Hospital Andrews, TX

Permian Regional Medical Center Andrews County Ho

Listed in its price file as “Andrews County Hospital District”.

Permian Regional Medical Center Andrews County Ho in Andrews, TX publishes cash prices for 315 common procedures listed here, from its own machine-readable price file updated Dec 3, 2025. Compared with other hospitals in the state, its outpatient cash prices are below the Texas median for 253 of 310 procedures and above it for 57. By typical cash price it ranks #38 of 240 Texas hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

720 Hospital Drive, Andrews, TX 79714 Collected Sep 27, 2026 Source price file (432) 523-2200

Acute care hospital Emergency department CCN 450144 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE 4 VIEWS	$187.00	$374.00	$38.05–$488.70	48% below	50%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE 4 VIEWS	$187.00	$374.00	$243.10–$299.20	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Lt bilat n-invasive Phys Study	$170.50	$341.00	$84.16–$272.80	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 Lt bilat n-invasive Phys Study	$170.50	$341.00	$221.65–$272.80	—	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS BARIUM SWALLOW	$367.00	$734.00	$64.64–$1,014.43	27% below	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR ESOPHAGUS BARIUM SWALLOW	$367.00	$734.00	$477.10–$587.20	—	50%
Bone scan, whole body (nuclear medicine) CPT 78306 NM WHOLE BODY BONE SCAN	$871.50	$1,743.00	$213.56–$2,186.33	52% below	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM WHOLE BODY BONE SCAN	$871.50	$1,743.00	$1,132.95–$1,394.40	—	50%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST BILATERAL COMPLETE	$215.70	$431.40	$59.11–$601.20	—	50%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILAT COMPLETE	$205.90	$411.80	$59.11–$601.20	53% below	50%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BREAST BILATERAL COMPLETE	$215.70	$431.40	$280.41–$345.12	—	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST UNILAT COMPLETE	$205.90	$411.80	$267.67–$329.44	—	50%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BREAST BILATERAL LIMITED	$195.00	$390.00	$59.11–$488.70	—	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RT UNI LIMITED	$195.00	$390.00	$59.11–$488.70	44% below	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LT UNI LIMITED	$195.00	$390.00	$59.11–$488.70	44% below	50%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US BREAST BILATERAL LIMITED	$195.00	$390.00	$253.50–$312.00	—	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LT UNI LIMITED	$195.00	$390.00	$253.50–$312.00	—	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST RT UNI LIMITED	$195.00	$390.00	$253.50–$312.00	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W&WO CONT	$1,656.50	$3,313.00	$152.06–$2,650.40	49% below	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W&WO CONT	$1,656.50	$3,313.00	$2,153.45–$2,650.40	—	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA W/WO CONTRAST	$1,568.50	$3,137.00	$152.06–$2,509.60	6% below	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA W/WO CON STRXR	$1,568.50	$3,137.00	$152.06–$2,509.60	6% below	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA W/WO CON QUAN CALCIUM	$1,568.50	$3,137.00	$152.06–$2,509.60	6% below	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA W/WO CON STRXR QUAN CALC	$1,568.50	$3,137.00	$152.06–$2,509.60	6% below	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA W/WO CON STRXR QUAN CALC	$1,568.50	$3,137.00	$2,039.05–$2,509.60	—	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA W/WO CON QUAN CALCIUM	$1,568.50	$3,137.00	$2,039.05–$2,509.60	—	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA W/WO CON STRXR	$1,568.50	$3,137.00	$2,039.05–$2,509.60	—	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA W/WO CONTRAST	$1,568.50	$3,137.00	$2,039.05–$2,509.60	—	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$194.00	$388.00	$8.15–$488.70	6% below	50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST	$194.00	$388.00	$252.20–$310.40	—	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS WO CONTRAST	$1,761.50	$3,523.00	$123.24–$2,818.40	48% below	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS WO CONTRAST	$1,761.50	$3,523.00	$2,289.95–$2,818.40	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W CONTRAST	$2,114.00	$4,228.00	$223.24–$3,382.40	46% below	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W CONTRAST	$2,114.00	$4,228.00	$2,748.20–$3,382.40	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS W&WO CONTRAST	$2,465.00	$4,930.00	$223.24–$3,944.00	41% below	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELVIS W&WO CONTRAST	$2,465.00	$4,930.00	$3,204.50–$3,944.00	—	50%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONT	$1,619.50	$3,239.00	$152.06–$2,591.20	39% below	50%
CT scan of the abdomen with contrast CPT 74160 CT RENAL WITH CONTRAST	$1,619.50	$3,239.00	$152.06–$2,591.20	39% below	50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONT	$1,619.50	$3,239.00	$2,105.35–$2,591.20	—	50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT RENAL WITH CONTRAST	$1,619.50	$3,239.00	$2,105.35–$2,591.20	—	50%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST	$1,446.00	$2,892.00	$72.22–$2,313.60	32% below	50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST	$1,446.00	$2,892.00	$1,879.80–$2,313.60	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W CONTRAST	$1,163.00	$2,326.00	$72.22–$1,860.80	32% below	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES LIMITED WO CONT	$1,198.50	$2,397.00	$72.22–$1,917.60	29% below	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLA-FACIAL WO CONT	$1,198.50	$2,397.00	$72.22–$1,917.60	29% below	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W CONTRAST	$1,163.00	$2,326.00	$1,511.90–$1,860.80	—	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLA-FACIAL WO CONT	$1,198.50	$2,397.00	$1,558.05–$1,917.60	—	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES LIMITED WO CONT	$1,198.50	$2,397.00	$1,558.05–$1,917.60	—	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO CONTRAST	$1,198.50	$2,397.00	$72.22–$1,917.60	38% below	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN WO CONTRAST	$1,198.50	$2,397.00	$1,558.05–$1,917.60	—	50%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W CONTRAST	$1,374.50	$2,749.00	$152.06–$2,199.20	32% below	50%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W CONTRAST	$1,374.50	$2,749.00	$1,786.85–$2,199.20	—	50%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W&WO CONT	$1,656.50	$3,313.00	$152.06–$2,650.40	29% below	50%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W&WO CONT	$1,656.50	$3,313.00	$2,153.45–$2,650.40	—	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE WO CONTRAST	$1,446.00	$2,892.00	$72.22–$2,313.60	36% below	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L-SPINE WO CONTRAST	$1,446.00	$2,892.00	$1,879.80–$2,313.60	—	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE WO CONTRAST	$1,446.00	$2,892.00	$72.22–$2,313.60	32% below	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE WO CONTRAST	$1,446.00	$2,892.00	$1,879.80–$2,313.60	—	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST	$1,550.50	$3,101.00	$152.06–$2,480.80	31% below	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST	$1,550.50	$3,101.00	$2,015.65–$2,480.80	—	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID DOPPLER BILAT	$470.50	$941.00	$145.03–$752.80	—	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID DOPPLER BILAT	$470.50	$941.00	$611.65–$752.80	—	50%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS	$203.00	$406.00	$34.60–$488.70	51% below	50%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS	$203.00	$406.00	$263.90–$324.80	—	50%
Chest X-ray, single view CPT 71045 XR CHEST STATE	$49.50	$99.00	$26.67–$488.70	86% below	50%
Chest X-ray, single view CPT 71045 XR CHEST DECUBITUS	$188.50	$377.00	$26.67–$488.70	46% below	50%
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW	$188.50	$377.00	$26.67–$488.70	46% below	50%
Chest X-ray, single view CPT 71045 XR CHEST EXPIRATION	$188.50	$377.00	$26.67–$488.70	46% below	50%
Chest X-ray, single view inpatient CPT 71045 XR CHEST STATE	$49.50	$99.00	$64.35–$79.20	—	50%
Chest X-ray, single view inpatient CPT 71045 XR CHEST EXPIRATION	$188.50	$377.00	$245.05–$301.60	—	50%
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW	$188.50	$377.00	$245.05–$301.60	—	50%
Chest X-ray, single view inpatient CPT 71045 XR CHEST DECUBITUS	$188.50	$377.00	$245.05–$301.60	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US ABD AORTA	$382.00	$764.00	$98.60–$611.20	49% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL	$382.00	$764.00	$98.60–$611.20	49% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US ABD AORTA	$382.00	$764.00	$496.60–$611.20	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL	$382.00	$764.00	$496.60–$611.20	—	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DEXA BONE DENSITY AXIAL	$194.00	$388.00	$39.08–$601.20	53% below	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR DEXA BONE DENSITY AXIAL	$194.00	$388.00	$252.20–$310.40	—	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST	$1,446.00	$2,892.00	$72.22–$2,313.60	26% below	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONTRAST	$1,446.00	$2,892.00	$1,879.80–$2,313.60	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST	$1,550.50	$3,101.00	$152.06–$2,480.80	31% below	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/CONTRAST	$1,550.50	$3,101.00	$2,015.65–$2,480.80	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAM DX DIGITAL BILAT	$280.50	$561.00	$102.39–$636.65	—	50%
Diagnostic mammogram, both breasts CPT 77066 MAMMO DX AFTER SCREEN DIGITAL	$183.50	$367.00	$102.39–$636.65	50% below	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMOGRAM DX DIGITAL BILAT	$280.50	$561.00	$364.65–$448.80	—	50%
Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMO DX AFTER SCREEN DIGITAL	$183.50	$367.00	$238.55–$293.60	—	50%
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAM DX DIGITAL UNILAT	$217.50	$435.00	$80.39–$499.40	20% below	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAM DX DIGITAL UNILAT	$217.50	$435.00	$282.75–$348.00	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US DUPLEX LE ART BILAT	$547.50	$1,095.00	$145.03–$876.00	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US DUPLEX LE ART BILAT	$547.50	$1,095.00	$711.75–$876.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUPLEX EXTREM VEINS BILAT	$547.50	$1,095.00	$145.03–$876.00	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUPLEX EXTREM VEINS BILAT	$547.50	$1,095.00	$711.75–$876.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHOCARADIOGRAM W DOPPLER	$628.00	$1,256.00	$201.13–$1,004.80	76% below	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHOCARADIOGRAM W DOPPLER	$628.00	$1,256.00	$816.40–$1,004.80	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM BILIARY SCAN INCL GB	$793.50	$1,587.00	$213.56–$2,186.33	53% below	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM BILIARY SCAN INCL GB	$793.50	$1,587.00	$1,031.55–$1,269.60	—	50%
Knee X-ray, 3 views CPT 73562 XR KNEE 3 VIEWS	$187.00	$374.00	$39.03–$488.70	46% below	50%
Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3 VIEWS	$187.00	$374.00	$243.10–$299.20	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN	$382.00	$764.00	$90.81–$611.20	43% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$382.00	$764.00	$90.81–$611.20	43% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US HEPATIC LIVER	$382.00	$764.00	$90.81–$611.20	43% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS	$382.00	$764.00	$90.81–$611.20	43% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER	$382.00	$764.00	$90.81–$611.20	43% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$382.00	$764.00	$496.60–$611.20	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER	$382.00	$764.00	$496.60–$611.20	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US HEPATIC LIVER	$382.00	$764.00	$496.60–$611.20	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS	$382.00	$764.00	$496.60–$611.20	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN	$382.00	$764.00	$496.60–$611.20	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Cancer Screen	$299.00	$598.00	$99.85–$601.20	24% above	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Cancer Screen	$299.00	$598.00	$388.70–$478.40	—	50%
MRI of both breasts, without and then with contrast dye CPT 77049 MRI BOTH BREASTS W/WO CONTRAST	$1,920.50	$3,841.00	$369.17–$3,072.80	42% above	50%
MRI of both breasts, without and then with contrast dye CPT 77049 MRI BOTH BREASTS W CONTRAST	$1,920.50	$3,841.00	$369.17–$3,072.80	42% above	50%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI BOTH BREASTS W CONTRAST	$1,920.50	$3,841.00	$2,496.65–$3,072.80	—	50%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI BOTH BREASTS W/WO CONTRAST	$1,920.50	$3,841.00	$2,496.65–$3,072.80	—	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER JOINT WO CONTRAST	$1,409.00	$2,818.00	$175.61–$2,254.40	35% below	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER JOINT WO CONTRAST	$1,409.00	$2,818.00	$1,831.70–$2,254.40	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI KNEE W&WO CONTRAST	$1,831.50	$3,663.00	$291.67–$2,930.40	39% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI KNEE W&WO CONTRAST	$1,831.50	$3,663.00	$2,380.95–$2,930.40	—	50%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST	$1,339.00	$2,678.00	$175.61–$2,142.40	41% below	50%
MRI of the abdomen without contrast CPT 74181 MRI LIVER WO CONTRAST	$1,339.00	$2,678.00	$175.61–$2,142.40	41% below	50%
MRI of the abdomen without contrast CPT 74181 MRI KIDNEYS WO CONTRAST	$1,339.00	$2,678.00	$175.61–$2,142.40	41% below	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI KIDNEYS WO CONTRAST	$1,339.00	$2,678.00	$1,740.70–$2,142.40	—	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI LIVER WO CONTRAST	$1,339.00	$2,678.00	$1,740.70–$2,142.40	—	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST	$1,339.00	$2,678.00	$1,740.70–$2,142.40	—	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W & WO CONTRAST	$1,884.50	$3,769.00	$291.67–$3,015.20	42% below	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W & WO CONTRAST	$1,884.50	$3,769.00	$2,449.85–$3,015.20	—	50%
MRI of the brain, no contrast dye CPT 70551 MRI HEAD/BRAIN WO CONTRAST	$1,420.50	$2,841.00	$175.61–$2,272.80	35% below	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI HEAD/BRAIN WO CONTRAST	$1,420.50	$2,841.00	$1,846.65–$2,272.80	—	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI HEAD/BRAIN W&WO CONT	$1,850.00	$3,700.00	$291.67–$2,960.00	39% below	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI HEAD/BRAIN W&WO CONT	$1,850.00	$3,700.00	$2,405.00–$2,960.00	—	50%
MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE WO CONTRAST	$1,619.50	$3,239.00	$175.61–$2,591.20	29% below	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-SPINE WO CONTRAST	$1,619.50	$3,239.00	$2,105.35–$2,591.20	—	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W&WO CONT	$2,096.50	$4,193.00	$291.67–$3,354.40	34% below	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L-SPINE W&WO CONT	$2,096.50	$4,193.00	$2,725.45–$3,354.40	—	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE WO CONTRAST	$1,619.50	$3,239.00	$175.61–$2,591.20	25% below	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T-SPINE WO CONTRAST	$1,619.50	$3,239.00	$2,105.35–$2,591.20	—	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W&WO CONT	$2,096.50	$4,193.00	$291.67–$3,354.40	36% below	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-SPINE W&WO CONT	$2,096.50	$4,193.00	$2,725.45–$3,354.40	—	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE WO CONT	$1,619.50	$3,239.00	$175.61–$2,591.20	32% below	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE WO CONT	$1,619.50	$3,239.00	$2,105.35–$2,591.20	—	50%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO CONTRAST	$1,884.50	$3,769.00	$291.67–$3,015.20	44% below	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO CONTRAST	$1,884.50	$3,769.00	$2,449.85–$3,015.20	—	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST	$1,339.00	$2,678.00	$175.61–$2,142.40	46% below	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS/UTERUS WO CONT	$1,339.00	$2,678.00	$175.61–$2,142.40	46% below	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST	$1,339.00	$2,678.00	$1,740.70–$2,142.40	—	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS/UTERUS WO CONT	$1,339.00	$2,678.00	$1,740.70–$2,142.40	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER JOINT WO CONTRAST	$1,409.00	$2,818.00	$175.61–$2,254.40	21% below	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER JOINT WO CONTRAST	$1,409.00	$2,818.00	$1,831.70–$2,254.40	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARD MULT R/S	$1,515.50	$3,031.00	$450.47–$7,465.90	65% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM CARDIOLITE STRESS	$1,796.50	$3,593.00	$450.47–$7,465.90	59% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARD MULT R/S	$1,515.50	$3,031.00	$1,970.15–$2,424.80	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM CARDIOLITE STRESS	$1,796.50	$3,593.00	$2,335.45–$2,874.40	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS NON OB COMPLETE	$408.00	$816.00	$98.60–$652.80	53% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS NON OB COMPLETE	$408.00	$816.00	$530.40–$652.80	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB COMP>14WKS SNGL/1ST FET	$407.00	$814.00	$98.60–$651.20	38% below	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB FOLLOW-UP SNGL/1ST FETUS	$407.00	$814.00	$98.60–$651.20	38% below	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB FOLLOW-UP SNGL/1ST FETUS	$407.00	$814.00	$529.10–$651.20	—	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB COMP>14WKS SNGL/1ST FET	$407.00	$814.00	$529.10–$651.20	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB COMP 1ST TRI SNGL/1ST F	$407.00	$814.00	$98.60–$651.20	38% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB COMP 1ST TRI SNGL/1ST F	$407.00	$814.00	$529.10–$651.20	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED 1+ FETUS(S)	$260.50	$521.00	$83.92–$601.20	47% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED 1+ FETUS(S)	$260.50	$521.00	$338.65–$416.80	—	50%
Screening mammogram, both breasts CPT 77067 MAMMOGRAM SCREEN DIGITAL BIL	$196.50	$393.00	$84.67–$528.03	36% below	50%
Screening mammogram, both breasts inpatient CPT 77067 MAMMOGRAM SCREEN DIGITAL BIL	$196.50	$393.00	$255.45–$314.40	—	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER 3 V COMPL	$187.00	$374.00	$35.63–$488.70	39% below	50%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER 3 V COMPL	$187.00	$374.00	$243.10–$299.20	—	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWLNG FUNCT C+	$211.00	$422.00	$64.64–$1,014.43	65% below	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 MODIFIED BARIUM SWALLOW	$240.50	$481.00	$64.64–$1,014.43	60% below	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR SWLNG FUNCT C+	$211.00	$422.00	$274.30–$337.60	—	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MODIFIED BARIUM SWALLOW	$240.50	$481.00	$312.65–$384.80	—	50%
Transvaginal pelvic ultrasound CPT 76830 US NON OB TRANSVAGINAL	$216.00	$432.00	$98.60–$601.20	67% below	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 US NON OB TRANSVAGINAL	$216.00	$432.00	$280.80–$345.60	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$216.00	$432.00	$95.63–$601.20	63% below	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL	$216.00	$432.00	$280.80–$345.60	—	50%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$491.00	$982.00	$98.60–$785.60	43% below	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$491.00	$982.00	$638.30–$785.60	—	50%
Ultrasound of the scrotum and testicles CPT 76870 US TESTICLE	$408.00	$816.00	$98.60–$652.80	45% below	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICLE	$408.00	$816.00	$530.40–$652.80	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$380.50	$761.00	$98.60–$608.80	41% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD & NECK	$380.50	$761.00	$98.60–$608.80	41% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD & NECK	$380.50	$761.00	$494.65–$608.80	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$380.50	$761.00	$494.65–$608.80	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX EXTREM VEINS UNILAT	$407.00	$814.00	$72.37–$651.20	49% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX EXTREM VEINS UNILAT	$407.00	$814.00	$529.10–$651.20	—	50%
Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST 3 VIEWS COMPL	$187.00	$374.00	$39.03–$488.70	48% below	50%
Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST 4 VIEWS COMPL	$187.00	$374.00	$39.03–$488.70	48% below	50%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST 3 VIEWS COMPL	$187.00	$374.00	$243.10–$299.20	—	50%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST 4 VIEWS COMPL	$187.00	$374.00	$243.10–$299.20	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNILAT W PELVIS 2-3 VW	$187.00	$374.00	$39.03–$488.70	54% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP UNILAT W PELVIS 2-3 VW	$187.00	$374.00	$243.10–$299.20	—	50%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN-LAT DECUB	$187.00	$374.00	$30.81–$488.70	45% below	50%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW (KUB)	$187.00	$374.00	$30.81–$488.70	45% below	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW (KUB)	$187.00	$374.00	$243.10–$299.20	—	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN-LAT DECUB	$187.00	$374.00	$243.10–$299.20	—	50%
X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2 VIEWS	$187.00	$374.00	$33.57–$488.70	35% below	50%
X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEWS	$187.00	$374.00	$243.10–$299.20	—	50%
X-ray of the finger(s), 2 or more views CPT 73140 XR FINGERS MIN 2 VIEWS	$187.00	$374.00	$39.03–$488.70	22% below	50%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGERS MIN 2 VIEWS	$187.00	$374.00	$243.10–$299.20	—	50%
X-ray of the foot, 2 views CPT 73620 XR WT BEARING FOOT AP & LAT	$187.00	$374.00	$29.09–$488.70	44% below	50%
X-ray of the foot, 2 views inpatient CPT 73620 XR WT BEARING FOOT AP & LAT	$187.00	$374.00	$243.10–$299.20	—	50%
X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT MIN 3V COMPLETE	$187.00	$374.00	$35.29–$488.70	50% below	50%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT MIN 3V COMPLETE	$187.00	$374.00	$243.10–$299.20	—	50%
X-ray of the hand, 3 or more views CPT 73130 XR HAND 3 VIEWS MIN	$187.00	$374.00	$38.05–$488.70	51% below	50%
X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND 3 VIEWS MIN	$187.00	$374.00	$243.10–$299.20	—	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 2V RT WT BEARING	$187.00	$374.00	$35.29–$488.70	33% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 2 VIEWS LEFT	$187.00	$374.00	$35.29–$488.70	33% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 2V LT WT BEARING	$187.00	$374.00	$35.29–$488.70	33% below	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 2 VIEWS LEFT	$187.00	$374.00	$243.10–$299.20	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 2V RT WT BEARING	$187.00	$374.00	$243.10–$299.20	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 2V LT WT BEARING	$187.00	$374.00	$243.10–$299.20	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBAR 3 VIEW	$201.00	$402.00	$41.15–$601.20	58% below	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBAR 3 VIEW	$201.00	$402.00	$261.30–$321.60	—	50%
X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBAR MIN 4 VIEWS	$320.00	$640.00	$52.87–$601.20	51% below	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBAR MIN 4 VIEWS	$320.00	$640.00	$416.00–$512.00	—	50%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMPL MIN 3 VW	$135.50	$271.00	$39.03–$488.70	54% below	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES COMPL MIN 3 VW	$135.50	$271.00	$176.15–$216.80	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERV 2 VIEW	$201.00	$402.00	$40.80–$488.70	46% below	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERV 2 VIEW	$201.00	$402.00	$261.30–$321.60	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 VIEW	$117.50	$235.00	$28.74–$601.20	68% below	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 VIEW	$117.50	$235.00	$152.75–$188.00	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM & COCCYX MIN 2V	$201.00	$402.00	$33.57–$488.70	39% below	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM & COCCYX 3 VIEWS	$225.00	$450.00	$33.57–$488.70	31% below	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM & COCCYX MIN 2V	$201.00	$402.00	$261.30–$321.60	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM & COCCYX 3 VIEWS	$225.00	$450.00	$292.50–$360.00	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE AMINO	$53.00	$106.00	$5.30–$84.80	10% below	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALANINE AMINO	$53.00	$106.00	$68.90–$84.80	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST OR SGOT	$53.00	$106.00	$5.18–$84.80	10% below	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST OR SGOT	$53.00	$106.00	$68.90–$84.80	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE	$268.00	$536.00	$47.63–$428.80	31% below	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE	$268.00	$536.00	$348.40–$428.80	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE; FOOD-MILK	$24.45	$48.90	$5.22–$39.12	5% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SP IGE QUAN/SEMIQUAN	$25.50	$51.00	$5.22–$40.80	at median	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE; FOOD-MILK	$24.45	$48.90	$31.79–$39.12	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SP IGE QUAN/SEMIQUAN	$25.50	$51.00	$33.15–$40.80	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$69.00	$138.00	$12.95–$110.40	34% above	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY	$69.00	$138.00	$89.70–$110.40	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB	$80.00	$160.00	$12.09–$128.00	22% below	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB	$80.00	$160.00	$104.00–$128.00	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PEPTIDE	$117.00	$234.00	$39.26–$187.20	40% below	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC PEPTIDE	$117.00	$234.00	$152.10–$187.20	—	50%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$94.50	$189.00	$8.46–$151.20	63% below	50%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$94.50	$189.00	$122.85–$151.20	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM LEVEL IV	$233.50	$467.00	$50.17–$373.60	24% below	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM LEVEL IV	$233.50	$467.00	$303.55–$373.60	—	50%
Blood culture for bacteria CPT 87040 CULTURE BLOOD PEDI	$63.50	$127.00	$10.32–$101.60	73% below	50%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$70.50	$141.00	$10.32–$112.80	71% below	50%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD PEDI	$63.50	$127.00	$82.55–$101.60	—	50%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$70.50	$141.00	$91.65–$112.80	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 SANE VENIPUNCTURE	$7.50	$15.00	$7.80–$1,350.00	63% below	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE	$13.00	$26.00	$8.57–$1,350.00	37% below	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 SANE VENIPUNCTURE	$7.50	$15.00	$9.75–$12.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE	$13.00	$26.00	$16.90–$20.80	—	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING OR RANDOM	$31.00	$62.00	$3.93–$49.60	37% below	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE 2HR MEAL	$41.00	$82.00	$3.93–$65.60	17% below	50%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING OR RANDOM	$31.00	$62.00	$40.30–$49.60	—	50%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 2HR MEAL	$41.00	$82.00	$53.30–$65.60	—	50%
Blood lead test CPT 83655 LEAD	$62.50	$125.00	$12.11–$100.00	23% above	50%
Blood lead test inpatient CPT 83655 LEAD	$62.50	$125.00	$81.25–$100.00	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST URINE	$51.00	$102.00	$7.52–$81.60	72% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM	$57.50	$115.00	$7.52–$92.00	68% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST URINE	$51.00	$102.00	$66.30–$81.60	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST SERUM	$57.50	$115.00	$74.75–$92.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPE SCREEN	$54.50	$109.00	$2.99–$378.33	38% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$173.00	$346.00	$2.99–$378.33	96% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPE SCREEN	$54.50	$109.00	$70.85–$87.20	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$173.00	$346.00	$224.90–$276.80	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$26.00	$52.00	$5.18–$41.60	55% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$26.00	$52.00	$33.80–$41.60	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 IA QUANT CA 19-9	$105.50	$211.00	$20.81–$168.80	21% below	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IA QUANT CA 19-9	$105.50	$211.00	$137.15–$168.80	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 IA QUANT CA 125	$117.00	$234.00	$20.81–$187.20	27% below	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IA QUANT CA 125	$117.00	$234.00	$152.10–$187.20	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AMP PROBE	$96.00	$192.00	$35.09–$153.60	23% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMPLIF NA PROBE	$193.50	$387.00	$35.09–$309.60	56% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH DNA AMP PROBE	$96.00	$192.00	$124.80–$153.60	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA T AMPLIF NA PROBE	$193.50	$387.00	$251.55–$309.60	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 NMR LIPOPROFILE W/GRAPH	$32.61	$65.22	$13.39–$52.18	87% below	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$78.50	$157.00	$13.39–$125.60	68% below	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 NMR LIPOPROFILE W/GRAPH	$32.61	$65.22	$42.39–$52.18	—	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$78.50	$157.00	$102.05–$125.60	—	50%
Complete blood count (CBC) with differential CPT 85025 CBC AUTO DIFF	$50.50	$101.00	$7.77–$80.80	46% below	50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO DIFF	$50.50	$101.00	$65.65–$80.80	—	50%
Complete blood count (CBC), no differential CPT 85027 CBC HEMGRAM	$40.00	$80.00	$6.47–$64.00	62% below	50%
Complete blood count (CBC), no differential CPT 85027 CBC NO DIFFERENTIAL	$43.50	$87.00	$6.47–$69.60	59% below	50%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC HEMGRAM	$40.00	$80.00	$52.00–$64.00	—	50%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC NO DIFFERENTIAL	$43.50	$87.00	$56.55–$69.60	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 CMP	$65.00	$130.00	$10.56–$104.00	82% below	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP	$65.00	$130.00	$84.50–$104.00	—	50%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUAN	$76.50	$153.00	$10.18–$122.40	58% below	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUAN	$76.50	$153.00	$99.45–$122.40	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$129.50	$259.00	$22.23–$207.20	18% below	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$129.50	$259.00	$168.35–$207.20	—	50%
Estradiol blood test CPT 82670 ESTRADIOL LEVEL	$158.00	$316.00	$27.94–$252.80	4% above	50%
Estradiol blood test inpatient CPT 82670 ESTRADIOL LEVEL	$158.00	$316.00	$205.40–$252.80	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN FSH	$54.50	$109.00	$18.58–$87.20	66% below	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN FSH	$54.50	$109.00	$70.85–$87.20	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$135.50	$271.00	$19.63–$216.80	37% below	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$135.50	$271.00	$176.15–$216.80	—	50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$73.50	$147.00	$13.63–$117.60	28% below	50%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$73.50	$147.00	$95.55–$117.60	—	50%
Folate (folic acid) blood test CPT 82746 FOLATE SERUM	$86.50	$173.00	$14.70–$138.40	5% above	50%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM	$86.50	$173.00	$112.45–$138.40	—	50%
Free T3 thyroid hormone test CPT 84481 T3 FREE/TRIIODOTHYRONINE	$161.00	$322.00	$16.94–$257.60	6% above	50%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE/TRIIODOTHYRONINE	$161.00	$322.00	$209.30–$257.60	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE/T4 FREE	$68.00	$136.00	$9.02–$108.80	34% below	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE/T4 FREE	$68.00	$136.00	$88.40–$108.80	—	50%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$142.00	$284.00	$25.47–$227.20	28% above	50%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$142.00	$284.00	$184.60–$227.20	—	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$265.00	$530.00	$91.49–$424.00	43% below	50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$265.00	$530.00	$344.50–$424.00	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUC DOSE	$29.00	$58.00	$4.75–$46.40	75% below	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUC DOSE	$29.00	$58.00	$37.70–$46.40	—	50%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 3 SPECM	$90.50	$181.00	$12.87–$144.80	44% below	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 3 SPECM	$90.50	$181.00	$117.65–$144.80	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE DNA AMP PROBE	$80.00	$160.00	$35.09–$128.00	43% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA AMPLIF NA PROBE	$193.50	$387.00	$35.09–$309.60	37% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE DNA AMP PROBE	$80.00	$160.00	$104.00–$128.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA AMPLIF NA PROBE	$193.50	$387.00	$251.55–$309.60	—	50%
H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODY	$112.00	$224.00	$9.74–$179.20	14% below	50%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI ANTIBODY	$112.00	$224.00	$145.60–$179.20	—	50%
H. pylori stool antigen test CPT 87338 H PYLORI STOOL EIA	$130.50	$261.00	$14.38–$208.80	60% above	50%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL EIA	$130.50	$261.00	$169.65–$208.80	—	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT & REVRSE TRNSCRP	$429.50	$859.00	$85.10–$687.20	32% above	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT & REVRSE TRNSCRP	$429.50	$859.00	$558.35–$687.20	—	50%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 SINGLE RESULT	$73.50	$147.00	$13.71–$117.60	23% below	50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV-2 SINGLE RESULT	$73.50	$147.00	$95.55–$117.60	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$136.00	$272.00	$24.08–$217.60	6% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$136.00	$272.00	$176.80–$217.60	—	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES	$64.50	$129.00	$35.09–$121.76	9% below	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK TYPES	$64.50	$129.00	$83.85–$103.20	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$51.50	$103.00	$9.71–$82.40	44% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$51.50	$103.00	$66.95–$82.40	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$61.00	$122.00	$10.74–$97.60	4% below	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$61.00	$122.00	$79.30–$97.60	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG EIA	$58.50	$117.00	$10.33–$93.60	26% below	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG EIA	$58.50	$117.00	$76.05–$93.60	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$81.00	$162.00	$14.27–$129.60	7% below	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$81.00	$162.00	$105.30–$129.60	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$239.50	$479.00	$33.79–$383.20	25% below	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$239.50	$479.00	$311.35–$383.20	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 AB	$68.50	$137.00	$13.19–$109.60	20% below	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 AB	$68.50	$137.00	$89.05–$109.60	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 ANTIBODY	$107.50	$215.00	$19.35–$172.00	19% above	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 ANTIBODY	$107.50	$215.00	$139.75–$172.00	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-HIGH SENSITIVITY	$132.50	$265.00	$12.95–$212.00	66% above	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP-HIGH SENSITIVITY	$132.50	$265.00	$172.25–$212.00	—	50%
Homocysteine blood test CPT 83090 HOMOSYSTINE ASSAY	$141.50	$283.00	$17.92–$226.40	6% below	50%
Homocysteine blood test inpatient CPT 83090 HOMOSYSTINE ASSAY	$141.50	$283.00	$183.95–$226.40	—	50%
Insulin blood test CPT 83525 INSULIN TOTAL	$63.50	$127.00	$11.43–$101.60	25% below	50%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$63.50	$127.00	$82.55–$101.60	—	50%
Iron blood test (serum iron) CPT 83540 IRON SERUM	$46.00	$92.00	$6.47–$73.60	48% below	50%
Iron blood test (serum iron) inpatient CPT 83540 IRON SERUM	$46.00	$92.00	$59.80–$73.60	—	50%
Iron-binding capacity (TIBC) test CPT 83550 TIBC/IRON BINDING CAPACITY	$50.50	$101.00	$8.74–$80.80	48% below	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC/IRON BINDING CAPACITY	$50.50	$101.00	$65.65–$80.80	—	50%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$109.00	$218.00	$8.68–$174.40	67% below	50%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$109.00	$218.00	$141.70–$174.40	—	50%
LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE	$97.00	$194.00	$18.52–$155.20	36% below	50%
LH (luteinizing hormone) test inpatient CPT 83002 LUTENIZING HORMONE	$97.00	$194.00	$126.10–$155.20	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$77.00	$154.00	$6.89–$123.20	22% below	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$77.00	$154.00	$100.10–$123.20	—	50%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$84.00	$168.00	$8.17–$134.40	71% below	50%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$84.00	$168.00	$109.20–$134.40	—	50%
Lyme disease antibody test CPT 86618 LYMES DISEASE ANTIBODIES	$87.00	$174.00	$17.03–$139.20	5% above	50%
Lyme disease antibody test inpatient CPT 86618 LYMES DISEASE ANTIBODIES	$87.00	$174.00	$113.10–$139.20	—	50%
Magnesium blood test CPT 83735 MAGNESIUM	$56.00	$112.00	$6.70–$89.60	22% above	50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$56.00	$112.00	$72.80–$89.60	—	50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$75.50	$151.00	$12.88–$120.80	188% above	50%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$75.50	$151.00	$98.15–$120.80	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN	$41.50	$83.00	$5.18–$66.40	57% below	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SCREEN	$41.50	$83.00	$53.95–$66.40	—	50%
Obstetric blood test panel CPT 80055 OB PROFILE	$150.00	$300.00	$47.81–$240.00	41% below	50%
Obstetric blood test panel inpatient CPT 80055 OB PROFILE	$150.00	$300.00	$195.00–$240.00	—	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$94.00	$188.00	$18.39–$150.40	17% below	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$94.00	$188.00	$122.20–$150.40	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL DIAGNOSTIC	$94.00	$188.00	$18.39–$150.40	13% above	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL DIAGNOSTIC	$94.00	$188.00	$122.20–$150.40	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$49.00	$98.00	$26.61–$92.34	33% below	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$49.00	$98.00	$63.70–$78.40	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH VAGINAL OR CERVICAL	$50.00	$100.00	$20.26–$80.00	45% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH VAGINAL OR CERVICAL	$50.00	$100.00	$65.00–$80.00	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$227.50	$455.00	$41.28–$364.00	2% above	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$227.50	$455.00	$295.75–$364.00	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT PLASMA OR WHOLE BLOOD	$56.50	$113.00	$6.01–$90.40	6% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT PLASMA OR WHOLE BLOOD	$56.50	$113.00	$73.45–$90.40	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPLOIDY	$757.00	$1,514.00	$696.54–$2,633.90	13% below	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FETAL CHRMOML ANEUPLOIDY	$757.00	$1,514.00	$984.10–$1,211.20	—	50%
Progesterone blood test CPT 84144 PROGESTERONE ASSAY	$105.50	$211.00	$20.86–$168.80	13% below	50%
Progesterone blood test inpatient CPT 84144 PROGESTERONE ASSAY	$105.50	$211.00	$137.15–$168.80	—	50%
Prolactin blood test CPT 84146 PROLACTIN ASSAY	$99.50	$199.00	$19.38–$159.20	17% below	50%
Prolactin blood test inpatient CPT 84146 PROLACTIN ASSAY	$99.50	$199.00	$129.35–$159.20	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME/PT	$33.00	$66.00	$4.29–$52.80	30% below	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME/PT	$33.00	$66.00	$42.90–$52.80	—	50%
Rheumatoid factor (RF) test CPT 86431 RHEUM FACTOR QUAN	$29.50	$59.00	$5.67–$47.20	47% below	50%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUM FACTOR QUAN	$29.50	$59.00	$38.35–$47.20	—	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$73.50	$147.00	$14.39–$117.60	87% above	50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$73.50	$147.00	$95.55–$117.60	—	50%
Stool ova and parasites exam CPT 87177 OVA & PARASITES DIR SMR W ID	$56.50	$113.00	$8.90–$90.40	45% below	50%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES DIR SMR W ID	$56.50	$113.00	$73.45–$90.40	—	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD FHG QUAL 1-3	$28.00	$56.00	$15.92–$55.24	64% below	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD FHG QUAL 1-3	$28.00	$56.00	$36.40–$44.80	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL; CSF	$8.50	$17.00	$4.27–$14.82	85% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RAPID PLASMA REAGIN	$34.00	$68.00	$4.27–$54.40	40% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL; CSF	$8.50	$17.00	$11.05–$13.60	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RAPID PLASMA REAGIN	$34.00	$68.00	$44.20–$54.40	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$313.00	$626.00	$61.98–$500.80	42% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE	$313.00	$626.00	$406.90–$500.80	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$136.50	$273.00	$25.81–$218.40	9% above	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$136.50	$273.00	$177.45–$218.40	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB EACH	$84.50	$169.00	$14.55–$135.20	13% below	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB EACH	$84.50	$169.00	$109.85–$135.20	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$85.00	$170.00	$16.80–$136.00	35% below	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$85.00	$170.00	$110.50–$136.00	—	50%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$193.50	$387.00	$35.09–$309.60	121% above	50%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$193.50	$387.00	$251.55–$309.60	—	50%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$38.50	$77.00	$4.52–$61.60	65% below	50%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$38.50	$77.00	$50.05–$61.60	—	50%
Urinalysis with microscope exam, automated CPT 81001 UA W/MICROSCOPY	$55.50	$111.00	$3.17–$88.80	53% below	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA W/MICROSCOPY	$55.50	$111.00	$72.15–$88.80	—	50%
Urinalysis with microscope exam, manual CPT 81000 GLUCOSE URINE DIPSTICK	$19.50	$39.00	$3.77–$31.20	50% below	50%
Urinalysis with microscope exam, manual inpatient CPT 81000 GLUCOSE URINE DIPSTICK	$19.50	$39.00	$25.35–$31.20	—	50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS WO MICRO	$29.50	$59.00	$2.25–$47.20	45% below	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS WO MICRO	$29.50	$59.00	$38.35–$47.20	—	50%
Urinalysis without microscope exam, manual CPT 81002 POC URINE PROTEIN DIP STICK	$20.50	$41.00	$3.04–$32.80	43% below	50%
Urinalysis without microscope exam, manual CPT 81002 UA NONAUTO W/O SCOPE	$20.50	$41.00	$3.04–$32.80	43% below	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA NONAUTO W/O SCOPE	$20.50	$41.00	$26.65–$32.80	—	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 POC URINE PROTEIN DIP STICK	$20.50	$41.00	$26.65–$32.80	—	50%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$60.50	$121.00	$8.07–$96.80	57% below	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$60.50	$121.00	$78.65–$96.80	—	50%
Urine pregnancy test, read by color change CPT 81025 SANE PREGNANCY TEST	$7.50	$15.00	$7.52–$29.88	92% below	50%
Urine pregnancy test, read by color change inpatient CPT 81025 SANE PREGNANCY TEST	$7.50	$15.00	$9.75–$12.00	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 LEVEL	$76.50	$153.00	$15.08–$122.40	16% below	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 LEVEL	$76.50	$153.00	$99.45–$122.40	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$136.50	$273.00	$29.60–$218.40	16% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$136.50	$273.00	$177.45–$218.40	—	50%
Zinc blood test CPT 84630 ZINC	$58.50	$117.00	$11.39–$93.60	15% below	50%
Zinc blood test inpatient CPT 84630 ZINC	$58.50	$117.00	$76.05–$93.60	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUAN	$90.00	$180.00	$10.40–$144.00	20% below	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUAN	$90.00	$180.00	$117.00–$144.00	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS	$2,137.50	$4,275.00	$216.73–$5,329.06	43% below	50%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 REMOVAL OF ADENOIDS	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY FOR RUPTURE	$3,317.00	$6,634.00	$867.02–$5,307.20	6% above	50%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDECTOMY FOR RUPTURE	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Appendectomy, open surgery CPT 44950 APPENDECTOMY OPEN	$2,137.50	$4,275.00	$635.60–$10,253.25	63% below	50%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY OPEN	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 FRACTURE ANKLE FIBULA	$557.00	$1,114.00	$209.17–$891.20	19% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CL TX DSTL FIB FX WO MANIP	$1,743.50	$3,487.00	$209.17–$2,789.60	274% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 FRACTURE ANKLE FIBULA	$557.00	$1,114.00	$724.10–$891.20	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CL TX DSTL FIB FX WO MANIP	$1,743.50	$3,487.00	$1,000.00–$2,371.16	—	50%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 BUNION CORRCT W MTRSL BONE INC	$2,531.00	$5,062.00	$517.79–$5,331.59	37% below	50%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 BUNION CORRCT W MTRSL BONE INC	$2,531.00	$5,062.00	$1,000.00–$3,442.16	—	50%
Bunion correction with removal of part of the big toe joint CPT 28292 SIMPLE BUNION CORRECTION	$2,531.00	$5,062.00	$488.46–$5,331.59	39% below	50%
Bunion correction with removal of part of the big toe joint CPT 28292 BUNION CORR KELLR/MCBRDE/MAYO	$2,531.00	$5,062.00	$488.46–$5,331.59	39% below	50%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 BUNION CORR KELLR/MCBRDE/MAYO	$2,531.00	$5,062.00	$1,000.00–$3,442.16	—	50%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 SIMPLE BUNION CORRECTION	$2,531.00	$5,062.00	$1,000.00–$3,442.16	—	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$768.00	$1,536.00	$108.18–$1,228.80	55% below	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$768.00	$1,536.00	$998.40–$1,228.80	—	50%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL RELEASE	$2,137.50	$4,275.00	$444.86–$3,420.00	45% below	50%
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL RELEASE	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Cataract surgery with lens implant CPT 66984 EXTRACAPS CATARACT REM W INS I	$2,137.50	$4,275.00	$545.36–$3,747.73	27% below	50%
Cataract surgery with lens implant inpatient CPT 66984 EXTRACAPS CATARACT REM W INS I	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Cervical biopsy CPT 57500 CERVICAL BX W PUNCH	$1,350.50	$2,701.00	$74.88–$2,160.80	19% above	50%
Cervical biopsy inpatient CPT 57500 CERVICAL BX W PUNCH	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM EXC NOT CLAMP/DEV/D SLI	$2,137.50	$4,275.00	$197.12–$3,420.00	9% below	50%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUM EXC NOT CLAMP/DEV/D SLI	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$2,137.50	$4,275.00	$95.63–$3,420.00	74% above	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE	$860.96	$1,721.92	$145.08–$2,515.00	62% below	50%
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION NEONATE	$860.96	$1,721.92	$1,119.25–$1,377.54	—	50%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W SNARE	$1,743.50	$3,487.00	$251.05–$2,789.60	46% above	50%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W SNARE	$1,743.50	$3,487.00	$1,000.00–$2,371.16	—	50%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W BIOPSY	$1,743.50	$3,487.00	$198.43–$2,789.60	46% above	50%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W BIOPSY	$1,743.50	$3,487.00	$1,000.00–$2,371.16	—	50%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY DIAGNOSTIC	$1,743.50	$3,487.00	$182.44–$2,789.60	19% above	50%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY DIAGNOSTIC	$1,743.50	$3,487.00	$1,000.00–$2,371.16	—	50%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 CERV COLP LEEP W BX	$2,137.50	$4,275.00	$158.93–$5,224.65	40% below	50%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 CERV COLP LEEP W BX	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX OF CERVIX W/SCOPE	$1,350.50	$2,701.00	$70.36–$2,160.80	447% above	50%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 BX OF CERVIX W/SCOPE	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Complex cataract surgery with lens implant CPT 66982 CATARACT SURG W/IOL COMPLEX	$2,137.50	$4,275.00	$746.42–$3,747.73	51% below	50%
Complex cataract surgery with lens implant inpatient CPT 66982 CATARACT SURG W/IOL COMPLEX	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$1,350.50	$2,701.00	$79.36–$2,160.80	22% above	50%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
D&C (dilation and curettage), not related to pregnancy CPT 58120 D&C DX OR THERAP NON-OB	$2,137.50	$4,275.00	$235.47–$5,224.65	48% below	50%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 D&C DX OR THERAP NON-OB	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTR BENIGN/PM LES 1ST	$1,350.50	$2,701.00	$55.55–$2,160.80	565% above	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTR BENIGN/PM LES 1ST	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY GEN ANESTH	$1,743.50	$3,487.00	$162.62–$2,789.60	49% below	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY GEN ANESTH	$1,743.50	$3,487.00	$1,000.00–$2,371.16	—	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear one side CPT 69433 TYMPANOSTOMY LOCAL UNILAT	$1,350.50	$2,701.00	$134.07–$2,160.80	73% above	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient one side CPT 69433 TYMPANOSTOMY LOCAL UNILAT	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 EAR LAVAGE FOR IMPACTION	$86.50	$173.00	$15.75–$1,350.00	30% below	50%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 EAR LAVAGE FOR IMPACTION	$86.50	$173.00	$112.45–$138.40	—	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX WO CERVICAL DI	$1,350.50	$2,701.00	$49.01–$2,160.80	267% above	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BX WO CERVICAL DI	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY; FLEX; DX	$1,350.50	$2,701.00	$55.96–$2,160.80	71% above	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY; FLEX; DX	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Gallbladder removal, laparoscopic CPT 47562 LAP CHOLECYSTECOMY	$3,317.00	$6,634.00	$654.45–$9,587.11	45% below	50%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAP CHOLECYSTECOMY	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAP CHOLE W CHOLANGIOGRAPHY	$3,317.00	$6,634.00	$712.99–$9,587.11	60% below	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAP CHOLE W CHOLANGIOGRAPHY	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY OPEN	$3,317.00	$6,634.00	$875.00–$5,307.20	3% above	50%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLECYSTECTOMY OPEN	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Hammertoe correction surgery CPT 28285 HAMMERTOE OP; ONE TOE	$2,137.50	$4,275.00	$389.62–$5,331.59	39% below	50%
Hammertoe correction surgery inpatient CPT 28285 HAMMERTOE OP; ONE TOE	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Hemorrhoid banding (rubber band ligation) CPT 46221 BANDING OF HEMORRHOIDS	$1,350.50	$2,701.00	$180.63–$2,160.80	52% above	50%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 BANDING OF HEMORRHOIDS	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY I&E SIMPLE	$2,137.50	$4,275.00	$358.29–$4,506.34	41% below	50%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY I&E SIMPLE	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOM HYSTERECTOMY	$3,317.00	$6,634.00	$875.00–$5,307.20	21% below	50%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABDOM HYSTERECTOMY	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HYSTEROGR/SIS CONTR/SALINE INJ	$1,350.50	$2,701.00	$57.48–$2,160.80	253% above	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HYSTEROGR/SIS CONTR/SALINE INJ	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY; W ENDOMETRIAL AB	$2,531.00	$5,062.00	$244.94–$8,111.65	49% below	50%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY; W ENDOMETRIAL AB	$2,531.00	$5,062.00	$1,000.00–$3,442.16	—	50%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY W/BIOPSY	$2,137.50	$4,275.00	$230.30–$5,224.65	55% below	50%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY W/BIOPSY	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
IUD insertion (the device itself billed separately) CPT 58300 INSERT IUD	$1,350.50	$2,701.00	$50.66–$2,160.80	256% above	50%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT IUD	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABCESS SIMPLE	$355.00	$710.00	$52.87–$875.00	24% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAIN ABSCESS SIMPLE	$1,350.50	$2,701.00	$52.87–$2,160.80	189% above	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAIN ABSCESS SIMPLE	$238.00	$476.00	$309.40–$380.80	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABCESS SIMPLE	$355.00	$710.00	$461.50–$568.00	—	50%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HERNIA RPR INITIAL INGUINAL >5	$2,531.00	$5,062.00	$520.99–$5,799.00	59% below	50%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HERNIA RPR INITIAL INGUINAL >5	$2,531.00	$5,062.00	$1,000.00–$3,442.16	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDON SHEATH/LIGAMENT	$174.00	$348.00	$25.20–$875.00	61% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$1,350.50	$2,701.00	$25.20–$2,160.80	206% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT TENDON SHEATH/LIGAMENT	$174.00	$348.00	$226.20–$278.40	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA BEDSIDE	$264.00	$528.00	$21.63–$875.00	63% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHRO ASPIR/INJECT MAJ JOINT	$278.50	$557.00	$21.63–$875.00	61% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ MAJOR JNT/BURSA	$1,350.50	$2,701.00	$21.63–$2,160.80	89% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JOINT/BURSA BEDSIDE	$264.00	$528.00	$343.20–$422.40	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHRO ASPIR/INJECT MAJ JOINT	$278.50	$557.00	$362.05–$445.60	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ MAJOR JNT/BURSA	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$200.00	$400.00	$17.89–$875.00	68% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHRO ASPIR/INJECT MED JOINT	$200.00	$400.00	$17.89–$875.00	68% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ INTERM JNT/BURSA	$1,350.50	$2,701.00	$17.89–$2,160.80	114% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHRO ASPIR/INJECT MED JOINT	$200.00	$400.00	$260.00–$320.00	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$200.00	$400.00	$260.00–$320.00	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ INTERM JNT/BURSA	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHRO ASPIR/INJCT SMALL JOINT	$174.00	$348.00	$16.82–$875.00	63% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJECT SM JNT/BURSA	$1,350.50	$2,701.00	$16.82–$2,160.80	187% above	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHRO ASPIR/INJCT SMALL JOINT	$174.00	$348.00	$226.20–$278.40	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJECT SM JNT/BURSA	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPARO APPENDECTOMY	$3,317.00	$6,634.00	$598.66–$9,587.11	53% below	50%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPARO APPENDECTOMY	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 TLH; UTERUS 250 G OR LESS	$3,317.00	$6,634.00	$811.92–$17,107.87	60% below	50%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 TLH; UTERUS 250 G OR LESS	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 TLH W/T/O 250 G OR LESS	$3,317.00	$6,634.00	$911.79–$17,107.87	69% below	50%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 TLH W/T/O 250 G OR LESS	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 HERNIA REPAIR LAPARO INIT ING	$3,317.00	$6,634.00	$431.85–$9,587.11	73% below	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 HERNIA REPAIR LAPARO INIT ING	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 HERNIA REPAIR LAPARO RECUR	$3,317.00	$6,634.00	$563.62–$9,587.11	59% below	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 HERNIA REPAIR LAPARO RECUR	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAP W REM ADNEXAL STRUCTURES	$3,317.00	$6,634.00	$654.40–$9,587.11	61% below	50%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAP W REM ADNEXAL STRUCTURES	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 wnd scp axi trnk ext 2.5 cm <	$240.00	$480.00	$152.84–$875.00	56% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INT REP S/A/T/EX; 2.5CM/<	$1,350.50	$2,701.00	$152.84–$2,160.80	149% above	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 wnd scp axi trnk ext 2.5 cm <	$240.00	$480.00	$312.00–$384.00	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INT REP S/A/T/EX; 2.5CM/<	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL	$2,137.50	$4,275.00	$656.31–$6,292.33	50% below	50%
Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Mastectomy (total removal of the breast) both sides CPT 19303 MASTECTOMY SIMPLE COMP BILAT	$2,996.50	$5,993.00	$950.35–$10,716.16	—	50%
Mastectomy (total removal of the breast) one side CPT 19303 MASTECTOMY SIMPLE UNILAT	$2,531.00	$5,062.00	$950.35–$10,716.16	58% below	50%
Mastectomy (total removal of the breast) inpatient both sides CPT 19303 MASTECTOMY SIMPLE COMP BILAT	$2,996.50	$5,993.00	$1,000.00–$4,075.24	—	50%
Mastectomy (total removal of the breast) inpatient one side CPT 19303 MASTECTOMY SIMPLE UNILAT	$2,531.00	$5,062.00	$1,000.00–$3,442.16	—	50%
Miscarriage treatment with D&C, first trimester CPT 59820 SURG TX MISCARRIAGE 1ST TRIM	$2,137.50	$4,275.00	$387.25–$5,224.65	41% below	50%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 SURG TX MISCARRIAGE 1ST TRIM	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 < CM	$1,350.50	$2,701.00	$85.26–$2,160.80	65% above	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR-EXT B9+MARG 0.5 < CM	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC LESION FACE B9 0.5CM/<	$1,350.50	$2,701.00	$98.37–$2,160.80	47% above	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC LESION FACE B9 0.5CM/<	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Nail removal (partial or complete), one nail CPT 11730 REMOVE NAIL & PLATE SINGLE	$174.50	$349.00	$53.76–$875.00	51% below	50%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$1,350.50	$2,701.00	$53.76–$2,160.80	279% above	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVE NAIL & PLATE SINGLE	$174.50	$349.00	$226.85–$279.20	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Occipital nerve block (injection for headaches) CPT 64405 NERVE BLOCK OCCIPITAL	$442.00	$884.00	$32.20–$875.00	4% above	50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 NERVE BLOCK OCCIPITAL	$442.00	$884.00	$574.60–$707.20	—	50%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,743.50	$3,487.00	$105.56–$2,789.60	7% above	50%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$1,743.50	$3,487.00	$2,266.55–$2,789.60	—	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL PLATE & MATRIX	$341.50	$683.00	$96.27–$875.00	57% below	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL & MATRIX	$1,350.50	$2,701.00	$96.27–$2,160.80	70% above	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL PLATE & MATRIX	$341.50	$683.00	$443.95–$546.40	—	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL & MATRIX	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Prostate biopsy CPT 55700 PROSTATE NEEDLE PUNCH BX	$1,743.50	$3,487.00	$128.19–$3,366.14	34% below	50%
Prostate biopsy inpatient CPT 55700 PROSTATE NEEDLE PUNCH BX	$1,743.50	$3,487.00	$1,000.00–$2,371.16	—	50%
Removal of a breast lump, open surgery CPT 19120 EXC BREAST LESION ONE/MORE	$2,137.50	$4,275.00	$417.24–$6,292.33	57% below	50%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC BREAST LESION ONE/MORE	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY SIMPLE	$1,350.50	$2,701.00	$103.63–$2,160.80	112% above	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY SIMPLE	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 TOTAL THYROID LOBECTOMY; UNILA	$3,317.00	$6,634.00	$708.95–$9,587.11	57% below	50%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 TOTAL THYROID LOBECTOMY; UNILA	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 SCRN COLONOSCOPY LOW RISK PT	$1,350.50	$2,701.00	$182.68–$2,160.80	73% above	50%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 SCRN COLONOSCOPY LOW RISK PT	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 SCRN COLONOSCOPY ON HI RISK PT	$1,350.50	$2,701.00	$182.44–$2,160.80	26% above	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 SCRN COLONOSCOPY ON HI RISK PT	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Short arm cast (elbow to hand) CPT 29075 CASTING ARM SHORT	$165.50	$331.00	$53.56–$875.00	46% below	50%
Short arm cast (elbow to hand) inpatient CPT 29075 CASTING ARM SHORT	$165.50	$331.00	$215.15–$264.80	—	50%
Short arm splint (forearm and hand) CPT 29125 SPLINT/STRAP ARM; SHORT	$144.50	$289.00	$40.66–$875.00	50% below	50%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT/STRAP ARM; SHORT	$144.50	$289.00	$187.85–$231.20	—	50%
Short leg cast (below the knee) CPT 29405 CASTING LEG SHORT	$183.00	$366.00	$46.91–$875.00	46% below	50%
Short leg cast (below the knee) inpatient CPT 29405 CASTING LEG SHORT	$183.00	$366.00	$237.90–$292.80	—	50%
Short leg splint (calf to foot) CPT 29515 SPLINT/STRAP LEG SHORT	$144.50	$289.00	$33.11–$875.00	54% below	50%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT/STRAP LEG SHORT	$144.50	$289.00	$187.85–$231.20	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SIMPLE 2.5CM OR LESS	$196.50	$393.00	$44.42–$875.00	53% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SREP S/N/A/G/TR/E; 2.5CM/<	$1,350.50	$2,701.00	$44.42–$2,160.80	220% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPAIR SIMPLE 2.5CM OR LESS	$196.50	$393.00	$255.45–$314.40	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SREP S/N/A/G/TR/E; 2.5CM/<	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$343.50	$687.00	$46.87–$1,350.00	25% below	50%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$343.50	$687.00	$446.55–$549.60	—	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC MLES;T/A/L;0.5CM/<	$1,350.50	$2,701.00	$123.17–$2,160.80	11% above	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC MLES;T/A/L;0.5CM/<	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAGS; TO 15	$1,350.50	$2,701.00	$77.54–$2,160.80	324% above	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKIN TAGS; TO 15	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$243.00	$486.00	$61.72–$1,137.96	77% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PUNCTURE LUMBAR BEDSIDE	$358.00	$716.00	$61.72–$1,137.96	66% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PUNCTURE LUMBAR	$1,350.50	$2,701.00	$61.72–$2,160.80	29% above	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$243.00	$486.00	$315.90–$388.80	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PUNCTURE LUMBAR BEDSIDE	$358.00	$716.00	$465.40–$572.80	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PUNCTURE LUMBAR	$358.00	$716.00	$465.40–$572.80	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SIMPLE 2.6-7.5CM	$205.50	$411.00	$58.03–$875.00	57% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SREPS/N/A/G/TR/E; 2.6-7.5CM	$1,350.50	$2,701.00	$58.03–$2,160.80	185% above	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPAIR SIMPLE 2.6-7.5CM	$205.50	$411.00	$267.15–$328.80	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SREPS/N/A/G/TR/E; 2.6-7.5CM	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR SIMPLE FACE 2.5CM<	$225.50	$451.00	$54.45–$875.00	47% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SREP F/E/N/L/MM; 2.5CM/<	$1,350.50	$2,701.00	$54.45–$2,160.80	218% above	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPAIR SIMPLE FACE 2.5CM<	$225.50	$451.00	$293.15–$360.80	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SREP F/E/N/L/MM; 2.5CM/<	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$1,350.50	$2,701.00	$37.87–$2,160.80	275% above	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$411.00	$822.00	$108.55–$1,350.00	71% below	50%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$411.00	$822.00	$534.30–$657.60	—	50%
Tonsil and adenoid removal, age 12 or older CPT 42821 T & A; AGE 12 OR MORE	$2,137.50	$4,275.00	$309.74–$5,329.06	43% below	50%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 T & A; AGE 12 OR MORE	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Tonsil and adenoid removal, child under 12 CPT 42820 T & A; UNDER AGE 12	$2,137.50	$4,275.00	$295.78–$9,720.70	55% below	50%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 T & A; UNDER AGE 12	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY; AGE 12 OR MORE	$2,137.50	$4,275.00	$260.53–$5,329.06	52% below	50%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY; AGE 12 OR MORE	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTOMY UNDER 12	$2,137.50	$4,275.00	$273.97–$9,720.70	53% below	50%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 TONSILLECTOMY UNDER 12	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMY TOTAL	$3,317.00	$6,634.00	$915.46–$9,587.11	65% below	50%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 THYROIDECTOMY TOTAL	$3,317.00	$6,634.00	$1,000.00–$4,511.12	—	50%
Trigger finger release surgery CPT 26055 TRIGGER FINGER RELEASE	$1,743.50	$3,487.00	$299.33–$2,789.60	48% below	50%
Trigger finger release surgery inpatient CPT 26055 TRIGGER FINGER RELEASE	$1,743.50	$3,487.00	$1,000.00–$2,371.16	—	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECT TRIGGER POINT 1-2	$154.00	$308.00	$29.41–$875.00	73% below	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECT TRIGGER POINT 1-2	$154.00	$308.00	$200.20–$246.40	—	50%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 TUBAL CAUTERY LAPARO	$2,480.50	$4,961.00	$375.24–$9,587.11	50% below	50%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 TUBAL CAUTERY LAPARO	$2,480.50	$4,961.00	$1,000.00–$3,373.48	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAGE	$1,646.50	$3,293.00	$152.90–$2,662.40	40% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BX 1ST LESION	$1,646.50	$3,293.00	$152.90–$2,662.40	40% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BX 1ST LESION	$1,646.50	$3,293.00	$1,000.00–$2,239.24	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST 1ST LESION US IMAGE	$1,646.50	$3,293.00	$1,000.00–$2,239.24	—	50%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD BALLOON DIL ESOPH < 30 M	$1,743.50	$3,487.00	$151.90–$3,117.16	19% above	50%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD BALLOON DIL ESOPH < 30 M	$1,743.50	$3,487.00	$1,000.00–$2,371.16	—	50%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$1,743.50	$3,487.00	$136.91–$2,789.60	82% above	50%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$1,743.50	$3,487.00	$1,000.00–$2,371.16	—	50%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD WITH REM T/P/LES BY SNARE	$1,743.50	$3,487.00	$193.81–$3,117.16	53% above	50%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD WITH REM T/P/LES BY SNARE	$1,743.50	$3,487.00	$1,000.00–$2,371.16	—	50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD W GUIDE WIRE AND DILATION	$1,743.50	$3,487.00	$164.21–$2,789.60	138% above	50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD W GUIDE WIRE AND DILATION	$1,743.50	$3,487.00	$1,000.00–$2,371.16	—	50%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC	$1,743.50	$3,487.00	$121.37–$2,789.60	65% above	50%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC	$1,743.50	$3,487.00	$1,000.00–$2,371.16	—	50%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY; UNIL OR BILAT	$2,137.50	$4,275.00	$230.20–$3,420.00	—	50%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY; UNIL OR BILAT	$2,137.50	$4,275.00	$1,000.00–$2,907.00	—	50%
Wart removal, up to 14 warts CPT 17110 DESTRUCT OF LESIONS UP TO 14	$1,350.50	$2,701.00	$68.20–$2,160.80	540% above	50%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT OF LESIONS UP TO 14	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRDE SKIN/TISS/MUSC 1ST 20CM	$223.00	$446.00	$59.76–$1,175.00	78% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$223.00	$446.00	$59.76–$1,175.00	78% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRDE SUBQ TISSUE 20CM<	$223.00	$446.00	$59.76–$1,175.00	78% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBR SKIN TO SQ TISS 1ST 20CM	$1,350.50	$2,701.00	$59.76–$2,160.80	32% above	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRDE SUBQ TISSUE 20CM<	$223.00	$446.00	$289.90–$356.80	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRDE SKIN/TISS/MUSC 1ST 20CM	$223.00	$446.00	$289.90–$356.80	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$223.00	$446.00	$289.90–$356.80	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBR SKIN TO SQ TISS 1ST 20CM	$1,350.50	$2,701.00	$1,000.00–$1,836.68	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSN UP TO 2 UNITS	$503.50	$1,007.00	$25.90–$875.00	47% below	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSN UP TO 2 UNITS	$503.50	$1,007.00	$654.55–$805.60	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HUMIDIFIER THERAPY PER DAY	$173.00	$346.00	$9.20–$432.31	15% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT EACH	$182.00	$364.00	$9.20–$432.31	11% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEBULIZER TREATMENT	$182.00	$364.00	$9.20–$432.31	11% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ULTRASONIC NEBULIZER TREATMENT	$182.00	$364.00	$9.20–$432.31	11% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MULTIDOSE INHALER TX W/AEROCH	$182.00	$364.00	$9.20–$432.31	11% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB INIT INCL O2	$182.00	$364.00	$9.20–$432.31	11% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL CONT MAX P/24 HR	$294.50	$589.00	$9.20–$471.20	45% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HUMIDIFIER THERAPY PER DAY	$173.00	$346.00	$224.90–$276.80	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TREATMENT EACH	$182.00	$364.00	$236.60–$291.20	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB INIT INCL O2	$182.00	$364.00	$236.60–$291.20	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND HELD NEBULIZER TREATMENT	$182.00	$364.00	$236.60–$291.20	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MULTIDOSE INHALER TX W/AEROCH	$182.00	$364.00	$236.60–$291.20	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ULTRASONIC NEBULIZER TREATMENT	$182.00	$364.00	$236.60–$291.20	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL CONT MAX P/24 HR	$294.50	$589.00	$382.85–$471.20	—	50%
Chemotherapy IV infusion, first hour CPT 96413 IV INFUSION 1ST HR REMICADE	$172.00	$344.00	$133.68–$545.04	72% below	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INFUSION 1ST HR REMICADE	$172.00	$344.00	$223.60–$275.20	—	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST 30-74 MINUTE	$360.00	$720.00	$213.11–$2,649.00	86% below	50%
Critical care, first 30 to 74 minutes CPT 99291 CRTCL CARE 1ST 30-74 MINS	$1,429.50	$2,859.00	$213.11–$2,649.00	45% below	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST 30-74 MINUTE	$360.00	$720.00	$468.00–$576.00	—	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRTCL CARE 1ST 30-74 MINS	$1,429.50	$2,859.00	$1,858.35–$2,287.20	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG RHYTHM STRIP	$200.50	$401.00	$6.44–$320.80	32% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD	$200.50	$401.00	$6.44–$320.80	32% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG RHYTHM STRIP	$200.50	$401.00	$260.65–$320.80	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD	$200.50	$401.00	$260.65–$320.80	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LEVEL 1	$145.50	$291.00	$11.65–$345.00	49% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED 2ND VISIT	$145.50	$291.00	$11.65–$345.00	49% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED 2ND VISIT	$145.50	$291.00	$189.15–$232.80	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED LEVEL 1	$145.50	$291.00	$189.15–$232.80	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LEVEL 2	$239.50	$479.00	$41.70–$512.00	50% below	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED LEVEL 2	$239.50	$479.00	$311.35–$383.20	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 SANE EXAM MODERATE	$116.50	$233.00	$71.54–$918.00	86% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LEVEL 3	$377.50	$755.00	$71.54–$918.00	54% below	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 SANE EXAM MODERATE	$116.50	$233.00	$151.45–$186.40	—	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED LEVEL 3	$377.50	$755.00	$490.75–$604.00	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 SANE EXAM HIGH	$116.50	$233.00	$72.70–$1,460.00	91% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED LEVEL 4	$601.00	$1,202.00	$120.58–$1,460.00	56% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 SANE EXAM HIGH	$116.50	$233.00	$151.45–$186.40	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED LEVEL 4	$601.00	$1,202.00	$781.30–$961.60	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LEVEL 5	$892.00	$1,784.00	$175.20–$1,850.00	62% below	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED LEVEL 5	$892.00	$1,784.00	$1,159.60–$1,427.20	—	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 LEXISCAN STRESS TEST	$478.50	$957.00	$36.67–$765.60	67% below	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOLYTE STRESS	$478.50	$957.00	$36.67–$765.60	67% below	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 LEXISCAN STRESS TEST	$478.50	$957.00	$622.05–$765.60	—	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOLYTE STRESS	$478.50	$957.00	$622.05–$765.60	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1ST HR ED	$98.50	$197.00	$33.33–$346.21	80% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1ST HR MED SURG	$98.50	$197.00	$33.33–$346.21	80% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1ST HR L&D	$98.50	$197.00	$33.33–$346.21	80% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1ST HR L&D	$98.50	$197.00	$128.05–$157.60	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1ST HR MED SURG	$98.50	$197.00	$128.05–$157.60	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1ST HR ED	$98.50	$197.00	$128.05–$157.60	—	50%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION TX 1ST HR L&D	$132.50	$265.00	$65.41–$346.21	74% below	50%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION TX 1ST HR ED	$132.50	$265.00	$65.41–$346.21	74% below	50%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION TX 1ST HR MED SURG	$132.50	$265.00	$65.41–$346.21	74% below	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION TX 1ST HR MED SURG	$132.50	$265.00	$172.25–$212.00	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION TX 1ST HR ED	$132.50	$265.00	$172.25–$212.00	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION TX 1ST HR L&D	$132.50	$265.00	$172.25–$212.00	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/SC	$47.50	$95.00	$14.37–$142.10	72% below	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM/SC	$47.50	$95.00	$61.75–$76.00	—	50%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSC RE-ED EA 15 MINS	$48.50	$97.00	$31.15–$100.00	57% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUC 15 MINS	$49.50	$99.00	$31.15–$100.00	56% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 SENSORY INTEGRATION 15 MIN	$64.00	$128.00	$31.15–$102.40	44% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 BALANCE DEVELOPMENT EA 15 MIN	$66.50	$133.00	$31.15–$106.40	42% below	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSC RE-ED EA 15 MINS	$48.50	$97.00	$63.05–$77.60	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUC 15 MINS	$49.50	$99.00	$64.35–$79.20	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 SENSORY INTEGRATION 15 MIN	$64.00	$128.00	$83.20–$102.40	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 BALANCE DEVELOPMENT EA 15 MIN	$66.50	$133.00	$86.45–$106.40	—	50%
New patient office visit, about 30 minutes CPT 99203 NURSING SVC NEW PT 30 MIN	$109.50	$219.00	$82.67–$182.08	57% below	50%
New patient office visit, about 30 minutes inpatient CPT 99203 NURSING SVC NEW PT 30 MIN	$109.50	$219.00	$142.35–$175.20	—	50%
New patient office visit, about 45 minutes CPT 99204 NURSING SVC NEW PT 45 MIN	$139.50	$279.00	$133.40–$308.27	57% below	50%
New patient office visit, about 45 minutes inpatient CPT 99204 NURSING SVC NEW PT 45 MIN	$139.50	$279.00	$181.35–$223.20	—	50%
New patient office visit, about 60 minutes CPT 99205 NON-FACILITY SETTING EXAM	$62.50	$125.00	$65.00–$402.30	81% below	50%
New patient office visit, about 60 minutes CPT 99205 NURSING SVC NEW PT 60 MIN	$204.00	$408.00	$181.16–$402.30	39% below	50%
New patient office visit, about 60 minutes inpatient CPT 99205 NON-FACILITY SETTING EXAM	$62.50	$125.00	$81.25–$100.00	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 NURSING SVC NEW PT 60 MIN	$204.00	$408.00	$265.20–$326.40	—	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NURSING SVC NEW PT 20 MIN	$86.00	$172.00	$48.11–$137.60	56% below	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NURSING SVC NEW PT 20 MIN	$86.00	$172.00	$111.80–$137.60	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INIT INDIV EA 15 MIN	$34.00	$68.00	$32.98–$100.00	42% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INIT INDIV EA 15 MIN	$34.00	$68.00	$44.20–$54.40	—	50%
Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION 30 MINS	$92.50	$185.00	$96.20–$218.50	66% below	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION 30 MINS	$92.50	$185.00	$120.25–$148.00	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION 45 MIN	$145.00	$290.00	$95.34–$232.00	53% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION 45 MIN	$145.00	$290.00	$188.50–$232.00	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION 20 MIN	$66.50	$133.00	$69.16–$203.25	72% below	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION 20 MIN	$66.50	$133.00	$86.45–$106.40	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION 30 MIN	$95.50	$191.00	$95.34–$203.25	67% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION 30 MIN	$95.50	$191.00	$124.15–$152.80	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 TRACTION P/DAY	$46.00	$92.00	$26.44–$100.00	59% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 TRACTION MANUAL EA 15 MINS	$47.50	$95.00	$26.44–$100.00	58% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 SOFT TISSUE MOBILIZ	$55.50	$111.00	$26.44–$100.00	51% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 JOINT MOBILIZATION	$55.50	$111.00	$26.44–$100.00	51% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MYOFASCIAL RELEASE EA 15 MINS	$58.00	$116.00	$26.44–$100.00	49% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL TRACTION	$70.00	$140.00	$26.44–$112.00	38% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 TRACTION P/DAY	$46.00	$92.00	$59.80–$73.60	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 TRACTION MANUAL EA 15 MINS	$47.50	$95.00	$61.75–$76.00	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 SOFT TISSUE MOBILIZ	$55.50	$111.00	$72.15–$88.80	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 JOINT MOBILIZATION	$55.50	$111.00	$72.15–$88.80	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MYOFASCIAL RELEASE EA 15 MINS	$58.00	$116.00	$75.40–$92.80	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL TRACTION	$70.00	$140.00	$91.00–$112.00	—	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THER EXERCISE EA 15 MIN	$33.50	$67.00	$28.00–$100.00	73% below	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE EA 15 MIN	$58.00	$116.00	$28.00–$100.00	53% below	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THER EXERCISE EA 15 MIN	$33.50	$67.00	$43.55–$53.60	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE EA 15 MIN	$58.00	$116.00	$75.40–$92.80	—	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 NURSING SVC EST PT 40 MIN	$139.00	$278.00	$143.71–$265.08	55% below	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 NURSING SVC EST PT 40 MIN	$139.00	$278.00	$180.70–$222.40	—	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 NURSING SVC EST PT 15 MIN	$86.00	$172.00	$66.17–$137.60	59% below	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 NURSING SVC EST PT 15 MIN	$86.00	$172.00	$111.80–$137.60	—	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 NURSING SVC EST PT 25 MIN	$109.50	$219.00	$97.80–$188.02	60% below	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 NURSING SVC EST PT 25 MIN	$109.50	$219.00	$142.35–$175.20	—	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 NURSING SVC EST PT 10 MIN	$83.00	$166.00	$35.56–$132.80	49% below	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 NURSING SVC EST PT 10 MIN	$83.00	$166.00	$107.90–$132.80	—	50%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMP EVAL	$168.00	$336.00	$100.00–$469.20	60% below	50%
Speech and language evaluation CPT 92523 ALTERNATIVE AUG CO 1st HOUR	$206.50	$413.00	$100.00–$469.20	51% below	50%
Speech and language evaluation CPT 92523 MYOFUNCTIONAL EVALUATION	$236.00	$472.00	$100.00–$469.20	44% below	50%
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMP EVAL	$168.00	$336.00	$218.40–$268.80	—	50%
Speech and language evaluation inpatient CPT 92523 ALTERNATIVE AUG CO 1st HOUR	$206.50	$413.00	$268.45–$330.40	—	50%
Speech and language evaluation inpatient CPT 92523 MYOFUNCTIONAL EVALUATION	$236.00	$472.00	$306.80–$377.60	—	50%
Speech therapy session, individual CPT 92507 SPEECH/LANG/VOICE THERAPY	$102.50	$205.00	$73.22–$188.87	55% below	50%
Speech therapy session, individual inpatient CPT 92507 SPEECH/LANG/VOICE THERAPY	$102.50	$205.00	$133.25–$164.00	—	50%
Spirometry (breathing test) CPT 94010 SIMPLE PFT RESP SCREEN	$173.00	$346.00	$27.36–$335.00	56% below	50%
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$201.00	$402.00	$27.36–$335.00	49% below	50%
Spirometry (breathing test) inpatient CPT 94010 SIMPLE PFT RESP SCREEN	$173.00	$346.00	$224.90–$276.80	—	50%
Spirometry (breathing test) inpatient CPT 94010 BREATHING CAPACITY TEST	$201.00	$402.00	$261.30–$321.60	—	50%
Spirometry before and after a bronchodilator CPT 94060 PFT PRE/POST	$253.00	$506.00	$39.43–$511.70	60% below	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT PRE/POST	$253.00	$506.00	$328.90–$404.80	—	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 KINETIC ACTIVITIES EA 15 MINS	$73.00	$146.00	$33.49–$116.80	38% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 LUMBAR SCREENING	$100.00	$200.00	$33.49–$160.00	15% below	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 KINETIC ACTIVITIES EA 15 MINS	$73.00	$146.00	$94.90–$116.80	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 LUMBAR SCREENING	$100.00	$200.00	$130.00–$160.00	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$78.00	$156.00	$81.12–$211.81	69% below	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$78.00	$156.00	$101.40–$124.80	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID VAC 30mcg/0.3mL -12y+	$115.00	$230.00	$119.60–$272.82	4% above	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID VAC 30mcg/0.3mL -12y+	$115.00	$230.00	$149.50–$184.00	—	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20	$112.66	$225.31	$117.16–$547.58	80% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20	$112.66	$225.31	$146.45–$180.25	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMO POLYS VACC 2YRS+ SQ/IM	$42.00	$84.00	$43.68–$233.57	84% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 0.5 ML INJ	$43.31	$86.62	$34.65–$233.57	84% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMO POLYS VACC 2YRS+ SQ/IM	$42.00	$84.00	$54.60–$67.20	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 0.5 ML INJ	$43.31	$86.62	$56.30–$69.30	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE NO PRSRV >= 7 IM	$10.46	$20.91	$8.36–$27.78	92% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACCINE NO PRSRV >= 7 IM	$10.46	$20.91	$13.59–$16.73	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL VACCINE INJ	$16.91	$33.82	$13.53–$40.31	90% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL VACCINE INJ	$16.91	$33.82	$21.98–$27.06	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN IMMUN SINGLE ED	$47.50	$95.00	$20.57–$142.10	39% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN IMMUN SINGLE L&D	$47.50	$95.00	$20.57–$142.10	39% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN IMMUN SINGLE MED/SURG	$47.50	$95.00	$20.57–$142.10	39% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN IMMUN SINGLE NURSERY	$47.50	$95.00	$20.57–$142.10	39% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN IMMUN SINGLE MED/SURG	$47.50	$95.00	$61.75–$76.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN IMMUN SINGLE L&D	$47.50	$95.00	$61.75–$76.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN IMMUN SINGLE NURSERY	$47.50	$95.00	$61.75–$76.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN IMMUN SINGLE ED	$47.50	$95.00	$61.75–$76.00	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN IMMUN EA ADDL L&D	$47.50	$95.00	$14.72–$76.00	11% below	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN IMMUN EA ADDL NURSERY	$47.50	$95.00	$14.72–$76.00	11% below	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN IMMUN EA ADDL MED/SURG	$47.50	$95.00	$14.72–$76.00	11% below	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN IMMUN EA ADDL L&D	$47.50	$95.00	$61.75–$76.00	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN IMMUN EA ADDL NURSERY	$47.50	$95.00	$61.75–$76.00	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN IMMUN EA ADDL MED/SURG	$47.50	$95.00	$61.75–$76.00	—	50%

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/7829/751997880_andrews-county-hospital-district_standardcharges.csv