12.60–$68.95	16% below	30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST BY OPTICAL OBSERVATION ANY # OF CLASSES	$31.50	$45.00	$38.25	—	30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLAS	$56.79	$81.12	$68.95	—	30%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN	$45.50	$65.00	$16.53–$55.25	14% above	30%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP SCREEN	$97.68	$139.53	$16.53–$118.60	146% above	30%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP SCREEN	$45.50	$65.00	$55.25	—	30%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP SCREEN	$97.68	$139.53	$118.60	—	30%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR IGA	$117.02	$167.17	$5.67–$142.09	162% above	30%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR IGM	$117.02	$167.17	$5.67–$142.09	162% above	30%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR IGG	$117.02	$167.17	$5.67–$142.09	162% above	30%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR TITER	$127.20	$181.71	$5.67–$154.45	185% above	30%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR IGM	$117.02	$167.17	$142.09	—	30%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR IGA	$117.02	$167.17	$142.09	—	30%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR IGG	$117.02	$167.17	$142.09	—	30%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR TITER	$127.20	$181.71	$154.45	—	30%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM	$134.01	$191.44	$14.39–$162.72	154% above	30%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG	$137.58	$196.53	$14.39–$167.05	161% above	30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM	$134.01	$191.44	$162.72	—	30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG	$137.58	$196.53	$167.05	—	30%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES	$155.22	$221.73	$8.90–$188.47	170% above	30%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES	$155.22	$221.73	$188.47	—	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREENING 1 TO 3 CARDS	$37.80	$54.00	$4.38–$45.90	76% above	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 FECAL OCCULT BLOOD DIAGNOSTIC	$44.67	$63.81	$4.38–$54.24	108% above	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN	$44.67	$63.81	$4.38–$54.24	108% above	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREENING 1 TO 3 CARDS	$37.80	$54.00	$45.90	—	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREEN	$44.67	$63.81	$54.24	—	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 FECAL OCCULT BLOOD DIAGNOSTIC	$44.67	$63.81	$54.24	—	30%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL	$42.70	$61.00	$15.92–$51.85	16% below	30%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 ASSAY TEST FOR BLOOD FECAL	$42.70	$61.00	$51.85	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$74.20	$106.00	$4.27–$90.10	151% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF	$114.93	$164.18	$4.27–$139.55	289% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$74.20	$106.00	$90.10	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF	$114.93	$164.18	$139.55	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON GOLD	$229.61	$328.01	$61.98–$278.81	21% above	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON GOLD	$229.61	$328.01	$278.81	—	30%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$169.94	$242.76	$25.81–$206.35	43% above	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$169.94	$242.76	$206.35	—	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER/KIDNEY MICROSOMAL ANTIBO	$214.54	$306.48	$14.55–$260.51	180% above	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODY	$436.10	$623.00	$14.55–$529.55	469% above	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER/KIDNEY MICROSOMAL ANTIBO	$214.54	$306.48	$260.51	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODY	$436.10	$623.00	$529.55	—	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$136.29	$194.69	$16.80–$165.49	198% above	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$136.29	$194.69	$165.49	—	30%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS NAA	$420.21	$600.29	$35.09–$510.25	205% above	30%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS NAA	$420.21	$600.29	$510.25	—	30%
Uric acid blood test CPT 84550 URIC ACID	$77.98	$111.40	$4.52–$94.69	85% above	30%
Uric acid blood test inpatient CPT 84550 URIC ACID	$77.98	$111.40	$94.69	—	30%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS MICRO	$13.30	$19.00	$3.17–$16.15	64% below	30%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS	$129.47	$184.95	$3.17–$157.21	246% above	30%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS MICRO	$13.30	$19.00	$16.15	—	30%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS	$129.47	$184.95	$157.21	—	30%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTOMATED W/O MICROSCOPY	$16.10	$23.00	$2.25–$19.55	20% below	30%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY (SPGR) UA	$41.73	$59.61	$2.25–$50.67	108% above	30%
Urinalysis without microscope exam, automated CPT 81003 DIPSTICK UA	$42.53	$60.75	$2.25–$51.64	112% above	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTOMATED W/O MICROSCOPY	$16.10	$23.00	$19.55	—	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY (SPGR) UA	$41.73	$59.61	$50.67	—	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 DIPSTICK UA	$42.53	$60.75	$51.64	—	30%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NON-AUTOMATED	$9.10	$13.00	$3.48–$11.05	30% below	30%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$9.10	$13.00	$3.48–$11.05	30% below	30%
Urinalysis without microscope exam, manual CPT 81002 PH UA	$22.29	$31.84	$3.48–$27.06	71% above	30%
Urinalysis without microscope exam, manual CPT 81002 URINE KETONES	$37.62	$53.74	$3.48–$45.68	189% above	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NON-AUTOMATED	$9.10	$13.00	$11.05	—	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$9.10	$13.00	$11.05	—	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 PH UA	$22.29	$31.84	$27.06	—	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE KETONES	$37.62	$53.74	$45.68	—	30%
Urine culture for bacteria, with colony count CPT 87086 UA CULTURE	$142.80	$203.99	$8.07–$173.39	122% above	30%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$155.22	$221.73	$8.07–$188.47	141% above	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 UA CULTURE	$142.80	$203.99	$173.39	—	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE	$155.22	$221.73	$188.47	—	30%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON	$25.20	$36.00	$8.61–$30.60	49% below	30%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST	$122.66	$175.22	$8.61–$148.94	146% above	30%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON	$25.20	$36.00	$30.60	—	30%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST	$122.66	$175.22	$148.94	—	30%
Vitamin B12 (cobalamin) blood test CPT 82607 B-12	$184.74	$263.91	$15.08–$224.32	140% above	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B-12	$184.74	$263.91	$224.32	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D TOTAL	$53.99	$77.12	$29.60–$65.55	60% below	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D FRACTIONATED D2 D3	$552.70	$789.57	$29.60–$671.13	307% above	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D TOTAL	$53.99	$77.12	$65.55	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D FRACTIONATED D2 D3	$552.70	$789.57	$671.13	—	30%
Zinc blood test CPT 84630 ZINC SERUM	$119.63	$170.89	$11.39–$145.26	96% above	30%
Zinc blood test CPT 84630 ZINC WHOLE BLOOD	$128.17	$183.09	$11.39–$155.63	110% above	30%
Zinc blood test inpatient CPT 84630 ZINC SERUM	$119.63	$170.89	$145.26	—	30%
Zinc blood test inpatient CPT 84630 ZINC WHOLE BLOOD	$128.17	$183.09	$155.63	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TUMOR MARKER	$34.19	$48.84	$15.05–$41.51	60% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG TOTAL	$180.20	$257.42	$15.05–$218.81	112% above	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG TUMOR MARKER	$34.19	$48.84	$41.51	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG TOTAL	$180.20	$257.42	$218.81	—	30%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 ADENOIDECTOMY, PRIMARY; YOUNGER THAN AGE 12	$412.13	$588.75	$142.35–$500.44	87% below	30%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ADENOIDECTOMY, PRIMARY; YOUNGER THAN AGE 12	$412.13	$588.75	$142.35–$500.44	—	30%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTATION OR RECONSTRUCTION	$1,885.45	$2,693.50	$589.56–$2,289.48	90% below	30%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTATION OR RECONSTRUCTION	$1,885.45	$2,693.50	$589.56–$2,289.48	—	30%
Botox injections for chronic migraine both sides CPT 64615 CHEMODENERVATION OF MUSCLE BILATERAL	$327.60	$468.00	$92.86–$397.80	—	30%
Botox injections for chronic migraine both sides CPT 64615 CHEMODENERVATION OF MUSCLE BILATERAL	$400.40	$572.00	$307.45–$486.20	—	30%
Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION OF MUSCLE BILATERAL	$327.60	$468.00	$92.86–$397.80	—	30%
Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION OF MUSCLE BILATERAL	$400.40	$572.00	$486.20	—	30%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECTION, HALLUX VALGUS (BUNIONECTOMY), WITH SESAMOIDECTOMY, WHEN PERFORMED; WITH DISTAL METATARSAL OSTEOTOMY, ANY METHOD	$847.00	$1,210.00	$457.60–$1,028.50	54% below	30%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRECTION, HALLUX VALGUS (BUNIONECTOMY), WITH SESAMOIDECTOMY, WHEN PERFORMED; WITH DISTAL METATARSAL OSTEOTOMY, ANY METHOD	$847.00	$1,210.00	$457.60–$1,028.50	—	30%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH RESECTION OF PROXIMAL PHALANX BASE, WHEN PERFORMED, ANY METHOD	$944.06	$1,348.65	$418.04–$1,146.35	20% below	30%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORRECTION, HALLUX VALGUS WITH BUNIONECTOMY, WITH SESAMOIDECTOMY WHEN PERFORMED; WITH RESECTION OF PROXIMAL PHALANX BASE, WHEN PERFORMED, ANY METHOD	$944.06	$1,348.65	$418.04–$1,146.35	—	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION (P)	$533.78	$762.53	$175.25–$662.01	35% below	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 PRO CARDIOVERSION ELECTRIC EXT	$615.30	$879.00	$91.32–$747.15	25% below	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$1,299.89	$1,856.98	$175.25–$1,578.43	58% above	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION (P)	$533.78	$762.53	$648.15	—	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 PRO CARDIOVERSION ELECTRIC EXT	$615.30	$879.00	$91.32–$747.15	—	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$1,299.89	$1,856.98	$1,578.43	—	30%
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL	$859.95	$1,228.50	$268.60–$1,044.23	72% below	30%
Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL	$859.95	$1,228.50	$268.60–$1,044.23	—	30%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION, SURGICAL OLDER THAN 28 DAYS OF AGE	$582.40	$832.00	$118.07–$707.20	82% below	30%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION, SURGICAL OLDER THAN 28 DAYS OF AGE	$582.40	$832.00	$118.07–$707.20	—	30%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY WITH REMOVAL OF TUMOR(S) POLYP(S) OR OTHER LESION(S) BY SNARE TECHNIQUE	$1,055.60	$1,508.00	$215.08–$1,281.80	38% below	30%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY WITH REMOVAL OF TUMOR(S) POLYP(S) OR OTHER LESION(S) BY SNARE TECHNIQUE	$1,055.60	$1,508.00	$215.08–$1,281.80	—	30%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY WITH BIOPSY SINGLE OR MULTIPLE	$982.80	$1,404.00	$170.74–$1,193.40	45% below	30%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE	$982.80	$1,404.00	$170.74–$1,193.40	45% below	30%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE	$982.80	$1,404.00	$170.74–$1,193.40	—	30%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY WITH BIOPSY SINGLE OR MULTIPLE	$982.80	$1,404.00	$170.74–$1,193.40	—	30%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY DIAGNOSTIC INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING WHEN PERFORMED (SEPARATE PROCEDURE)	$764.40	$1,092.00	$158.13–$928.20	40% below	30%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY DIAGNOSTIC INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING WHEN PERFORMED (SEPARATE PROCEDURE)	$764.40	$1,092.00	$158.13–$928.20	—	30%
Cystoscopy with ureteral stent placement CPT 52332 DX SP RENAL STENT PLACEMENT	$1,594.50	$2,277.85	$1,936.17–$3,530.67	73% below	30%
Cystoscopy with ureteral stent placement inpatient CPT 52332 DX SP RENAL STENT PLACEMENT	$1,594.50	$2,277.85	$1,936.17	—	30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 PRO CYSTOURETHROSCOPY (SEPARATE PROCEDURE)	$454.30	$649.00	$68.94–$551.65	58% below	30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTO, DIAGNOSTIC	$1,349.99	$1,928.55	$698.42–$1,639.27	26% above	30%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 PRO CYSTOURETHROSCOPY (SEPARATE PROCEDURE)	$454.30	$649.00	$68.94–$551.65	—	30%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTO, DIAGNOSTIC	$1,349.99	$1,928.55	$1,639.27	—	30%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE), GENERAL ANESTHESIA	$262.50	$375.00	$112.67–$318.75	92% below	30%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE), GENERAL ANESTHESIA BIL	$367.50	$525.00	$112.67–$446.25	89% below	30%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE), GENERAL ANESTHESIA	$262.50	$375.00	$112.67–$318.75	—	30%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE), GENERAL ANESTHESIA BIL	$367.50	$525.00	$112.67–$446.25	—	30%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING; LOCAL ANEST	$255.50	$365.00	$110.91–$310.25	38% below	30%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING; LOCAL ANEST	$633.31	$904.72	$540.20–$769.01	54% above	30%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 CREATE EARDRUM OPENING; LOCAL ANEST	$255.50	$365.00	$110.91–$310.25	—	30%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 CREATE EARDRUM OPENING; LOCAL ANEST	$633.31	$904.72	$769.01	—	30%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$125.38	$179.11	$59.09–$152.24	69% above	30%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI	$125.38	$179.11	$152.24	—	30%
Earwax removal with instruments, one ear both sides CPT 69210 REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION BILAT	$101.50	$145.00	$26.30–$123.25	—	30%
Earwax removal with instruments, one ear both sides CPT 69210 REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION BILAT	$126.00	$180.00	$59.09–$153.00	—	30%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX	$66.50	$95.00	$26.30–$80.75	27% below	30%
Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL (P)	$103.73	$148.18	$59.09–$125.95	13% above	30%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX	$104.65	$149.50	$59.09–$127.08	14% above	30%
Earwax removal with instruments, one ear inpatient both sides CPT 69210 REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION BILAT	$101.50	$145.00	$26.30–$123.25	—	30%
Earwax removal with instruments, one ear inpatient both sides CPT 69210 REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION BILAT	$126.00	$180.00	$153.00	—	30%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX	$66.50	$95.00	$26.30–$80.75	—	30%
Earwax removal with instruments, one ear inpatient CPT 69210 CERUMEN REMOVAL (P)	$103.73	$148.18	$125.95	—	30%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX	$104.65	$149.50	$127.08	—	30%
Endoscopic sinus surgery: full ethmoid sinus opening both sides CPT 31255 NASAL/SINUS ENDOSCOPY, SURGICAL WITH ETHMOIDECTOMY; TOTAL (ANTERIOR AND POSTERIOR) BILAT	$876.30	$1,251.85	$264.44–$1,064.07	—	30%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NASAL/SINUS ENDOSCOPY, SURGICAL WITH ETHMOIDECTOMY; TOTAL (ANTERIOR AND POSTERIOR)	$631.30	$901.85	$264.44–$766.57	93% below	30%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient both sides CPT 31255 NASAL/SINUS ENDOSCOPY, SURGICAL WITH ETHMOIDECTOMY; TOTAL (ANTERIOR AND POSTERIOR) BILAT	$876.30	$1,251.85	$264.44–$1,064.07	—	30%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 NASAL/SINUS ENDOSCOPY, SURGICAL WITH ETHMOIDECTOMY; TOTAL (ANTERIOR AND POSTERIOR)	$631.30	$901.85	$264.44–$766.57	—	30%
Endoscopic sinus surgery: opening the frontal sinus both sides CPT 31276 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH FRONTAL SINUS EXPLORATION, INCLUDING REMOVAL OF TISSUE FROM FRONTAL SINUS BILAT	$770.07	$1,100.10	$235.13–$935.09	—	30%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH FRONTAL SINUS EXPLORATION, INCLUDING REMOVAL OF TISSUE FROM FRONTAL SINUS, WHEN PERFORMED	$630.07	$900.10	$235.13–$765.09	92% below	30%
Endoscopic sinus surgery: opening the frontal sinus inpatient both sides CPT 31276 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH FRONTAL SINUS EXPLORATION, INCLUDING REMOVAL OF TISSUE FROM FRONTAL SINUS BILAT	$770.07	$1,100.10	$235.13–$935.09	—	30%
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH FRONTAL SINUS EXPLORATION, INCLUDING REMOVAL OF TISSUE FROM FRONTAL SINUS, WHEN PERFORMED	$630.07	$900.10	$235.13–$765.09	—	30%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY	$353.50	$505.00	$135.57–$429.25	88% below	30%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY	$353.50	$505.00	$135.57–$429.25	—	30%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY; WITH REMOVAL OF TISSUE FROM MAXILLARY SINUS	$444.85	$635.50	$203.36–$540.18	95% below	30%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY; WITH REMOVAL OF TISSUE FROM MAXILLARY SINUS	$444.85	$635.50	$203.36–$540.18	—	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECT SUBSTANCE INTO SPINAL CANAL OF UPPER OR MIDDLE BACK USING IMAGING GUIDANCE	$833.00	$1,190.00	$91.77–$1,011.50	18% below	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 DX SP EPIDURAL INJ CERV/THOR W IMAGING	$1,976.85	$2,824.06	$707.02–$2,400.45	94% above	30%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECT SUBSTANCE INTO SPINAL CANAL OF UPPER OR MIDDLE BACK USING IMAGING GUIDANCE	$833.00	$1,190.00	$91.77–$1,011.50	—	30%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 DX SP EPIDURAL INJ CERV/THOR W IMAGING	$1,976.85	$2,824.06	$2,400.45	—	30%
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 DX SP FACET INJ LUMB/SAC BILAT	$1,397.46	$1,996.36	$885.90–$1,696.91	—	30%
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 INJECT AGENT, PARAVERTEBRAL FACET JOINT OR NERVES WITH IMAGE LUMBAR OR SACRAL SINGLE BILAT	$1,931.30	$2,759.00	$77.60–$2,345.15	—	30%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 DX SP FACET INJ LUMB/SAC SINGLE LEVEL	$811.64	$1,159.48	$885.90–$985.56	22% below	30%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECT AGENT, PARAVERTEBRAL FACET JOINT OR NERVES WITH IMAGE LUMBAR OR SACRAL SINGLE LEVEL	$1,287.30	$1,839.00	$77.60–$1,563.15	24% above	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient both sides CPT 64493 DX SP FACET INJ LUMB/SAC BILAT	$1,397.46	$1,996.36	$1,696.91	—	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient both sides CPT 64493 INJECT AGENT, PARAVERTEBRAL FACET JOINT OR NERVES WITH IMAGE LUMBAR OR SACRAL SINGLE BILAT	$1,931.30	$2,759.00	$77.60–$2,345.15	—	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 DX SP FACET INJ LUMB/SAC SINGLE LEVEL	$811.64	$1,159.48	$985.56	—	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJECT AGENT, PARAVERTEBRAL FACET JOINT OR NERVES WITH IMAGE LUMBAR OR SACRAL SINGLE LEVEL	$1,287.30	$1,839.00	$77.60–$1,563.15	—	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING WHEN PERFORMED (SEPARATE PROCEDURE)	$537.60	$768.00	$50.58–$652.80	52% below	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING WHEN PERFORMED (SEPARATE PROCEDURE)	$537.60	$768.00	$50.58–$652.80	—	30%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY SURGICAL CHOLECYSTECTOMY	$1,601.60	$2,288.00	$400.94–$1,944.80	73% below	30%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPY SURGICAL CHOLECYSTECTOMY	$1,601.60	$2,288.00	$400.94–$1,944.80	—	30%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 COLONOSCOPY WITH REMOVAL OF TUMOR(S) POLYP(S) OR OTHER LESION(S) BY SNARE TECHNIQUE	$1,284.50	$1,835.00	$436.28–$1,559.75	79% below	30%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 COLONOSCOPY WITH REMOVAL OF TUMOR(S) POLYP(S) OR OTHER LESION(S) BY SNARE TECHNIQUE	$1,284.50	$1,835.00	$436.28–$1,559.75	—	30%
Hammertoe correction surgery CPT 28285 CORRECTION, HAMMERTOE (EG, INTERPHALANGEAL FUSION, PARTIAL OR TOTAL PHALANGECTOMY)	$633.50	$905.00	$323.12–$769.25	74% below	30%
Hammertoe correction surgery inpatient CPT 28285 CORRECTION, HAMMERTOE (EG, INTERPHALANGEAL FUSION, PARTIAL OR TOTAL PHALANGECTOMY)	$633.50	$905.00	$323.12–$769.25	—	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 US SP HYSTERO SALINE INJECTION	$106.00	$151.42	$128.71–$208.62	63% below	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 DX SP HYSTERO CATHETERIZATION/SALINE INJECTION PF	$118.49	$169.26	$49.69–$168.99	59% below	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 DX SP HYSTERO SALINE INJECTION	$288.47	$412.09	$208.62–$350.28	at median	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 US SP HYSTERO SALINE INJECTION	$106.00	$151.42	$128.71	—	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 DX SP HYSTERO CATHETERIZATION/SALINE INJECTION PF	$118.49	$169.26	$49.69–$168.99	—	30%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 DX SP HYSTERO SALINE INJECTION	$288.47	$412.09	$350.28	—	30%
Incision and drainage of a simple or single skin abscess CPT 10060 INC & DRAIN OF ABSCESS	$203.00	$290.00	$75.17–$246.50	10% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 INC & DRAIN OF ABSCESS	$354.20	$506.00	$200.96–$430.10	57% above	30%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR SU...	$450.49	$643.55	$200.96–$547.02	100% above	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INC & DRAIN OF ABSCESS	$203.00	$290.00	$75.17–$246.50	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INC & DRAIN OF ABSCESS	$354.20	$506.00	$430.10	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR SU...	$450.49	$643.55	$547.02	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT SINGLE TENDON SHEATH, OR LIGAMENT	$120.40	$172.00	$32.49–$146.20	39% below	30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION TENDON SHEATH/LIGAMENT	$325.50	$465.00	$307.45–$395.25	64% above	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT SINGLE TENDON SHEATH, OR LIGAMENT	$120.40	$172.00	$32.49–$146.20	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION TENDON SHEATH/LIGAMENT	$325.50	$465.00	$395.25	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, KNEE, SUBACROMIAL BURSA); WITHOUT ULTRASOUND GUIDANCE BILATERAL	$847.00	$1,210.00	$38.30–$1,028.50	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, KNEE, SUBACROMIAL BURSA); WITHOUT ULTRASOUND GUIDANCE BILATERAL	$1,191.40	$1,702.00	$307.45–$1,446.70	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, KNEE, SUBACROMIAL BURSA); WITHOUT ULTRASOUND GUIDANCE	$97.56	$139.36	$38.30–$118.46	54% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP INJ. A/I MAJOR JT OR BURSA	$424.20	$606.00	$38.30–$515.10	98% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, KNEE...	$623.70	$891.00	$307.45–$757.35	192% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DX SP ARTHROCENTESIS MAJOR JOINT	$839.35	$1,199.06	$307.45–$1,019.20	292% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, KNEE, SUBACROMIAL BURSA); WITHOUT ULTRASOUND GUIDANCE BILATERAL	$847.00	$1,210.00	$38.30–$1,028.50	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, KNEE, SUBACROMIAL BURSA); WITHOUT ULTRASOUND GUIDANCE BILATERAL	$1,191.40	$1,702.00	$1,446.70	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, KNEE, SUBACROMIAL BURSA); WITHOUT ULTRASOUND GUIDANCE	$97.56	$139.36	$38.30–$118.46	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP INJ. A/I MAJOR JT OR BURSA	$424.20	$606.00	$38.30–$515.10	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, KNEE...	$623.70	$891.00	$757.35	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DX SP ARTHROCENTESIS MAJOR JOINT	$839.35	$1,199.06	$1,019.20	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 DX SP ARTHROCENTESIS INTERMEDIATE JOINT BILAT	$89.78	$128.25	$30.98–$109.01	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 DX SP ARTHROCENTESIS INTERMEDIATE JOINT BILAT	$625.54	$893.62	$307.45–$759.58	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DX SP ARTHROCENTESIS INTERMEDIATE JOINT PF	$72.42	$103.45	$30.98–$87.93	64% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP INJ. A/I INT.JOINT OR BURS	$189.70	$271.00	$30.98–$230.35	5% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJECT JOINT/BURSA	$380.10	$543.00	$307.45–$461.55	90% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF MEDIUM JOINT OR JOINT CAPSULE W/O US	$445.19	$635.98	$307.45–$540.58	123% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DX SP ARTHROCENTESIS RAD SUP	$511.06	$730.08	$307.45–$620.57	156% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DX SP ARTHROCENTESIS INTERMEDIATE JOINT	$511.97	$731.38	$307.45–$621.67	156% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 DX SP ARTHROCENTESIS INTERMEDIATE JOINT BILAT	$89.78	$128.25	$30.98–$109.01	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 DX SP ARTHROCENTESIS INTERMEDIATE JOINT BILAT	$625.54	$893.62	$759.58	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DX SP ARTHROCENTESIS INTERMEDIATE JOINT PF	$72.42	$103.45	$30.98–$87.93	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP INJ. A/I INT.JOINT OR BURS	$189.70	$271.00	$30.98–$230.35	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJECT JOINT/BURSA	$380.10	$543.00	$461.55	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATION AND/OR INJECTION OF MEDIUM JOINT OR JOINT CAPSULE W/O US	$445.19	$635.98	$540.58	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DX SP ARTHROCENTESIS RAD SUP	$511.06	$730.08	$620.57	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DX SP ARTHROCENTESIS INTERMEDIATE JOINT	$511.97	$731.38	$621.67	—	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DX SP ARTHROCENTESIS, SMALL JOINT PF	$71.01	$101.43	$30.31–$86.22	65% below	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASP INJ. A/I SM JOINT OR BURSA	$189.70	$271.00	$30.31–$230.35	6% below	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJECT JOINT/BURSA	$349.70	$499.56	$307.45–$424.63	74% above	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DX SP ARTHROCENTESIS, SMALL JOINT	$409.57	$585.10	$307.45–$497.34	104% above	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DX SP ARTHROCENTESIS, SMALL JOINT PF	$71.01	$101.43	$30.31–$86.22	—	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASP INJ. A/I SM JOINT OR BURSA	$189.70	$271.00	$30.31–$230.35	—	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJECT JOINT/BURSA	$349.70	$499.56	$424.63	—	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DX SP ARTHROCENTESIS, SMALL JOINT	$409.57	$585.10	$497.34	—	30%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCUS REPAIR (MEDIAL OR LATERAL)	$1,365.00	$1,950.00	$416.24–$1,657.50	87% below	30%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCUS REPAIR (MEDIAL OR LATERAL)	$1,365.00	$1,950.00	$416.24–$1,657.50	—	30%
Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENISCAL SHAVING) INCLUDING DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY), SAME OR SEPARATE COMPARTMENT(S), WHEN PERFORMED	$1,074.50	$1,535.00	$327.64–$1,304.75	84% below	30%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENISCAL SHAVING) INCLUDING DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY), SAME OR SEPARATE COMPARTMENT(S), WHEN PERFORMED	$1,074.50	$1,535.00	$327.64–$1,304.75	—	30%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL AND LATERAL, INCLUDING ANY MENISCAL SHAVING) INCLUDING DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY), SAME OR SEPARATE COMPARTMENT(S), WHEN PERFORMED	$1,089.38	$1,556.25	$340.05–$1,322.81	84% below	30%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL AND LATERAL, INCLUDING ANY MENISCAL SHAVING) INCLUDING DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY), SAME OR SEPARATE COMPARTMENT(S), WHEN PERFORMED	$1,089.38	$1,556.25	$340.05–$1,322.81	—	30%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY SURGICAL APPENDECTOMY	$1,346.80	$1,924.00	$365.51–$1,635.40	83% below	30%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY SURGICAL APPENDECTOMY	$1,346.80	$1,924.00	$365.51–$1,635.40	—	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$654.76	$935.37	$407.17–$795.06	72% above	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$654.76	$935.37	$795.06	—	30%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECT SUBSTANCE INTERLAMINAR EPIDURAL OR SUBARACHNOID, LUMBAR OR SACRAL (CAUDAL); WITH IMAGING GUIDANCE	$757.40	$1,082.00	$85.62–$919.70	22% below	30%
Lower-back epidural injection, with imaging guidance CPT 62323 DX SP EPIDURAL INJ LUMB/SAC W IMAGING	$1,929.90	$2,757.00	$707.02–$2,343.45	99% above	30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECT SUBSTANCE INTERLAMINAR EPIDURAL OR SUBARACHNOID, LUMBAR OR SACRAL (CAUDAL); WITH IMAGING GUIDANCE	$757.40	$1,082.00	$85.62–$919.70	—	30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 DX SP EPIDURAL INJ LUMB/SAC W IMAGING	$1,929.90	$2,757.00	$2,343.45	—	30%
Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM W/O IMAGING GUIDANCE	$568.40	$812.00	$71.44–$690.20	49% below	30%
Lower-back epidural injection, without imaging guidance CPT 62322 INJECT DIAG/ THERAPEUTIC SUBSTANCE NOT INCLUDING NEUROLYTIC SUBSTANCE	$1,387.05	$1,981.49	$71.44–$1,684.27	24% above	30%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION OF SUBSTANCE INTO SPINAL CANAL OF LOWER BACK OR SACRUM W/O IMAGING GUIDANCE	$568.40	$812.00	$71.44–$690.20	—	30%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECT DIAG/ THERAPEUTIC SUBSTANCE NOT INCLUDING NEUROLYTIC SUBSTANCE	$1,387.05	$1,981.49	$71.44–$1,684.27	—	30%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 DX SP TRANSFORAMINAL INJ LUMB/SAC BILAT	$1,215.18	$1,735.97	$885.90–$1,475.57	—	30%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 DX SP TRANSFORAMINAL INJ, LUMB/SAC, SINGLE	$811.64	$1,159.48	$885.90–$985.56	46% below	30%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION TRANSFORAMINAL EPIDURAL, W IMAGING ; LUMBAR OR SACRAL, SINGLE LEVEL	$1,092.00	$1,560.00	$94.96–$1,326.00	27% below	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 DX SP TRANSFORAMINAL INJ LUMB/SAC BILAT	$1,215.18	$1,735.97	$1,475.57	—	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 DX SP TRANSFORAMINAL INJ, LUMB/SAC, SINGLE	$811.64	$1,159.48	$985.56	—	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJECTION TRANSFORAMINAL EPIDURAL, W IMAGING ; LUMBAR OR SACRAL, SINGLE LEVEL	$1,092.00	$1,560.00	$94.96–$1,326.00	—	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 0.5 CM OR LESS	$203.00	$290.00	$87.06–$246.50	30% below	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 0.5 CM OR LESS	$1,334.90	$1,907.00	$709.28–$1,620.95	362% above	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 0.5 CM OR LESS	$203.00	$290.00	$87.06–$246.50	—	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 0.5 CM OR LESS	$1,334.90	$1,907.00	$1,620.95	—	30%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE	$89.92	$128.45	$47.04–$109.18	45% below	30%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$277.90	$397.00	$200.96–$337.45	69% above	30%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE	$325.57	$465.09	$200.96–$395.33	98% above	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE	$89.92	$128.45	$47.04–$109.18	—	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE	$277.90	$397.00	$337.45	—	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE	$325.57	$465.09	$395.33	—	30%
Occipital nerve block (injection for headaches) both sides CPT 64405 INJ(S), ANEST AGENT(S) AND/OR STEROID; GREATER OCCIPITAL NERVE BILAT PRO FEE	$353.50	$505.00	$44.47–$429.25	—	30%
Occipital nerve block (injection for headaches) both sides CPT 64405 INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; GREATER OCCIPITAL NERVE BILAT	$506.80	$724.00	$307.45–$615.40	—	30%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION ANESTHETIC AGENT; GREATER OCCIPITAL NERVE	$265.30	$379.00	$44.47–$322.15	13% below	30%
Occipital nerve block (injection for headaches) CPT 64405 N BLOCK INJ OCCIPITAL	$380.10	$543.00	$307.45–$461.55	25% above	30%
Occipital nerve block (injection for headaches) CPT 64405 INJ(S), ANEST AGENT(S) AND/OR STEROID; GREATER OCCIPITAL NERVE BIL PRO FEE	$397.95	$568.50	$44.47–$483.23	30% above	30%
Occipital nerve block (injection for headaches) inpatient both sides CPT 64405 INJ(S), ANEST AGENT(S) AND/OR STEROID; GREATER OCCIPITAL NERVE BILAT PRO FEE	$353.50	$505.00	$44.47–$429.25	—	30%
Occipital nerve block (injection for headaches) inpatient both sides CPT 64405 INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; GREATER OCCIPITAL NERVE BILAT	$506.80	$724.00	$615.40	—	30%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION ANESTHETIC AGENT; GREATER OCCIPITAL NERVE	$265.30	$379.00	$44.47–$322.15	—	30%
Occipital nerve block (injection for headaches) inpatient CPT 64405 N BLOCK INJ OCCIPITAL	$380.10	$543.00	$461.55	—	30%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ(S), ANEST AGENT(S) AND/OR STEROID; GREATER OCCIPITAL NERVE BIL PRO FEE	$397.95	$568.50	$44.47–$483.23	—	30%
Paracentesis with imaging guidance CPT 49083 US SP PARACENTESIS INITIAL PF	$226.89	$324.12	$89.81–$275.50	74% below	30%
Paracentesis with imaging guidance CPT 49083 US SP PARACENTESIS, SUBSEQUENT	$729.87	$1,042.66	$886.26–$908.45	15% below	30%
Paracentesis with imaging guidance CPT 49083 US SP PARACENTESIS INITIAL	$839.35	$1,199.06	$908.45–$1,019.20	3% below	30%
Paracentesis with imaging guidance inpatient CPT 49083 US SP PARACENTESIS INITIAL PF	$226.89	$324.12	$89.81–$275.50	—	30%
Paracentesis with imaging guidance inpatient CPT 49083 US SP PARACENTESIS, SUBSEQUENT	$729.87	$1,042.66	$886.26	—	30%
Paracentesis with imaging guidance inpatient CPT 49083 US SP PARACENTESIS INITIAL	$839.35	$1,199.06	$1,019.20	—	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE (EG, INGROWN OR DEFORMED NAIL), FOR PERMANENT REMOVAL	$165.55	$236.50	$88.81–$201.03	58% below	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPL	$454.67	$649.52	$407.17–$552.09	15% above	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE (EG, INGROWN OR DEFORMED NAIL), FOR ...	$943.37	$1,347.67	$407.17–$1,145.52	138% above	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE (EG, INGROWN OR DEFORMED NAIL), FOR PERMANENT REMOVAL	$165.55	$236.50	$88.81–$201.03	—	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPL	$454.67	$649.52	$552.09	—	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE (EG, INGROWN OR DEFORMED NAIL), FOR ...	$943.37	$1,347.67	$1,145.52	—	30%
Prostate biopsy CPT 55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH	$587.30	$839.00	$147.04–$713.15	80% below	30%
Prostate biopsy CPT 55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTI	$1,568.00	$2,240.00	$1,904.00	47% below	30%
Prostate biopsy CPT 55700 US PROSTATE BIOPSY	$1,834.51	$2,620.72	$2,227.61	38% below	30%
Prostate biopsy inpatient CPT 55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH	$587.30	$839.00	$147.04–$713.15	—	30%
Prostate biopsy inpatient CPT 55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTI	$1,568.00	$2,240.00	$1,904.00	—	30%
Prostate biopsy inpatient CPT 55700 US PROSTATE BIOPSY	$1,834.51	$2,620.72	$2,227.61	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE(S), WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT); LUMBAR OR SACRAL, SINGLE FACET JOINT BILAT	$2,828.00	$4,040.00	$165.16–$3,434.00	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 DX SP RF ABLATION LUMB/SAC SINGLE BILAT	$3,258.12	$4,654.45	$1,955.88–$3,956.28	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 INJECT PARAVERTEBRAL FACET JOINT NERVE(S), WITH IMAGING; LUMBAR OR SACRAL, SINGLE FACET JOINT	$1,414.00	$2,020.00	$165.16–$1,717.00	2% below	30%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DX SP RF ABLATION LUMB/SAC SINGLE	$1,416.57	$2,023.67	$1,720.12–$1,955.88	1% below	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient both sides CPT 64635 DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE(S), WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT); LUMBAR OR SACRAL, SINGLE FACET JOINT BILAT	$2,828.00	$4,040.00	$165.16–$3,434.00	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient both sides CPT 64635 DX SP RF ABLATION LUMB/SAC SINGLE BILAT	$3,258.12	$4,654.45	$3,956.28	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 INJECT PARAVERTEBRAL FACET JOINT NERVE(S), WITH IMAGING; LUMBAR OR SACRAL, SINGLE FACET JOINT	$1,414.00	$2,020.00	$165.16–$1,717.00	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DX SP RF ABLATION LUMB/SAC SINGLE	$1,416.57	$2,023.67	$1,720.12	—	30%
Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE	$652.86	$932.65	$407.17–$792.75	114% above	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE	$652.86	$932.65	$792.75	—	30%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 SCREENING COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$764.40	$1,092.00	$158.46–$928.20	at median	30%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 SCREENING COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$764.40	$1,092.00	$158.46–$928.20	—	30%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 SCREENING COLONOSCOPY ON INDIVIDUAL AT HIGH RISK	$764.40	$1,092.00	$158.13–$928.20	1% above	30%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 SCREENING COLONOSCOPY ON INDIVIDUAL AT HIGH RISK	$764.40	$1,092.00	$158.13–$928.20	—	30%
Septoplasty to straighten the nasal septum CPT 30520 SEPTOPLASTY OR SUBMUCOUS RESECTION, WITH OR WITHOUT CARTILAGE SCORING, CONTOURING OR REPLACEMENT WITH GRAFT	$1,100.40	$1,572.00	$413.27–$1,336.20	84% below	30%
Septoplasty to straighten the nasal septum inpatient CPT 30520 SEPTOPLASTY OR SUBMUCOUS RESECTION, WITH OR WITHOUT CARTILAGE SCORING, CONTOURING OR REPLACEMENT WITH GRAFT	$1,100.40	$1,572.00	$413.27–$1,336.20	—	30%
Short arm cast (elbow to hand) CPT 29075 CAST SP.APP.SHORT ARM CAST (OR	$101.50	$145.00	$51.61–$123.25	58% below	30%
Short arm cast (elbow to hand) CPT 29075 APPLICATION, CAST; ELBOW TO FINGER (SHORT ARM)	$121.24	$173.20	$51.61–$147.22	50% below	30%
Short arm cast (elbow to hand) CPT 29075 APPLICATION, CAST; ELBOW TO FINGER (SHORT ARM)	$396.67	$566.67	$280.14–$481.67	65% above	30%
Short arm cast (elbow to hand) inpatient CPT 29075 CAST SP.APP.SHORT ARM CAST (OR	$101.50	$145.00	$51.61–$123.25	—	30%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION, CAST; ELBOW TO FINGER (SHORT ARM)	$121.24	$173.20	$51.61–$147.22	—	30%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION, CAST; ELBOW TO FINGER (SHORT ARM)	$396.67	$566.67	$481.67	—	30%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT	$66.50	$95.00	$38.01–$80.75	55% below	30%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$278.10	$397.28	$133.26–$337.69	88% above	30%
Short arm splint (forearm and hand) CPT 29125 SPLINT/FOREARM-HAND/STATIC	$497.35	$710.49	$133.26–$603.92	237% above	30%
Short arm splint (forearm and hand) CPT 29125 SPLINTING SHORT ARM (P)	$540.59	$772.26	$133.26–$656.42	266% above	30%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT	$66.50	$95.00	$38.01–$80.75	—	30%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$278.10	$397.28	$337.69	—	30%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT/FOREARM-HAND/STATIC	$497.35	$710.49	$603.92	—	30%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINTING SHORT ARM (P)	$540.59	$772.26	$656.42	—	30%
Short leg cast (below the knee) CPT 29405 CAST SP.APP.SHORT LEG CAST (OR	$94.50	$135.00	$47.40–$114.75	66% below	30%
Short leg cast (below the knee) inpatient CPT 29405 CAST SP.APP.SHORT LEG CAST (OR	$94.50	$135.00	$47.40–$114.75	—	30%
Short leg splint (calf to foot) CPT 29515 CAST SP.APP.SHORT LEG SPLINT (	$74.90	$107.00	$42.32–$90.95	55% below	30%
Short leg splint (calf to foot) CPT 29515 SPLINT SH.LEG/ANK/FOOT (P)	$284.68	$406.68	$162.76–$345.68	72% above	30%
Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)	$293.43	$419.18	$162.76–$356.30	78% above	30%
Short leg splint (calf to foot) inpatient CPT 29515 CAST SP.APP.SHORT LEG SPLINT (	$74.90	$107.00	$42.32–$90.95	—	30%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT SH.LEG/ANK/FOOT (P)	$284.68	$406.68	$345.68	—	30%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)	$293.43	$419.18	$356.30	—	30%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPRESSION OF SUBACROMIAL SPACE WITH PARTIAL ACROMIOPLASTY, WITH CORACOACROMIAL LIGAMENT (IE, ARCH) RELEASE, WHEN PERFORMED (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE	$333.90	$477.00	$142.93–$405.45	98% below	30%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPRESSION OF SUBACROMIAL SPACE WITH PARTIAL ACROMIOPLASTY, WITH CORACOACROMIAL LIGAMENT (IE, ARCH) RELEASE, WHEN PERFORMED (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE	$333.90	$477.00	$142.93–$405.45	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND...	$358.88	$512.68	$200.96–$435.78	62% above	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 2.5 CM OR LESS	$363.42	$519.17	$200.96–$441.29	64% above	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND...	$358.88	$512.68	$435.78	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 2.5 CM OR LESS	$363.42	$519.17	$441.29	—	30%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (INCLUDING SIMPLE CLOSURE, WHEN PERFORMED); SINGLE LESION	$401.28	$573.25	$407.17–$487.26	53% above	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (INCLUDING SIMPLE CLOSURE, WHEN PERFORMED); SINGLE LESION	$401.28	$573.25	$487.26	—	30%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS UP TO 15	$146.13	$208.75	$54.35–$177.44	1% below	30%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS UP TO 15	$320.95	$458.50	$200.96–$389.73	118% above	30%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 LESIONS	$426.26	$608.94	$200.96–$517.60	190% above	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS UP TO 15	$146.13	$208.75	$54.35–$177.44	—	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS UP TO 15	$320.95	$458.50	$389.73	—	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 LESIONS	$426.26	$608.94	$517.60	—	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX SP SPINAL PUNCTURE PF	$140.26	$200.37	$57.24–$170.31	72% below	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC	$383.11	$547.29	$57.24–$465.20	24% below	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX SP SPINAL PUNCTURE	$821.48	$1,173.54	$707.02–$997.51	63% above	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCT-DIAGNOSTIC (P)	$944.70	$1,349.57	$707.02–$1,147.13	88% above	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DX SP SPINAL PUNCTURE PF	$140.26	$200.37	$57.24–$170.31	—	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC	$383.11	$547.29	$57.24–$465.20	—	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DX SP SPINAL PUNCTURE	$821.48	$1,173.54	$997.51	—	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCT-DIAGNOSTIC (P)	$944.70	$1,349.57	$1,147.13	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND...	$369.48	$527.82	$200.96–$448.65	28% above	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND...	$369.48	$527.82	$448.65	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBR...	$358.88	$512.68	$200.96–$435.78	35% above	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBR...	$358.88	$512.68	$435.78	—	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION	$77.00	$110.00	$29.09–$93.50	60% below	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION	$320.95	$458.50	$389.73–$407.17	67% above	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION	$77.00	$110.00	$29.09–$93.50	—	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION	$320.95	$458.50	$389.73	—	30%
Thoracentesis with imaging guidance CPT 32555 US SP PARACENTESIS, SUBSEQUENT PF	$233.73	$333.89	$91.91–$361.91	74% below	30%
Thoracentesis with imaging guidance CPT 32555 US SP THORACENTESIS-INT OR SUB	$729.87	$1,042.66	$628.32–$886.26	19% below	30%
Thoracentesis with imaging guidance inpatient CPT 32555 US SP PARACENTESIS, SUBSEQUENT PF	$233.73	$333.89	$91.91–$361.91	—	30%
Thoracentesis with imaging guidance inpatient CPT 32555 US SP THORACENTESIS-INT OR SUB	$729.87	$1,042.66	$886.26	—	30%
Tonsil and adenoid removal, age 12 or older CPT 42821 TONSILLECTOMY AND ADENOIDECTOMY; AGE 12 OR OVER	$593.08	$847.25	$202.89–$720.16	85% below	30%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 TONSILLECTOMY AND ADENOIDECTOMY; AGE 12 OR OVER	$593.08	$847.25	$202.89–$720.16	—	30%
Tonsil and adenoid removal, child under 12 CPT 42820 TONSILLECTOMY AND ADENOIDECTOMY; YOUNGER THAN AGE 12	$469.00	$670.00	$181.23–$569.50	88% below	30%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 TONSILLECTOMY AND ADENOIDECTOMY; YOUNGER THAN AGE 12	$469.00	$670.00	$181.23–$569.50	—	30%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY, PRIMARY OR SECONDARY; AGE 12 OR OVER	$423.50	$605.00	$172.05–$514.25	87% below	30%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY, PRIMARY OR SECONDARY; AGE 12 OR OVER	$423.50	$605.00	$172.05–$514.25	—	30%
Total hip replacement CPT 27130 ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHROPLASTY), WITH OR WITHOUT AUTOGRAFT OR ALLOGRAFT	$2,490.46	$3,557.80	$1,104.57–$3,024.13	16% below	30%
Total hip replacement inpatient CPT 27130 ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHROPLASTY), WITH OR WITHOUT AUTOGRAFT OR ALLOGRAFT	$2,490.46	$3,557.80	$1,104.57–$3,024.13	—	30%
Total knee replacement CPT 27447 ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHOUT PATELLA RESURFACING (TOTAL KNEE ARTHROPLASTY)	$2,487.45	$3,553.50	$772.22–$3,020.48	20% below	30%
Total knee replacement inpatient CPT 27447 ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHOUT PATELLA RESURFACING (TOTAL KNEE ARTHROPLASTY)	$2,487.45	$3,553.50	$772.22–$3,020.48	—	30%
Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMY, TOTAL OR COMPLETE	$1,783.85	$2,548.35	$554.72–$2,166.10	87% below	30%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 THYROIDECTOMY, TOTAL OR COMPLETE	$1,783.85	$2,548.35	$554.72–$2,166.10	—	30%
Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER)	$577.50	$825.00	$264.03–$701.25	64% below	30%
Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER)	$577.50	$825.00	$264.03–$701.25	—	30%
Trigger point injections, 1 or 2 muscles CPT 20552 ASP INJ. TRIGGER POINT (1-2) M	$151.90	$217.00	$32.39–$184.45	26% below	30%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE OR MULTIPLE TRIGGER POINT(S)	$324.69	$463.84	$307.45–$394.26	59% above	30%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJECTION 1 OR 2 MUSCLES	$406.58	$580.82	$307.45–$493.70	99% above	30%
Trigger point injections, 1 or 2 muscles CPT 20552 DX SP TRIGGER POINT INJ 1-2 LEVELS	$665.91	$951.29	$307.45–$808.60	225% above	30%
Trigger point injections, 1 or 2 muscles CPT 20552 DX SP ILEOPSOAS INJECTION	$665.91	$951.29	$307.45–$808.60	225% above	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ASP INJ. TRIGGER POINT (1-2) M	$151.90	$217.00	$32.39–$184.45	—	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE OR MULTIPLE TRIGGER POINT(S)	$324.69	$463.84	$394.26	—	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJECTION 1 OR 2 MUSCLES	$406.58	$580.82	$493.70	—	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 DX SP TRIGGER POINT INJ 1-2 LEVELS	$665.91	$951.29	$808.60	—	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 DX SP ILEOPSOAS INJECTION	$665.91	$951.29	$808.60	—	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY, BREAST, WITH PLACEMENT OF BREAST LOCALIZATION DEVICE(S) (EG, CLIP, METALLIC PELLET), WHEN PERFORMED, AND IMAGING OF THE BIOPSY SPECIMEN, WHEN PERFORMED, PERCUTANEOUS; FIRST LESION, INCLUDING ULTRASOUND GUIDANCE	$309.40	$442.00	$127.77–$375.70	83% below	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US MG BREAST BIOPSY INITIAL	$1,751.98	$2,502.82	$1,654.26–$2,127.40	2% below	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY, BREAST, WITH PLACEMENT OF BREAST LOCALIZATION DEVICE(S) (EG, CLIP, METALLIC PELLET), WHEN PERFORMED, AND IMAGING OF THE BIOPSY SPECIMEN, WHEN PERFORMED, PERCUTANEOUS; FIRST LESION, INCLUDING ULTRASOUND GUIDANCE	$309.40	$442.00	$127.77–$375.70	—	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US MG BREAST BIOPSY INITIAL	$1,751.98	$2,502.82	$2,127.40	—	30%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD WITH TRANSENDOSCOPIC BALLOON DILATION OF ESOPHAGUS (LESS THAN 30 MM DIAMETER	$982.80	$1,404.00	$130.58–$1,193.40	60% below	30%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD WITH TRANSENDOSCOPIC BALLOON DILATION OF ESOPHAGUS (LESS THAN 30 MM DIAMETER	$982.80	$1,404.00	$130.58–$1,193.40	—	30%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD WITH BIOPSY, SINGLE OR MULTIPLE	$764.40	$1,092.00	$118.28–$928.20	55% below	30%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD WITH BIOPSY, SINGLE OR MULTIPLE	$764.40	$1,092.00	$118.28–$928.20	—	30%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE	$2,202.20	$3,146.00	$118.28–$2,674.10	8% above	30%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE	$2,202.20	$3,146.00	$118.28–$2,674.10	—	30%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE	$910.00	$1,300.00	$166.18–$1,105.00	54% below	30%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE	$910.00	$1,300.00	$166.18–$1,105.00	—	30%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD WITH INSERTION OF GUIDE WIRE FOLLOWED BY PASSAGE OF DILATOR(S) THROUGH ESOPHAGUS OVER GUIDE WIRE	$782.60	$1,118.00	$141.91–$950.30	32% below	30%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD WITH INSERTION OF GUIDE WIRE FOLLOWED BY PASSAGE OF DILATOR(S) THROUGH ESOPHAGUS OVER GUIDE WIRE	$782.60	$1,118.00	$141.91–$950.30	—	30%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDUR	$582.40	$832.00	$105.60–$707.20	47% below	30%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDUR	$582.40	$832.00	$105.60–$707.20	—	30%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY, UNILATERAL OR BILATERAL	$2,717.40	$3,882.00	$2,093.76–$3,299.70	—	30%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 PRO VASECTOMY	$454.30	$649.00	$204.74–$551.65	46% below	30%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY, UNILATERAL OR BILATERAL	$2,717.40	$3,882.00	$3,299.70	—	30%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 PRO VASECTOMY	$454.30	$649.00	$204.74–$551.65	—	30%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURGERY, SURGICAL CURETTEMENT), OF BENIGN LESIONS OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR PROLIFERATIVE LESIONS; UP TO 14 LESIONS	$109.80	$156.85	$56.95–$133.32	31% below	30%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF SKIN LESIONS UP TO 14 LESIONS	$217.68	$310.96	$200.96–$264.32	37% above	30%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURGERY, SURGICAL CURETTEMENT), OF BENIGN LESIONS OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR PROLIFERATIVE LESIONS; UP TO 14 LESIONS	$109.80	$156.85	$56.95–$133.32	—	30%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION OF SKIN LESIONS UP TO 14 LESIONS	$217.68	$310.96	$264.32	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LESS	$101.50	$145.00	$53.09–$123.25	74% below	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 1ST SQ CM/<	$311.50	$445.00	$378.25–$407.17	19% below	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LESS	$101.50	$145.00	$53.09–$123.25	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 1ST SQ CM/<	$311.50	$445.00	$378.25	—	30%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPEN TREATMENT OF DISTAL RADIAL EXTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION, WITH INTERNAL FIXATION	$1,442.00	$2,060.00	$446.86–$1,751.00	71% below	30%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 OPEN TREATMENT OF DISTAL RADIAL EXTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION, WITH INTERNAL FIXATION	$1,442.00	$2,060.00	$446.86–$1,751.00	—	30%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION >=5 TO <7 HOURS	$716.13	$1,023.04	$441.89–$869.58	9% above	30%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 6	$866.18	$1,237.40	$441.89–$1,051.79	32% above	30%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION FEE	$910.06	$1,300.08	$441.89–$1,105.07	39% above	30%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD & BLOOD PRODUCTS TRANSFUSION > 6 HOURS	$942.18	$1,345.96	$441.89–$1,144.07	44% above	30%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION	$1,101.62	$1,573.73	$441.89–$1,337.67	68% above	30%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD OR BLOOD COMPONENTS TRANSFUSION	$1,149.31	$1,641.87	$441.89–$1,395.59	75% above	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION >=5 TO <7 HOURS	$716.13	$1,023.04	$869.58	—	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION UP TO 6	$866.18	$1,237.40	$1,051.79	—	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION FEE	$910.06	$1,300.08	$1,105.07	—	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD & BLOOD PRODUCTS TRANSFUSION > 6 HOURS	$942.18	$1,345.96	$1,144.07	—	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION	$1,101.62	$1,573.73	$1,337.67	—	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD OR BLOOD COMPONENTS TRANSFUSION	$1,149.31	$1,641.87	$1,395.59	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 XOPENEX 0.63MG/ATROVENT 2.5ML	$164.30	$234.71	$12.07–$219.33	4% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 XOPENEX 1.25MG./ATROVENT 2.5ML	$164.30	$234.71	$12.07–$219.33	4% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PULMICORT 0.5MG-NEBULIZER	$164.30	$234.71	$12.07–$219.33	4% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RACEMIC EPINEPHRINE 0.5ML-NEBU	$164.30	$234.71	$12.07–$219.33	4% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NORMAL SALINE-NEBULIZER	$164.30	$234.71	$12.07–$219.33	4% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ATROVENT-NEBULIZER	$164.30	$234.71	$12.07–$219.33	4% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ALBUTEROL 0.25ML/NS(ACCUNEB)-N	$164.30	$234.71	$12.07–$219.33	4% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB SUBSEQUENT	$164.30	$234.71	$12.07–$219.33	4% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERSOL TREATMENT SUBSEQUENT	$164.30	$234.71	$12.07–$219.33	4% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB INITIAL	$164.30	$234.71	$12.07–$219.33	4% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AFORMOTEROL NEBULIZER	$177.93	$254.18	$12.07–$219.33	12% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ALBUTEROL 0.5ML/ATROVENT-NEBUL	$188.94	$269.91	$12.07–$229.42	19% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT INITIAL	$188.94	$269.91	$12.07–$229.42	19% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ALBUTEROL 0.5ML/NS-NEBULIZER	$188.94	$269.91	$12.07–$229.42	19% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 XOPENEX 1.25MG-NEBULIZER	$188.94	$269.91	$12.07–$229.42	19% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 XOPENEX 0.63MG-NEBULIZER	$188.94	$269.91	$12.07–$229.42	19% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PULMICORT 0.25MG-NEBULIZIER	$188.94	$269.91	$12.07–$229.42	19% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ACCUNEB/ATROVENT	$188.94	$269.91	$12.07–$229.42	19% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI	$188.94	$269.91	$12.07–$229.42	19% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NORMAL SALINE-NEBULIZER	$164.30	$234.71	$199.50	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ATROVENT-NEBULIZER	$164.30	$234.71	$199.50	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ALBUTEROL 0.25ML/NS(ACCUNEB)-N	$164.30	$234.71	$199.50	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB SUBSEQUENT	$164.30	$234.71	$199.50	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERSOL TREATMENT SUBSEQUENT	$164.30	$234.71	$199.50	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB INITIAL	$164.30	$234.71	$199.50	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 XOPENEX 0.63MG/ATROVENT 2.5ML	$164.30	$234.71	$199.50	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 XOPENEX 1.25MG./ATROVENT 2.5ML	$164.30	$234.71	$199.50	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PULMICORT 0.5MG-NEBULIZER	$164.30	$234.71	$199.50	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RACEMIC EPINEPHRINE 0.5ML-NEBU	$164.30	$234.71	$199.50	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AFORMOTEROL NEBULIZER	$177.93	$254.18	$216.05	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ACCUNEB/ATROVENT	$188.94	$269.91	$229.42	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI	$188.94	$269.91	$229.42	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ALBUTEROL 0.5ML/ATROVENT-NEBUL	$188.94	$269.91	$229.42	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 XOPENEX 0.63MG-NEBULIZER	$188.94	$269.91	$229.42	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ALBUTEROL 0.5ML/NS-NEBULIZER	$188.94	$269.91	$229.42	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 XOPENEX 1.25MG-NEBULIZER	$188.94	$269.91	$229.42	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TREATMENT INITIAL	$188.94	$269.91	$229.42	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PULMICORT 0.25MG-NEBULIZIER	$188.94	$269.91	$229.42	—	30%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION INITIAL	$293.02	$418.60	$102.56–$355.81	32% below	30%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION INITIAL	$293.02	$418.60	$355.81	—	30%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE AUDIOMETRY THRESHOLD EVALUATION AND RECOGNITION	$28.00	$40.00	$24.97–$34.00	84% below	30%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE AUDIOMETRY THRESHOLD EVALUATION AND SPEECH RECOGNITION	$90.16	$128.80	$109.48–$128.88	47% below	30%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE AUDIOMETRY THRESHOLD EVALUATION AND RECOGNITION	$28.00	$40.00	$24.97–$34.00	—	30%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE AUDIOMETRY THRESHOLD EVALUATION AND SPEECH RECOGNITION	$90.16	$128.80	$109.48	—	30%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST 30 TO 74 MINUTES	$2,138.11	$3,054.44	$231.34–$2,596.27	59% above	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST 30 TO 74 MINUTES	$2,138.11	$3,054.44	$2,596.27	—	30%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM	$67.90	$97.00	$14.10–$82.45	at median	30%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ELECTROCARDIOGRAM	$67.90	$97.00	$82.45	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM: TRACING ONLY	$46.90	$67.00	$56.95–$59.09	75% below	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM: TRACING ONL	$46.90	$67.00	$56.95–$59.09	75% below	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG-12 LEAD-ER	$152.94	$218.48	$59.09–$185.71	20% below	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$297.55	$425.07	$59.09–$361.31	56% above	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM: TRACING ONL	$46.90	$67.00	$56.95	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM: TRACING ONLY	$46.90	$67.00	$56.95	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG-12 LEAD-ER	$152.94	$218.48	$185.71	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$297.55	$425.07	$361.31	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY VISIT 1 W/ PROC.	$293.25	$418.92	$18.83–$356.08	110% above	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY VISIT I	$318.75	$455.35	$18.83–$387.05	128% above	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY VISIT 1 W/ PROC.	$293.25	$418.92	$356.08	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY VISIT I	$318.75	$455.35	$387.05	—	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY SERVICES LEVEL II	$437.01	$624.30	$35.15–$530.66	84% above	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY VISIT II W/ PROC.	$437.01	$624.30	$35.15–$530.66	84% above	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY VISIT II W/ PROC.	$437.01	$624.30	$530.66	—	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY SERVICES LEVEL II	$437.01	$624.30	$530.66	—	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY SERVICES LEVEL III	$636.23	$908.89	$59.80–$772.56	46% above	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY VISIT III W/ PROC.	$636.23	$908.89	$59.80–$772.56	46% above	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY VISIT III W/ PROC.	$636.23	$908.89	$772.56	—	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY SERVICES LEVEL III	$636.23	$908.89	$772.56	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY SERVICES LEVEL IV	$1,033.08	$1,475.82	$100.99–$1,254.45	54% above	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY VISIT IV W/ PROC.	$1,033.08	$1,475.82	$100.99–$1,254.45	54% above	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY VISIT IV W/ PROC.	$1,033.08	$1,475.82	$1,254.45	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY SERVICES LEVEL IV	$1,033.08	$1,475.82	$1,254.45	—	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY VISIT V W/ PROC.	$1,450.40	$2,072.00	$146.64–$1,761.20	37% above	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMER. VISIT V	$1,450.40	$2,072.00	$146.64–$1,761.20	37% above	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY VISIT V W/ PROC.	$1,450.40	$2,072.00	$1,761.20	—	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMER. VISIT V	$1,450.40	$2,072.00	$1,761.20	—	30%
Exercise stress test, tracing only, the hospital charge CPT 93017 NM TREADMILL ONLY STRESS TEST	$1,199.28	$1,713.25	$216.27–$1,456.26	46% above	30%
Exercise stress test, tracing only, the hospital charge CPT 93017 NM CARDIOVASCULAR STRESS TEST	$1,199.28	$1,713.25	$216.27–$1,456.26	46% above	30%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NM CARDIOVASCULAR STRESS TEST	$1,199.28	$1,713.25	$1,456.26	—	30%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NM TREADMILL ONLY STRESS TEST	$1,199.28	$1,713.25	$1,456.26	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION, HYDRATION INITIAL 31 MINUTES TO 1 HOUR	$364.31	$520.43	$35.78–$442.37	48% above	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL	$389.62	$556.60	$35.78–$473.11	58% above	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION (HYDRATION) INITIA	$395.98	$565.68	$35.78–$480.83	60% above	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION, HYDRATION INITIAL 31 MINUTES TO 1 HOUR	$364.31	$520.43	$442.37	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL	$389.62	$556.60	$473.11	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION (HYDRATION) INITIA	$395.98	$565.68	$480.83	—	30%
IV infusion of a medicine, first hour CPT 96365 IV THERAPEUTIC (INITIAL)	$496.69	$709.55	$50.71–$603.12	64% above	30%
IV infusion of a medicine, first hour CPT 96365 INTRAVENOUS INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS	$507.27	$724.67	$50.71–$615.97	67% above	30%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPEUTIC (INITIAL)	$496.69	$709.55	$603.12	—	30%
IV infusion of a medicine, first hour inpatient CPT 96365 INTRAVENOUS INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS	$507.27	$724.67	$615.97	—	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM OR SUBQ INJECTION INITIAL	$66.01	$94.30	$72.12–$80.16	32% below	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM ANTIBIOTIC (P)	$133.05	$190.06	$72.12–$161.55	37% above	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); SUBCUTANEO...	$144.62	$206.59	$72.12–$175.60	49% above	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJ-SUBSEQUENT (P)	$144.62	$206.59	$72.12–$175.60	49% above	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJ-THERAPEUTIC-INITIAL	$144.62	$206.59	$72.12–$175.60	49% above	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM OR SUBQ INJECTION INITIAL	$66.01	$94.30	$80.16	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM ANTIBIOTIC (P)	$133.05	$190.06	$161.55	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); SUBCUTANEO...	$144.62	$206.59	$175.60	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJ-SUBSEQUENT (P)	$144.62	$206.59	$175.60	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJ-THERAPEUTIC-INITIAL	$144.62	$206.59	$175.60	—	30%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDY 7-8 STUDIES	$141.40	$202.00	$79.82–$171.70	69% below	30%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDY 7-8 STUDIES	$577.50	$825.00	$135.79–$701.25	25% above	30%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDY 7-8 STUDIES	$141.40	$202.00	$79.82–$171.70	—	30%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDY 7-8 STUDIES	$577.50	$825.00	$701.25	—	30%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE EDUCATION	$132.67	$189.52	$28.61–$161.09	49% above	30%
Neuromuscular re-education, 15 minutes CPT 97112 THER.PRO/NEURO RE-ED/KINES./UN	$168.84	$241.20	$28.61–$205.02	90% above	30%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED/PNF/PROPRIOCEPTION	$168.84	$241.20	$28.61–$205.02	90% above	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE EDUCATION	$132.67	$189.52	$161.09	—	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED/PNF/PROPRIOCEPTION	$168.84	$241.20	$205.02	—	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 THER.PRO/NEURO RE-ED/KINES./UN	$168.84	$241.20	$205.02	—	30%
New patient office visit, about 30 minutes CPT 99203 NEW PAT. DETAILED	$136.50	$195.00	$69.59–$165.75	1% above	30%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEVEL 3 W/PROC.	$142.67	$203.81	$92.91–$173.24	6% above	30%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEVEL 3	$142.67	$203.81	$92.91–$173.24	6% above	30%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PAT. DETAILED	$136.50	$195.00	$69.59–$165.75	—	30%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT LEVEL 3	$142.67	$203.81	$173.24	—	30%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT LEVEL 3 W/PROC.	$142.67	$203.81	$173.24	—	30%
New patient office visit, about 45 minutes CPT 99204 NEW PAT. COMPREHENSIVE MOD	$185.50	$265.00	$113.65–$225.25	2% above	30%
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LEVEL 4 W/PROC.	$213.17	$304.52	$138.56–$258.84	18% above	30%
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LEVEL 4	$213.17	$304.52	$138.56–$258.84	18% above	30%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PAT. COMPREHENSIVE MOD	$185.50	$265.00	$113.65–$225.25	—	30%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT LEVEL 4	$213.17	$304.52	$258.84	—	30%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT LEVEL 4 W/PROC.	$213.17	$304.52	$258.84	—	30%
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT COMPREHENSIVE HIGH	$214.90	$307.00	$155.68–$260.95	17% below	30%
New patient office visit, about 60 minutes CPT 99205 NEW PT MOD/HIGH	$297.50	$425.00	$155.68–$361.25	15% above	30%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT COMPREHENSIVE HIGH	$214.90	$307.00	$155.68–$260.95	—	30%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT MOD/HIGH	$297.50	$425.00	$155.68–$361.25	—	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT LEVEL 2 W/PROCEDURE	$125.58	$179.40	$60.41–$152.49	26% above	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT LEVEL 2	$125.58	$179.40	$60.41–$152.49	26% above	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PAT. EXPANDED	$126.70	$181.00	$39.96–$153.85	27% above	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PATIENT LEVEL 2	$125.58	$179.40	$152.49	—	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PATIENT LEVEL 2 W/PROCEDURE	$125.58	$179.40	$152.49	—	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PAT. EXPANDED	$126.70	$181.00	$39.96–$153.85	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION THERAPY; INITIAL ASSESSMENT AND INTERVENTION, INDIVIDUAL, FACE-TO-FACE WITH THE PATIENT, EACH 15 MINUTES	$34.07	$48.67	$25.23–$41.37	22% below	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT IND. INSTR. INITIAL CONSUL PER 15 MINUTES	$49.65	$70.92	$30.59–$60.28	14% above	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION THERAPY; INITIAL ASSESSMENT AND INTERVENTION, INDIVIDUAL, FACE-TO-FACE WITH THE PATIENT, EACH 15 MINUTES	$34.07	$48.67	$25.23–$41.37	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT IND. INSTR. INITIAL CONSUL PER 15 MINUTES	$49.65	$70.92	$60.28	—	30%
Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION- LOW COMPLEXITY	$355.85	$508.35	$76.29–$432.10	156% above	30%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION- LOW COMPLEXITY	$355.85	$508.35	$432.10	—	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEXITY	$326.51	$466.44	$75.78–$396.47	90% above	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION- HIGH COMPLEXITY	$414.91	$592.72	$75.78–$503.81	141% above	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY	$326.51	$466.44	$396.47	—	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION- HIGH COMPLEXITY	$414.91	$592.72	$503.81	—	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL - LOW COMPLEXITY	$280.14	$400.20	$75.78–$340.17	121% above	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW COMPLEXITY	$355.85	$508.35	$75.78–$432.10	180% above	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL - LOW COMPLEXITY	$280.14	$400.20	$340.17	—	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW COMPLEXITY	$355.85	$508.35	$432.10	—	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MODERATE COMPLEXITY	$327.60	$468.00	$75.78–$397.80	109% above	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION-MODERATE COMPLEXITY	$383.11	$547.29	$75.78–$465.20	145% above	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MODERATE COMPLEXITY	$327.60	$468.00	$397.80	—	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION-MODERATE COMPLEXITY	$383.11	$547.29	$465.20	—	30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY WITHOUT EXERCIS	$166.57	$237.95	$20.49–$202.26	105% above	30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY WITHOUT EXERCIS	$166.57	$237.95	$202.26	—	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE	$132.67	$189.52	$24.65–$161.09	71% above	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER.PRO/EX/STRENGTH/ROM/MAINT	$168.84	$241.20	$24.65–$205.02	118% above	30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE	$132.67	$189.52	$161.09	—	30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER.PRO/EX/STRENGTH/ROM/MAINT	$168.84	$241.20	$205.02	—	30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTE	$38.62	$55.16	$10.39–$46.89	75% above	30%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTE	$38.62	$55.16	$10.39–$46.89	—	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PAT. COMPREHENSIVE HIGH	$136.87	$195.52	$149.71–$179.53	32% below	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT COMPREHENSIVE	$241.50	$345.00	$121.95–$293.25	19% above	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST PAT. COMPREHENSIVE HIGH	$136.87	$195.52	$166.19	—	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE VISIT COMPREHENSIVE	$241.50	$345.00	$121.95–$293.25	—	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EXT PAT. EXPANDED	$156.10	$223.00	$55.85–$189.55	34% above	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST. PATIENT LEVEL 3 W/PROC.	$156.10	$223.00	$75.21–$189.55	34% above	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST. PATIENT LEVEL 3	$156.10	$223.00	$75.21–$189.55	34% above	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EXT PAT. EXPANDED	$156.10	$223.00	$55.85–$189.55	—	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST. PATIENT LEVEL 3	$156.10	$223.00	$189.55	—	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST. PATIENT LEVEL 3 W/PROC.	$156.10	$223.00	$189.55	—	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTB PATIENT LEVEL 4 W/PROC	$205.44	$293.48	$106.15–$249.46	29% above	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST. PATIENT LEVEL 4	$205.44	$293.48	$106.15–$249.46	29% above	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EXT PAT. DETAILED	$223.30	$319.00	$82.22–$271.15	40% above	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTB PATIENT LEVEL 4 W/PROC	$205.44	$293.48	$249.46	—	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST. PATIENT LEVEL 4	$205.44	$293.48	$249.46	—	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EXT PAT. DETAILED	$223.30	$319.00	$82.22–$271.15	—	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TREATMENT ROOM NON PROCEDURE	$74.20	$106.00	$46.85–$90.10	8% above	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EXT PAT. FOCUSED	$130.90	$187.00	$30.23–$158.95	91% above	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST. PATIENT LEVEL 2 W/PROC.	$130.90	$187.00	$46.85–$158.95	91% above	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTAB PATIENT LEVEL 2	$130.90	$187.00	$46.85–$158.95	91% above	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TREATMENT ROOM NON PROCEDURE	$74.20	$106.00	$90.10	—	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTAB PATIENT LEVEL 2	$130.90	$187.00	$158.95	—	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EXT PAT. FOCUSED	$130.90	$187.00	$30.23–$158.95	—	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST. PATIENT LEVEL 2 W/PROC.	$130.90	$187.00	$158.95	—	30%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE OUTPATIENT CONSULTATION DETAILED	$142.10	$203.00	$172.55	21% below	30%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULT 40 MIN	$231.00	$330.00	$105.74–$280.50	29% above	30%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE OUTPATIENT CONSULTATION DETAILED	$142.10	$203.00	$172.55	—	30%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULT 40 MIN	$231.00	$330.00	$280.50	—	30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT 60 MIN PF	$224.00	$320.00	$272.00	8% below	30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT 60 MIN	$315.00	$450.00	$151.81–$382.50	29% above	30%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULT 60 MIN PF	$224.00	$320.00	$272.00	—	30%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULT 60 MIN	$315.00	$450.00	$382.50	—	30%
Speech and language evaluation CPT 92523 EVALUATION OF LANGUAGE COMPREHENSION & EXPRESSION	$374.02	$534.31	$171.59–$454.16	38% above	30%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$400.52	$572.17	$171.59–$486.34	47% above	30%
Speech and language evaluation inpatient CPT 92523 EVALUATION OF LANGUAGE COMPREHENSION & EXPRESSION	$374.02	$534.31	$454.16	—	30%
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN	$400.52	$572.17	$486.34	—	30%
Speech therapy session, individual CPT 92507 SPEECH TX/UNIT	$298.31	$426.15	$57.95–$362.23	88% above	30%
Speech therapy session, individual inpatient CPT 92507 SPEECH TX/UNIT	$298.31	$426.15	$362.23	—	30%
Spirometry (breathing test) CPT 94010 SIMPLE SPIROMETRY	$142.34	$203.34	$21.64–$216.27	34% below	30%
Spirometry (breathing test) inpatient CPT 94010 SIMPLE SPIROMETRY	$142.34	$203.34	$172.84	—	30%
Spirometry before and after a bronchodilator CPT 94060 BONCHODILATION RESPONSE	$527.72	$753.88	$37.24–$640.80	17% above	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 BONCHODILATION RESPONSE	$527.72	$753.88	$640.80	—	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$124.30	$177.56	$31.09–$150.93	51% above	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER.ACT/DIRECT CONTACT/PNF/UNIT	$158.24	$226.05	$31.09–$192.14	92% above	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES	$124.30	$177.56	$150.93	—	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER.ACT/DIRECT CONTACT/PNF/UNIT	$158.24	$226.05	$192.14	—	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$193.20	$276.00	$76.09–$234.60	3% above	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$193.20	$276.00	$234.60	—	30%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone 2025-2026 SYRINGE 1 ea, 0.5 mL	$105.00	$150.00	$23.22–$127.50	76% above	30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluzone 2025-2026 SYRINGE 1 ea, 0.5 mL	$105.00	$150.00	$127.50	—	30%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix-B 20 MCG/ML VIAL 1 mL, 1 mL	$157.50	$225.00	$75.15–$191.25	101% above	30%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Engerix-B 20 MCG/ML VIAL 1 mL, 1 mL	$157.50	$225.00	$191.25	—	30%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VIRUS VACCINE (IIV), SPLIT VIRUS, PRESERVATIVE FREE, ENHANCED IMMUNOGENICITY VIA INCREASED ANTIGEN CONTENT, FOR INTRAMUSCULAR USE	$98.00	$140.00	$98.16–$119.00	3% below	30%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone HIGH-DOSE 2025-26 SYR 1 ea, 0.5 mL	$402.50	$575.00	$98.16–$488.75	297% above	30%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VIRUS VACCINE (IIV), SPLIT VIRUS, PRESERVATIVE FREE, ENHANCED IMMUNOGENICITY VIA INCREASED ANTIGEN CONTENT, FOR INTRAMUSCULAR USE	$98.00	$140.00	$119.00	—	30%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone HIGH-DOSE 2025-26 SYR 1 ea, 0.5 mL	$402.50	$575.00	$488.75	—	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMONIA VACCINE	$210.00	$300.00	$133.47–$255.00	13% above	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMONIA VACCINE	$210.00	$300.00	$255.00	—	30%
Rabies vaccine, one dose CPT 90675 IMOVAX RABIES VACCINE+DILUENT 1 mL, 1 each	$665.00	$950.00	$319.75–$807.50	24% below	30%
Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES VACCINE+DILUENT 1 mL, 1 each	$665.00	$950.00	$807.50	—	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOXOIDS (TD) ADSORBED WHEN ADMINISTERED TO INDIVIDUALS 7 YEARS OR O...	$89.35	$127.63	$108.49	25% above	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS DIPHTHERIA ADULT 0.5ML	$105.00	$150.00	$127.50	47% above	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOXOIDS (TD) ADSORBED WHEN ADMINISTERED TO INDIVIDUALS 7 YEARS OR O...	$89.35	$127.63	$108.49	—	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS DIPHTHERIA ADULT 0.5ML	$105.00	$150.00	$127.50	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX TDAP VACCINE SYRINGE 0.5 mL, 0.5 mL	$140.00	$200.00	$170.00	38% above	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL VACCINE	$157.50	$225.00	$191.25	56% above	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (TDAP), WHEN ADMINISTERED TO I...	$164.30	$234.71	$199.50	62% above	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX TDAP VACCINE SYRINGE 0.5 mL, 0.5 mL	$140.00	$200.00	$170.00	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL VACCINE	$157.50	$225.00	$191.25	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (TDAP), WHEN ADMINISTERED TO I...	$164.30	$234.71	$199.50	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION	$93.38	$133.40	$13.21–$113.39	58% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION INITIAL	$118.87	$169.81	$13.21–$144.34	101% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUS...	$118.87	$169.81	$13.21–$144.34	101% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION	$93.38	$133.40	$113.39	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUS...	$118.87	$169.81	$144.34	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION INITIAL	$118.87	$169.81	$144.34	—	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION EA ADDL	$29.61	$42.29	$10.45–$35.95	38% below	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUS..	$46.90	$67.00	$10.45–$56.95	1% below	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUS...	$52.25	$74.63	$10.45–$63.44	10% above	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION EA ADDL	$29.61	$42.29	$35.95	—	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUS..	$46.90	$67.00	$56.95	—	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUS...	$52.25	$74.63	$63.44	—	30%

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/7803/436052772_bates-county-memorial-hospital_standardcharges.csv