Hospital

Harrison County Community Hospital

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

Harrison County Community Hospital in Bethany, MO publishes cash prices for 338 common procedures listed here, from its own machine-readable price file updated Sep 10, 2025. Compared with other hospitals in the state, its outpatient cash prices are below the Missouri median for 306 of 335 procedures and above it for 26. By typical cash price it ranks #9 of 60 Missouri hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

2600 Miller Street, Bethany, MO 64424 Collected Sep 27, 2026 Source price file (660) 425-2211

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 3 of 5 CCN 261312 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 ANKLE BILATERAL 3 VIEW	$195.00	$300.00	$100.48–$270.00	—	35%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE LEFT 3 VIEW	$195.00	$300.00	$100.48–$270.00	35% below	35%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE RIGHT 3 VIEW	$195.00	$300.00	$100.48–$270.00	35% below	35%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 ANKLE BILATERAL 3 VIEW	$195.00	$300.00	$240.00–$270.00	—	35%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE RIGHT 3 VIEW	$195.00	$300.00	$240.00–$270.00	—	35%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE LEFT 3 VIEW	$195.00	$300.00	$240.00–$270.00	—	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ABI	$72.07	$110.87	$63.20–$140.07	79% below	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ABI	$72.07	$110.87	$88.70–$99.78	—	35%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS	$224.25	$345.00	$196.65–$310.50	48% below	35%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS	$224.25	$345.00	$276.00–$310.50	—	35%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE/JOINT WHOLE BODY	$742.62	$1,142.48	$468.27–$1,028.23	50% below	35%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE/JOINT WHOLE BODY	$742.62	$1,142.48	$913.98–$1,028.23	—	35%
Breast ultrasound, complete, one breast both sides CPT 76641 BILATERAL BREAST COM W/ 50 MOD	$390.00	$600.00	$135.24–$540.00	—	35%
Breast ultrasound, complete, one breast one side CPT 76641 UNILATERAL BREAST COM W/LT MOD	$325.00	$500.00	$135.24–$450.00	15% below	35%
Breast ultrasound, complete, one breast one side CPT 76641 UNILATERAL BREAST COM W/RT MOD	$325.00	$500.00	$135.24–$450.00	15% below	35%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 BILATERAL BREAST COM W/ 50 MOD	$390.00	$600.00	$480.00–$540.00	—	35%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 UNILATERAL BREAST COM W/RT MOD	$325.00	$500.00	$400.00–$450.00	—	35%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 UNILATERAL BREAST COM W/LT MOD	$325.00	$500.00	$400.00–$450.00	—	35%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 BILATERAL BREAST LIM W/ 50 MOD	$325.00	$500.00	$100.48–$450.00	—	35%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 UNILATERAL BREAST LIM W/LT MOD	$260.00	$400.00	$100.48–$360.00	12% below	35%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 UNILATERAL BREAST LIM W/RT MOD	$260.00	$400.00	$100.48–$360.00	12% below	35%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 BILATERAL BREAST LIM W/ 50 MOD	$325.00	$500.00	$400.00–$450.00	—	35%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 UNILATERAL BREAST LIM W/LT MOD	$260.00	$400.00	$320.00–$360.00	—	35%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 UNILATERAL BREAST LIM W/RT MOD	$260.00	$400.00	$320.00–$360.00	—	35%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST W/WO	$1,300.00	$2,000.00	$221.89–$1,800.00	33% below	35%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO PULMONARY	$1,365.00	$2,100.00	$221.89–$1,890.00	30% below	35%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO THORACIC AORTA	$1,365.00	$2,100.00	$221.89–$1,890.00	30% below	35%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST W/WO	$1,300.00	$2,000.00	$1,600.00–$1,800.00	—	35%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO THORACIC AORTA	$1,365.00	$2,100.00	$1,680.00–$1,890.00	—	35%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO PULMONARY	$1,365.00	$2,100.00	$1,680.00–$1,890.00	—	35%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PELVIS WO	$1,755.00	$2,700.00	$285.82–$2,430.00	17% below	35%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD PELVIS WO	$1,755.00	$2,700.00	$2,160.00–$2,430.00	—	35%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PELVIS W	$1,852.50	$2,850.00	$457.44–$2,565.00	22% below	35%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD PELVIS W	$1,852.50	$2,850.00	$2,280.00–$2,565.00	—	35%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD PELVIS W/WO	$1,982.50	$3,050.00	$457.44–$2,745.00	32% below	35%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD PELVIS W/WO	$1,982.50	$3,050.00	$2,440.00–$2,745.00	—	35%
CT scan of the abdomen with contrast CPT 74160 CT ABD W/CONT	$1,202.50	$1,850.00	$221.89–$1,665.00	23% below	35%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD W/CONT	$1,202.50	$1,850.00	$1,480.00–$1,665.00	—	35%
CT scan of the abdomen without contrast CPT 74150 CT ABD W/O CONT	$1,105.00	$1,700.00	$135.24–$1,530.00	3% above	35%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD W/O CONT	$1,105.00	$1,700.00	$1,360.00–$1,530.00	—	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXOFACL AREA W/O CONTRAST	$926.25	$1,425.00	$135.24–$1,282.50	14% below	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES COMPLETE W/O	$1,007.50	$1,550.00	$135.24–$1,395.00	7% below	35%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXOFACL AREA W/O CONTRAST	$926.25	$1,425.00	$1,140.00–$1,282.50	—	35%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES COMPLETE W/O	$1,007.50	$1,550.00	$1,240.00–$1,395.00	—	35%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONT	$910.00	$1,400.00	$135.24–$1,260.00	28% below	35%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONT	$910.00	$1,400.00	$1,120.00–$1,260.00	—	35%
CT scan of the head with contrast CPT 70460 CT HEAD W/CONT	$1,007.50	$1,550.00	$221.89–$1,395.00	30% below	35%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/CONT	$1,007.50	$1,550.00	$1,240.00–$1,395.00	—	35%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONT	$1,137.50	$1,750.00	$221.89–$1,575.00	36% below	35%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO CONT	$1,137.50	$1,750.00	$1,400.00–$1,575.00	—	35%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONT	$1,040.00	$1,600.00	$135.24–$1,440.00	25% below	35%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONT	$1,040.00	$1,600.00	$1,280.00–$1,440.00	—	35%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERV SPINE W/O CONT	$975.00	$1,500.00	$135.24–$1,350.00	40% below	35%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERV SPINE W/O CONT	$975.00	$1,500.00	$1,200.00–$1,350.00	—	35%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONT	$1,056.25	$1,625.00	$221.89–$1,462.50	35% below	35%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONT	$1,056.25	$1,625.00	$1,300.00–$1,462.50	—	35%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID DOPPLER	$512.87	$789.02	$285.82–$710.12	38% below	35%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID DOPPLER	$512.87	$789.02	$631.22–$710.12	—	35%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEW OBLIQUE	$156.00	$240.00	$100.48–$216.00	38% below	35%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEW SUBSEQUENT	$156.00	$240.00	$100.48–$216.00	38% below	35%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEW FRONT/LAT	$156.00	$240.00	$100.48–$216.00	38% below	35%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEW FRONT/LAT	$156.00	$240.00	$192.00–$216.00	—	35%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEW OBLIQUE	$156.00	$240.00	$192.00–$216.00	—	35%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEW SUBSEQUENT	$156.00	$240.00	$192.00–$216.00	—	35%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW SUBSEQUENT	$162.50	$250.00	$100.48–$225.00	23% below	35%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW - PORTABLE OR PA	$162.50	$250.00	$100.48–$225.00	23% below	35%
Chest X-ray, single view CPT 71045 RADIOLOGY	$162.50	$250.00	$100.48–$225.00	23% below	35%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW - PORTABLE OR PA	$162.50	$250.00	$200.00–$225.00	—	35%
Chest X-ray, single view inpatient CPT 71045 RADIOLOGY	$162.50	$250.00	$200.00–$225.00	—	35%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW SUBSEQUENT	$162.50	$250.00	$200.00–$225.00	—	35%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL	$455.00	$700.00	$135.24–$630.00	20% below	35%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL	$455.00	$700.00	$560.00–$630.00	—	35%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA	$247.00	$380.00	$135.24–$342.00	28% below	35%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA	$247.00	$380.00	$304.00–$342.00	—	35%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX W/O CONT	$910.00	$1,400.00	$135.24–$1,260.00	29% below	35%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX W/O CONT	$910.00	$1,400.00	$1,120.00–$1,260.00	—	35%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONT	$1,072.50	$1,650.00	$221.89–$1,485.00	35% below	35%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONT	$1,072.50	$1,650.00	$1,320.00–$1,485.00	—	35%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG DIGITAL BILAT	$169.00	$260.00	$148.20–$234.00	—	35%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIAG DIGITAL BILAT	$169.00	$260.00	$208.00–$234.00	—	35%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG DIGITAL UNI LT	$136.50	$210.00	$119.70–$189.00	41% below	35%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG DIGITAL UNI RT	$136.50	$210.00	$119.70–$189.00	41% below	35%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG DIGITAL UNI RT	$136.50	$210.00	$168.00–$189.00	—	35%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG DIGITAL UNI LT	$136.50	$210.00	$168.00–$189.00	—	35%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX LOW EXT ART BILAT	$409.23	$629.58	$285.82–$566.62	—	35%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUPLEX LOW EXT ART BILAT	$409.23	$629.58	$503.66–$566.62	—	35%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX EXT VEINS BILAT	$521.10	$801.69	$285.82–$721.52	—	35%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX EXT VEINS BILAT	$521.10	$801.69	$641.35–$721.52	—	35%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMPLETE	$796.84	$1,225.90	$600.22–$1,103.31	47% below	35%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO COMPLETE	$796.84	$1,225.90	$980.72–$1,103.31	—	35%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATO BILIARY DUCT IMAG	$709.16	$1,091.01	$468.27–$981.91	48% below	35%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATO BILIARY DUCT IMAG	$709.16	$1,091.01	$872.81–$981.91	—	35%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Home Sleep Test	$399.75	$615.00	$173.43–$553.50	40% below	35%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Home Sleep Test	$399.75	$615.00	$492.00–$553.50	—	35%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG W/CPAP	$2,671.50	$4,110.00	$1,142.85–$3,699.00	2% above	35%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG W/CPAP	$2,671.50	$4,110.00	$3,288.00–$3,699.00	—	35%
Knee X-ray, 3 views both sides CPT 73562 KNEE BILATERAL 3 VIEW	$174.20	$268.00	$100.48–$241.20	—	35%
Knee X-ray, 3 views one side CPT 73562 KNEE LEFT 3 VIEW	$174.20	$268.00	$100.48–$241.20	36% below	35%
Knee X-ray, 3 views one side CPT 73562 KNEE RIGHT 3 VIEW	$174.20	$268.00	$100.48–$241.20	36% below	35%
Knee X-ray, 3 views inpatient both sides CPT 73562 KNEE BILATERAL 3 VIEW	$174.20	$268.00	$214.40–$241.20	—	35%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE LEFT 3 VIEW	$174.20	$268.00	$214.40–$241.20	—	35%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE RIGHT 3 VIEW	$174.20	$268.00	$214.40–$241.20	—	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$432.25	$665.00	$135.24–$598.50	14% below	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$432.25	$665.00	$532.00–$598.50	—	35%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI R HIP KNEE ANKLE WO	$1,131.00	$1,740.00	$285.82–$1,566.00	39% below	35%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI L HIP KNEE ANKLE WO	$1,131.00	$1,740.00	$285.82–$1,566.00	39% below	35%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI L HIP KNEE ANKLE WO	$1,131.00	$1,740.00	$1,392.00–$1,566.00	—	35%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI R HIP KNEE ANKLE WO	$1,131.00	$1,740.00	$1,392.00–$1,566.00	—	35%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI L HIP KNEE ANKL WO/W	$1,430.00	$2,200.00	$457.44–$1,980.00	36% below	35%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LE JT RT WO/W	$1,430.00	$2,200.00	$457.44–$1,980.00	36% below	35%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI L HIP KNEE ANKL WO/W	$1,430.00	$2,200.00	$1,760.00–$1,980.00	—	35%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LE JT RT WO/W	$1,430.00	$2,200.00	$1,760.00–$1,980.00	—	35%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO	$1,105.00	$1,700.00	$285.82–$1,530.00	33% below	35%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO	$1,105.00	$1,700.00	$1,360.00–$1,530.00	—	35%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO/W	$1,430.00	$2,200.00	$457.44–$1,980.00	41% below	35%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI OF ABD W/WO INCLUDES EVST	$2,015.00	$3,100.00	$457.44–$2,790.00	17% below	35%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO/W	$1,430.00	$2,200.00	$1,760.00–$1,980.00	—	35%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI OF ABD W/WO INCLUDES EVST	$2,015.00	$3,100.00	$2,480.00–$2,790.00	—	35%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO	$1,040.00	$1,600.00	$285.82–$1,440.00	36% below	35%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO	$1,040.00	$1,600.00	$1,280.00–$1,440.00	—	35%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/W	$1,365.00	$2,100.00	$457.44–$1,890.00	46% below	35%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO/W	$1,365.00	$2,100.00	$1,680.00–$1,890.00	—	35%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO	$1,007.50	$1,550.00	$285.82–$1,395.00	46% below	35%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WO	$1,007.50	$1,550.00	$1,240.00–$1,395.00	—	35%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE WO/W	$1,300.00	$2,000.00	$457.44–$1,800.00	48% below	35%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE WO/W	$1,300.00	$2,000.00	$1,600.00–$1,800.00	—	35%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE WO	$1,007.50	$1,550.00	$285.82–$1,395.00	43% below	35%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE WO	$1,007.50	$1,550.00	$1,240.00–$1,395.00	—	35%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE WO/W	$1,300.00	$2,000.00	$457.44–$1,800.00	48% below	35%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE WO/W	$1,300.00	$2,000.00	$1,600.00–$1,800.00	—	35%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE WO	$1,007.50	$1,550.00	$285.82–$1,395.00	49% below	35%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE WO	$1,007.50	$1,550.00	$1,240.00–$1,395.00	—	35%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/W	$1,365.00	$2,100.00	$457.44–$1,890.00	47% below	35%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO/W	$1,365.00	$2,100.00	$1,680.00–$1,890.00	—	35%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO	$1,040.00	$1,600.00	$285.82–$1,440.00	45% below	35%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO	$1,040.00	$1,600.00	$1,280.00–$1,440.00	—	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI R SHOLD ELBO WRST WO	$1,131.00	$1,740.00	$285.82–$1,566.00	39% below	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI L SHOLD ELBO WRST WO	$1,131.00	$1,740.00	$285.82–$1,566.00	39% below	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI R SHOLD ELBO WRST WO	$1,131.00	$1,740.00	$1,392.00–$1,566.00	—	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI L SHOLD ELBO WRST WO	$1,131.00	$1,740.00	$1,392.00–$1,566.00	—	35%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARD PERF SPECT MULTI	$1,641.72	$2,525.71	$1,439.65–$2,273.14	60% below	35%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARD PERF SPECT MULTI	$1,641.72	$2,525.71	$2,020.57–$2,273.14	—	35%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LTD	$221.00	$340.00	$135.24–$306.00	45% below	35%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LTD	$221.00	$340.00	$272.00–$306.00	—	35%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS COMP	$429.00	$660.00	$135.24–$594.00	34% below	35%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS COMP	$429.00	$660.00	$528.00–$594.00	—	35%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS > 14 WK	$290.55	$447.00	$135.24–$402.30	49% below	35%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTERUS > 14 WK	$290.55	$447.00	$357.60–$402.30	—	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTERUS < 14 WK	$396.50	$610.00	$135.24–$549.00	22% below	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTERUS < 14 WK	$396.50	$610.00	$488.00–$549.00	—	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREG UTERUS LIMITED	$214.50	$330.00	$135.24–$297.00	40% below	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREG UTERUS LIMITED	$214.50	$330.00	$264.00–$297.00	—	35%
Screening mammogram, both breasts CPT 77067 MAMMO SCREEN DIGITL ALL V	$136.50	$210.00	$119.70–$189.00	17% below	35%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN DIGITAL RT	$113.75	$175.00	$99.75–$163.60	31% below	35%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN DIGITAL LT	$113.75	$175.00	$99.75–$163.60	31% below	35%
Screening mammogram, both breasts inpatient CPT 77067 MAMMO SCREEN DIGITL ALL V	$136.50	$210.00	$168.00–$189.00	—	35%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN DIGITAL RT	$113.75	$175.00	$140.00–$157.50	—	35%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN DIGITAL LT	$113.75	$175.00	$140.00–$157.50	—	35%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LT COMP MIN 2VW	$151.45	$233.00	$100.48–$209.70	44% below	35%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RT COMP MIN 2VW	$151.45	$233.00	$100.48–$209.70	44% below	35%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER LT COMP MIN 2VW	$151.45	$233.00	$186.40–$209.70	—	35%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER RT COMP MIN 2VW	$151.45	$233.00	$186.40–$209.70	—	35%
Sleep study in a lab (polysomnography) CPT 95810 FULL SLEEP STUDY/PSG	$2,177.50	$3,350.00	$1,142.85–$3,015.00	14% below	35%
Sleep study in a lab (polysomnography) inpatient CPT 95810 FULL SLEEP STUDY/PSG	$2,177.50	$3,350.00	$2,680.00–$3,015.00	—	35%
Swallow study (modified barium swallow, video X-ray) CPT 74230 PHARYNGEAL EVAL VIDEO	$292.50	$450.00	$221.89–$405.00	34% below	35%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 PHARYNGEAL EVAL VIDEO	$292.50	$450.00	$360.00–$405.00	—	35%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$390.00	$600.00	$135.24–$540.00	33% below	35%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$390.00	$600.00	$480.00–$540.00	—	35%
Transvaginal ultrasound during pregnancy CPT 76817 US PREG UTERUS EV	$260.00	$400.00	$135.24–$360.00	44% below	35%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG UTERUS EV	$260.00	$400.00	$320.00–$360.00	—	35%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMP	$568.75	$875.00	$135.24–$787.50	28% below	35%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMP	$568.75	$875.00	$700.00–$787.50	—	35%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$382.20	$588.00	$135.24–$529.20	34% below	35%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$382.20	$588.00	$470.40–$529.20	—	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 THYROID	$325.00	$500.00	$135.24–$450.00	42% below	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$325.00	$500.00	$135.24–$450.00	42% below	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 THYROID	$325.00	$500.00	$400.00–$450.00	—	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK	$325.00	$500.00	$400.00–$450.00	—	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX EXT VEINS LEFT	$362.05	$556.99	$135.24–$501.29	36% below	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX EXT VEINS RIGHT	$362.05	$556.99	$135.24–$501.29	36% below	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX EXT VEINS RIGHT	$362.05	$556.99	$445.59–$501.29	—	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX EXT VEINS LEFT	$362.05	$556.99	$445.59–$501.29	—	35%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST LEFT MIN 3 VIEW	$175.50	$270.00	$100.48–$243.00	33% below	35%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST RIGHT MIN 3 VIEW	$175.50	$270.00	$100.48–$243.00	33% below	35%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST LEFT MIN 3 VIEW	$175.50	$270.00	$216.00–$243.00	—	35%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST RIGHT MIN 3 VIEW	$175.50	$270.00	$216.00–$243.00	—	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 PELVIS/HIP CHILD MIN 2 VW	$169.00	$260.00	$100.48–$234.00	29% below	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP RT UNILAT W/PELVIS 2-3 VWS	$169.00	$260.00	$100.48–$234.00	29% below	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP LT UNILAT W/PELVIS 2-3 VWS	$169.00	$260.00	$100.48–$234.00	29% below	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 PELVIS/HIP CHILD MIN 2 VW	$169.00	$260.00	$208.00–$234.00	—	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP RT UNILAT W/PELVIS 2-3 VWS	$169.00	$260.00	$208.00–$234.00	—	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP LT UNILAT W/PELVIS 2-3 VWS	$169.00	$260.00	$208.00–$234.00	—	35%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN SINGLE VIEW	$130.00	$200.00	$100.48–$180.00	40% below	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN SINGLE VIEW	$130.00	$200.00	$160.00–$180.00	—	35%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE RIGHT 2 VIEW	$119.60	$184.00	$100.48–$165.60	37% below	35%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE LEFT 2 VIEW	$119.60	$184.00	$100.48–$165.60	37% below	35%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE LEFT 2 VIEW	$119.60	$184.00	$147.20–$165.60	—	35%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE RIGHT 2 VIEW	$119.60	$184.00	$147.20–$165.60	—	35%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND 4TH DIG RT MIN 2 VW	$91.00	$140.00	$79.80–$126.00	56% below	35%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND THUMB LT MIN 2 VW	$91.00	$140.00	$79.80–$126.00	56% below	35%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND 5TH DIG RT MIN 2 VW	$91.00	$140.00	$79.80–$126.00	56% below	35%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND 4TH DIG LT MIN 2 VW	$91.00	$140.00	$79.80–$126.00	56% below	35%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND 3RD DIG LT MIN 2 VW	$91.00	$140.00	$79.80–$126.00	56% below	35%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND 3RD DIG RT MIN 2 VW	$91.00	$140.00	$79.80–$126.00	56% below	35%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND THUMB RT MIN 2 VW	$91.00	$140.00	$79.80–$126.00	56% below	35%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND 5TH DIG LT MIN 2 VW	$91.00	$140.00	$79.80–$126.00	56% below	35%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND 2ND DIG RT MIN 2 VW	$91.00	$140.00	$79.80–$126.00	56% below	35%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND 2ND DIG LT MIN 2 VW	$91.00	$140.00	$79.80–$126.00	56% below	35%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND THUMB RT MIN 2 VW	$91.00	$140.00	$112.00–$126.00	—	35%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND 4TH DIG LT MIN 2 VW	$91.00	$140.00	$112.00–$126.00	—	35%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND 3RD DIG LT MIN 2 VW	$91.00	$140.00	$112.00–$126.00	—	35%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND 4TH DIG RT MIN 2 VW	$91.00	$140.00	$112.00–$126.00	—	35%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND 5TH DIG LT MIN 2 VW	$91.00	$140.00	$112.00–$126.00	—	35%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND 2ND DIG RT MIN 2 VW	$91.00	$140.00	$112.00–$126.00	—	35%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND 5TH DIG RT MIN 2 VW	$91.00	$140.00	$112.00–$126.00	—	35%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND 2ND DIG LT MIN 2 VW	$91.00	$140.00	$112.00–$126.00	—	35%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND 3RD DIG RT MIN 2 VW	$91.00	$140.00	$112.00–$126.00	—	35%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND THUMB LT MIN 2 VW	$91.00	$140.00	$112.00–$126.00	—	35%
X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT 2 VIEW	$109.20	$168.00	$95.76–$151.20	45% below	35%
X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT 2 VIEW	$109.20	$168.00	$95.76–$151.20	45% below	35%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LEFT 2 VIEW	$109.20	$168.00	$134.40–$151.20	—	35%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RIGHT 2 VIEW	$109.20	$168.00	$134.40–$151.20	—	35%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT RIGHT MINEMUM 3 VW	$169.00	$260.00	$100.48–$234.00	38% below	35%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT LEFT MINEMUM 3 VW	$169.00	$260.00	$100.48–$234.00	38% below	35%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT RIGHT MINEMUM 3 VW	$169.00	$260.00	$208.00–$234.00	—	35%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT LEFT MINEMUM 3 VW	$169.00	$260.00	$208.00–$234.00	—	35%
X-ray of the hand, 3 or more views both sides CPT 73130 HAND BILATERAL MIN 3 VW	$169.00	$260.00	$100.48–$234.00	—	35%
X-ray of the hand, 3 or more views one side CPT 73130 HAND RIGHT MIN 3 VIEW	$169.00	$260.00	$100.48–$234.00	33% below	35%
X-ray of the hand, 3 or more views one side CPT 73130 HAND LEFT MIN 3 VIEW	$169.00	$260.00	$100.48–$234.00	33% below	35%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HAND BILATERAL MIN 3 VW	$169.00	$260.00	$208.00–$234.00	—	35%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND RIGHT MIN 3 VIEW	$169.00	$260.00	$208.00–$234.00	—	35%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND LEFT MIN 3 VIEW	$169.00	$260.00	$208.00–$234.00	—	35%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LEFT 1 OR 2 VIEW	$122.85	$189.00	$100.48–$170.10	46% below	35%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RIGHT 1 OR 2 VIEW	$122.85	$189.00	$100.48–$170.10	46% below	35%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LEFT 1 OR 2 VIEW	$122.85	$189.00	$151.20–$170.10	—	35%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE RIGHT 1 OR 2 VIEW	$122.85	$189.00	$151.20–$170.10	—	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2 OR 3 VIEW	$191.75	$295.00	$135.24–$265.50	35% below	35%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 2 OR 3 VIEW	$191.75	$295.00	$236.00–$265.50	—	35%
X-ray of the lower back, 4 or more views CPT 72110 L/SPINE COMP MIN 4VW	$273.00	$420.00	$135.24–$378.00	36% below	35%
X-ray of the lower back, 4 or more views inpatient CPT 72110 L/SPINE COMP MIN 4VW	$273.00	$420.00	$336.00–$378.00	—	35%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VIEW	$154.70	$238.00	$135.24–$214.20	41% below	35%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2 VIEW	$154.70	$238.00	$190.40–$214.20	—	35%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES COMP MIN 3VW	$135.20	$208.00	$100.48–$187.20	46% below	35%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES COMP MIN 3VW	$135.20	$208.00	$166.40–$187.20	—	35%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL-SPINE 3 VW OR LESS	$172.25	$265.00	$100.48–$238.50	43% below	35%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL-SPINE 3 VW OR LESS	$172.25	$265.00	$212.00–$238.50	—	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VW	$139.75	$215.00	$122.55–$193.50	38% below	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 PF PELVIS TC	$139.75	$215.00	$23.69–$182.75	38% below	35%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 OR 2 VW	$139.75	$215.00	$172.00–$193.50	—	35%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PF PELVIS TC	$139.75	$215.00	$23.69–$182.75	—	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 COCCYX & SACRUM 2 VIEW	$135.85	$209.00	$100.48–$188.10	48% below	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 COCCYX & SACRUM 2 VIEW	$135.85	$209.00	$167.20–$188.10	—	35%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$5.85	$9.00	$5.13–$8.10	88% below	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALTI (SGPT) W/MOD	$29.25	$45.00	$6.68–$40.50	40% below	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALT SGPT	$29.25	$45.00	$6.68–$40.50	40% below	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 NASH ALT	$44.85	$69.00	$6.68–$62.10	7% below	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ASH ALT	$44.85	$69.00	$6.68–$62.10	7% below	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HCV ALT	$49.40	$76.00	$6.68–$68.40	2% above	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$5.85	$9.00	$7.20–$8.10	—	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALTI (SGPT) W/MOD	$29.25	$45.00	$36.00–$40.50	—	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALT SGPT	$29.25	$45.00	$36.00–$40.50	—	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 NASH ALT	$44.85	$69.00	$55.20–$62.10	—	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ASH ALT	$44.85	$69.00	$55.20–$62.10	—	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HCV ALT	$49.40	$76.00	$60.80–$68.40	—	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$5.85	$9.00	$5.13–$8.10	87% below	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) W/MOD	$21.45	$33.00	$6.52–$29.70	54% below	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE/(AST)(SGOT)	$21.45	$33.00	$6.52–$29.70	54% below	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 NASH AST	$44.85	$69.00	$6.52–$62.10	4% below	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 ASH AST	$44.85	$69.00	$6.52–$62.10	4% below	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$5.85	$9.00	$7.20–$8.10	—	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE/(AST)(SGOT)	$21.45	$33.00	$26.40–$29.70	—	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT) W/MOD	$21.45	$33.00	$26.40–$29.70	—	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 ASH AST	$44.85	$69.00	$55.20–$62.10	—	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 NASH AST	$44.85	$69.00	$55.20–$62.10	—	35%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$100.75	$155.00	$60.02–$139.50	57% below	35%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$100.75	$155.00	$124.00–$139.50	—	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F031 IGE CARROT	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 PARROT AUSTRALIAN DRPPINGS IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MOLD PANEL	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CLAM IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F343 IGE RASPBERRY	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 I205 IGE BUMBLEBEE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F009 IGE RICE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F214 IGE SPINACH	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F215 IGE LETTUCE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 K079 IGE PHTHALIC ANHYDRIDE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F244 IGE CUCUMBER	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F014 IGE SOYBEAN	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F033 IGE ORANGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F017 IGE HAZELNUT	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F037-IGE MUSSEL	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 K076 IGE ISOCYANATE MDI	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F020 IGE ALMOND	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEABN IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 I004 IGE PAPER WASP	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M009 IGE FUSARIUM PROLIFERATUM	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F201 IGE PECAN NUT	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 PARROT AUSTRALIAN FEATHERS IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOP IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 W009 IGE PLANTAIN, ENGLISH	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 POTATO, WHITE IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F077 IGE BETA LACTOGLOBULIN	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 I002 IGE HORNET, WHITE FACE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 I005 IGE HORNET, YELLOW	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F076 IGE ALPHA LACTALBUMIN	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 YEAST IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 MULBERRY IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 G008 IGE BLUEEGRASS, KENTUCKY	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CHILI PEPPER IgE-F279	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F216 IGE CABBAGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 K077 IGE ISOCYANATE HDI	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M005-IGE CANDIDA ALICANS	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M008 IGE SETOMELANOMMA ROSTRAT	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F018 IGE BRAZIL NUT	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 K079 IGE TRIMELLITIC ANHYDRIDE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F082 IGE CHEESE, MOLD TYPE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F291 IGE CAULIFLOWER	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F027 IGE BEEF	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M012 IGE AUREOBASIDI PULLULANS	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F023 IGE CRAB	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM NOTATUM IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F288 IGE BLUEBERRY	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 I001 IGE HONEYBEE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F048-IGE, ONION	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F414 IGE-TILAPIA	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F085 IGE CELERY	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F225 IGE PUMPKIN	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 I003 IGE YELLOW JACKET	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM MOLD IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F005 IGE RYE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 NETTLE IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F092 IGE BANANA	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ELM IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F306 IGE LIME	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F095 IGE PEACH	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 T003 IGE COMMON SILVER BIRCH	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F302 IGE TANGERINE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M014 IGE EPICOCCUM PURPUR	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F075 IGE ISOCYANATE TDI	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F044 IGE STRAWBERRY	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M011 IGE RHIZOPUS NIGRICANS	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CHOCOLATE/CACAO IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 PORK IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M010 IGE STEMPHYLIUM HERBARUM	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS MOLD IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M013 IGE PHOMA BETAE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F049 IGE APPLE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F208 IGE LEMON	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F308 IGE-SARDINE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F012 IGE GREEN PEA	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORREL IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F080 IGE LOBSTER	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 GARLIC IgE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F209 IGE GRAPEFRUIT	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 E004 IGE COW DANDER	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F094 IGE PEAR	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F290 IGE OYSTER	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F260 IGE BROCCOLI	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F078 IGE CASEIN	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F315 IGE GREEN BEAN	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M004 IGE MUCOR RACEMOSUS	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 E070 IGE GOOSE FEATHERS	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 OAT IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F287 IGE KIDNEY BEAN	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 E086 IGE DUCK FEATHERS	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F259 IGE GRAPE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F081 IGE CHEESE, CHEDDAR TYPE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 D. MICROCERAS	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 E085 IGE CHICKEN FEATHERS	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F079-IGE GLUTEN	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 OAK IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA MOLD IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CORN IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 Egg Yolk IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK IGE	$24.05	$37.00	$6.58–$33.30	9% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 TRIMELLITIC ANHYDRIDE IGE	$25.35	$39.00	$6.58–$35.10	15% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 PHTHALIC ANHYDRIDE	$25.35	$39.00	$6.58–$35.10	15% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F342-IGE, OLIVE, BLACK	$28.60	$44.00	$6.58–$39.60	29% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 W016 IGE ROUGH MARSHELDER	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M006 IGE ALTERNARIA ALTERNATE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 D PTERONYSSINUS (MITE) IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M003 IGE ASPERGILLUS FUMIGATUS	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 I006 IGE COCKROACH, GERMAN	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 T070 IGE WHITE MULBERRY	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 W014 IGE PIGWEED, COMMON	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 D FARINAE (DUST MITE) IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 BOX ELDER MAPLE IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 RUSSIAN THISTLE IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M001 IGE PENICILLIUM CRYSOGEN	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 T011 IGE MAPLE LEAF SYCAMORE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 RAGWEED SHORT IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 T022 IGE PECAN, HICKORY	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 E072 IGE MOUSE URINE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUNTAIN CEDAR IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE ASH IGE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 M002 IGE CLADOSPORIUM HERBARUM	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 T007 IGE OAK, WHITE	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 T008 IGE ELM, AMERICAN	$29.90	$46.00	$6.58–$41.40	35% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 BUDERIGAR FEATHER	$32.50	$50.00	$6.58–$45.00	47% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 PAPRIKA/SWEET PEPPER IgE-F218	$32.50	$50.00	$6.58–$45.00	47% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 JALEPENO PEPPER, IGE	$53.30	$82.00	$6.58–$73.80	141% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALPHA GAL IGE	$57.20	$88.00	$6.58–$79.20	159% above	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M009 IGE FUSARIUM PROLIFERATUM	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F048-IGE, ONION	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 K079 IGE PHTHALIC ANHYDRIDE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F209 IGE GRAPEFRUIT	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M012 IGE AUREOBASIDI PULLULANS	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 K076 IGE ISOCYANATE MDI	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGE IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F018 IGE BRAZIL NUT	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M011 IGE RHIZOPUS NIGRICANS	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F005 IGE RYE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP SORREL IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F094 IGE PEAR	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GARLIC IgE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F075 IGE ISOCYANATE TDI	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F031 IGE CARROT	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F315 IGE GREEN BEAN	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F287 IGE KIDNEY BEAN	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F215 IGE LETTUCE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F225 IGE PUMPKIN	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg Yolk IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PARROT AUSTRALIAN FEATHERS IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ELM IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F020 IGE ALMOND	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I003 IGE YELLOW JACKET	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA MOLD IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F291 IGE CAULIFLOWER	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F080 IGE LOBSTER	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M004 IGE MUCOR RACEMOSUS	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIUM NOTATUM IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F023 IGE CRAB	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F308 IGE-SARDINE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G008 IGE BLUEEGRASS, KENTUCKY	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHOCOLATE/CACAO IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BARLEY IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F259 IGE GRAPE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F414 IGE-TILAPIA	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM MOLD IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLAM IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I002 IGE HORNET, WHITE FACE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHILI PEPPER IgE-F279	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST MOLD PANEL	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M013 IGE PHOMA BETAE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I005 IGE HORNET, YELLOW	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E070 IGE GOOSE FEATHERS	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F290 IGE OYSTER	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F077 IGE BETA LACTOGLOBULIN	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F260 IGE BROCCOLI	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F027 IGE BEEF	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F082 IGE CHEESE, MOLD TYPE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M005-IGE CANDIDA ALICANS	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. MICROCERAS	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 K077 IGE ISOCYANATE HDI	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEABN IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E085 IGE CHICKEN FEATHERS	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F009 IGE RICE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I001 IGE HONEYBEE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS MOLD IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I004 IGE PAPER WASP	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F214 IGE SPINACH	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F081 IGE CHEESE, CHEDDAR TYPE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 K079 IGE TRIMELLITIC ANHYDRIDE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F216 IGE CABBAGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F079-IGE GLUTEN	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F201 IGE PECAN NUT	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F095 IGE PEACH	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F302 IGE TANGERINE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W009 IGE PLANTAIN, ENGLISH	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MULBERRY IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F049 IGE APPLE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F012 IGE GREEN PEA	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F044 IGE STRAWBERRY	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAK IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YEAST IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I205 IGE BUMBLEBEE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PARROT AUSTRALIAN DRPPINGS IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F076 IGE ALPHA LACTALBUMIN	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F092 IGE BANANA	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F208 IGE LEMON	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M014 IGE EPICOCCUM PURPUR	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F033 IGE ORANGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F014 IGE SOYBEAN	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POTATO, WHITE IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F343 IGE RASPBERRY	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F306 IGE LIME	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F017 IGE HAZELNUT	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E004 IGE COW DANDER	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E086 IGE DUCK FEATHERS	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOP IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T003 IGE COMMON SILVER BIRCH	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F085 IGE CELERY	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F078 IGE CASEIN	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NETTLE IGE	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F288 IGE BLUEBERRY	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M010 IGE STEMPHYLIUM HERBARUM	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F244 IGE CUCUMBER	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M008 IGE SETOMELANOMMA ROSTRAT	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F037-IGE MUSSEL	$24.05	$37.00	$29.60–$33.30	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PHTHALIC ANHYDRIDE	$25.35	$39.00	$31.20–$35.10	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TRIMELLITIC ANHYDRIDE IGE	$25.35	$39.00	$31.20–$35.10	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F342-IGE, OLIVE, BLACK	$28.60	$44.00	$35.20–$39.60	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BOX ELDER MAPLE IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T022 IGE PECAN, HICKORY	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T008 IGE ELM, AMERICAN	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I006 IGE COCKROACH, GERMAN	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COTTONWOOD IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E072 IGE MOUSE URINE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUNTAIN CEDAR IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RUSSIAN THISTLE IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M003 IGE ASPERGILLUS FUMIGATUS	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W014 IGE PIGWEED, COMMON	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D FARINAE (DUST MITE) IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T070 IGE WHITE MULBERRY	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T007 IGE OAK, WHITE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAGWEED SHORT IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T011 IGE MAPLE LEAF SYCAMORE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M001 IGE PENICILLIUM CRYSOGEN	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M002 IGE CLADOSPORIUM HERBARUM	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M006 IGE ALTERNARIA ALTERNATE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE ASH IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D PTERONYSSINUS (MITE) IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W016 IGE ROUGH MARSHELDER	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS IGE	$29.90	$46.00	$36.80–$41.40	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPRIKA/SWEET PEPPER IgE-F218	$32.50	$50.00	$40.00–$45.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BUDERIGAR FEATHER	$32.50	$50.00	$40.00–$45.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JALEPENO PEPPER, IGE	$53.30	$82.00	$65.60–$73.80	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALPHA GAL IGE	$57.20	$88.00	$70.40–$79.20	—	35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRUL PEPT-CCP AB	$45.50	$70.00	$16.31–$63.00	43% below	35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC C PEPTIDE	$45.50	$70.00	$16.31–$63.00	43% below	35%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRUL PEPT-CCP AB	$45.50	$70.00	$56.00–$63.00	—	35%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC C PEPTIDE	$45.50	$70.00	$56.00–$63.00	—	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 FANA	$17.55	$27.00	$15.23–$24.30	74% below	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINCLR ANTIBODIES IFA (ANA)	$65.00	$100.00	$15.23–$90.00	5% below	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 FANA	$17.55	$27.00	$21.60–$24.30	—	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINCLR ANTIBODIES IFA (ANA)	$65.00	$100.00	$80.00–$90.00	—	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$61.75	$95.00	$49.46–$85.50	50% below	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO BNP	$102.70	$158.00	$49.46–$142.20	16% below	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$61.75	$95.00	$76.00–$85.50	—	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO BNP	$102.70	$158.00	$126.40–$142.20	—	35%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$81.25	$125.00	$10.65–$112.50	35% below	35%
Basic metabolic panel (blood test) CPT 80048 ISTAT CEM 8+ PANEL	$81.25	$125.00	$10.65–$112.50	35% below	35%
Basic metabolic panel (blood test) CPT 80048 BASiC METABOLIC PAN W/MOD	$81.25	$125.00	$10.65–$112.50	35% below	35%
Basic metabolic panel (blood test) inpatient CPT 80048 BASiC METABOLIC PAN W/MOD	$81.25	$125.00	$100.00–$112.50	—	35%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$81.25	$125.00	$100.00–$112.50	—	35%
Basic metabolic panel (blood test) inpatient CPT 80048 ISTAT CEM 8+ PANEL	$81.25	$125.00	$100.00–$112.50	—	35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH IV- TC	$162.50	$250.00	$61.73–$225.00	20% below	35%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH IV- TC	$162.50	$250.00	$200.00–$225.00	—	35%
Blood culture for bacteria CPT 87040 CULTURE BACT/BLOOD	$52.00	$80.00	$13.01–$72.00	53% below	35%
Blood culture for bacteria inpatient CPT 87040 CULTURE BACT/BLOOD	$52.00	$80.00	$64.00–$72.00	—	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRAW FEE	$9.10	$14.00	$7.98–$12.60	46% below	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DRAW FEE	$9.10	$14.00	$11.20–$12.60	—	35%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$5.85	$9.00	$4.96–$8.10	82% below	35%
Blood glucose (sugar) test CPT 82947 GLUCOSE/QNT/BLD W/MOD	$20.80	$32.00	$4.96–$28.80	36% below	35%
Blood glucose (sugar) test CPT 82947 GLUCOSE/QUANT/BLOOD	$20.80	$32.00	$4.96–$28.80	36% below	35%
Blood glucose (sugar) test CPT 82947 NASH GLUCOSE	$44.85	$69.00	$4.96–$62.10	38% above	35%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$44.85	$69.00	$4.96–$62.10	38% above	35%
Blood glucose (sugar) test CPT 82947 ASH GLUCOSE	$44.85	$69.00	$4.96–$62.10	38% above	35%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$5.85	$9.00	$7.20–$8.10	—	35%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE/QUANT/BLOOD	$20.80	$32.00	$25.60–$28.80	—	35%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE/QNT/BLD W/MOD	$20.80	$32.00	$25.60–$28.80	—	35%
Blood glucose (sugar) test inpatient CPT 82947 NASH GLUCOSE	$44.85	$69.00	$55.20–$62.10	—	35%
Blood glucose (sugar) test inpatient CPT 82947 ASH GLUCOSE	$44.85	$69.00	$55.20–$62.10	—	35%
Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$44.85	$69.00	$55.20–$62.10	—	35%
Blood lead test CPT 83655 POC LEAD	$22.10	$34.00	$15.26–$30.60	60% below	35%
Blood lead test CPT 83655 LEAD	$35.75	$55.00	$15.26–$49.50	35% below	35%
Blood lead test inpatient CPT 83655 POC LEAD	$22.10	$34.00	$27.20–$30.60	—	35%
Blood lead test inpatient CPT 83655 LEAD	$35.75	$55.00	$44.00–$49.50	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG - QUALITATIVE	$44.85	$69.00	$9.48–$62.10	16% below	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG - QUALITATIVE	$44.85	$69.00	$55.20–$62.10	—	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 IRL-ABO TYPE	$78.00	$120.00	$68.40–$140.07	8% above	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$78.00	$120.00	$68.40–$140.07	8% above	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 IRL-ABO TYPE	$78.00	$120.00	$96.00–$108.00	—	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO	$78.00	$120.00	$96.00–$108.00	—	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$50.70	$78.00	$6.52–$70.20	15% below	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$50.70	$78.00	$62.40–$70.20	—	35%
CA 19-9 blood test (tumor marker) CPT 86301 CA-19-9	$59.15	$91.00	$26.22–$81.90	46% below	35%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA-19-9	$59.15	$91.00	$72.80–$81.90	—	35%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$50.70	$78.00	$26.22–$70.20	54% below	35%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125	$50.70	$78.00	$62.40–$70.20	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS MAWD 19 (COVID)	$55.25	$85.00	$48.45–$76.50	45% below	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS 19 NON CDC 2019 (COVID)	$65.00	$100.00	$57.00–$90.00	35% below	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS19NONCDC(COVID)-IN HSE TST	$78.00	$120.00	$68.40–$108.00	22% below	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS MAWD 19 (COVID)	$55.25	$85.00	$68.00–$76.50	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS 19 NON CDC 2019 (COVID)	$65.00	$100.00	$80.00–$90.00	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS19NONCDC(COVID)-IN HSE TST	$78.00	$120.00	$96.00–$108.00	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA PCR URINE	$65.00	$100.00	$44.21–$90.00	28% below	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA PCR	$65.00	$100.00	$44.21–$90.00	28% below	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA PCR	$65.00	$100.00	$80.00–$90.00	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA PCR URINE	$65.00	$100.00	$80.00–$90.00	—	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$61.75	$95.00	$16.87–$85.50	40% below	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL LAB CORE	$61.75	$95.00	$16.87–$85.50	40% below	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL LAB CORE	$61.75	$95.00	$76.00–$85.50	—	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$61.75	$95.00	$76.00–$85.50	—	35%
Complete blood count (CBC) with differential CPT 85025 CBC AUTO DIFF (PRL)	$55.25	$85.00	$9.79–$76.50	4% above	35%
Complete blood count (CBC) with differential CPT 85025 CBC/AUTO DIFF	$55.25	$85.00	$9.79–$76.50	4% above	35%
Complete blood count (CBC) with differential CPT 85025 BLD COUNT/AUTO DIF/MOD	$55.25	$85.00	$9.79–$76.50	4% above	35%
Complete blood count (CBC) with differential CPT 85025 NEUTROPHIL TO LYM/CBC W PLATEL	$55.25	$85.00	$9.79–$76.50	4% above	35%
Complete blood count (CBC) with differential inpatient CPT 85025 BLD COUNT/AUTO DIF/MOD	$55.25	$85.00	$68.00–$76.50	—	35%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC/AUTO DIFF	$55.25	$85.00	$68.00–$76.50	—	35%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO DIFF (PRL)	$55.25	$85.00	$68.00–$76.50	—	35%
Complete blood count (CBC) with differential inpatient CPT 85025 NEUTROPHIL TO LYM/CBC W PLATEL	$55.25	$85.00	$68.00–$76.50	—	35%
Complete blood count (CBC), no differential CPT 85027 CBC WO DIFF/ W MOD	$44.85	$69.00	$8.15–$62.10	9% below	35%
Complete blood count (CBC), no differential CPT 85027 CBC W/WO DIFF	$44.85	$69.00	$8.15–$62.10	9% below	35%
Complete blood count (CBC), no differential CPT 85027 HEMOGLOBINOPATHY CBC	$66.95	$103.00	$8.15–$92.70	36% above	35%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WO DIFF/ W MOD	$44.85	$69.00	$55.20–$62.10	—	35%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/WO DIFF	$44.85	$69.00	$55.20–$62.10	—	35%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGLOBINOPATHY CBC	$66.95	$103.00	$82.40–$92.70	—	35%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$107.25	$165.00	$13.30–$148.50	15% below	35%
Comprehensive metabolic panel (blood test) CPT 80053 COMP META PANEL W/MOD	$107.25	$165.00	$13.30–$148.50	15% below	35%
Comprehensive metabolic panel (blood test) CPT 80053 CMP (PRL)	$107.25	$165.00	$13.30–$148.50	15% below	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP (PRL)	$107.25	$165.00	$132.00–$148.50	—	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$107.25	$165.00	$132.00–$148.50	—	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP META PANEL W/MOD	$107.25	$165.00	$132.00–$148.50	—	35%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEG PRO-D-DIMER	$65.00	$100.00	$12.82–$90.00	48% below	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEG PRO-D-DIMER	$65.00	$100.00	$80.00–$90.00	—	35%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA	$15.60	$24.00	$13.68–$28.01	89% below	35%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$81.25	$125.00	$28.01–$112.50	40% below	35%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA	$15.60	$24.00	$19.20–$21.60	—	35%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$81.25	$125.00	$100.00–$112.50	—	35%
Estradiol blood test CPT 82670 ESTRADIOL	$78.00	$120.00	$35.21–$108.00	46% below	35%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$78.00	$120.00	$96.00–$108.00	—	35%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$71.50	$110.00	$23.41–$99.00	30% below	35%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$71.50	$110.00	$88.00–$99.00	—	35%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL	$201.50	$310.00	$24.74–$279.00	8% above	35%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL	$201.50	$310.00	$248.00–$279.00	—	35%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$61.75	$95.00	$17.18–$85.50	26% below	35%
Ferritin blood test (iron stores) CPT 82728 HEMOGLOBINOPATHY FERRITIN	$61.75	$95.00	$17.18–$85.50	26% below	35%
Ferritin blood test (iron stores) inpatient CPT 82728 HEMOGLOBINOPATHY FERRITIN	$61.75	$95.00	$76.00–$85.50	—	35%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$61.75	$95.00	$76.00–$85.50	—	35%
Folate (folic acid) blood test CPT 82746 FOLIC ACID/SERUM	$61.75	$95.00	$18.52–$85.50	19% below	35%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID/SERUM	$61.75	$95.00	$76.00–$85.50	—	35%
Free T3 thyroid hormone test CPT 84481 FREE T3	$78.00	$120.00	$21.35–$108.00	21% below	35%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$78.00	$120.00	$96.00–$108.00	—	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$55.25	$85.00	$11.37–$76.50	25% below	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FT4 (PRL)	$55.25	$85.00	$11.37–$76.50	25% below	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 BY DIALYSIS/MASS SPEC	$55.25	$85.00	$11.37–$76.50	25% below	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FT4 (PRL)	$55.25	$85.00	$68.00–$76.50	—	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 BY DIALYSIS/MASS SPEC	$55.25	$85.00	$68.00–$76.50	—	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$55.25	$85.00	$68.00–$76.50	—	35%
Free testosterone test CPT 84402 TESTOSTERONE (FREE)	$55.25	$85.00	$32.09–$76.50	56% below	35%
Free testosterone test CPT 84402 TESTOSTERONE BIO AVAILABLE	$55.25	$85.00	$32.09–$76.50	56% below	35%
Free testosterone test inpatient CPT 84402 TESTOSTERONE (FREE)	$55.25	$85.00	$68.00–$76.50	—	35%
Free testosterone test inpatient CPT 84402 TESTOSTERONE BIO AVAILABLE	$55.25	$85.00	$68.00–$76.50	—	35%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$201.50	$310.00	$176.70–$279.00	27% below	35%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$201.50	$310.00	$248.00–$279.00	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE - 1HR PP	$20.80	$32.00	$5.99–$28.80	51% below	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE - 2 HR PP	$20.80	$32.00	$5.99–$28.80	51% below	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE/POST(50GM CH)	$28.60	$44.00	$5.99–$39.60	33% below	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE - 1HR PP	$20.80	$32.00	$25.60–$28.80	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE - 2 HR PP	$20.80	$32.00	$25.60–$28.80	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE/POST(50GM CH)	$28.60	$44.00	$35.20–$39.60	—	35%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPEC	$52.00	$80.00	$16.21–$72.00	43% below	35%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 SPEC	$52.00	$80.00	$64.00–$72.00	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE, DNA AMP PROB	$52.00	$80.00	$44.21–$72.00	36% below	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC DNA, PCR	$52.00	$80.00	$44.21–$72.00	36% below	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC DNA PCR URINE	$52.00	$80.00	$44.21–$72.00	36% below	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE, DNA AMP PROB	$52.00	$80.00	$64.00–$72.00	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC DNA PCR URINE	$52.00	$80.00	$64.00–$72.00	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC DNA, PCR	$52.00	$80.00	$64.00–$72.00	—	35%
H. pylori antibody blood test CPT 86677 H PYLORI AB - IGA	$51.35	$79.00	$21.24–$71.10	32% below	35%
H. pylori antibody blood test CPT 86677 H PYLORI AB - IGG	$51.35	$79.00	$21.24–$71.10	32% below	35%
H. pylori antibody blood test CPT 86677 H PYLORI AB - IGM	$51.35	$79.00	$21.24–$71.10	32% below	35%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB - IGM	$51.35	$79.00	$63.20–$71.10	—	35%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB - IGA	$51.35	$79.00	$63.20–$71.10	—	35%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB - IGG	$51.35	$79.00	$63.20–$71.10	—	35%
H. pylori stool antigen test CPT 87338 H.PYLORI AG STOOL	$95.55	$147.00	$18.12–$132.30	20% below	35%
H. pylori stool antigen test inpatient CPT 87338 H.PYLORI AG STOOL	$95.55	$147.00	$117.60–$132.30	—	35%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA PCR QUANT	$349.05	$537.00	$107.23–$483.30	at median	35%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1,QUANT, RNA (ABBTT RLTME)	$373.75	$575.00	$107.23–$517.50	7% above	35%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA PCR QUANT	$349.05	$537.00	$429.60–$483.30	—	35%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1,QUANT, RNA (ABBTT RLTME)	$373.75	$575.00	$460.00–$517.50	—	35%
HIV-1 and HIV-2 antibody test CPT 86703 HIV RAPID	$16.90	$26.00	$14.82–$23.40	85% below	35%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1 & HIV-2 SINGLE AS	$50.70	$78.00	$17.28–$70.20	56% below	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV RAPID	$16.90	$26.00	$20.80–$23.40	—	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1 & HIV-2 SINGLE AS	$50.70	$78.00	$62.40–$70.20	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV SCREEN, 4TH GENERATION	$16.25	$25.00	$14.25–$30.34	80% below	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV SCREEN, 4TH GENERATION	$16.25	$25.00	$20.00–$22.50	—	35%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV PROBE AMPLIFIED (X3)	$65.00	$100.00	$44.21–$90.00	41% below	35%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV PROBE AMPLIFIED	$107.90	$166.00	$44.21–$149.40	2% below	35%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV PROBE AMPLIFIED (X3)	$65.00	$100.00	$80.00–$90.00	—	35%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV PROBE AMPLIFIED	$107.90	$166.00	$132.80–$149.40	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGA1C-WELLNESS	$6.50	$10.00	$5.70–$12.24	89% below	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN ALC PRL	$48.75	$75.00	$12.24–$67.50	21% below	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGBA1C	$48.75	$75.00	$12.24–$67.50	21% below	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGA1C-WELLNESS	$6.50	$10.00	$8.00–$9.00	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN ALC PRL	$48.75	$75.00	$60.00–$67.50	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGBA1C	$48.75	$75.00	$60.00–$67.50	—	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB (HBSAB)	$73.45	$113.00	$13.54–$101.70	7% above	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB (HBSAB)	$73.45	$113.00	$90.40–$101.70	—	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SUR ANTIGEN HBSAG	$58.50	$90.00	$13.02–$81.00	10% below	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SUR ANTIGEN HBSAG	$58.50	$90.00	$72.00–$81.00	—	35%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C VIRUS AB	$19.50	$30.00	$17.10–$27.00	77% below	35%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C VIRUS AB	$54.60	$84.00	$17.98–$75.60	36% below	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIRUS AB	$19.50	$30.00	$24.00–$27.00	—	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C VIRUS AB	$54.60	$84.00	$67.20–$75.60	—	35%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV REAL TIME ABBOTT (HepC)	$166.40	$256.00	$53.98–$230.40	44% below	35%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV REAL TIME ABBOTT (HepC)	$166.40	$256.00	$204.80–$230.40	—	35%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 IGG	$75.40	$116.00	$16.62–$104.40	14% above	35%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1 IGG	$75.40	$116.00	$92.80–$104.40	—	35%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 IGG	$20.80	$32.00	$18.24–$28.80	66% below	35%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 IGG	$20.80	$32.00	$25.60–$28.80	—	35%
High-sensitivity CRP (hs-CRP) test CPT 86141 CPR HIGH SENSITIVITY (PRL)	$22.75	$35.00	$16.31–$31.50	68% below	35%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY	$46.80	$72.00	$16.31–$64.80	34% below	35%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CPR HIGH SENSITIVITY (PRL)	$22.75	$35.00	$28.00–$31.50	—	35%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY	$46.80	$72.00	$57.60–$64.80	—	35%
Homocysteine blood test CPT 83090 HOMOCYSTINE	$58.50	$90.00	$22.58–$81.00	46% below	35%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE	$58.50	$90.00	$72.00–$81.00	—	35%
Insulin blood test CPT 83525 INSULIN-WELLNESS	$13.00	$20.00	$11.40–$18.00	78% below	35%
Insulin blood test CPT 83525 INSULIN 1/2 HR	$13.65	$21.00	$11.97–$18.90	77% below	35%
Insulin blood test CPT 83525 INSULIN 1HR	$13.65	$21.00	$11.97–$18.90	77% below	35%
Insulin blood test CPT 83525 INSULIN FASTING	$13.65	$21.00	$11.97–$18.90	77% below	35%
Insulin blood test CPT 83525 INSULIN 2 HR	$13.65	$21.00	$11.97–$18.90	77% below	35%
Insulin blood test CPT 83525 INSULIN; TOTAL	$74.10	$114.00	$14.41–$102.60	25% above	35%
Insulin blood test CPT 83525 INSULIN TOTAL W/MOD	$74.10	$114.00	$14.41–$102.60	25% above	35%
Insulin blood test inpatient CPT 83525 INSULIN-WELLNESS	$13.00	$20.00	$16.00–$18.00	—	35%
Insulin blood test inpatient CPT 83525 INSULIN 1/2 HR	$13.65	$21.00	$16.80–$18.90	—	35%
Insulin blood test inpatient CPT 83525 INSULIN FASTING	$13.65	$21.00	$16.80–$18.90	—	35%
Insulin blood test inpatient CPT 83525 INSULIN 2 HR	$13.65	$21.00	$16.80–$18.90	—	35%
Insulin blood test inpatient CPT 83525 INSULIN 1HR	$13.65	$21.00	$16.80–$18.90	—	35%
Insulin blood test inpatient CPT 83525 INSULIN; TOTAL	$74.10	$114.00	$91.20–$102.60	—	35%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL W/MOD	$74.10	$114.00	$91.20–$102.60	—	35%
Iron blood test (serum iron) CPT 83540 IRON SATURATION	$36.40	$56.00	$8.15–$50.40	21% below	35%
Iron blood test (serum iron) CPT 83540 IRON	$37.05	$57.00	$8.15–$51.30	20% below	35%
Iron blood test (serum iron) inpatient CPT 83540 IRON SATURATION	$36.40	$56.00	$44.80–$50.40	—	35%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$37.05	$57.00	$45.60–$51.30	—	35%
Iron-binding capacity (TIBC) test CPT 83550 IRON BIND (TIBC)	$45.50	$70.00	$11.02–$63.00	33% below	35%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BIND (TIBC)	$45.50	$70.00	$56.00–$63.00	—	35%
Kidney function blood test panel CPT 80069 RENAL PANEL W/MOD	$71.50	$110.00	$10.93–$99.00	33% below	35%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$71.50	$110.00	$10.93–$99.00	33% below	35%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$71.50	$110.00	$88.00–$99.00	—	35%
Kidney function blood test panel inpatient CPT 80069 RENAL PANEL W/MOD	$71.50	$110.00	$88.00–$99.00	—	35%
LH (luteinizing hormone) test CPT 83002 LH	$26.00	$40.00	$22.80–$36.00	75% below	35%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$26.00	$40.00	$32.00–$36.00	—	35%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE W/MOD	$58.50	$90.00	$8.68–$81.00	7% below	35%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$58.50	$90.00	$8.68–$81.00	7% below	35%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$58.50	$90.00	$72.00–$81.00	—	35%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE W/MOD	$58.50	$90.00	$72.00–$81.00	—	35%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION W/MOD	$81.25	$125.00	$10.29–$112.50	39% below	35%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$81.25	$125.00	$10.29–$112.50	39% below	35%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$81.25	$125.00	$100.00–$112.50	—	35%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION W/MOD	$81.25	$125.00	$100.00–$112.50	—	35%
Lyme disease antibody test CPT 86618 LYME, TOTAL AB TEST/REFLEX	$55.25	$85.00	$21.46–$76.50	40% below	35%
Lyme disease antibody test CPT 86618 LYME AB /GM (SERUM)	$59.15	$91.00	$21.46–$81.90	35% below	35%
Lyme disease antibody test CPT 86618 LYME AB/GG (SERUM)	$59.15	$91.00	$21.46–$81.90	35% below	35%
Lyme disease antibody test CPT 86618 LYME AB SCREEN	$59.15	$91.00	$21.46–$81.90	35% below	35%
Lyme disease antibody test inpatient CPT 86618 LYME, TOTAL AB TEST/REFLEX	$55.25	$85.00	$68.00–$76.50	—	35%
Lyme disease antibody test inpatient CPT 86618 LYME AB/GG (SERUM)	$59.15	$91.00	$72.80–$81.90	—	35%
Lyme disease antibody test inpatient CPT 86618 LYME AB /GM (SERUM)	$59.15	$91.00	$72.80–$81.90	—	35%
Lyme disease antibody test inpatient CPT 86618 LYME AB SCREEN	$59.15	$91.00	$72.80–$81.90	—	35%
Magnesium blood test CPT 83735 MAGNESIUM, RBC	$26.00	$40.00	$8.44–$36.00	45% below	35%
Magnesium blood test CPT 83735 MAGNESIUM URINE 24 HR	$45.50	$70.00	$8.44–$63.00	3% below	35%
Magnesium blood test CPT 83735 MAGNESIUM W/MOD	$45.50	$70.00	$8.44–$63.00	3% below	35%
Magnesium blood test CPT 83735 MAGNESIUM	$45.50	$70.00	$8.44–$63.00	3% below	35%
Magnesium blood test CPT 83735 MAGNESIUM (URORISK)	$45.50	$70.00	$8.44–$63.00	3% below	35%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, RBC	$26.00	$40.00	$32.00–$36.00	—	35%
Magnesium blood test inpatient CPT 83735 MAGNESIUM (URORISK)	$45.50	$70.00	$56.00–$63.00	—	35%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$45.50	$70.00	$56.00–$63.00	—	35%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE 24 HR	$45.50	$70.00	$56.00–$63.00	—	35%
Magnesium blood test inpatient CPT 83735 MAGNESIUM W/MOD	$45.50	$70.00	$56.00–$63.00	—	35%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGG	$59.15	$91.00	$16.23–$81.90	at median	35%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGM	$93.60	$144.00	$16.23–$129.60	58% above	35%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGG	$59.15	$91.00	$72.80–$81.90	—	35%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGM	$93.60	$144.00	$115.20–$129.60	—	35%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE (MONO)	$9.75	$15.00	$6.52–$13.50	76% below	35%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB/(MONO)	$23.40	$36.00	$6.52–$32.40	43% below	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE (MONO)	$9.75	$15.00	$12.00–$13.50	—	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB/(MONO)	$23.40	$36.00	$28.80–$32.40	—	35%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA/FREE	$57.20	$88.00	$23.17–$79.20	25% below	35%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA/FREE	$57.20	$88.00	$70.40–$79.20	—	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL (NON MC PSAORTEST)	$51.35	$79.00	$23.17–$71.10	33% below	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA/TOTAL	$52.65	$81.00	$23.17–$72.90	32% below	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL PRL	$54.60	$84.00	$23.17–$75.60	29% below	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$65.00	$100.00	$23.17–$90.00	16% below	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRA SENSITIVE	$113.75	$175.00	$23.17–$157.50	48% above	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRASEN W/SERIAL MONIT	$139.10	$214.00	$23.17–$192.60	81% above	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL (NON MC PSAORTEST)	$51.35	$79.00	$63.20–$71.10	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA/TOTAL	$52.65	$81.00	$64.80–$72.90	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL PRL	$54.60	$84.00	$67.20–$75.60	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$65.00	$100.00	$80.00–$90.00	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRA SENSITIVE	$113.75	$175.00	$140.00–$157.50	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRASEN W/SERIAL MONIT	$139.10	$214.00	$171.20–$192.60	—	35%
Pap test (liquid-based, automated screening with review) CPT 88175 THIN PREP	$107.90	$166.00	$33.53–$149.40	45% above	35%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THIN PREP	$107.90	$166.00	$132.80–$149.40	—	35%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$123.50	$190.00	$52.01–$171.00	28% below	35%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$123.50	$190.00	$152.00–$171.00	—	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$48.75	$75.00	$7.57–$67.50	7% below	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT W/MOD	$48.75	$75.00	$7.57–$67.50	7% below	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 APS PTT	$48.75	$75.00	$7.57–$67.50	7% below	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME	$96.20	$148.00	$7.57–$133.20	83% above	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$48.75	$75.00	$60.00–$67.50	—	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APS PTT	$48.75	$75.00	$60.00–$67.50	—	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT W/MOD	$48.75	$75.00	$60.00–$67.50	—	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME	$96.20	$148.00	$118.40–$133.20	—	35%
Progesterone blood test CPT 84144 PROGESTERONE	$35.75	$55.00	$26.28–$49.50	68% below	35%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$35.75	$55.00	$44.00–$49.50	—	35%
Prolactin blood test CPT 84146 PROLACTIN	$48.75	$75.00	$24.42–$67.50	60% below	35%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$48.75	$75.00	$60.00–$67.50	—	35%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$29.25	$45.00	$5.40–$40.50	4% above	35%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (POCT)	$29.25	$45.00	$5.40–$40.50	4% above	35%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME W/MOD	$29.25	$45.00	$5.40–$40.50	4% above	35%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME LUPUS	$29.25	$45.00	$5.40–$40.50	4% above	35%
Prothrombin time (PT/INR) clotting test CPT 85610 APS PROTHROMBIN TIME	$44.20	$68.00	$5.40–$61.20	58% above	35%
Prothrombin time (PT/INR) clotting test CPT 85610 INR LUPUS	$101.83	$156.65	$5.40–$140.99	264% above	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$29.25	$45.00	$36.00–$40.50	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME LUPUS	$29.25	$45.00	$36.00–$40.50	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME W/MOD	$29.25	$45.00	$36.00–$40.50	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (POCT)	$29.25	$45.00	$36.00–$40.50	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 APS PROTHROMBIN TIME	$44.20	$68.00	$54.40–$61.20	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR LUPUS	$101.83	$156.65	$125.32–$140.99	—	35%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PSRMV DIR OPT OBS	$40.30	$62.00	$15.88–$55.80	41% below	35%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PSRMV DIR OPT OBS	$40.30	$62.00	$49.60–$55.80	—	35%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$22.75	$35.00	$19.95–$31.50	62% below	35%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A &B-send out	$53.30	$82.00	$20.86–$73.80	11% below	35%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A & B- in house	$53.30	$82.00	$20.86–$73.80	11% below	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC	$27.30	$42.00	$33.60–$37.80	—	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A & B- in house	$53.30	$82.00	$65.60–$73.80	—	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A &B-send out	$53.30	$82.00	$65.60–$73.80	—	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC	$19.50	$30.00	$17.10–$27.00	51% below	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP	$39.00	$60.00	$20.83–$54.00	2% below	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP A	$48.75	$75.00	$20.83–$67.50	23% above	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC	$19.50	$30.00	$24.00–$27.00	—	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP	$39.00	$60.00	$48.00–$54.00	—	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP A	$48.75	$75.00	$60.00–$67.50	—	35%
Rheumatoid factor (RF) test CPT 86431 RHEUMATIOD FACTOR QUANT	$31.20	$48.00	$7.14–$43.20	30% below	35%
Rheumatoid factor (RF) test CPT 86431 RHEUMOTOID FACTOR	$79.30	$122.00	$7.14–$109.80	78% above	35%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATIOD FACTOR QUANT	$31.20	$48.00	$38.40–$43.20	—	35%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMOTOID FACTOR	$79.30	$122.00	$97.60–$109.80	—	35%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG	$43.55	$67.00	$18.13–$60.30	17% below	35%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGG	$43.55	$67.00	$53.60–$60.30	—	35%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR (SED RATE) AUTO	$22.75	$35.00	$3.40–$31.50	34% below	35%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE, WESTERGREN	$22.75	$35.00	$3.40–$31.50	34% below	35%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR (SED RATE) AUTO	$22.75	$35.00	$28.00–$31.50	—	35%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE, WESTERGREN	$22.75	$35.00	$28.00–$31.50	—	35%
Stool ova and parasites exam CPT 87177 PARASITE STUDIES	$10.40	$16.00	$9.12–$14.40	82% below	35%
Stool ova and parasites exam CPT 87177 OVA & PARASITES/DIRECT	$27.95	$43.00	$11.21–$38.70	51% below	35%
Stool ova and parasites exam CPT 87177 OVA & PARASITES EXAM UR	$76.70	$118.00	$11.21–$106.20	33% above	35%
Stool ova and parasites exam inpatient CPT 87177 PARASITE STUDIES	$10.40	$16.00	$12.80–$14.40	—	35%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES/DIRECT	$27.95	$43.00	$34.40–$38.70	—	35%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES EXAM UR	$76.70	$118.00	$94.40–$106.20	—	35%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOCCULT NEO	$20.80	$32.00	$5.52–$28.80	3% below	35%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HEMOCCULT NEO	$20.80	$32.00	$25.60–$28.80	—	35%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD, FECAL IA	$44.20	$68.00	$20.06–$61.20	13% below	35%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD, FECAL IA	$44.20	$68.00	$54.40–$61.20	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR W/RFLX QUAN RPR/CNFRM T PL	$14.30	$22.00	$5.38–$19.80	52% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR REFLEX	$14.30	$22.00	$5.38–$19.80	52% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS AB 1GG	$28.60	$44.00	$5.38–$39.60	3% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR W/RFLX QUAN RPR/CNFRM T PL	$14.30	$22.00	$17.60–$19.80	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR REFLEX	$14.30	$22.00	$17.60–$19.80	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS AB 1GG	$28.60	$44.00	$35.20–$39.60	—	35%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$113.75	$175.00	$78.09–$157.50	40% below	35%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD	$113.75	$175.00	$140.00–$157.50	—	35%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE - TOTAL	$35.75	$55.00	$31.35–$49.50	70% below	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE - TOTAL	$35.75	$55.00	$44.00–$49.50	—	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-MICROSOMAL LVR/KDNY TYP 1	$34.45	$53.00	$18.34–$47.70	55% below	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 THY PEROX (TPO) AB	$58.50	$90.00	$18.34–$81.00	24% below	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES	$72.80	$112.00	$18.34–$100.80	5% below	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-MICROSOMAL LVR/KDNY TYP 1	$34.45	$53.00	$42.40–$47.70	—	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THY PEROX (TPO) AB	$58.50	$90.00	$72.00–$81.00	—	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES	$72.80	$112.00	$89.60–$100.80	—	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH PRL	$61.75	$95.00	$21.17–$85.50	35% above	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 3RD GENERATION	$61.75	$95.00	$21.17–$85.50	35% above	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$61.75	$95.00	$21.17–$85.50	35% above	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$61.75	$95.00	$76.00–$85.50	—	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 3RD GENERATION	$61.75	$95.00	$76.00–$85.50	—	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH PRL	$61.75	$95.00	$76.00–$85.50	—	35%
Trichomonas test (NAAT) CPT 87661 TRICHOMONIS VAGINALIS BY NAA	$29.90	$46.00	$26.22–$44.21	78% below	35%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONIS VAGINALIS BY NAA	$29.90	$46.00	$36.80–$41.40	—	35%
Uric acid blood test CPT 84550 URIC ACID/BLOOD	$32.50	$50.00	$5.70–$45.00	23% below	35%
Uric acid blood test inpatient CPT 84550 URIC ACID/BLOOD	$32.50	$50.00	$40.00–$45.00	—	35%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W MICRO	$32.50	$50.00	$3.99–$45.00	13% below	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W MICRO	$32.50	$50.00	$40.00–$45.00	—	35%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$9.75	$15.00	$2.83–$13.50	51% below	35%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/O MICRO	$16.25	$25.00	$2.83–$22.50	19% below	35%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS/AUTO W/MOD	$16.25	$25.00	$2.83–$22.50	19% below	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE	$9.75	$15.00	$12.00–$13.50	—	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/O MICRO	$16.25	$25.00	$20.00–$22.50	—	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS/AUTO W/MOD	$16.25	$25.00	$20.00–$22.50	—	35%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$42.25	$65.00	$10.16–$58.50	34% below	35%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE	$42.25	$65.00	$52.00–$58.50	—	35%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$10.40	$16.00	$9.12–$14.40	79% below	35%
Urine pregnancy test, read by color change CPT 81025 URINE PREG TEST	$32.50	$50.00	$10.85–$45.00	35% below	35%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$10.40	$16.00	$12.80–$14.40	—	35%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREG TEST	$32.50	$50.00	$40.00–$45.00	—	35%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$65.00	$100.00	$19.00–$90.00	16% below	35%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$65.00	$100.00	$80.00–$90.00	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-WELLNESS	$13.00	$20.00	$11.40–$37.30	90% below	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D	$65.00	$100.00	$37.30–$90.00	52% below	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D 25-OH (D2+D3)	$65.00	$100.00	$37.30–$90.00	52% below	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D-WELLNESS	$13.00	$20.00	$16.00–$18.00	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VIT D 25-OH (D2+D3)	$65.00	$100.00	$80.00–$90.00	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D	$65.00	$100.00	$80.00–$90.00	—	35%
Zinc blood test CPT 84630 ZINC	$37.70	$58.00	$14.35–$52.20	38% below	35%
Zinc blood test inpatient CPT 84630 ZINC	$37.70	$58.00	$46.40–$52.20	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG-BETA QNT (PRL)	$24.05	$37.00	$18.97–$33.30	72% below	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 LC HCG, QUANT	$65.00	$100.00	$18.97–$90.00	23% below	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT	$65.00	$100.00	$18.97–$90.00	23% below	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG-BETA QNT (PRL)	$24.05	$37.00	$29.60–$33.30	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 LC HCG, QUANT	$65.00	$100.00	$80.00–$90.00	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT	$65.00	$100.00	$80.00–$90.00	—	35%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 PF REMOVAL OF ADENOIDS	$351.65	$541.00	$185.10–$3,442.57	89% below	35%
Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS	$3,347.50	$5,150.00	$2,935.50–$4,635.00	4% above	35%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 PF REMOVAL OF ADENOIDS	$351.65	$541.00	$185.10–$3,442.57	—	35%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 REMOVAL OF ADENOIDS	$3,347.50	$5,150.00	$4,120.00–$4,635.00	—	35%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 PF ARTHROSCO AID ANT	$780.00	$1,200.00	$857.16–$8,003.91	96% below	35%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 ARTHROSCO AID ANT	$8,034.00	$12,360.00	$7,045.20–$11,124.00	58% below	35%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 PF ARTHROSCO AID ANT	$780.00	$1,200.00	$857.16–$8,003.91	—	35%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 ARTHROSCO AID ANT	$8,034.00	$12,360.00	$9,888.00–$11,124.00	—	35%
Botox injections for chronic migraine CPT 64615 PF CHEMODENERV MUSC MIGRANE	$130.00	$200.00	$108.56–$329.00	50% below	35%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRANE	$227.50	$350.00	$199.50–$324.55	12% below	35%
Botox injections for chronic migraine inpatient CPT 64615 PF CHEMODENERV MUSC MIGRANE	$130.00	$200.00	$108.56–$329.00	—	35%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRANE	$227.50	$350.00	$280.00–$315.00	—	35%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 PF DIST FIB FRCT W/O MANI	$229.45	$353.00	$250.49–$386.64	53% below	35%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 DIST FIB FRCT W/O MANI	$248.95	$383.00	$218.31–$344.70	49% below	35%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 PF DIST FIB FRCT W/O MANI	$229.45	$353.00	$250.49–$386.64	—	35%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 DIST FIB FRCT W/O MANI	$248.95	$383.00	$306.40–$344.70	—	35%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 PF META FRCT W/O MANI EACH	$162.50	$250.00	$177.54–$273.99	59% below	35%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 META FRCT W/O MANI EACH	$248.95	$383.00	$218.31–$344.70	37% below	35%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 PF META FRCT W/O MANI EACH	$162.50	$250.00	$177.54–$273.99	—	35%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 META FRCT W/O MANI EACH	$248.95	$383.00	$306.40–$344.70	—	35%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 PF CORRECTION HALLUX VALGUS	$1,071.20	$1,648.00	$449.70–$3,601.86	41% below	35%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECTION HALLUX VALGUS	$3,347.50	$5,150.00	$2,935.50–$4,635.00	84% above	35%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 PF CORRECTION HALLUX VALGUS	$1,071.20	$1,648.00	$449.70–$3,601.86	—	35%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRECTION HALLUX VALGUS	$3,347.50	$5,150.00	$4,120.00–$4,635.00	—	35%
Bunion correction with removal of part of the big toe joint CPT 28292 PF CORRECTION HALLUX VALGUS	$520.00	$800.00	$422.79–$3,601.86	56% below	35%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRECTION HALLUX VALGUS	$3,380.00	$5,200.00	$2,964.00–$4,680.00	187% above	35%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 PF CORRECTION HALLUX VALGUS	$520.00	$800.00	$422.79–$3,601.86	—	35%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORRECTION HALLUX VALGUS	$3,380.00	$5,200.00	$4,160.00–$4,680.00	—	35%
Cardioversion, elective (restoring heart rhythm) CPT 92960 PF CARDIOVERSION ELECTRIC EXT	$166.40	$256.00	$96.37–$711.66	80% below	35%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$481.00	$740.00	$421.80–$697.83	42% below	35%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$574.60	$884.00	$503.88–$795.60	30% below	35%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 PF CARDIOVERSION ELECTRIC EXT	$166.40	$256.00	$96.37–$711.66	—	35%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$481.00	$740.00	$592.00–$666.00	—	35%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$574.60	$884.00	$707.20–$795.60	—	35%
Carpal tunnel release, open surgery CPT 64721 PF CARPAL TUNNEL SURGERY	$669.50	$1,030.00	$379.79–$2,175.07	78% below	35%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$2,008.50	$3,090.00	$1,761.30–$2,781.00	34% below	35%
Carpal tunnel release, open surgery inpatient CPT 64721 PF CARPAL TUNNEL SURGERY	$669.50	$1,030.00	$379.79–$2,175.07	—	35%
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL SURGERY	$2,008.50	$3,090.00	$2,472.00–$2,781.00	—	35%
Cataract surgery with lens implant CPT 66984 CTRCT RMV W/INSERT W/O ENDSCPC	$2,470.00	$3,800.00	$2,166.00–$3,420.00	52% below	35%
Cataract surgery with lens implant inpatient CPT 66984 CTRCT RMV W/INSERT W/O ENDSCPC	$2,470.00	$3,800.00	$3,040.00–$3,420.00	—	35%
Cervical biopsy CPT 57500 PF BIOPSY OF CERVIX	$97.50	$150.00	$65.84–$851.23	91% below	35%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$975.00	$1,500.00	$787.53–$1,350.00	8% below	35%
Cervical biopsy inpatient CPT 57500 PF BIOPSY OF CERVIX	$97.50	$150.00	$65.84–$851.23	—	35%
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX	$975.00	$1,500.00	$1,200.00–$1,350.00	—	35%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TRT DISTAL RADIAL FRAC	$260.00	$400.00	$228.00–$360.00	56% below	35%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 PF CLSD TRT DISTAL RADL FRAC	$338.00	$520.00	$250.49–$442.00	43% below	35%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TRT DISTAL RADIAL FRAC	$260.00	$400.00	$320.00–$360.00	—	35%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 PF CLSD TRT DISTAL RADL FRAC	$338.00	$520.00	$250.49–$442.00	—	35%
Colonoscopy with polyp removal CPT 45385 ADD COLONOSCOPY W/LESION REMOV	$167.70	$258.00	$147.06–$1,288.15	90% below	35%
Colonoscopy with polyp removal CPT 45385 PF COLONOSCOPY W/LESION REMVAL	$669.50	$1,030.00	$222.43–$1,310.36	61% below	35%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LESION REMOVAL	$1,430.00	$2,200.00	$1,254.00–$1,980.00	16% below	35%
Colonoscopy with polyp removal inpatient CPT 45385 ADD COLONOSCOPY W/LESION REMOV	$167.70	$258.00	$206.40–$232.20	—	35%
Colonoscopy with polyp removal inpatient CPT 45385 PF COLONOSCOPY W/LESION REMVAL	$669.50	$1,030.00	$222.43–$1,310.36	—	35%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/LESION REMOVAL	$1,430.00	$2,200.00	$1,760.00–$1,980.00	—	35%
Colonoscopy with tissue sample CPT 45380 ADD COLONOSCOPY AND BIOPSTY	$167.70	$258.00	$147.06–$1,288.15	91% below	35%
Colonoscopy with tissue sample CPT 45380 PF COLONOSCOPY AND BIOPSY	$669.50	$1,030.00	$175.61–$1,310.36	62% below	35%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$1,339.00	$2,060.00	$1,174.20–$1,854.00	25% below	35%
Colonoscopy with tissue sample inpatient CPT 45380 ADD COLONOSCOPY AND BIOPSTY	$167.70	$258.00	$206.40–$232.20	—	35%
Colonoscopy with tissue sample inpatient CPT 45380 PF COLONOSCOPY AND BIOPSY	$669.50	$1,030.00	$175.61–$1,310.36	—	35%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY AND BIOPSY	$1,339.00	$2,060.00	$1,648.00–$1,854.00	—	35%
Colonoscopy, diagnostic CPT 45378 ADD DIAGNOSTIC COLOSCOPY	$167.70	$258.00	$147.06–$985.80	87% below	35%
Colonoscopy, diagnostic CPT 45378 PF DIAGNOSTIC COLONOSCOPY	$341.25	$525.00	$161.55–$1,005.58	73% below	35%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$1,300.00	$2,000.00	$985.80–$1,800.00	3% above	35%
Colonoscopy, diagnostic inpatient CPT 45378 ADD DIAGNOSTIC COLOSCOPY	$167.70	$258.00	$206.40–$232.20	—	35%
Colonoscopy, diagnostic inpatient CPT 45378 PF DIAGNOSTIC COLONOSCOPY	$341.25	$525.00	$161.55–$1,005.58	—	35%
Colonoscopy, diagnostic inpatient CPT 45378 DIAGNOSTIC COLONOSCOPY	$1,300.00	$2,000.00	$1,600.00–$1,800.00	—	35%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 PF BX OF CERVIX W/SCOPE LEEP	$351.65	$541.00	$141.59–$3,421.29	83% below	35%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP	$2,925.00	$4,500.00	$2,565.00–$4,050.00	43% above	35%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 PF BX OF CERVIX W/SCOPE LEEP	$351.65	$541.00	$141.59–$3,421.29	—	35%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 BX OF CERVIX W/SCOPE LEEP	$2,925.00	$4,500.00	$3,600.00–$4,050.00	—	35%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 PF BX/CURETT OF CERVIX W/SCOPE	$351.65	$541.00	$117.89–$459.85	22% below	35%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$399.75	$615.00	$350.34–$553.50	11% below	35%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 PF BX/CURETT OF CERVIX W/SCOPE	$351.65	$541.00	$117.89–$459.85	—	35%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$399.75	$615.00	$492.00–$553.50	—	35%
Complex cataract surgery with lens implant CPT 66982 CTRCT REM W/INSERT OF LENS COM	$2,730.00	$4,200.00	$2,394.00–$3,780.00	38% below	35%
Complex cataract surgery with lens implant inpatient CPT 66982 CTRCT REM W/INSERT OF LENS COM	$2,730.00	$4,200.00	$3,360.00–$3,780.00	—	35%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 PF CYSTOURETHROSCOPY	$100.75	$155.00	$70.86–$756.67	91% below	35%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$1,625.00	$2,500.00	$714.66–$2,250.00	52% above	35%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 PF CYSTOURETHROSCOPY	$100.75	$155.00	$70.86–$756.67	—	35%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$1,625.00	$2,500.00	$2,000.00–$2,250.00	—	35%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PF DESTRUCT PREMALG LESION	$100.75	$155.00	$46.80–$218.51	14% below	35%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION	$308.75	$475.00	$223.08–$427.50	164% above	35%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 PF DESTRUCT PREMALG LESION	$100.75	$155.00	$46.80–$218.51	—	35%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT PREMALG LESION	$308.75	$475.00	$380.00–$427.50	—	35%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 PF CREATE EARDRUM OPENING	$351.65	$541.00	$138.91–$1,679.69	89% below	35%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 PF CREATE EARDRUM OPENING-BIL	$487.50	$750.00	$138.91–$1,679.69	85% below	35%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING	$1,339.00	$2,060.00	$1,174.20–$1,854.00	59% below	35%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING-BIL	$2,080.00	$3,200.00	$1,680.38–$2,880.00	37% below	35%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 PF CREATE EARDRUM OPENING	$351.65	$541.00	$138.91–$1,679.69	—	35%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 PF CREATE EARDRUM OPENING-BIL	$487.50	$750.00	$138.91–$1,679.69	—	35%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 CREATE EARDRUM OPENING	$1,339.00	$2,060.00	$1,648.00–$1,854.00	—	35%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 CREATE EARDRUM OPENING-BIL	$2,080.00	$3,200.00	$2,560.00–$2,880.00	—	35%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 PF CREATE EARDRUM OPENING	$351.65	$541.00	$114.73–$552.76	15% below	35%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 PF CREATE EARDRUM OPENING-BIL	$487.50	$750.00	$114.73–$637.50	18% above	35%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING	$669.50	$1,030.00	$561.82–$927.00	62% above	35%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING-BIL	$1,105.00	$1,700.00	$561.82–$1,530.00	168% above	35%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 PF CREATE EARDRUM OPENING	$351.65	$541.00	$114.73–$552.76	—	35%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 PF CREATE EARDRUM OPENING-BIL	$487.50	$750.00	$114.73–$637.50	—	35%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 CREATE EARDRUM OPENING	$669.50	$1,030.00	$824.00–$927.00	—	35%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 CREATE EARDRUM OPENING-BIL	$1,105.00	$1,700.00	$1,360.00–$1,530.00	—	35%
Earwax removal by irrigation (rinsing), one ear CPT 69209 PF REM IMPT CER W/IRRIG	$10.40	$16.00	$12.41–$69.55	86% below	35%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMPT CER W/IRRIG	$61.75	$95.00	$54.15–$85.50	17% below	35%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 PF REM IMPT CER W/IRRIG	$10.40	$16.00	$12.41–$69.55	—	35%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM IMPT CER W/IRRIG	$61.75	$95.00	$76.00–$85.50	—	35%
Earwax removal with instruments, one ear CPT 69210 PF REMOVE IMPACTED EAR WAX UNI	$50.70	$78.00	$29.04–$69.55	45% below	35%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$63.05	$97.00	$55.29–$87.30	31% below	35%
Earwax removal with instruments, one ear inpatient CPT 69210 PF REMOVE IMPACTED EAR WAX UNI	$50.70	$78.00	$29.04–$69.55	—	35%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX UNI	$61.75	$95.00	$76.00–$85.50	—	35%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 PF BIOPSY OF UTERUS LINING	$100.75	$155.00	$56.46–$215.54	62% below	35%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$260.00	$400.00	$211.62–$360.00	1% below	35%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 PF BIOPSY OF UTERUS LINING	$100.75	$155.00	$56.46–$215.54	—	35%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING	$260.00	$400.00	$320.00–$360.00	—	35%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 PF NJX INTERLAMINAR CRV/THRC	$351.65	$541.00	$94.06–$779.66	66% below	35%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$796.25	$1,225.00	$698.25–$1,102.50	22% below	35%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 PF NJX INTERLAMINAR CRV/THRC	$351.65	$541.00	$94.06–$779.66	—	35%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTERLAMINAR CRV/THRC	$796.25	$1,225.00	$980.00–$1,102.50	—	35%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 PF INJ PARAVRT F JNT L/S 1 LEV	$351.65	$541.00	$79.13–$1,031.17	66% below	35%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$1,072.50	$1,650.00	$940.50–$1,485.00	3% above	35%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 PF INJ PARAVRT F JNT L/S 1 LEV	$351.65	$541.00	$79.13–$1,031.17	—	35%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$1,072.50	$1,650.00	$1,320.00–$1,485.00	—	35%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 PF REPAIR ANTERIOR ABD HERNIA	$650.00	$1,000.00	$510.98–$4,285.85	90% below	35%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR ANTERIOR ABD HERNIA	$3,900.00	$6,000.00	$3,420.00–$5,400.00	40% below	35%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 PF REPAIR ANTERIOR ABD HERNIA	$650.00	$1,000.00	$510.98–$4,285.85	—	35%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 REPAIR ANTERIOR ABD HERNIA	$3,900.00	$6,000.00	$4,800.00–$5,400.00	—	35%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 PF RPR ANT ABD HERN <3CM	$351.00	$540.00	$304.18–$4,285.85	93% below	35%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPR ANTER ABDOM HERNIA <3CM	$3,347.50	$5,150.00	$2,935.50–$4,635.00	29% below	35%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 PF RPR ANT ABD HERN <3CM	$351.00	$540.00	$304.18–$4,285.85	—	35%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 REPR ANTER ABDOM HERNIA <3CM	$3,347.50	$5,150.00	$4,120.00–$4,635.00	—	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 PF DIAGNOSTIC SIGMOIDOSCOPY	$100.75	$155.00	$48.74–$1,005.58	91% below	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 ADD DIAGNOSTIC SIGMOIDOSCOPY	$167.70	$258.00	$147.06–$985.80	85% below	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$1,056.25	$1,625.00	$926.25–$1,462.50	6% below	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 PF DIAGNOSTIC SIGMOIDOSCOPY	$100.75	$155.00	$48.74–$1,005.58	—	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 ADD DIAGNOSTIC SIGMOIDOSCOPY	$167.70	$258.00	$206.40–$232.20	—	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$1,056.25	$1,625.00	$1,300.00–$1,462.50	—	35%
Gallbladder removal, laparoscopic CPT 47562 PF LAPAROSCOPI CHOLECYSTECTOMY	$669.50	$1,030.00	$583.99–$6,306.87	89% below	35%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$7,029.75	$10,815.00	$6,164.55–$9,733.50	17% above	35%
Gallbladder removal, laparoscopic inpatient CPT 47562 PF LAPAROSCOPI CHOLECYSTECTOMY	$669.50	$1,030.00	$583.99–$6,306.87	—	35%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$7,029.75	$10,815.00	$8,652.00–$9,733.50	—	35%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 PF LAPARO CHOLECYSTECTOM/GRAPH	$669.50	$1,030.00	$636.92–$6,306.87	89% below	35%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$7,029.75	$10,815.00	$6,164.55–$9,733.50	13% above	35%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 PF LAPARO CHOLECYSTECTOM/GRAPH	$669.50	$1,030.00	$636.92–$6,306.87	—	35%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$7,029.75	$10,815.00	$8,652.00–$9,733.50	—	35%
Hammertoe correction surgery CPT 28285 PF HAMMERTOE CORRECTION	$390.00	$600.00	$335.86–$3,601.86	84% below	35%
Hammertoe correction surgery CPT 28285 HAMMERTOE CORRECTION-BIL	$412.75	$635.00	$335.86–$3,601.86	83% below	35%
Hammertoe correction surgery CPT 28285 HAMMERTOE CORRECTION	$1,950.00	$3,000.00	$1,710.00–$3,517.91	19% below	35%
Hammertoe correction surgery CPT 28285 HAMMERTOE CORRECTION-BIL	$3,250.00	$5,000.00	$2,850.00–$4,500.00	36% above	35%
Hammertoe correction surgery inpatient CPT 28285 PF HAMMERTOE CORRECTION	$390.00	$600.00	$335.86–$3,601.86	—	35%
Hammertoe correction surgery inpatient CPT 28285 HAMMERTOE CORRECTION-BIL	$412.75	$635.00	$335.86–$3,601.86	—	35%
Hammertoe correction surgery inpatient CPT 28285 HAMMERTOE CORRECTION	$1,950.00	$3,000.00	$2,400.00–$2,700.00	—	35%
Hammertoe correction surgery inpatient CPT 28285 HAMMERTOE CORRECTION-BIL	$3,250.00	$5,000.00	$4,000.00–$4,500.00	—	35%
Hemorrhoid banding (rubber band ligation) CPT 46221 PF LIGATION OF HEMORRHOID(S)	$351.65	$541.00	$166.77–$1,005.58	74% below	35%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$1,300.00	$2,000.00	$985.80–$1,800.00	4% below	35%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 PF LIGATION OF HEMORRHOID(S)	$351.65	$541.00	$166.77–$1,005.58	—	35%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LIGATION OF HEMORRHOID(S)	$1,300.00	$2,000.00	$1,600.00–$1,800.00	—	35%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$230.75	$355.00	$202.35–$319.50	63% below	35%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE	$230.75	$355.00	$284.00–$319.50	—	35%
Incision and drainage of a simple or single skin abscess CPT 10060 PF DRAIN OF SKIN ABSCESS SMPL	$123.50	$190.00	$90.36–$218.51	45% below	35%
Incision and drainage of a simple or single skin abscess CPT 10060 PF INCISION & DRAIN ABSCESS	$149.50	$230.00	$90.36–$218.51	34% below	35%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS	$167.70	$258.00	$147.06–$232.20	25% below	35%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAIN OF SKIN ABSCESS SIMPLE	$189.15	$291.00	$165.87–$261.90	16% below	35%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D OF ABSCESS OR CYST-SIMPLE	$208.00	$320.00	$182.40–$288.00	8% below	35%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 PF DRAIN OF SKIN ABSCESS SMPL	$123.50	$190.00	$90.36–$218.51	—	35%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 PF INCISION & DRAIN ABSCESS	$149.50	$230.00	$90.36–$218.51	—	35%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABSCESS	$175.50	$270.00	$216.00–$243.00	—	35%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAIN OF SKIN ABSCESS SIMPLE	$189.15	$291.00	$232.80–$261.90	—	35%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D OF ABSCESS OR CYST-SIMPLE	$208.00	$320.00	$256.00–$288.00	—	35%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PF PRP/HERN INIT REDUC >5YR	$403.00	$620.00	$462.54–$4,285.85	94% below	35%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP/HERN INIT REDUC >5YR	$4,550.00	$7,000.00	$3,952.21–$6,300.00	27% below	35%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PF PRP/HERN INIT REDUC >5YR	$403.00	$620.00	$462.54–$4,285.85	—	35%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PRP/HERN INIT REDUC >5YR	$4,550.00	$7,000.00	$5,600.00–$6,300.00	—	35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PF INJ TENDON SHEATH/LIGAMENT	$100.75	$155.00	$34.83–$329.00	49% below	35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PF INJ TENDON SHEAT/LGMENT BIL	$162.50	$250.00	$34.83–$329.00	18% below	35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$309.40	$476.00	$271.32–$428.40	56% above	35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT-BIL	$568.75	$875.00	$324.55–$787.50	187% above	35%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PF INJ TENDON SHEATH/LIGAMENT	$100.75	$155.00	$34.83–$329.00	—	35%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PF INJ TENDON SHEAT/LGMENT BIL	$162.50	$250.00	$34.83–$329.00	—	35%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT	$334.75	$515.00	$412.00–$463.50	—	35%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT-BIL	$568.75	$875.00	$700.00–$787.50	—	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PF DRAIN/INJ JNT/BURSA W/O US	$100.75	$155.00	$39.89–$329.00	53% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PF DRN/INJ JNT/BRSA W/O US BIL	$201.50	$310.00	$39.89–$329.00	6% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$286.00	$440.00	$250.80–$396.00	34% above	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRN/INJ JOINT/BURSA W/O US-BIL	$572.00	$880.00	$324.55–$792.00	167% above	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PF DRAIN/INJ JNT/BURSA W/O US	$100.75	$155.00	$39.89–$329.00	—	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PF DRN/INJ JNT/BRSA W/O US BIL	$201.50	$310.00	$39.89–$329.00	—	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$286.00	$440.00	$352.00–$396.00	—	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRN/INJ JOINT/BURSA W/O US-BIL	$572.00	$880.00	$704.00–$792.00	—	35%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 PF INSERTION DRUG DLVR IMPLANT	$26.65	$41.00	$32.80–$140.50	85% below	35%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVR IMPLANT	$159.25	$245.00	$139.65–$220.50	12% below	35%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 PF INSERTION DRUG DLVR IMPLANT	$26.65	$41.00	$32.80–$140.50	—	35%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DLVR IMPLANT	$240.50	$370.00	$296.00–$333.00	—	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 PF DRN/INJ JNT/BURSA W/O US-BI	$100.75	$155.00	$32.89–$329.00	—	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PF DRAIN/INJ JNT/BURSA W/O US	$53.30	$82.00	$32.89–$329.00	73% below	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PF DRAIN/INJ JOINT/BURSA W/OUS	$100.75	$155.00	$32.89–$329.00	50% below	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 XR INJECPROC WRIST/ELBOW/ANKLE	$274.30	$422.00	$240.54–$379.80	37% above	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$334.75	$515.00	$293.55–$463.50	67% above	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRN/INJ JOINT/BURSA W/O US-BIL	$669.50	$1,030.00	$324.55–$927.00	235% above	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 PF DRN/INJ JNT/BURSA W/O US-BI	$100.75	$155.00	$32.89–$329.00	—	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PF DRAIN/INJ JNT/BURSA W/O US	$53.30	$82.00	$32.89–$329.00	—	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PF DRAIN/INJ JOINT/BURSA W/OUS	$100.75	$155.00	$32.89–$329.00	—	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$130.00	$200.00	$160.00–$180.00	—	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 XR INJECPROC WRIST/ELBOW/ANKLE	$274.30	$422.00	$337.60–$379.80	—	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRN/INJ JOINT/BURSA W/O US-BIL	$669.50	$1,030.00	$824.00–$927.00	—	35%
Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 PF DRN/INJ JNT/BURSA W/O US-BI	$100.75	$155.00	$31.42–$329.00	—	35%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 PF DRN/INJ JOINT/BURS W/O US	$50.70	$78.00	$31.42–$329.00	75% below	35%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 PF DRAIN/INJ JOINT/BURSA W/OUS	$100.75	$155.00	$31.42–$329.00	50% below	35%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$334.75	$515.00	$293.55–$463.50	67% above	35%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRN/INJ JOINT/BURSA W/O US-BIL	$669.50	$1,030.00	$324.55–$927.00	233% above	35%
Joint injection or drainage, small joint (fingers, toes) inpatient both sides CPT 20600 PF DRN/INJ JNT/BURSA W/O US-BI	$100.75	$155.00	$31.42–$329.00	—	35%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 PF DRN/INJ JOINT/BURS W/O US	$50.70	$78.00	$31.42–$329.00	—	35%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 PF DRAIN/INJ JOINT/BURSA W/OUS	$100.75	$155.00	$31.42–$329.00	—	35%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$334.75	$515.00	$412.00–$463.50	—	35%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRN/INJ JOINT/BURSA W/O US-BIL	$669.50	$1,030.00	$824.00–$927.00	—	35%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 PF KNEE SRGRY W/MENSCS REPAIR	$669.50	$1,030.00	$605.67–$3,601.86	94% below	35%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE SURGERY W/MENISCUS REPAIR	$4,017.00	$6,180.00	$3,517.91–$5,562.00	63% below	35%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 PF KNEE SRGRY W/MENSCS REPAIR	$669.50	$1,030.00	$605.67–$3,601.86	—	35%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 KNEE SURGERY W/MENISCUS REPAIR	$4,017.00	$6,180.00	$4,944.00–$5,562.00	—	35%
Knee arthroscopy with meniscus trim CPT 29881 PF KNEE SURGRY W/MENIS IN DEBR	$669.50	$1,030.00	$474.11–$3,601.86	90% below	35%
Knee arthroscopy with meniscus trim CPT 29881 KNEE SURGERY W/MENIS INC DEBR	$4,550.00	$7,000.00	$3,517.91–$6,300.00	34% below	35%
Knee arthroscopy with meniscus trim inpatient CPT 29881 PF KNEE SURGRY W/MENIS IN DEBR	$669.50	$1,030.00	$474.11–$3,601.86	—	35%
Knee arthroscopy with meniscus trim inpatient CPT 29881 KNEE SURGERY W/MENIS INC DEBR	$4,550.00	$7,000.00	$5,600.00–$6,300.00	—	35%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 PF KNEE SURGERY W/MENISECTOMY	$669.50	$1,030.00	$492.86–$3,601.86	90% below	35%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE SURGERY W/MENISECTOMY	$4,017.00	$6,180.00	$3,517.91–$5,562.00	42% below	35%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 PF KNEE SURGERY W/MENISECTOMY	$669.50	$1,030.00	$492.86–$3,601.86	—	35%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 KNEE SURGERY W/MENISECTOMY	$4,017.00	$6,180.00	$4,944.00–$5,562.00	—	35%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 PF KNEE SURGERY DEBRID/SHAVING	$669.50	$1,030.00	$544.71–$3,601.86	89% below	35%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE SURGERY DEBRID/SHAVING	$4,017.00	$6,180.00	$3,517.91–$5,562.00	35% below	35%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 PF KNEE SURGERY DEBRID/SHAVING	$669.50	$1,030.00	$544.71–$3,601.86	—	35%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 KNEE SURGERY DEBRID/SHAVING	$4,017.00	$6,180.00	$4,944.00–$5,562.00	—	35%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 PF LAPAROSCOPY APPENDECTOMY	$669.50	$1,030.00	$533.14–$6,306.87	92% below	35%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY	$6,695.00	$10,300.00	$5,871.00–$9,270.00	16% below	35%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 PF LAPAROSCOPY APPENDECTOMY	$669.50	$1,030.00	$533.14–$6,306.87	—	35%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY APPENDECTOMY	$6,695.00	$10,300.00	$8,240.00–$9,270.00	—	35%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 PF LAP ING HERNIA REPAIR INIT	$351.65	$541.00	$381.62–$6,306.87	95% below	35%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT	$6,175.00	$9,500.00	$5,415.00–$8,550.00	16% below	35%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 PF LAP ING HERNIA REPAIR INIT	$351.65	$541.00	$381.62–$6,306.87	—	35%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAP ING HERNIA REPAIR INIT	$6,175.00	$9,500.00	$7,600.00–$8,550.00	—	35%
Laser treatment of clouding after cataract surgery (YAG) both sides CPT 66821 YAG LASER SEC CAT BI	$669.50	$1,030.00	$587.10–$927.00	—	35%
Laser treatment of clouding after cataract surgery (YAG) one side CPT 66821 YAG LASER SEC CAT LT	$535.60	$824.00	$469.68–$741.60	25% below	35%
Laser treatment of clouding after cataract surgery (YAG) one side CPT 66821 YAG LASER SEC CAT RT	$535.60	$824.00	$469.68–$741.60	25% below	35%
Laser treatment of clouding after cataract surgery (YAG) inpatient both sides CPT 66821 YAG LASER SEC CAT BI	$669.50	$1,030.00	$824.00–$927.00	—	35%
Laser treatment of clouding after cataract surgery (YAG) inpatient one side CPT 66821 YAG LASER SEC CAT RT	$535.60	$824.00	$659.20–$741.60	—	35%
Laser treatment of clouding after cataract surgery (YAG) inpatient one side CPT 66821 YAG LASER SEC CAT LT	$535.60	$824.00	$659.20–$741.60	—	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PF INTMD RP S/A/T/EXT 2.5 CM/<	$100.75	$155.00	$124.00–$451.42	73% below	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PF INT RP S/A/T/EXT 2.5 CM/<	$245.70	$378.00	$131.03–$451.42	35% below	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$348.40	$536.00	$305.52–$482.40	8% below	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 PF INTMD RP S/A/T/EXT 2.5 CM/<	$100.75	$155.00	$124.00–$451.42	—	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 PF INT RP S/A/T/EXT 2.5 CM/<	$245.70	$378.00	$131.03–$451.42	—	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$334.75	$515.00	$412.00–$463.50	—	35%
Lower-back epidural injection, with imaging guidance CPT 62323 PF NJX INTERLAMINAR LMBR/SAC	$351.65	$541.00	$87.17–$779.66	64% below	35%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,004.25	$1,545.00	$788.80–$1,390.50	4% above	35%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PF NJX INTERLAMINAR LMBR/SAC	$351.65	$541.00	$87.17–$779.66	—	35%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,004.25	$1,545.00	$1,236.00–$1,390.50	—	35%
Lower-back epidural injection, without imaging guidance CPT 62322 PF NJX INTERLAMINAR LMBR/SAC	$351.65	$541.00	$71.47–$1,031.17	68% below	35%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$1,004.25	$1,545.00	$788.80–$1,390.50	10% below	35%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PF NJX INTERLAMINAR LMBR/SAC	$351.65	$541.00	$71.47–$1,031.17	—	35%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX INTERLAMINAR LMBR/SAC	$1,004.25	$1,545.00	$1,236.00–$1,390.50	—	35%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PF NJX AA&/STRD TFRM EPI L/S 1	$351.65	$541.00	$97.05–$1,031.17	76% below	35%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$1,339.00	$2,060.00	$1,022.59–$1,854.00	10% below	35%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PF NJX AA&/STRD TFRM EPI L/S 1	$351.65	$541.00	$97.05–$1,031.17	—	35%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$1,339.00	$2,060.00	$1,648.00–$1,854.00	—	35%
Lumbar spinal fusion (posterior), one level CPT 22612 PF ARTHRD PST TQ1NTRSPC LUMBAR	$1,489.80	$2,292.00	$1,397.52–$26,496.82	39% below	35%
Lumbar spinal fusion (posterior), one level CPT 22612 ARTHRD PST TQ 1NTRSPC LUMBAR	$11,700.00	$18,000.00	$10,260.00–$16,200.00	376% above	35%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 PF ARTHRD PST TQ1NTRSPC LUMBAR	$1,489.80	$2,292.00	$1,397.52–$26,496.82	—	35%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 ARTHRD PST TQ 1NTRSPC LUMBAR	$11,700.00	$18,000.00	$14,400.00–$16,200.00	—	35%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 PF EXC TR-EXT B9+MARG 0.5 CM<	$100.75	$155.00	$71.92–$785.27	59% below	35%
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<	$650.00	$1,000.00	$570.00–$900.00	163% above	35%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 PF EXC TR-EXT B9+MARG 0.5 CM<	$100.75	$155.00	$71.92–$785.27	—	35%
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<	$650.00	$1,000.00	$800.00–$900.00	—	35%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 PF EXC FACE-MM B9+MARG 0.5CM/<	$351.65	$541.00	$90.38–$785.27	22% above	35%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$669.50	$1,030.00	$587.10–$927.00	132% above	35%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 PF EXC FACE-MM B9+MARG 0.5CM/<	$351.65	$541.00	$90.38–$785.27	—	35%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$669.50	$1,030.00	$824.00–$927.00	—	35%
Nail removal (partial or complete), one nail CPT 11730 PF REMOVAL OF NAIL PLATE	$100.75	$155.00	$47.78–$218.51	39% below	35%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$240.50	$370.00	$210.90–$333.00	46% above	35%
Nail removal (partial or complete), one nail inpatient CPT 11730 PF REMOVAL OF NAIL PLATE	$100.75	$155.00	$47.78–$218.51	—	35%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE	$240.50	$370.00	$296.00–$333.00	—	35%
Occipital nerve block (injection for headaches) both sides CPT 64405 PF NJX AA&/STRD GR OCPL NRV-BI	$162.50	$250.00	$46.92–$329.00	—	35%
Occipital nerve block (injection for headaches) CPT 64405 PF NJX AA&/STRD GR OCPL NRV	$100.75	$155.00	$46.92–$329.00	67% below	35%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$334.75	$515.00	$293.55–$463.50	10% above	35%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV-BIL	$568.75	$875.00	$324.55–$787.50	86% above	35%
Occipital nerve block (injection for headaches) inpatient both sides CPT 64405 PF NJX AA&/STRD GR OCPL NRV-BI	$162.50	$250.00	$46.92–$329.00	—	35%
Occipital nerve block (injection for headaches) inpatient CPT 64405 PF NJX AA&/STRD GR OCPL NRV	$100.75	$155.00	$46.92–$329.00	—	35%
Occipital nerve block (injection for headaches) inpatient CPT 64405 NJX AA&/STRD GR OCPL NRV	$334.75	$515.00	$412.00–$463.50	—	35%
Occipital nerve block (injection for headaches) inpatient CPT 64405 NJX AA&/STRD GR OCPL NRV-BIL	$568.75	$875.00	$700.00–$787.50	—	35%
Paracentesis with imaging guidance CPT 49083 PF ABD PARACENTESIS W/IMAGING	$301.60	$464.00	$93.48–$998.90	65% below	35%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$833.95	$1,283.00	$731.31–$1,154.70	3% below	35%
Paracentesis with imaging guidance CPT 49083 ABDONMINAL PARACENTESIS	$910.00	$1,400.00	$798.00–$1,260.00	5% above	35%
Paracentesis with imaging guidance inpatient CPT 49083 PF ABD PARACENTESIS W/IMAGING	$301.60	$464.00	$93.48–$998.90	—	35%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$833.95	$1,283.00	$1,026.40–$1,154.70	—	35%
Paracentesis with imaging guidance inpatient CPT 49083 ABDONMINAL PARACENTESIS	$910.00	$1,400.00	$1,120.00–$1,260.00	—	35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$334.75	$515.00	$293.55–$463.50	16% below	35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PF REMOVAL OF NAIL BED	$351.65	$541.00	$87.96–$459.85	11% below	35%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED	$334.75	$515.00	$412.00–$463.50	—	35%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 PF REMOVAL OF NAIL BED	$351.65	$541.00	$87.96–$459.85	—	35%
Prostate biopsy CPT 55700 PF PROSTATE NDL BIOPSY ANY APP	$250.25	$385.00	$114.52–$2,244.47	92% below	35%
Prostate biopsy CPT 55700 PROSTATE NDL BIOPSY ANY APPR	$1,950.00	$3,000.00	$1,710.00–$2,700.00	34% below	35%
Prostate biopsy inpatient CPT 55700 PF PROSTATE NDL BIOPSY ANY APP	$250.25	$385.00	$114.52–$2,244.47	—	35%
Prostate biopsy inpatient CPT 55700 PROSTATE NDL BIOPSY ANY APPR	$1,950.00	$3,000.00	$2,400.00–$2,700.00	—	35%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 PF DESTROY LUMB/SAC FACET JNT	$520.00	$800.00	$168.12–$2,175.07	64% below	35%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 PF DSTRY LUM/SAC FACET JNT-BIL	$650.00	$1,000.00	$168.12–$2,175.07	55% below	35%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$1,625.00	$2,500.00	$1,425.00–$2,250.00	13% above	35%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT-BIL	$2,405.00	$3,700.00	$2,109.00–$3,330.00	67% above	35%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 PF DESTROY LUMB/SAC FACET JNT	$520.00	$800.00	$168.12–$2,175.07	—	35%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 PF DSTRY LUM/SAC FACET JNT-BIL	$650.00	$1,000.00	$168.12–$2,175.07	—	35%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTROY LUMB/SAC FACET JNT	$1,625.00	$2,500.00	$2,000.00–$2,250.00	—	35%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTROY LUMB/SAC FACET JNT-BIL	$2,405.00	$3,700.00	$2,960.00–$3,330.00	—	35%
Removal of a breast lump, open surgery CPT 19120 PF EXCISION CYST B9/MAL TUMOR	$442.00	$680.00	$367.03–$4,159.85	56% below	35%
Removal of a breast lump, open surgery CPT 19120 EXCISION CYST B9/MAL TUMOR	$2,990.00	$4,600.00	$2,622.00–$4,140.00	200% above	35%
Removal of a breast lump, open surgery inpatient CPT 19120 PF EXCISION CYST B9/MAL TUMOR	$442.00	$680.00	$367.03–$4,159.85	—	35%
Removal of a breast lump, open surgery inpatient CPT 19120 EXCISION CYST B9/MAL TUMOR	$2,990.00	$4,600.00	$3,680.00–$4,140.00	—	35%
Removal of a foreign object under the skin, simple CPT 10120 PF REMOVE FOREIGN BODY	$100.75	$155.00	$90.43–$451.42	67% below	35%
Removal of a foreign object under the skin, simple CPT 10120 PF REMOVE FOREIGN BODY SIMPLE	$157.95	$243.00	$90.43–$451.42	48% below	35%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY	$334.75	$515.00	$293.55–$463.50	10% above	35%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY SIMPLE	$348.40	$536.00	$305.52–$482.40	14% above	35%
Removal of a foreign object under the skin, simple inpatient CPT 10120 PF REMOVE FOREIGN BODY	$100.75	$155.00	$90.43–$451.42	—	35%
Removal of a foreign object under the skin, simple inpatient CPT 10120 PF REMOVE FOREIGN BODY SIMPLE	$157.95	$243.00	$90.43–$451.42	—	35%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY	$334.75	$515.00	$412.00–$463.50	—	35%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY SIMPLE	$348.40	$536.00	$428.80–$482.40	—	35%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 PF SCREENING COLONOSCOPY	$351.65	$541.00	$163.58–$459.85	54% below	35%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 SCREENING COLONOSCOPY	$1,264.25	$1,945.00	$1,108.65–$1,750.50	65% above	35%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 PF SCREENING COLONOSCOPY	$351.65	$541.00	$163.58–$459.85	—	35%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 SCREENING COLONOSCOPY	$1,264.25	$1,945.00	$1,556.00–$1,750.50	—	35%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 PF DIAGNOSTIC COLONOSCOPY	$351.65	$541.00	$163.29–$459.85	53% below	35%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 DIAGNOSTIC COLONOSCOPY	$1,264.25	$1,945.00	$1,108.65–$1,750.50	67% above	35%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 PF DIAGNOSTIC COLONOSCOPY	$351.65	$541.00	$163.29–$459.85	—	35%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 DIAGNOSTIC COLONOSCOPY	$1,264.25	$1,945.00	$1,556.00–$1,750.50	—	35%
Septoplasty to straighten the nasal septum CPT 30520 PF REPAIR OF NASAL SEPTUM	$650.00	$1,000.00	$584.78–$3,442.57	90% below	35%
Septoplasty to straighten the nasal septum CPT 30520 REPAIR OF NASAL SEPTUM	$2,925.00	$4,500.00	$2,565.00–$4,050.00	57% below	35%
Septoplasty to straighten the nasal septum inpatient CPT 30520 PF REPAIR OF NASAL SEPTUM	$650.00	$1,000.00	$584.78–$3,442.57	—	35%
Septoplasty to straighten the nasal septum inpatient CPT 30520 REPAIR OF NASAL SEPTUM	$2,925.00	$4,500.00	$3,600.00–$4,050.00	—	35%
Short arm cast (elbow to hand) CPT 29075 PF APPLICATION OF FOREARM CAST	$90.35	$139.00	$54.42–$290.30	62% below	35%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST	$265.85	$409.00	$233.13–$368.10	11% above	35%
Short arm cast (elbow to hand) inpatient CPT 29075 PF APPLICATION OF FOREARM CAST	$90.35	$139.00	$54.42–$290.30	—	35%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF FOREARM CAST	$265.85	$409.00	$327.20–$368.10	—	35%
Short arm splint (forearm and hand) CPT 29125 PF APPLY FOREARM SPLINT	$66.95	$103.00	$35.03–$140.50	55% below	35%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$178.75	$275.00	$140.07–$247.50	21% above	35%
Short arm splint (forearm and hand) inpatient CPT 29125 PF APPLY FOREARM SPLINT	$66.95	$103.00	$35.03–$140.50	—	35%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT	$178.75	$275.00	$220.00–$247.50	—	35%
Short leg cast (below the knee) CPT 29405 PF APPLY SHORT LEG CAST	$85.15	$131.00	$50.71–$290.30	70% below	35%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$265.85	$409.00	$233.13–$368.10	5% below	35%
Short leg cast (below the knee) inpatient CPT 29405 PF APPLY SHORT LEG CAST	$85.15	$131.00	$50.71–$290.30	—	35%
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST	$265.85	$409.00	$327.20–$368.10	—	35%
Short leg splint (calf to foot) CPT 29515 PF APPL LOWER LEG SPLINT	$75.40	$116.00	$43.11–$176.37	54% below	35%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$175.50	$270.00	$153.90–$243.00	6% above	35%
Short leg splint (calf to foot) inpatient CPT 29515 PF APPL LOWER LEG SPLINT	$75.40	$116.00	$43.11–$176.37	—	35%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION LOWER LEG SPLINT	$175.50	$270.00	$216.00–$243.00	—	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PF S/N/AZ/GEN/TRNK 2.5 CM/<	$94.25	$145.00	$40.19–$218.51	57% below	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 S/N/AX/GEN/TRNK 2.5 CM/<	$214.50	$330.00	$188.10–$297.00	3% below	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$243.75	$375.00	$213.75–$337.50	10% above	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 PF S/N/AZ/GEN/TRNK 2.5 CM/<	$94.25	$145.00	$40.19–$218.51	—	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 S/N/AX/GEN/TRNK 2.5 CM/<	$214.50	$330.00	$264.00–$297.00	—	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$243.75	$375.00	$300.00–$337.50	—	35%
Skin biopsy, punch, one lesion CPT 11104 PF BIOPSY SKIN SINGLE LESION	$80.60	$124.00	$43.06–$451.42	69% below	35%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$167.70	$258.00	$147.06–$429.37	36% below	35%
Skin biopsy, punch, one lesion inpatient CPT 11104 PF BIOPSY SKIN SINGLE LESION	$80.60	$124.00	$43.06–$451.42	—	35%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$167.70	$258.00	$206.40–$232.20	—	35%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 PF EXC TR-EXT MAL+MARG 0.5CM/<	$351.65	$541.00	$105.85–$785.27	2% above	35%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/<	$669.50	$1,030.00	$587.10–$927.00	94% above	35%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 PF EXC TR-EXT MAL+MARG 0.5CM/<	$351.65	$541.00	$105.85–$785.27	—	35%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/<	$669.50	$1,030.00	$824.00–$927.00	—	35%
Skin tag removal, up to 15 tags CPT 11200 PF REM SKN TAG ANY AREA UPW/15	$87.75	$135.00	$68.78–$218.51	40% below	35%
Skin tag removal, up to 15 tags CPT 11200 PF REMOVAL OF SKIN TAGS <W/15	$100.75	$155.00	$68.78–$218.51	32% below	35%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS <W/15	$148.85	$229.00	$130.53–$223.08	1% above	35%
Skin tag removal, up to 15 tags inpatient CPT 11200 PF REM SKN TAG ANY AREA UPW/15	$87.75	$135.00	$68.78–$218.51	—	35%
Skin tag removal, up to 15 tags inpatient CPT 11200 PF REMOVAL OF SKIN TAGS <W/15	$100.75	$155.00	$68.78–$218.51	—	35%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS <W/15	$167.70	$258.00	$206.40–$232.20	—	35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PF DX LMBR SPI PNXR	$100.75	$155.00	$56.02–$779.66	80% below	35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PF SPINAL PUNCTURE LUMBAR DIAG	$163.80	$252.00	$56.02–$779.66	67% below	35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$609.05	$937.00	$534.09–$843.30	21% above	35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$1,004.25	$1,545.00	$788.80–$1,390.50	99% above	35%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PF DX LMBR SPI PNXR	$100.75	$155.00	$56.02–$779.66	—	35%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PF SPINAL PUNCTURE LUMBAR DIAG	$163.80	$252.00	$56.02–$779.66	—	35%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$609.05	$937.00	$749.60–$843.30	—	35%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DX LMBR SPI PNXR	$1,004.25	$1,545.00	$1,236.00–$1,390.50	—	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PF RP S/N/AX/GN/TK 2.6-7.5 CM	$115.05	$177.00	$52.68–$218.51	60% below	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK 2.6-7.5 CM	$162.50	$250.00	$142.50–$225.00	44% below	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 PF RP S/N/AX/GN/TK 2.6-7.5 CM	$115.05	$177.00	$52.68–$218.51	—	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR S/N/AX/GEN/TRNK 2.6-7.5 CM	$162.50	$250.00	$200.00–$225.00	—	35%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PF RPR F/E/E/N/L/M 2.5 CM	$94.25	$145.00	$49.37–$218.51	65% below	35%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$214.50	$330.00	$188.10–$297.00	19% below	35%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 PF RPR F/E/E/N/L/M 2.5 CM	$94.25	$145.00	$49.37–$218.51	—	35%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$214.50	$330.00	$264.00–$297.00	—	35%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 PF BIOPSY (SKIN SUBCUTANEOUS	$80.60	$124.00	$33.29–$218.51	58% below	35%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$167.70	$258.00	$147.06–$232.20	13% below	35%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 PF BIOPSY (SKIN SUBCUTANEOUS	$80.60	$124.00	$33.29–$218.51	—	35%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES	$167.70	$258.00	$206.40–$232.20	—	35%
Thoracentesis with imaging guidance CPT 32555 PF ASPIRATE PLEURA W/ IMAGING	$297.70	$458.00	$97.16–$700.01	67% below	35%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$812.50	$1,250.00	$671.45–$1,125.00	9% below	35%
Thoracentesis with imaging guidance CPT 32555 LUNG THORACENTESIS	$812.50	$1,250.00	$671.45–$1,125.00	9% below	35%
Thoracentesis with imaging guidance inpatient CPT 32555 PF ASPIRATE PLEURA W/ IMAGING	$297.70	$458.00	$97.16–$700.01	—	35%
Thoracentesis with imaging guidance inpatient CPT 32555 LUNG THORACENTESIS	$812.50	$1,250.00	$1,000.00–$1,125.00	—	35%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$812.50	$1,250.00	$1,000.00–$1,125.00	—	35%
Tonsil and adenoid removal, age 12 or older CPT 42821 PF REMOVE TONSILS AND ADENOIDS	$351.65	$541.00	$268.21–$3,442.57	91% below	35%
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS AND ADENOIDS	$3,347.50	$5,150.00	$2,935.50–$4,635.00	18% below	35%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 PF REMOVE TONSILS AND ADENOIDS	$351.65	$541.00	$268.21–$3,442.57	—	35%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 REMOVE TONSILS AND ADENOIDS	$3,347.50	$5,150.00	$4,120.00–$4,635.00	—	35%
Tonsil and adenoid removal, child under 12 CPT 42820 PF REMOVE TONSILS AND ADENOIDS	$351.65	$541.00	$256.18–$6,461.18	91% below	35%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS	$3,347.50	$5,150.00	$2,935.50–$6,317.82	11% below	35%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 PF REMOVE TONSILS AND ADENOIDS	$351.65	$541.00	$256.18–$6,461.18	—	35%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 REMOVE TONSILS AND ADENOIDS	$3,347.50	$5,150.00	$4,120.00–$4,635.00	—	35%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 PF REMOVAL OF TONSILS	$351.65	$541.00	$224.24–$3,442.57	89% below	35%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS	$3,347.50	$5,150.00	$2,935.50–$4,635.00	3% above	35%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 PF REMOVAL OF TONSILS	$351.65	$541.00	$224.24–$3,442.57	—	35%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 REMOVAL OF TONSILS	$3,347.50	$5,150.00	$4,120.00–$4,635.00	—	35%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 PF REMOVAL OF TONSILS	$351.65	$541.00	$235.02–$6,461.18	92% below	35%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS	$3,347.50	$5,150.00	$2,935.50–$6,317.82	25% below	35%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 PF REMOVAL OF TONSILS	$351.65	$541.00	$235.02–$6,461.18	—	35%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 REMOVAL OF TONSILS	$3,347.50	$5,150.00	$4,120.00–$4,635.00	—	35%
Trigger finger release surgery CPT 26055 PF TNDN SHEATH INCISION TR FIN	$325.00	$500.00	$253.79–$1,735.82	80% below	35%
Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION TR FING	$2,145.00	$3,300.00	$1,730.20–$2,970.00	35% above	35%
Trigger finger release surgery inpatient CPT 26055 PF TNDN SHEATH INCISION TR FIN	$325.00	$500.00	$253.79–$1,735.82	—	35%
Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION TR FING	$2,145.00	$3,300.00	$2,640.00–$2,970.00	—	35%
Trigger point injections, 1 or 2 muscles CPT 20552 PF INJ TRIGGER POINT 1/2 MUSCL	$57.85	$89.00	$32.77–$329.00	72% below	35%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$274.30	$422.00	$240.54–$379.80	34% above	35%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PF INJ TRIGGER POINT 1/2 MUSCL	$57.85	$89.00	$32.77–$329.00	—	35%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$65.00	$100.00	$80.00–$90.00	—	35%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US BREAST BIOPSY INTIAL	$702.00	$1,080.00	$615.60–$1,747.83	61% below	35%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US BREAST BIOPSY INTIAL	$702.00	$1,080.00	$864.00–$972.00	—	35%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 PF ESOPH EGD DILATION <30 MM	$669.50	$1,030.00	$134.22–$2,107.38	73% below	35%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM	$1,673.75	$2,575.00	$1,467.75–$2,317.50	32% below	35%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 PF ESOPH EGD DILATION <30 MM	$669.50	$1,030.00	$134.22–$2,107.38	—	35%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ESOPH EGD DILATION <30 MM	$1,673.75	$2,575.00	$2,060.00–$2,317.50	—	35%
Upper endoscopy (EGD) with biopsy CPT 43239 ADD EGD BIOPSY SINGLE/MULTIPLE	$167.70	$258.00	$147.06–$1,005.14	90% below	35%
Upper endoscopy (EGD) with biopsy CPT 43239 PF EGD BIOPSY SINGLE/MULTIPLE	$351.65	$541.00	$120.74–$998.90	79% below	35%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$1,111.50	$1,710.00	$974.70–$1,539.00	35% below	35%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ADD EGD BIOPSY SINGLE/MULTIPLE	$167.70	$258.00	$206.40–$232.20	—	35%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PF EGD BIOPSY SINGLE/MULTIPLE	$351.65	$541.00	$120.74–$998.90	—	35%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$1,111.50	$1,710.00	$1,368.00–$1,539.00	—	35%
Upper endoscopy (EGD) with injection into the lining CPT 43236 PF UPPR GI SCOPE W/SUBMUC INJ	$351.65	$541.00	$120.17–$998.90	83% below	35%
Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPR GI SCOPE W/SUBMUC INJ	$1,004.25	$1,545.00	$880.65–$1,390.50	51% below	35%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 PF UPPR GI SCOPE W/SUBMUC INJ	$351.65	$541.00	$120.17–$998.90	—	35%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UPPR GI SCOPE W/SUBMUC INJ	$1,004.25	$1,545.00	$1,236.00–$1,390.50	—	35%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 PF EGD REMOVE LESION SNARE	$351.65	$541.00	$171.40–$2,107.38	82% below	35%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE	$1,673.75	$2,575.00	$1,467.75–$2,317.50	15% below	35%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 PF EGD REMOVE LESION SNARE	$351.65	$541.00	$171.40–$2,107.38	—	35%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD REMOVE LESION SNARE	$1,673.75	$2,575.00	$2,060.00–$2,317.50	—	35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 ADD EGD GUIDE WIRE INSERTION	$167.70	$258.00	$147.06–$1,005.14	85% below	35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 PF ADD EGD BUIDE WIRE INSERT	$1,111.50	$1,710.00	$145.03–$1,453.50	3% below	35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 PF EGD GUIDE WIRE INSERT	$1,111.50	$1,710.00	$145.03–$1,453.50	3% below	35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE INSERTION	$1,111.50	$1,710.00	$974.70–$1,539.00	3% below	35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 ADD EGD GUIDE WIRE INSERTION	$167.70	$258.00	$206.40–$232.20	—	35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD GUIDE WIRE INSERTION	$1,111.50	$1,710.00	$1,368.00–$1,539.00	—	35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 PF ADD EGD BUIDE WIRE INSERT	$1,111.50	$1,710.00	$145.03–$1,453.50	—	35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 PF EGD GUIDE WIRE INSERT	$1,111.50	$1,710.00	$145.03–$1,453.50	—	35%
Upper endoscopy (EGD), diagnostic CPT 43235 PF EGD DIAGNOSTIC BRUSH WASH	$351.65	$541.00	$106.93–$998.90	68% below	35%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$1,056.25	$1,625.00	$926.25–$1,462.50	3% below	35%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PF EGD DIAGNOSTIC BRUSH WASH	$351.65	$541.00	$106.93–$998.90	—	35%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$1,056.25	$1,625.00	$1,300.00–$1,462.50	—	35%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY-UNILATERAL/BILATERAL	$2,008.50	$3,090.00	$1,761.30–$2,781.00	—	35%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 PF VASECTOMY/UNIL/BIL	$351.00	$540.00	$199.21–$2,244.47	58% below	35%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY-UNILATERAL/BILATERAL	$2,008.50	$3,090.00	$2,472.00–$2,781.00	—	35%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 PF VASECTOMY/UNIL/BIL	$351.00	$540.00	$199.21–$2,244.47	—	35%
Wart removal, up to 14 warts CPT 17110 PF DESTRUCT B9 LESION 1-14	$100.75	$155.00	$57.20–$218.51	36% below	35%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14	$167.70	$258.00	$147.06–$232.20	6% above	35%
Wart removal, up to 14 warts inpatient CPT 17110 PF DESTRUCT B9 LESION 1-14	$100.75	$155.00	$57.20–$218.51	—	35%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT B9 LESION 1-14	$167.70	$258.00	$206.40–$232.20	—	35%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 PF DEB SUBQ TISSUE 20 SQ CM/<	$121.55	$187.00	$55.66–$451.42	68% below	35%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 PF DEBRIDE SUBQ TISS 1ST 20CM	$125.45	$193.00	$55.66–$451.42	67% below	35%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$357.50	$550.00	$313.50–$495.00	7% below	35%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 PF DEB SUBQ TISSUE 20 SQ CM/<	$121.55	$187.00	$55.66–$451.42	—	35%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 PF DEBRIDE SUBQ TISS 1ST 20CM	$125.45	$193.00	$55.66–$451.42	—	35%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$357.50	$550.00	$440.00–$495.00	—	35%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD INFUSION	$422.50	$650.00	$370.50–$585.00	36% below	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD INFUSION	$487.50	$750.00	$600.00–$675.00	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT SUBSQ	$120.25	$185.00	$105.45–$233.51	24% below	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT INIT	$152.75	$235.00	$133.95–$233.51	4% below	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION INITIAL	$152.75	$235.00	$133.95–$233.51	4% below	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY NHALATION TREATMENT	$263.25	$405.00	$230.85–$364.50	66% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TREATMENT SUBSQ	$120.25	$185.00	$148.00–$166.50	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION INITIAL	$152.75	$235.00	$188.00–$211.50	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TREATMENT INIT	$152.75	$235.00	$188.00–$211.50	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY NHALATION TREATMENT	$263.25	$405.00	$324.00–$364.50	—	35%
Critical care, first 30 to 74 minutes CPT 99291 PHY CRIT CARE 1ST 30-74M	$487.50	$750.00	$191.20–$928.97	64% below	35%
Critical care, first 30 to 74 minutes CPT 99291 PHY CRIT CARE 30-74 M +	$487.50	$750.00	$191.20–$928.97	64% below	35%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MIN	$1,072.50	$1,650.00	$925.29–$1,485.00	20% below	35%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 M +	$1,072.50	$1,650.00	$925.29–$1,485.00	20% below	35%
Critical care, first 30 to 74 minutes inpatient CPT 99291 PHY CRIT CARE 1ST 30-74M	$487.50	$750.00	$191.20–$928.97	—	35%
Critical care, first 30 to 74 minutes inpatient CPT 99291 PHY CRIT CARE 30-74 M +	$487.50	$750.00	$191.20–$928.97	—	35%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 30-74 M +	$1,072.50	$1,650.00	$1,320.00–$1,485.00	—	35%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 30-74 MIN	$1,072.50	$1,650.00	$1,320.00–$1,485.00	—	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD INITIAL	$143.00	$220.00	$69.15–$198.00	25% below	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD SUBSEQUENT	$143.00	$220.00	$69.15–$198.00	25% below	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD INITIAL	$143.00	$220.00	$176.00–$198.00	—	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD SUBSEQUENT	$143.00	$220.00	$176.00–$198.00	—	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PHY LEVEL I	$84.50	$130.00	$10.63–$110.50	39% below	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PHY LEVEL I + PROC	$84.50	$130.00	$10.63–$110.50	39% below	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LEVEL 1 +	$130.00	$200.00	$90.10–$180.00	7% below	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LEVEL I	$130.00	$200.00	$90.10–$180.00	7% below	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 PHY LEVEL I	$84.50	$130.00	$10.63–$110.50	—	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 PHY LEVEL I + PROC	$84.50	$130.00	$10.63–$110.50	—	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 LEVEL I	$130.00	$200.00	$160.00–$180.00	—	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 LEVEL 1 +	$130.00	$200.00	$160.00–$180.00	—	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PHY LEVEL II	$130.00	$200.00	$37.80–$170.00	45% below	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PHY LEVEL II + PROC	$130.00	$200.00	$37.80–$170.00	45% below	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LEVEL II	$195.00	$300.00	$163.17–$270.00	18% below	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LEVEL II +	$195.00	$300.00	$163.17–$270.00	18% below	35%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 PHY LEVEL II	$130.00	$200.00	$37.80–$170.00	—	35%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 PHY LEVEL II + PROC	$130.00	$200.00	$37.80–$170.00	—	35%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LEVEL II +	$195.00	$300.00	$240.00–$270.00	—	35%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LEVEL II	$195.00	$300.00	$240.00–$270.00	—	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PHY LEVEL III	$195.00	$300.00	$64.97–$296.49	55% below	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PHY LEVEL III + PROC	$195.00	$300.00	$64.97–$296.49	55% below	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LEVEL III	$357.50	$550.00	$287.48–$495.00	18% below	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LEVEL III +	$357.50	$550.00	$287.48–$495.00	18% below	35%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 PHY LEVEL III + PROC	$195.00	$300.00	$64.97–$296.49	—	35%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 PHY LEVEL III	$195.00	$300.00	$64.97–$296.49	—	35%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 LEVEL III +	$357.50	$550.00	$440.00–$495.00	—	35%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 LEVEL III	$357.50	$550.00	$440.00–$495.00	—	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PHY LEVEL IV	$260.00	$400.00	$109.38–$461.76	61% below	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PHY LEVEL IV + PROC	$260.00	$400.00	$109.38–$461.76	61% below	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LEVEL IV	$520.00	$800.00	$451.89–$720.00	23% below	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LEVEL IV +	$520.00	$800.00	$451.89–$720.00	23% below	35%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 PHY LEVEL IV	$260.00	$400.00	$109.38–$461.76	—	35%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 PHY LEVEL IV + PROC	$260.00	$400.00	$109.38–$461.76	—	35%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 LEVEL IV	$520.00	$800.00	$640.00–$720.00	—	35%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 LEVEL IV +	$520.00	$800.00	$640.00–$720.00	—	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PHY LEVEL V + PROC	$357.50	$550.00	$159.27–$663.24	66% below	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PHY LEVEL V	$357.50	$550.00	$159.27–$663.24	66% below	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LEVELV >76/CRT CARE<30+	$715.00	$1,100.00	$627.00–$990.00	32% below	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LEVEL V >76/CRIT CARE<30	$780.00	$1,200.00	$648.62–$1,080.00	26% below	35%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 PHY LEVEL V	$357.50	$550.00	$159.27–$663.24	—	35%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 PHY LEVEL V + PROC	$357.50	$550.00	$159.27–$663.24	—	35%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 LEVELV >76/CRT CARE<30+	$715.00	$1,100.00	$880.00–$990.00	—	35%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 LEVEL V >76/CRIT CARE<30	$780.00	$1,200.00	$960.00–$1,080.00	—	35%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST	$487.50	$750.00	$328.76–$675.00	41% below	35%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TEST	$487.50	$750.00	$600.00–$675.00	—	35%
Family therapy with the patient, 50 minutes CPT 90847 PSYCHOTHERAPY, FAM W/PATIENT	$297.05	$457.00	$166.21–$411.30	73% above	35%
Family therapy with the patient, 50 minutes inpatient CPT 90847 PSYCHOTHERAPY, FAM W/PATIENT	$297.05	$457.00	$365.60–$411.30	—	35%
Family therapy without the patient, 50 minutes CPT 90846 PSYCHOTHERAPY, FAM W/O PATIENT	$297.05	$457.00	$166.21–$411.30	27% above	35%
Family therapy without the patient, 50 minutes inpatient CPT 90846 PSYCHOTHERAPY, FAM W/O PATIENT	$297.05	$457.00	$365.60–$411.30	—	35%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY	$280.15	$431.00	$92.95–$387.90	33% above	35%
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY	$280.15	$431.00	$344.80–$387.90	—	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRA 1ST HR-INTL-MED SUR	$116.68	$179.50	$102.32–$254.11	53% below	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION FIRST HR-INITIAL	$116.68	$179.50	$102.32–$254.11	53% below	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1ST HR-INITIAL	$221.00	$340.00	$193.80–$306.00	10% below	35%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRA 1ST HR-INTL-MED SUR	$116.68	$179.50	$143.60–$161.55	—	35%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION FIRST HR-INITIAL	$117.00	$180.00	$144.00–$162.00	—	35%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1ST HR-INITIAL	$221.00	$340.00	$272.00–$306.00	—	35%
IV infusion of a medicine, first hour CPT 96365 IV INFSN 1ST HR-INTL-MED SUR	$211.25	$325.00	$185.25–$292.50	30% below	35%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION FIRST HR-INITIAL	$211.25	$325.00	$185.25–$292.50	30% below	35%
IV infusion of a medicine, first hour CPT 96365 IV DRUG INF 1ST HR-INITIAL	$227.50	$350.00	$199.50–$315.00	25% below	35%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFSN 1ST HR-INTL-MED SUR	$211.25	$325.00	$260.00–$292.50	—	35%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION FIRST HR-INITIAL	$211.25	$325.00	$260.00–$292.50	—	35%
IV infusion of a medicine, first hour inpatient CPT 96365 IV DRUG INF 1ST HR-INITIAL	$227.50	$350.00	$280.00–$315.00	—	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUBQ-MED SURG	$71.50	$110.00	$62.70–$99.00	26% below	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUBQ	$71.50	$110.00	$62.70–$99.00	26% below	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM/SQ EACH	$74.75	$115.00	$65.55–$103.50	23% below	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUBQ	$71.50	$110.00	$88.00–$99.00	—	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUBQ-MED SURG	$71.50	$110.00	$88.00–$99.00	—	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ IM/SQ EACH	$74.75	$115.00	$92.00–$103.50	—	35%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PF PSYCH DIAG EVAL	$256.75	$395.00	$166.21–$355.50	15% above	35%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PF PSYCH DIAG EVAL	$256.75	$395.00	$316.00–$355.50	—	35%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 PF NRV CNDJ TEST 7-8 STUDIES	$100.75	$155.00	$124.00–$338.88	78% below	35%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CNDJ TEST 7-8 STUDIES	$357.50	$550.00	$313.50–$495.00	23% below	35%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 PF NRV CNDJ TEST 7-8 STUDIES	$100.75	$155.00	$124.00–$338.88	—	35%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NRV CNDJ TEST 7-8 STUDIES	$357.50	$550.00	$440.00–$495.00	—	35%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO MUSC RE-ED	$65.00	$100.00	$43.43–$90.00	27% below	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO MUSC RE-ED	$65.00	$100.00	$80.00–$90.00	—	35%
New patient office visit, about 30 minutes CPT 99203 NURSE ONLY LEVEL 3 - NEW PT	$82.55	$127.00	$72.39–$114.30	39% below	35%
New patient office visit, about 30 minutes CPT 99203 OPN LEVEL 3 - NEW PT	$94.25	$145.00	$82.65–$130.50	30% below	35%
New patient office visit, about 30 minutes CPT 99203 PF PULM PF NEW PT LEVEL III	$123.50	$190.00	$73.57–$161.50	9% below	35%
New patient office visit, about 30 minutes CPT 99203 PF VISIT-NEW LEVEL 3-TELE	$123.50	$190.00	$73.57–$161.50	9% below	35%
New patient office visit, about 30 minutes CPT 99203 PF VISIT-NEW LEVEL 3	$123.50	$190.00	$73.57–$161.50	9% below	35%
New patient office visit, about 30 minutes CPT 99203 PF TELE NW PT COMP/MOD 30 MIN	$123.50	$190.00	$73.57–$161.50	9% below	35%
New patient office visit, about 30 minutes inpatient CPT 99203 NURSE ONLY LEVEL 3 - NEW PT	$82.55	$127.00	$101.60–$114.30	—	35%
New patient office visit, about 30 minutes inpatient CPT 99203 OPN LEVEL 3 - NEW PT	$94.25	$145.00	$116.00–$130.50	—	35%
New patient office visit, about 30 minutes inpatient CPT 99203 PF VISIT-NEW LEVEL 3	$123.50	$190.00	$73.57–$161.50	—	35%
New patient office visit, about 30 minutes inpatient CPT 99203 PF VISIT-NEW LEVEL 3-TELE	$123.50	$190.00	$73.57–$161.50	—	35%
New patient office visit, about 30 minutes inpatient CPT 99203 PF TELE NW PT COMP/MOD 30 MIN	$123.50	$190.00	$73.57–$161.50	—	35%
New patient office visit, about 30 minutes inpatient CPT 99203 PF PULM PF NEW PT LEVEL III	$123.50	$190.00	$73.57–$161.50	—	35%
New patient office visit, about 45 minutes CPT 99204 OPN LEVEL 4 - NEW PT	$150.80	$232.00	$132.24–$208.80	17% below	35%
New patient office visit, about 45 minutes CPT 99204 NURSE ONLY LEVEL 4 - NEW PT	$151.45	$233.00	$132.81–$209.70	16% below	35%
New patient office visit, about 45 minutes CPT 99204 PF VISIT-NEW LEVEL 4	$209.30	$322.00	$118.38–$273.70	16% above	35%
New patient office visit, about 45 minutes CPT 99204 PF PULM PF NEW PT LEVEL IV	$209.30	$322.00	$118.38–$273.70	16% above	35%
New patient office visit, about 45 minutes CPT 99204 PF TELE NW PT COMP/MOD 45 MIN	$209.30	$322.00	$118.38–$273.70	16% above	35%
New patient office visit, about 45 minutes CPT 99204 PF VISIT-NEW LEVEL 4-TELE	$209.30	$322.00	$118.38–$273.70	16% above	35%
New patient office visit, about 45 minutes inpatient CPT 99204 OPN LEVEL 4 - NEW PT	$150.80	$232.00	$185.60–$208.80	—	35%
New patient office visit, about 45 minutes inpatient CPT 99204 NURSE ONLY LEVEL 4 - NEW PT	$151.45	$233.00	$186.40–$209.70	—	35%
New patient office visit, about 45 minutes inpatient CPT 99204 PF VISIT-NEW LEVEL 4-TELE	$209.30	$322.00	$118.38–$273.70	—	35%
New patient office visit, about 45 minutes inpatient CPT 99204 PF VISIT-NEW LEVEL 4	$209.30	$322.00	$118.38–$273.70	—	35%
New patient office visit, about 45 minutes inpatient CPT 99204 PF PULM PF NEW PT LEVEL IV	$209.30	$322.00	$118.38–$273.70	—	35%
New patient office visit, about 45 minutes inpatient CPT 99204 PF TELE NW PT COMP/MOD 45 MIN	$209.30	$322.00	$118.38–$273.70	—	35%
New patient office visit, about 60 minutes CPT 99205 OPN LEVEL 5 - NEW PT	$222.95	$343.00	$195.51–$308.70	14% below	35%
New patient office visit, about 60 minutes CPT 99205 NURSE ONLY LEVEL 5 - NEW PT	$223.60	$344.00	$196.08–$309.60	14% below	35%
New patient office visit, about 60 minutes CPT 99205 PF VISIT-NEW LEVEL 5	$274.30	$422.00	$160.60–$358.70	6% above	35%
New patient office visit, about 60 minutes CPT 99205 PF VISIT-NEW LEVEL 5-TELE	$274.30	$422.00	$160.60–$358.70	6% above	35%
New patient office visit, about 60 minutes CPT 99205 PF PULM PF NEW PT LEVEL V	$274.30	$422.00	$160.60–$358.70	6% above	35%
New patient office visit, about 60 minutes CPT 99205 PF TELE NW PT COMP/MOD 60 MIN	$274.30	$422.00	$160.60–$358.70	6% above	35%
New patient office visit, about 60 minutes inpatient CPT 99205 OPN LEVEL 5 - NEW PT	$222.95	$343.00	$274.40–$308.70	—	35%
New patient office visit, about 60 minutes inpatient CPT 99205 NURSE ONLY LEVEL 5 - NEW PT	$223.60	$344.00	$275.20–$309.60	—	35%
New patient office visit, about 60 minutes inpatient CPT 99205 PF TELE NW PT COMP/MOD 60 MIN	$274.30	$422.00	$160.60–$358.70	—	35%
New patient office visit, about 60 minutes inpatient CPT 99205 PF VISIT-NEW LEVEL 5	$274.30	$422.00	$160.60–$358.70	—	35%
New patient office visit, about 60 minutes inpatient CPT 99205 PF VISIT-NEW LEVEL 5-TELE	$274.30	$422.00	$160.60–$358.70	—	35%
New patient office visit, about 60 minutes inpatient CPT 99205 PF PULM PF NEW PT LEVEL V	$274.30	$422.00	$160.60–$358.70	—	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OPN LEVEL 2 - NEW PT	$48.10	$74.00	$42.18–$66.60	52% below	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 EXAM ROOM NEW PATIENT	$48.75	$75.00	$42.75–$67.50	51% below	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 EXAM ROOM-NEW PT	$48.75	$75.00	$42.75–$67.50	51% below	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NURSE ONLY LEVEL 2 - NEW PT	$48.75	$75.00	$42.75–$67.50	51% below	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 EXAM ROOM - NEW PT	$48.75	$75.00	$42.75–$67.50	51% below	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PF VISIT-NEW LEVEL 2	$82.55	$127.00	$42.63–$107.95	17% below	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PF VISIT-NEW LEVEL 2-TELE	$82.55	$127.00	$42.63–$107.95	17% below	35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE NEW LEVEL 2	$91.00	$140.00	$79.80–$126.00	9% below	35%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OPN LEVEL 2 - NEW PT	$48.10	$74.00	$59.20–$66.60	—	35%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 EXAM ROOM NEW PATIENT	$48.75	$75.00	$60.00–$67.50	—	35%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NURSE ONLY LEVEL 2 - NEW PT	$48.75	$75.00	$60.00–$67.50	—	35%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 EXAM ROOM - NEW PT	$48.75	$75.00	$60.00–$67.50	—	35%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 EXAM ROOM-NEW PT	$48.75	$75.00	$60.00–$67.50	—	35%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PF VISIT-NEW LEVEL 2-TELE	$82.55	$127.00	$42.63–$107.95	—	35%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PF VISIT-NEW LEVEL 2	$82.55	$127.00	$42.63–$107.95	—	35%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE NEW LEVEL 2	$91.00	$140.00	$112.00–$126.00	—	35%
Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW COMPLEXITY	$133.25	$205.00	$116.85–$184.50	4% below	35%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW COMPLEXITY	$133.25	$205.00	$164.00–$184.50	—	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATOIN HIGH COMPLEXITY	$175.50	$270.00	$127.32–$243.00	2% above	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATOIN HIGH COMPLEXITY	$175.50	$270.00	$216.00–$243.00	—	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW COMPLEXITY	$130.00	$200.00	$114.00–$180.00	2% above	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW COMPLEXITY	$130.00	$200.00	$160.00–$180.00	—	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MODERATE COMP	$152.75	$235.00	$127.32–$211.50	2% below	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION MODERATE COMP	$152.75	$235.00	$188.00–$211.50	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY	$65.00	$100.00	$34.43–$90.00	20% below	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL, THERAPY	$65.00	$100.00	$34.43–$90.00	20% below	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY	$65.00	$100.00	$80.00–$90.00	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL, THERAPY	$65.00	$100.00	$80.00–$90.00	—	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE	$71.50	$110.00	$37.42–$99.00	8% below	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE	$71.50	$110.00	$88.00–$99.00	—	35%
Preventive checkup, new patient aged 18–39 CPT 99385 PF PREV VISIT NEW AGE 18-39	$143.00	$220.00	$83.86–$187.00	2% above	35%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PF PREV VISIT NEW AGE 18-39	$143.00	$220.00	$83.86–$187.00	—	35%
Preventive checkup, new patient aged 40–64 CPT 99386 PF PREV VISIT NEW AGE 40-64	$162.50	$250.00	$101.66–$212.50	3% below	35%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PF PREV VISIT NEW AGE 40-64	$162.50	$250.00	$101.66–$212.50	—	35%
Preventive checkup, new patient aged 65 or older CPT 99387 PF INIT PM E/M NEW PAT 65+ YRS	$162.50	$250.00	$109.48–$212.50	2% below	35%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PF INIT PM E/M NEW PAT 65+ YRS	$162.50	$250.00	$109.48–$212.50	—	35%
Preventive checkup, returning patient aged 18–39 CPT 99395 PF PER VISIT EST AGE 40-64	$136.50	$210.00	$76.59–$178.50	10% above	35%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PF PER VISIT EST AGE 40-64	$136.50	$210.00	$76.59–$178.50	—	35%
Preventive checkup, returning patient aged 40–64 CPT 99396 PF PER VISIT EST AGE 40-64	$136.50	$210.00	$82.94–$178.50	4% above	35%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PF PER VISIT EST AGE 40-64	$136.50	$210.00	$82.94–$178.50	—	35%
Preventive checkup, returning patient aged 65 or older CPT 99397 PF PER PM REEVAL EST PAT 65+YR	$146.25	$225.00	$87.19–$191.25	at median	35%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PF PER PM REEVAL EST PAT 65+YR	$146.25	$225.00	$87.19–$191.25	—	35%
Psychiatric evaluation with medical services CPT 90792 PF PSYCH DIAG EVAL W/MED SVCS	$256.75	$395.00	$166.21–$355.50	38% above	35%
Psychiatric evaluation with medical services inpatient CPT 90792 PF PSYCH DIAG EVAL W/MED SVCS	$256.75	$395.00	$316.00–$355.50	—	35%
Psychotherapy session, 30 minutes CPT 90832 COUNSELING 30 MINUTES	$32.50	$50.00	$28.50–$166.21	75% below	35%
Psychotherapy session, 30 minutes CPT 90832 INDIVIDUAL THER 30 MINS	$269.75	$415.00	$166.21–$373.50	112% above	35%
Psychotherapy session, 30 minutes inpatient CPT 90832 COUNSELING 30 MINUTES	$32.50	$50.00	$40.00–$45.00	—	35%
Psychotherapy session, 30 minutes inpatient CPT 90832 INDIVIDUAL THER 30 MINS	$269.75	$415.00	$332.00–$373.50	—	35%
Psychotherapy session, 45 minutes CPT 90834 INDIVIDUAL THER 38-52 MIN	$289.90	$446.00	$166.21–$401.40	71% above	35%
Psychotherapy session, 45 minutes inpatient CPT 90834 INDIVIDUAL THER 38-52 MIN	$289.90	$446.00	$356.80–$401.40	—	35%
Psychotherapy session, 60 minutes CPT 90837 COUNSELING 60 MINUTES	$65.00	$100.00	$57.00–$166.21	71% below	35%
Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL THER 53+ MIN	$297.05	$457.00	$166.21–$411.30	33% above	35%
Psychotherapy session, 60 minutes inpatient CPT 90837 COUNSELING 60 MINUTES	$65.00	$100.00	$80.00–$90.00	—	35%
Psychotherapy session, 60 minutes inpatient CPT 90837 INDIVIDUAL THER 53+ MIN	$297.05	$457.00	$365.60–$411.30	—	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF VISIT-EST LEVEL 5-TELE	$175.71	$270.31	$127.07–$229.76	13% below	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF PULM PF EST LEVEL V	$175.71	$270.31	$127.07–$229.76	13% below	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF VISIT-EST LEVEL 5	$175.71	$270.31	$127.07–$229.76	13% below	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF TELE PF EST PT HIGH 45 MIN	$175.71	$270.31	$127.07–$229.76	13% below	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OPN LEVEL 5 - EST PT	$229.45	$353.00	$201.21–$317.70	14% above	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 NURSE ONLY LEVEL 5 - EST PT	$229.45	$353.00	$201.21–$317.70	14% above	35%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF PULM PF EST LEVEL V	$175.71	$270.31	$127.07–$229.76	—	35%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF TELE PF EST PT HIGH 45 MIN	$175.71	$270.31	$127.07–$229.76	—	35%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF VISIT-EST LEVEL 5	$175.71	$270.31	$127.07–$229.76	—	35%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF VISIT-EST LEVEL 5-TELE	$175.71	$270.31	$127.07–$229.76	—	35%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OPN LEVEL 5 - EST PT	$229.45	$353.00	$282.40–$317.70	—	35%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 NURSE ONLY LEVEL 5 - EST PT	$229.45	$353.00	$282.40–$317.70	—	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OPN LEVEL 3 - EST PT	$89.05	$137.00	$78.09–$123.30	23% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF VISIT-EST LEVEL 3-TELE	$91.00	$140.00	$58.63–$119.00	22% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF VISIT-EST LEVEL 3	$91.00	$140.00	$58.63–$119.00	22% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF PULM PF EST PT LEVEL III	$91.00	$140.00	$58.63–$119.00	22% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF TELE EST PT LOW/MOD 15 MIN	$91.00	$140.00	$58.63–$119.00	22% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 NURSE ONLY LEVEL 3 - EST PT	$91.00	$140.00	$79.80–$126.00	22% below	35%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OPN LEVEL 3 - EST PT	$89.05	$137.00	$109.60–$123.30	—	35%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 NURSE ONLY LEVEL 3 - EST PT	$91.00	$140.00	$112.00–$126.00	—	35%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PF PULM PF EST PT LEVEL III	$91.00	$140.00	$58.63–$119.00	—	35%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PF TELE EST PT LOW/MOD 15 MIN	$91.00	$140.00	$58.63–$119.00	—	35%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PF VISIT-EST LEVEL 3-TELE	$91.00	$140.00	$58.63–$119.00	—	35%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PF VISIT-EST LEVEL 3	$91.00	$140.00	$58.63–$119.00	—	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF VISIT-EST LEVEL 4-TELE	$139.75	$215.00	$86.58–$182.75	12% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF VISIT-EST LEVEL 4	$139.75	$215.00	$86.58–$182.75	12% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF TELE EST PT MOD/HIGH 30 MIN	$139.75	$215.00	$86.58–$182.75	12% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF PULM PF EST PT LEVEL IV	$139.75	$215.00	$86.58–$182.75	12% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 NURSE ONLY LEVEL 4 - EST PT	$157.30	$242.00	$137.94–$217.80	1% below	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OPN LEVEL 4 - EST PT	$157.30	$242.00	$137.94–$217.80	1% below	35%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PF TELE EST PT MOD/HIGH 30 MIN	$139.75	$215.00	$86.58–$182.75	—	35%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PF VISIT-EST LEVEL 4	$139.75	$215.00	$86.58–$182.75	—	35%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PF PULM PF EST PT LEVEL IV	$139.75	$215.00	$86.58–$182.75	—	35%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PF VISIT-EST LEVEL 4-TELE	$139.75	$215.00	$86.58–$182.75	—	35%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OPN LEVEL 4 - EST PT	$157.30	$242.00	$193.60–$217.80	—	35%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 NURSE ONLY LEVEL 4 - EST PT	$157.30	$242.00	$193.60–$217.80	—	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EXAM ROOM -EST	$39.00	$60.00	$34.20–$54.00	43% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EXAM ROOM-EST PT	$39.00	$60.00	$34.20–$54.00	43% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 NURSE ONLY LEVEL 2 - EST PT	$48.75	$75.00	$42.75–$67.50	29% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OPN LEVEL 2 - EST PT	$54.60	$84.00	$47.88–$75.60	20% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PF VISIT-EST LEVEL 2-TELE	$58.50	$90.00	$31.58–$76.50	15% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PF VISIT-EST LEVEL 2	$58.50	$90.00	$31.58–$76.50	15% below	35%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EXAM ROOM -EST	$39.00	$60.00	$48.00–$54.00	—	35%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EXAM ROOM-EST PT	$39.00	$60.00	$48.00–$54.00	—	35%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 NURSE ONLY LEVEL 2 - EST PT	$48.75	$75.00	$60.00–$67.50	—	35%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OPN LEVEL 2 - EST PT	$54.60	$84.00	$67.20–$75.60	—	35%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PF VISIT-EST LEVEL 2-TELE	$58.50	$90.00	$31.58–$76.50	—	35%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PF VISIT-EST LEVEL 2	$58.50	$90.00	$31.58–$76.50	—	35%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PF OP CONSULT NEW LOW 30	$159.25	$245.00	$78.98–$208.25	11% below	35%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PF OP CONSULT NEW LOW 30	$159.25	$245.00	$78.98–$208.25	—	35%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PF CONSULT NEW/EST MOD 40	$214.50	$330.00	$120.32–$280.50	12% below	35%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PF CONSULT NEW/EST MOD 40	$214.50	$330.00	$120.32–$280.50	—	35%
Speech and language evaluation CPT 92523 EVAL OF SPEECH SOUND PROD	$224.25	$345.00	$196.65–$310.50	17% below	35%
Speech and language evaluation inpatient CPT 92523 EVAL OF SPEECH SOUND PROD	$224.25	$345.00	$276.00–$310.50	—	35%
Speech therapy session, individual CPT 92507 TELE TREAT SPEECH LANG-VOICE	$136.50	$210.00	$97.34–$189.00	14% below	35%
Speech therapy session, individual CPT 92507 TREAT SPEECH LANG-VOICE	$139.75	$215.00	$97.34–$193.50	12% below	35%
Speech therapy session, individual inpatient CPT 92507 TELE TREAT SPEECH LANG-VOICE	$136.50	$210.00	$168.00–$189.00	—	35%
Speech therapy session, individual inpatient CPT 92507 TREAT SPEECH LANG-VOICE	$139.75	$215.00	$172.00–$193.50	—	35%
Spirometry (breathing test) CPT 94010 SPIROMETRY SCREEN\FVL	$195.00	$300.00	$171.00–$270.00	9% below	35%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY SCREEN\FVL	$195.00	$300.00	$240.00–$270.00	—	35%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY PRE/POST	$357.50	$550.00	$313.50–$495.00	21% below	35%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY PRE/POST	$357.50	$550.00	$440.00–$495.00	—	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY	$61.75	$95.00	$47.19–$85.50	25% below	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY	$61.75	$95.00	$76.00–$85.50	—	35%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THER PHLEBOT	$70.85	$109.00	$62.13–$140.07	62% below	35%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THER PHLEBOT	$70.85	$109.00	$87.20–$98.10	—	35%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE SUBQ	$162.50	$250.00	$142.50–$225.00	11% below	35%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VAR VACCINE LIVE SUBQ	$162.50	$250.00	$200.00–$225.00	—	35%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACCINE 2/3 DOSE IM	$147.72	$227.25	$129.53–$204.53	55% below	35%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 9VHPV VACCINE 2/3 DOSE IM	$147.72	$227.25	$181.80–$204.53	—	35%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM	$57.37	$88.25	$50.30–$79.43	31% below	35%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE	$160.72	$247.25	$140.93–$222.53	95% above	35%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPA VACCINE ADULT IM	$57.37	$88.25	$70.60–$79.43	—	35%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE	$160.72	$247.25	$197.80–$222.53	—	35%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$48.10	$74.00	$42.18–$66.60	38% below	35%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACC INE [20 M	$136.67	$210.25	$119.84–$189.23	75% above	35%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$48.10	$74.00	$59.20–$66.60	—	35%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACC INE [20 M	$136.67	$210.25	$168.20–$189.23	—	35%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM	$48.75	$75.00	$42.75–$67.50	52% below	35%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 IIV NO PRSV INCREASED AG IM	$48.75	$75.00	$60.00–$67.50	—	35%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE 0.5 ML	$165.43	$254.50	$145.07–$229.05	1% below	35%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE 0.5 ML	$165.43	$254.50	$203.60–$229.05	—	35%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM	$143.00	$220.00	$125.40–$198.00	11% above	35%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENACWYD/MENACWYCRM VACC IM	$143.00	$220.00	$176.00–$198.00	—	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$130.00	$200.00	$114.00–$180.00	30% below	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-VAL P-SAC	$212.72	$327.25	$186.53–$294.53	14% above	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$130.00	$200.00	$160.00–$180.00	—	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23-VAL P-SAC	$212.72	$327.25	$261.80–$294.53	—	35%
Rabies vaccine, one dose CPT 90675 RABIES VAC PF CHICK-EMB C	$694.69	$1,068.75	$609.19–$961.88	20% below	35%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC PF CHICK-EMB C	$694.69	$1,068.75	$855.00–$961.88	—	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS DIPHTHERIA INJ [0	$64.19	$98.75	$56.29–$88.88	10% below	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS DIPHTHERIA INJ [0	$64.19	$98.75	$79.00–$88.88	—	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$58.50	$90.00	$51.30–$81.00	42% below	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX INJECTION	$97.34	$149.75	$85.36–$134.78	4% below	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE 7 YRS/> IM	$58.50	$90.00	$72.00–$81.00	—	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX INJECTION	$97.34	$149.75	$119.80–$134.78	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE	$65.00	$100.00	$57.00–$90.00	10% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACC ADMIN-INFLUENZA	$65.00	$100.00	$57.00–$90.00	10% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMINISTRATION-HEP B	$65.00	$100.00	$57.00–$90.00	10% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMINI-PNEUM	$65.00	$100.00	$57.00–$90.00	10% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACC ADMIN-PNEUMOCOCCAL	$65.00	$100.00	$57.00–$90.00	10% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACC ADMIN-INFLU-MED SUR	$65.00	$100.00	$57.00–$90.00	10% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACC ADMIN-MED SURG	$65.00	$100.00	$57.00–$90.00	10% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMIN-INFLUENZA	$65.00	$100.00	$57.00–$90.00	10% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACC ADMIN-PNEUMOC-MED SUR	$65.00	$100.00	$57.00–$90.00	10% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMINISTRATION	$65.00	$100.00	$57.00–$90.00	10% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINATION ADMIN-SINGLE	$71.50	$110.00	$62.70–$99.00	21% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMINISTRATION	$65.00	$100.00	$80.00–$90.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMIN-INFLUENZA	$65.00	$100.00	$80.00–$90.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACC ADMIN-MED SURG	$65.00	$100.00	$80.00–$90.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACC ADMIN-INFLU-MED SUR	$65.00	$100.00	$80.00–$90.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACC ADMIN-INFLUENZA	$65.00	$100.00	$80.00–$90.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMINI-PNEUM	$65.00	$100.00	$80.00–$90.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACC ADMIN-PNEUMOCOCCAL	$65.00	$100.00	$80.00–$90.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMINISTRATION-HEP B	$65.00	$100.00	$80.00–$90.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE	$65.00	$100.00	$80.00–$90.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACC ADMIN-PNEUMOC-MED SUR	$65.00	$100.00	$80.00–$90.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINATION ADMIN-SINGLE	$71.50	$110.00	$88.00–$99.00	—	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACC-ADD'L-PNEUM-MED SUR	$10.30	$15.84	$9.03–$14.26	78% below	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINATION-ADD'L-MED SURG	$10.30	$15.84	$9.03–$14.26	78% below	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACC ADD'L-INFLUENZA	$10.30	$15.84	$9.03–$14.26	78% below	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINATION-ADD'L	$10.30	$15.84	$9.03–$14.26	78% below	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACC-ADD'L-INFLU-MED SUR	$10.30	$15.84	$9.03–$14.26	78% below	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACC-ADD'L-PNEUMOCOCCAL	$10.30	$15.84	$9.03–$14.26	78% below	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINATION-ADD'L-PNEUMOCOCCAL	$10.30	$15.84	$9.03–$14.26	78% below	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINATION-ADD'L-INFLUENZA	$10.30	$15.84	$9.03–$14.26	78% below	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINATION-ADD'L-MED SURG	$10.30	$15.84	$12.67–$14.26	—	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINATION-ADD'L-PNEUMOCOCCAL	$10.30	$15.84	$12.67–$14.26	—	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACC-ADD'L-PNEUMOCOCCAL	$10.30	$15.84	$12.67–$14.26	—	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINATION-ADD'L	$10.30	$15.84	$12.67–$14.26	—	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACC-ADD'L-PNEUM-MED SUR	$10.30	$15.84	$12.67–$14.26	—	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACC-ADD'L-INFLU-MED SUR	$10.30	$15.84	$12.67–$14.26	—	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINATION-ADD'L-INFLUENZA	$10.30	$15.84	$12.67–$14.26	—	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACC ADD'L-INFLUENZA	$10.30	$15.84	$12.67–$14.26	—	35%

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/7846/431530883_harrison-county-community-hospital-district_standardcharges.csv