Hospital Brattleboro, VT

Grace Cottage Hospital

Grace Cottage Hospital in Townshend, VT publishes cash prices for 328 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Vermont median for 199 of 321 procedures and above it for 103. By typical cash price it ranks #4 of 11 Vermont hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

po box 216, Townshend, VT 05353 Collected Sep 28, 2026 Source price file Check a bill from this hospital (802) 365-7920

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital No emergency department CCN 471300 · CMS hospital register

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Vermont	Off list
Abdominal CT scan without and with contrast CPT 74170 Ct Liver Mass/hemangioma	$2,739.00	$3,424.00	$1,027.00–$3,424.00	8% below	20%
Abdominal CT scan without and with contrast CPT 74170 Ct Adrenal Mass Protocol	$2,739.00	$3,424.00	$1,027.00–$3,424.00	8% below	20%
Abdominal CT scan without and with contrast CPT 74170 Ct Pancreas Protocol	$2,739.00	$3,424.00	$1,027.00–$3,424.00	8% below	20%
Abdominal CT scan without and with contrast CPT 74170 Ct Abdomen W/ + W/o Contrast	$2,978.00	$3,722.00	$1,117.00–$3,722.00	1% above	20%
Abdominal X-ray, 2 views CPT 74019 Xr Abdomen 2 Views	$442.00	$552.00	$166.00–$552.00	30% below	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle 3 Views Right	$354.00	$442.00	$133.00–$442.00	35% below	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle 3 Views Left	$356.00	$445.00	$134.00–$445.00	34% below	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Upper Extremity W/o Contrast Left	$2,174.00	$2,717.00	$815.00–$2,717.00	3% above	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Left	$616.00	$770.00	$231.00–$770.00	7% above	20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Ct Aortic Dissection	$3,923.00	$4,904.00	$1,471.00–$4,904.00	at median	20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Ct Angio Abdomen/pelvis	$4,231.00	$5,289.00	$1,587.00–$5,289.00	8% above	20%
CT angiography (CTA) of the head CPT 70496 Ct Angio Head W/ + W/o Contrast	$3,126.00	$3,908.00	$1,172.00–$3,908.00	10% below	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Ct Angio Pulmonary	$3,716.00	$4,645.00	$1,394.00–$4,645.00	30% above	20%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Ct Cardiac Calcium Scoring	$160.00	$200.00	$60.00–$200.00	at median	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Stone Protocol	$3,222.00	$4,027.00	$1,208.00–$4,027.00	4% above	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abdomen/pelvis W/o Contrast	$3,518.00	$4,398.00	$1,319.00–$4,398.00	13% above	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast	$4,231.00	$5,289.00	$1,587.00–$5,289.00	at median	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Hematuria/urogram	$4,707.00	$5,884.00	$1,765.00–$5,884.00	at median	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abdomen/pelvis W/ + W/o Contrast	$5,049.00	$6,311.00	$1,893.00–$6,311.00	7% above	20%
CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W/ Contrast	$2,819.00	$3,524.00	$1,057.00–$3,524.00	4% above	20%
CT scan of the abdomen without contrast CPT 74150 Ct Abdomen W/o Contrast	$2,455.00	$3,069.00	$921.00–$3,069.00	6% above	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Maxillofacial W/o Contrast	$2,146.00	$2,682.00	$805.00–$2,682.00	2% above	20%
CT scan of the head or brain, no contrast dye CPT 70450 CT scan	$2,118.00	$2,647.00	$794.00–$2,647.00	13% above	20%
CT scan of the head with contrast CPT 70460 Ct Head Or Brain W/ Contrast	$2,446.00	$3,057.00	$917.00–$3,057.00	7% above	20%
CT scan of the head without and with contrast CPT 70470 Ct Head Or Brain W/ + W/o Contrast	$2,950.00	$3,687.00	$1,106.00–$3,687.00	6% above	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Spine Lumbar W/o Contrast	$2,418.00	$3,023.00	$907.00–$3,023.00	11% above	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Spine Cervical W/o Contrast	$2,418.00	$3,023.00	$907.00–$3,023.00	13% above	20%
CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast	$2,748.00	$3,435.00	$1,031.00–$3,435.00	6% above	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Us Duplex Extracranial Arteries Bilateral	$989.00	$1,236.00	$371.00–$1,236.00	—	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Us Carotid Duplex Bilateral	$989.00	$1,236.00	$371.00–$1,236.00	—	20%
Chest CT scan without and with contrast CPT 71270 Ct Chest W/ + W/o Contrast	$3,487.00	$4,359.00	$1,308.00–$4,359.00	55% above	20%
Chest X-ray, 2 views CPT 71046 Xr Chest 2 Views W/ Obliques	$371.00	$464.00	$139.00–$464.00	20% below	20%
Chest X-ray, 2 views CPT 71046 Xr Chest 3 Views W/ Apical Lordotic	$371.00	$464.00	$139.00–$464.00	20% below	20%
Chest X-ray, 2 views CPT 71046 Xr Chest 2 Views	$371.00	$464.00	$139.00–$464.00	20% below	20%
Chest X-ray, single view CPT 71045 Xr Chest 1 View Frontal	$256.00	$320.00	$96.00–$320.00	29% below	20%
Chest X-ray, single view one side CPT 71045 Xr Chest Decubitus Left	$219.00	$274.00	$82.00–$274.00	40% below	20%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 Xr Clavicle Bilateral	$339.00	$424.00	$127.00–$424.00	—	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle Left	$332.00	$415.00	$125.00–$415.00	34% below	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle Right	$332.00	$415.00	$125.00–$415.00	34% below	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Retroperitoneal Complete	$812.00	$1,015.00	$305.00–$1,015.00	12% above	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bd Bone Density Dexa Axial Skeleton	$570.00	$712.00	$214.00–$712.00	13% below	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Bd Bone Density Dexa App Skeleton	$403.00	$504.00	$151.00–$504.00	13% above	20%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Us Pregnancy Complete W/ Detail	$1,022.00	$1,278.00	$383.00–$1,278.00	7% below	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest W/o Contrast	$2,418.00	$3,023.00	$907.00–$3,023.00	9% above	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest W/ Contrast	$2,930.00	$3,662.00	$1,099.00–$3,662.00	8% above	20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Us Duplex Le Arteries Or Art Graft Bilateral	$1,072.00	$1,340.00	$402.00–$1,340.00	—	20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Us Le Arterial Duplex Bilateral	$1,072.00	$1,340.00	$402.00–$1,340.00	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Reflux Le Bilateral	$1,183.00	$1,479.00	$444.00–$1,479.00	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Ue Venous Duplex Bilateral	$1,322.00	$1,653.00	$496.00–$1,653.00	—	20%
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 2 Views Right	$310.00	$387.00	$116.00–$387.00	23% below	20%
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 2 Views Left	$310.00	$387.00	$116.00–$387.00	23% below	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow Complete Right	$356.00	$445.00	$134.00–$445.00	38% below	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow Complete Left	$356.00	$445.00	$134.00–$445.00	38% below	20%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Iac W/o Contrast	$2,223.00	$2,779.00	$834.00–$2,779.00	at median	20%
Facial bones X-ray, complete, 3 or more views CPT 70150 Xr Facial Bones Minimum 3 Views	$365.00	$456.00	$137.00–$456.00	41% below	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 2 Views Left	$264.00	$330.00	$99.00–$330.00	43% below	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 2 Views Right	$264.00	$330.00	$99.00–$330.00	43% below	20%
Hand X-ray, 2 views both sides CPT 73120 Xr Hand 2 Views Bilateral	$346.00	$432.00	$130.00–$432.00	—	20%
Hand X-ray, 2 views one side CPT 73120 Xr Hand 2 Views Right	$346.00	$432.00	$130.00–$432.00	28% below	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Calcaneus Min 2 View Rt	$337.00	$421.00	$126.00–$421.00	14% below	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Calcaneus Min 2 View Lt	$337.00	$421.00	$126.00–$421.00	14% below	20%
Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Right	$448.00	$560.00	$168.00–$560.00	24% below	20%
Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Left	$454.00	$567.00	$170.00–$567.00	23% below	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee 4 Views Min Lt	$469.00	$586.00	$176.00–$586.00	31% below	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee 4 Views Min Rt	$469.00	$586.00	$176.00–$586.00	31% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Lower Extremity W/o Contrast Left	$2,172.00	$2,715.00	$815.00–$2,715.00	4% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen Limited	$723.00	$904.00	$271.00–$904.00	11% above	20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Us Le Non-vascular Limited Bil	$684.00	$855.00	$257.00–$855.00	20% above	20%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Us Le Non-vascular Limited Rt	$598.00	$747.00	$224.00–$747.00	5% above	20%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Us Le Non-vascular Limited Lt	$598.00	$747.00	$224.00–$747.00	5% above	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia +Fibula 2 Views Rt	$313.00	$391.00	$117.00–$391.00	34% below	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia +Fibula 2 Views Lt	$313.00	$391.00	$117.00–$391.00	34% below	20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Xr Spine Cervical 4-5 Views	$322.00	$403.00	$121.00–$403.00	54% below	20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Xr Spine Cervical Min 4 Views	$322.00	$403.00	$121.00–$403.00	54% below	20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Xr Spine Cervical Minimum 4 Views	$364.00	$455.00	$137.00–$455.00	48% below	20%
Neck soft tissue CT scan with contrast CPT 70491 Ct Soft Tissue Neck W/ Contrast	$2,516.00	$3,145.00	$944.00–$3,145.00	5% above	20%
Neck soft tissue CT scan without contrast CPT 70490 Ct Soft Tissue Neck W/o Contrast	$2,178.00	$2,722.00	$817.00–$2,722.00	6% above	20%
Neck soft tissue X-ray CPT 70360 Xr Neck Soft Tissue	$248.00	$310.00	$93.00–$310.00	34% below	20%
Pelvic CT scan without contrast CPT 72192 Ct Pelvis W/o Contrast	$2,483.00	$3,104.00	$931.00–$3,104.00	15% above	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Pelvis Non-ob Limited	$631.00	$789.00	$237.00–$789.00	at median	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvis Non-ob Complete	$715.00	$894.00	$268.00–$894.00	6% above	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Abdomial ultrasound of pregnant uterus	$914.00	$1,142.00	$343.00–$1,142.00	33% above	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Us Pregnancy 1st Trimester	$1,035.00	$1,294.00	$388.00–$1,294.00	33% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Pregnancy Limited	$417.00	$521.00	$156.00–$521.00	33% below	20%
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs 2 Views Right	$362.00	$453.00	$136.00–$453.00	31% below	20%
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs 2 Views Left	$362.00	$453.00	$136.00–$453.00	31% below	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs W/ Pa Chest Right	$575.00	$719.00	$216.00–$719.00	11% below	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs W/ Pa Chest Left	$575.00	$719.00	$216.00–$719.00	11% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder 2 Views Left	$354.00	$442.00	$133.00–$442.00	31% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder 2 Views Right	$354.00	$442.00	$133.00–$442.00	31% below	20%
Sinus X-ray, complete, 3 or more views CPT 70220 Xr Sinuses Complete	$586.00	$733.00	$220.00–$733.00	26% above	20%
Skull X-ray, fewer than 4 views CPT 70250 Xr Skull < 4 Views	$369.00	$461.00	$138.00–$461.00	31% below	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur 2 Views Lt	$358.00	$447.00	$134.00–$447.00	15% below	20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 Ct Spine Thoracic W/o Contrast	$2,444.00	$3,055.00	$917.00–$3,055.00	37% above	20%
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe(s) 2 Views Min Lt	$253.00	$316.00	$95.00–$316.00	35% below	20%
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe(s) 2 Views Min Rt	$253.00	$316.00	$95.00–$316.00	35% below	20%
Transvaginal pelvic ultrasound CPT 76830 Ultrasound pelvis through vagina	$961.00	$1,201.00	$360.00–$1,201.00	17% above	20%
Transvaginal ultrasound during pregnancy CPT 76817 Us Pregnancy Transvaginal	$914.00	$1,142.00	$343.00–$1,142.00	27% above	20%
Ultrasound of the abdomen, complete CPT 76700 Ultrasound of abdomen	$963.00	$1,204.00	$361.00–$1,204.00	6% above	20%
Ultrasound of the scrotum and testicles CPT 76870 Report	$112.00	$140.00	$42.00–$140.00	83% below	20%
Ultrasound of the scrotum and testicles CPT 76870 Us Scrotum (Contents)	$580.00	$725.00	$218.00–$725.00	14% below	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Thyroid	$882.00	$1,102.00	$331.00–$1,102.00	1% above	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus 2 Views Min Rt	$356.00	$445.00	$134.00–$445.00	30% below	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus 2 Views Min Lt	$356.00	$445.00	$134.00–$445.00	30% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Reflux Le Right	$1,043.00	$1,304.00	$391.00–$1,304.00	55% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Ue Venous Duplex Left	$1,172.00	$1,465.00	$440.00–$1,465.00	74% above	20%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 2 Views Right	$321.00	$401.00	$120.00–$401.00	34% below	20%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 2 Views Left	$321.00	$401.00	$120.00–$401.00	34% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete W/ Navicular Left	$332.00	$415.00	$125.00–$415.00	43% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete W/ Navicular Right	$334.00	$418.00	$125.00–$418.00	43% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist 3 Views Min Lt	$334.00	$418.00	$125.00–$418.00	43% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip 2-3 Views Lt W/ Pelvis	$403.00	$504.00	$151.00–$504.00	29% below	20%
X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen Kub	$310.00	$388.00	$116.00–$388.00	22% below	20%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Right	$333.00	$416.00	$125.00–$416.00	29% below	20%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Left	$335.00	$419.00	$126.00–$419.00	28% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(s) 2 Views Min Lt	$250.00	$312.00	$94.00–$312.00	36% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger(s) 2 Views Min Rt	$250.00	$312.00	$94.00–$312.00	36% below	20%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Left	$351.00	$439.00	$132.00–$439.00	26% below	20%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Right	$354.00	$442.00	$133.00–$442.00	26% below	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot 3 Views Min Rt	$354.00	$442.00	$133.00–$442.00	31% below	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot 3 Views Min Lt	$356.00	$445.00	$134.00–$445.00	30% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand 3 Views Min Rt	$354.00	$442.00	$133.00–$442.00	30% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand 3 Views Min Lt	$356.00	$445.00	$134.00–$445.00	29% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 2 Views Right	$322.00	$402.00	$121.00–$402.00	36% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 2 Views Left	$322.00	$402.00	$121.00–$402.00	36% below	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr Spine Lumbosacral 2 Or 3 Views	$391.00	$489.00	$147.00–$489.00	41% below	20%
X-ray of the lower back, 4 or more views CPT 72110 X-Ray of lower back	$570.00	$712.00	$214.00–$712.00	32% below	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr Spine Thoracic 2 Views	$348.00	$435.00	$131.00–$435.00	33% below	20%
X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones Minimum 3 Views	$351.00	$439.00	$132.00–$439.00	37% below	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr Spine Cervical 1-3 Views	$314.00	$393.00	$118.00–$393.00	38% below	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr Spine Cervical 2 Or 3 Views	$355.00	$444.00	$133.00–$444.00	29% below	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis 1 Or 2 Views	$353.00	$441.00	$132.00–$441.00	19% below	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum/coccyx Minimum 2 Views	$356.00	$445.00	$134.00–$445.00	30% below	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Vermont	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Liver Fibrosis, Fibrotest	$15.00	$19.00	$6.00–$19.00	62% below	21%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alt	$15.00	$19.00	$6.00–$19.00	62% below	21%
AST (aspartate aminotransferase) enzyme test CPT 84450 Ast	$14.00	$18.00	$5.00–$18.00	78% below	22%
Aldosterone blood test CPT 82088 Aldosterone, 24 Hour Urine Mayo	$114.00	$143.00	$43.00–$143.00	74% below	20%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$14.00	$18.00	$5.00–$18.00	69% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Garlic, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Maple, Box Elder, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Mango, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Lemon, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Latex, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Lamb's Quarter, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Kiwi, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Zzjalapenos, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 House Dust Mites/d. Pteronyss, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Horse Serum Protein, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Guinea Pig Epithelium, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Green Pepper, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Goldenrod, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Fusarium Moniforme, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Fir, Douglas, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Fescue, Meadow, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 English Plantain, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Elm, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Eggplant, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Coriander, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Coffee, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Cladosporium (Hormodendrum), Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Cheese, Cheddar, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Cedar, Mountain, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Cashew, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Capsicum (Chili Pepper), Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Candida Albicans, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Blackberry, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Birch, Silver, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Banana, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Amoxicillin, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Codfish, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 White Ash, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 White Pine, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Corn-food, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Strawberry, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Beech, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Almond, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Alternaria Tenuis, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Yellow Faced Hornet Venom, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Wasp Venom, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Wheat, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 White Faced Hornet Venom, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Tomato, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Timothy Grass, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Short Ragweed, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Soybean, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Shrimp, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Sesame Seed, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Scallop, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Rye Grass, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Rice, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Oyster, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Oat, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Blue Mussel, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Milk, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 June Grass, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Horse Dander, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 House Dust/greer Lab, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Honeybee Venom, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Gluten, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 European Hornet, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Egg White, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Dog Dander, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 House Dust Mites/dermatophagoides Farinae, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Crab, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Cacao/cocoa, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Clam, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Cat Epithelium, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Bermuda Grass, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Apple, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Pineapple Ige	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 86003-alpha Gal Panel Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Galactose-alpha-1,3-galactose (Alpha-gal) Mammalian Meat Allergy Profile, Serum Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Stinging Insects Profile Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Hazelnut-food, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen-food Seafood Panel	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Nuts Allergen Profile, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Yeast, Baker's, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Walnut, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Tobacco, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Tea, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Sweet Potato, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Squid, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Spruce, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Sorrel, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Ragweed, Giant, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Rabbit Epithelium, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Potato, White, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Pork, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Pistachio, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Penicillium, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Penicillin V, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Penicillin G, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Pecan, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Pea, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Paprika, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Ovomucoid, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Ovalbumin, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Orange, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 Oak, Ige Mayo	$14.00	$18.00	$5.00–$18.00	71% below	22%
Alpha-fetoprotein (AFP) blood test CPT 82105 Afp Tumor Marker Fah	$47.00	$59.00	$18.00–$59.00	60% below	20%
Ammonia blood test CPT 82140 Ammonia Fah	$41.00	$51.00	$15.00–$51.00	69% below	20%
Amylase blood test CPT 82150 Amylase Level	$18.00	$23.00	$7.00–$23.00	66% below	22%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp Ab Mayo	$36.00	$45.00	$14.00–$45.00	69% below	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp Abs Fah	$36.00	$45.00	$14.00–$45.00	69% below	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab Mayo	$34.00	$42.00	$13.00–$42.00	67% below	19%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Nt-pro B-type Natriuretic Peptide (Bnp) Fah	$110.00	$137.00	$41.00–$137.00	56% below	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Bnp	$110.00	$137.00	$41.00–$137.00	56% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Respiratory	$24.00	$30.00	$9.00–$30.00	72% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Throat	$24.00	$30.00	$9.00–$30.00	72% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Ear	$24.00	$30.00	$9.00–$30.00	72% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Body Fluid	$24.00	$30.00	$9.00–$30.00	72% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Bacteria, Other	$24.00	$30.00	$9.00–$30.00	72% below	20%
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel	$24.00	$30.00	$9.00–$30.00	74% below	20%
Bilirubin blood test, total CPT 82247 Bili Total	$14.00	$18.00	$5.00–$18.00	73% below	22%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Collection: Ap Specimen	$62.00	$78.00	$23.00–$78.00	76% below	21%
Blood culture for bacteria CPT 87040 Bacterial Culture, Blood Fah	$29.00	$36.00	$11.00–$36.00	79% below	19%
Blood culture for bacteria CPT 87040 Culture Blood	$29.00	$36.00	$11.00–$36.00	79% below	19%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection: Venous Draw	$26.00	$32.00	$10.00–$32.00	10% below	19%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Specimen Draw	$26.00	$33.00	$10.00–$33.00	10% below	21%
Blood glucose (sugar) test CPT 82947 Glucose Random	$11.00	$14.00	$4.00–$14.00	73% below	21%
Blood lead test CPT 83655 Lead, Capillary Fah	$34.00	$42.00	$13.00–$42.00	47% below	19%
Blood lead test CPT 83655 Lead Testing Poc	$34.00	$42.00	$13.00–$42.00	47% below	19%
Blood lead test CPT 83655 Lead Vdh	$34.00	$42.00	$13.00–$42.00	47% below	19%
Blood lead test CPT 83655 Lead Fah	$34.00	$42.00	$13.00–$42.00	47% below	19%
Blood lead test CPT 83655 Cadmium Mayo	$34.00	$42.00	$13.00–$42.00	47% below	19%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta Human Chorionic Gonadotropin Qualitative	$21.00	$26.00	$8.00–$26.00	75% below	19%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen	$11.00	$14.00	$4.00–$14.00	74% below	21%
C-peptide blood test CPT 84681 C-peptide Mayo	$58.00	$73.00	$22.00–$73.00	69% below	21%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive Protein Fah	$14.00	$18.00	$5.00–$18.00	77% below	22%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive Protein	$14.00	$18.00	$5.00–$18.00	77% below	22%
C. difficile toxin gene test (stool PCR) CPT 87493 C. Difficile Pcr Fah	$104.00	$130.00	$39.00–$130.00	56% below	20%
CA 19-9 blood test (tumor marker) CPT 86301 Ca 19-9 Mayo	$58.00	$73.00	$22.00–$73.00	74% below	21%
CA-125 blood test (ovarian cancer marker) CPT 86304 Ca 125 Fah	$58.00	$73.00	$22.00–$73.00	69% below	21%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-19 Pcr Testing Gch	$144.00	$180.00	$54.00–$180.00	37% above	20%
Calcium blood test, total CPT 82310 Calcium Level	$14.00	$18.00	$5.00–$18.00	60% below	22%
Carcinoembryonic antigen (CEA) test CPT 82378 Cea Fah	$53.00	$66.00	$20.00–$66.00	72% below	20%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-zoster Ab, Igm And Igg Mayo	$36.00	$45.00	$14.00–$45.00	62% below	20%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-zoster Ab, Igm Mayo	$36.00	$45.00	$14.00–$45.00	62% below	20%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-zoster Ab, Igg Mayo	$36.00	$45.00	$14.00–$45.00	62% below	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Amplified Chlamydia Fah	$98.00	$123.00	$37.00–$123.00	19% below	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Amplified Chlamydia, Urine Fah	$98.00	$123.00	$37.00–$123.00	19% below	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia/gc Amplified Misc. Sites Mayo	$98.00	$123.00	$37.00–$123.00	19% below	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids	$38.00	$47.00	$14.00–$47.00	61% below	19%
Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (CBC), automated	$18.00	$23.00	$7.00–$23.00	69% below	22%
Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals	$30.00	$37.00	$11.00–$37.00	79% below	19%
Cortisol blood test, total CPT 82533 Cortisol Fah	$46.00	$57.00	$17.00–$57.00	62% below	19%
Cortisol blood test, total CPT 82533 Cortisol, Stim Baseline Fah	$46.00	$57.00	$17.00–$57.00	62% below	19%
Cortisol blood test, total CPT 82533 Cortisol, Stim 60 Min Fah	$46.00	$57.00	$17.00–$57.00	62% below	19%
Cortisol blood test, total CPT 82533 Cortisol, Stim 30 Min Fah	$46.00	$57.00	$17.00–$57.00	62% below	19%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase	$18.00	$23.00	$7.00–$23.00	76% below	22%
Creatinine blood test CPT 82565 Creatinine	$14.00	$18.00	$5.00–$18.00	69% below	22%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Ab, Igg Mayo	$40.00	$50.00	$15.00–$50.00	50% below	20%
D-dimer blood test (blood clot marker) CPT 85379 .D-dimer Mayo	$29.00	$36.00	$11.00–$36.00	69% below	19%
D-dimer blood test (blood clot marker) CPT 85379 D-dimer	$29.00	$36.00	$11.00–$36.00	69% below	19%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea Sulfate Fah	$62.00	$78.00	$23.00–$78.00	76% below	21%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ctl Fentanyl Screen, Urine Fah	$174.00	$217.00	$65.00–$217.00	5% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ctl Amphetamines Screen, Urine Fah	$174.00	$217.00	$65.00–$217.00	5% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ctl Synthetic Cannabinoids Screen, Urine Fah	$174.00	$217.00	$65.00–$217.00	5% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ctl Methadone Screen, Urine Fah	$174.00	$217.00	$65.00–$217.00	5% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ctl Opioids Screen, Urine Fah	$174.00	$217.00	$65.00–$217.00	5% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ctl Oxycodone Screen, Urine Fah	$174.00	$217.00	$65.00–$217.00	5% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ctl Buprenorphine Screen, Urine Fah	$174.00	$217.00	$65.00–$217.00	5% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ctl Alcohol Metabolite (Etg) Screen, Urine	$174.00	$217.00	$65.00–$217.00	5% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ctl Cotinine Screen, Urine Fah	$174.00	$217.00	$65.00–$217.00	5% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ctl Thc Metabolites (Cannabinoids) Screen, Urine Fah	$174.00	$217.00	$65.00–$217.00	5% above	20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Lytes	$20.00	$25.00	$8.00–$25.00	75% below	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 Ebv Vca Igg Ab Mayo	$50.00	$63.00	$19.00–$63.00	55% below	21%
Epstein-Barr virus (EBV) antibody test CPT 86665 Ebv Vca Igm Ab Mayo	$50.00	$63.00	$19.00–$63.00	55% below	21%
Estradiol blood test CPT 82670 Estradiol Fah	$78.00	$98.00	$29.00–$98.00	55% below	20%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Feces Mayo	$55.00	$69.00	$21.00–$69.00	83% below	20%
Ferritin blood test (iron stores) CPT 82728 Ferritin Fah	$38.00	$48.00	$14.00–$48.00	69% below	21%
Ferritin blood test (iron stores) CPT 82728 Ferritin Serum 2	$38.00	$48.00	$14.00–$48.00	69% below	21%
Fibrinogen blood test CPT 85384 .Fibrinogen Mayo	$27.00	$34.00	$10.00–$34.00	59% below	21%
Folate (folic acid) blood test CPT 82746 Folate Fah	$41.00	$51.00	$15.00–$51.00	64% below	20%
Free T3 thyroid hormone test CPT 84481 T3, Free Fah	$47.00	$59.00	$18.00–$59.00	69% below	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 2	$26.00	$32.00	$10.00–$32.00	75% below	19%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, Free Fah	$26.00	$32.00	$10.00–$32.00	75% below	19%
Free testosterone test CPT 84402 Testosterone, Free Mayo	$71.00	$89.00	$27.00–$89.00	23% below	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase	$20.00	$25.00	$8.00–$25.00	57% below	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance Test 1 Hr	$14.00	$17.00	$5.00–$17.00	74% below	18%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance Test 2hr	$14.00	$17.00	$5.00–$17.00	74% below	18%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gc Result Fah	$98.00	$123.00	$37.00–$123.00	38% below	20%
H. pylori antibody blood test CPT 86677 H. Pylori Igg Ab Fah	$47.00	$59.00	$18.00–$59.00	16% below	20%
H. pylori stool antigen test CPT 87338 H. Pylori Ag, Feces Mayo	$40.00	$50.00	$15.00–$50.00	81% below	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Rna Quant Mayo	$238.00	$298.00	$89.00–$298.00	36% below	20%
HIV-1 and HIV-2 antibody test CPT 86703 Hiv 1/2 Ab Fah	$38.00	$48.00	$14.00–$48.00	64% below	21%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Rapid Hiv	$67.00	$84.00	$25.00–$84.00	27% below	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv Fah	$98.00	$123.00	$37.00–$123.00	36% below	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$27.00	$34.00	$10.00–$34.00	69% below	21%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c Rrmc	$27.00	$34.00	$10.00–$34.00	69% below	21%
Hemoglobin blood test CPT 85018 Poc: Hemoglobin	$6.00	$8.00	$2.00–$8.00	73% below	25%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Total Abs Mayo	$34.00	$42.00	$13.00–$42.00	66% below	19%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B S Ab Mayo	$30.00	$38.00	$11.00–$38.00	69% below	21%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab Fah	$30.00	$38.00	$11.00–$38.00	69% below	21%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag Fah	$29.00	$36.00	$11.00–$36.00	69% below	19%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab With Reflex To Hcv Rna	$40.00	$50.00	$15.00–$50.00	64% below	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus Rna Quant Fah	$120.00	$150.00	$45.00–$150.00	74% below	20%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 Hepatitis C Virus Rna Detect And Quant Rt-pcr Mayo	$120.00	$150.00	$45.00–$150.00	74% below	20%
Herpes blood test, HSV-1 antibody CPT 86695 Hsv Type 1 Ab, Igg Mayo	$37.00	$46.00	$14.00–$46.00	66% below	20%
Herpes blood test, HSV-2 antibody CPT 86696 Hsv Type 2 Ab, Igg Mayo	$54.00	$68.00	$20.00–$68.00	55% below	21%
High-sensitivity CRP (hs-CRP) test CPT 86141 High Sensitivity Crp Fah	$36.00	$45.00	$14.00–$45.00	62% below	20%
Homocysteine blood test CPT 83090 Homocysteine Fah	$50.00	$63.00	$19.00–$63.00	75% below	21%
Insulin blood test CPT 83525 Insulin Fah	$32.00	$40.00	$12.00–$40.00	69% below	20%
Iron blood test (serum iron) CPT 83540 Iron Fah	$18.00	$23.00	$7.00–$23.00	74% below	22%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity Fah	$25.00	$31.00	$9.00–$31.00	69% below	19%
Kidney function blood test panel CPT 80069 Kidney function panel test	$24.00	$30.00	$9.00–$30.00	80% below	20%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$52.00	$65.00	$20.00–$65.00	68% below	20%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid Fah	$33.00	$41.00	$12.00–$41.00	71% below	20%
Lactate (lactic acid) blood test CPT 83605 Lactate Mayo	$33.00	$41.00	$12.00–$41.00	71% below	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase	$17.00	$21.00	$6.00–$21.00	80% below	19%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh, Fluid Fah	$17.00	$21.00	$6.00–$21.00	80% below	19%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$19.00	$24.00	$7.00–$24.00	61% below	21%
Liver function blood test panel CPT 80076 Liver function blood test	$23.00	$29.00	$9.00–$29.00	79% below	21%
Lyme disease antibody test CPT 86618 Lyme Cns Infection Igg W/ Ai Reflex Mayo	$48.00	$60.00	$18.00–$60.00	52% below	20%
Lyme disease antibody test CPT 86618 Lyme Disease Serology Mayo	$48.00	$60.00	$18.00–$60.00	52% below	20%
Magnesium blood test CPT 83735 Magnesium Level	$18.00	$23.00	$7.00–$23.00	68% below	22%
Magnesium blood test CPT 83735 Magnesium, 24 Hr Urine Fah	$18.00	$23.00	$7.00–$23.00	68% below	22%
Magnesium blood test CPT 83735 Magnesium, Urine Fah	$18.00	$23.00	$7.00–$23.00	68% below	22%
Measles (rubeola) antibody test CPT 86765 Rubeola Igg Ab Fah	$36.00	$45.00	$14.00–$45.00	55% below	20%
Mono test (heterophile antibody, Monospot) CPT 86308 Rapid Mono	$14.00	$18.00	$5.00–$18.00	71% below	22%
Mumps immunity blood test CPT 86735 Mumps Ab Igg Fah	$37.00	$46.00	$14.00–$46.00	66% below	20%
Mumps immunity blood test CPT 86735 Mumps Igg Screen Mayo	$37.00	$46.00	$14.00–$46.00	66% below	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 Total prostate-specific antigen (PSA) test	$51.00	$64.00	$19.00–$64.00	64% below	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 Total prostate-specific antigen (PSA) test	$51.00	$64.00	$19.00–$64.00	62% below	20%
Pap test (liquid-based, automated screening with review) CPT 88175 Pap Complete	$74.00	$93.00	$28.00–$93.00	24% below	20%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Mayo	$115.00	$144.00	$43.00–$144.00	54% below	20%
Parathyroid hormone (PTH) blood test CPT 83970 Pth, Intact Fah	$115.00	$144.00	$43.00–$144.00	54% below	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test	$17.00	$21.00	$6.00–$21.00	69% below	19%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level	$14.00	$17.00	$5.00–$17.00	69% below	18%
Potassium blood test CPT 84132 Potassium Level	$14.00	$17.00	$5.00–$17.00	66% below	18%
Progesterone blood test CPT 84144 Progesterone Fah	$58.00	$73.00	$22.00–$73.00	67% below	21%
Prolactin blood test CPT 84146 Prolactin Fah	$54.00	$68.00	$20.00–$68.00	62% below	21%
Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time	$12.00	$15.00	$5.00–$15.00	68% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Screen Complete	$35.00	$44.00	$13.00–$44.00	9% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Acetaminophen Level	$35.00	$44.00	$13.00–$44.00	9% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Ethanol Level	$35.00	$44.00	$13.00–$44.00	9% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Toxicology Drug Screen Poc	$35.00	$44.00	$13.00–$44.00	9% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Test By Cup	$35.00	$44.00	$13.00–$44.00	9% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Urine Drug Screen.	$35.00	$44.00	$13.00–$44.00	9% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Dau W/confirm, Urine Mayo	$35.00	$44.00	$13.00–$44.00	9% below	20%
Rapid flu test (influenza antigen) CPT 87804 Influenza B	$46.00	$58.00	$17.00–$58.00	at median	21%
Rapid flu test (influenza antigen) CPT 87804 Influenza A	$46.00	$58.00	$17.00–$58.00	at median	21%
Rapid flu test (influenza antigen) CPT 87804 Influenza A/b Poc	$109.00	$136.00	$41.00–$136.00	137% above	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 87880 Rapid Strep Poc	$46.00	$58.00	$17.00–$58.00	31% below	21%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Screen, Throat	$46.00	$58.00	$17.00–$58.00	31% below	21%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Poc	$100.00	$125.00	$38.00–$125.00	49% above	20%
Renin blood test CPT 84244 Renin Activity Mayo	$62.00	$77.00	$23.00–$77.00	70% below	19%
Rh blood typing CPT 86901 A1 Cells	$8.00	$10.00	$3.00–$10.00	84% below	20%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Fah	$16.00	$20.00	$6.00–$20.00	72% below	20%
Rubella antibody test (immunity check) CPT 86762 Rubella Igg Ab Fah	$40.00	$50.00	$15.00–$50.00	59% below	20%
Sodium blood test CPT 84295 Sodium Level	$14.00	$17.00	$5.00–$17.00	69% below	18%
Stool ova and parasites exam CPT 87177 Result, Fah	$25.00	$31.00	$9.00–$31.00	75% below	19%
Stool ova and parasites exam CPT 87177 Ova And Parasite, Feces	$25.00	$31.00	$9.00–$31.00	75% below	19%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood, Screening	$12.00	$15.00	$5.00–$15.00	34% below	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Poc-gcfh: Stool For Occult	$36.00	$45.00	$14.00–$45.00	97% above	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 82270 Fecal Occult Blood, Guiac Poc	$36.00	$45.00	$14.00–$45.00	97% above	20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood (Fiobt)	$45.00	$56.00	$17.00–$56.00	54% below	20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Poc-gcfh: Stool For Occult	$45.00	$56.00	$17.00–$56.00	54% below	20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Poc: Stool For Occult	$45.00	$56.00	$17.00–$56.00	54% below	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Ab, Igg Mayo	$37.00	$46.00	$14.00–$46.00	36% below	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Serology Fah	$37.00	$46.00	$14.00–$46.00	36% below	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 .Syphilis Igg W/ Reflex Rpr Fah	$37.00	$46.00	$14.00–$46.00	36% below	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 Do Not Use Syphilis Total Ab W/ Reflex, S Mayo	$37.00	$46.00	$14.00–$46.00	36% below	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 Rtppa 86780	$37.00	$46.00	$14.00–$46.00	36% below	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Vdrl, Spinal Fluid Mayo	$12.00	$15.00	$5.00–$15.00	83% below	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 .Rapid Plasma Reagin W/reflex Mayo	$12.00	$15.00	$5.00–$15.00	83% below	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Mycobacterium Tuberculosis By Quantiferon-tb Gold Mayo	$174.00	$217.00	$65.00–$217.00	13% below	20%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total Mayo	$72.00	$90.00	$27.00–$90.00	64% below	20%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total And Bioavailable,serum	$72.00	$90.00	$27.00–$90.00	64% below	20%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Fah	$72.00	$90.00	$27.00–$90.00	64% below	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver/kidney Microsome Type 1 Abs Mayo	$41.00	$51.00	$15.00–$51.00	66% below	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroperoxidase Ab Fah	$41.00	$51.00	$15.00–$51.00	66% below	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH)	$47.00	$59.00	$18.00–$59.00	75% below	20%
Total IgE blood test CPT 82785 Ige Fah	$46.00	$58.00	$17.00–$58.00	45% below	21%
Total cholesterol blood test CPT 82465 Cholesterol Total	$12.00	$15.00	$5.00–$15.00	71% below	20%
Total thyroxine (T4) blood test CPT 84436 T4 Fah	$19.00	$24.00	$7.00–$24.00	67% below	21%
Total triiodothyronine (T3) blood test CPT 84480 T3, Total Fah	$40.00	$50.00	$15.00–$50.00	68% below	20%
Transferrin blood test CPT 84466 Transferrin Fah	$36.00	$45.00	$14.00–$45.00	64% below	20%
Triglycerides blood test CPT 84478 Triglycerides	$16.00	$20.00	$6.00–$20.00	60% below	20%
Troponin test, quantitative CPT 84484 Troponin I	$35.00	$44.00	$13.00–$44.00	79% below	20%
Uric acid blood test CPT 84550 Uric Acid	$13.00	$16.00	$5.00–$16.00	80% below	19%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis test using microscope	$9.00	$11.00	$3.00–$11.00	81% below	18%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis test using microscope	$11.00	$14.00	$4.00–$14.00	43% below	21%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis test	$6.00	$8.00	$2.00–$8.00	84% below	25%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis test	$32.00	$40.00	$12.00–$40.00	39% above	20%
Urine culture for bacteria, with colony count CPT 87086 Culture Urine	$22.00	$28.00	$8.00–$28.00	71% below	21%
Urine microalbumin (albumin) test CPT 82043 Albumin, Urine Fah	$16.00	$20.00	$6.00–$20.00	68% below	20%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test Poc	$26.00	$32.00	$10.00–$32.00	34% below	19%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level 1	$42.00	$53.00	$16.00–$53.00	62% below	21%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Fah	$42.00	$53.00	$16.00–$53.00	62% below	21%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D Total	$83.00	$104.00	$31.00–$104.00	61% below	20%
Zinc blood test CPT 84630 Zinc, Serum Mayo	$168.00	$210.00	$63.00–$210.00	9% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Fah	$42.00	$53.00	$16.00–$53.00	66% below	21%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Vermont	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 Cardioversion, Elective, Electrical Conversion Of Arrhythmia; External	$1,525.00	$1,906.00	$572.00–$1,906.00	at median	20%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 54161 Circumcision, Surgical Excision Other Than Clamp, Device, Or Dorsal Slit, Older Than 28 Days O	$643.00	$804.00	$241.00–$804.00	at median	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600 Closed Treatment Of Distal Radial Fracture	$1,459.00	$1,824.00	$547.00–$1,824.00	170% above	20%
Cystoscopy with ureteral stent placement CPT 52332 52332 Cystourethroscopy, With Insertion Of Indwelling Ureteral Stent	$510.00	$638.00	$191.00–$638.00	35% below	20%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 52000 Cystoscopy Uretheral Dilation	$438.00	$548.00	$164.00–$548.00	at median	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruction (Eg, Laser Surgery), Premalignant Lesions (Eg, Actinic Keratoses); First Lesion	$178.00	$223.00	$67.00–$223.00	115% above	20%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 Removal Impacted Cerumen Using Irrigation/lavage, Unilateral	$162.00	$203.00	$61.00–$203.00	63% above	20%
Earwax removal with instruments, one ear one side CPT 69210 69210 Removal Of Impacted Cerumen W/ Instrumentation, Unilateral	$234.00	$292.00	$88.00–$292.00	41% above	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial Sampling (Bx) With Or Without Endocervical Sampling (Bx), Without Cervical Dilation	$241.00	$301.00	$90.00–$301.00	3% above	20%
IUD insertion (the device itself billed separately) CPT 58300 Insertion Of Intrauterine Device (Iud)	$518.00	$648.00	$194.00–$648.00	at median	20%
Incision and drainage of a simple or single skin abscess CPT 10060 I&d Abscess/paronychia; Simp/single Charge	$633.00	$791.00	$237.00–$791.00	37% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection(s); Single Tendon Sheath, Or Ligament, Aponeurosis (Eg, Plantar "Fascia")	$125.00	$156.00	$47.00–$156.00	56% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Intra-articular Glenohumeral Joint Injection, W/out Ultrasound Guidance	$702.00	$878.00	$263.00–$878.00	3% above	20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion, Non-biodegradable Drug Delivery Implant.	$384.00	$480.00	$144.00–$480.00	106% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis Intermediate	$528.00	$660.00	$198.00–$660.00	90% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis, Aspiration And/or Injection; Small Joint Or Bursa (Eg, Fingers, Toes)	$111.00	$139.00	$42.00–$139.00	69% below	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis Small Joint	$528.00	$660.00	$198.00–$660.00	47% above	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Intermediate Suture 2.5 Or Less.	$1,227.00	$1,534.00	$460.00–$1,534.00	170% above	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 Excision, Benign Lesion Including Margins, Trunk, Arms Or Legs; Excised Diameter 0.5 Cm Or Les	$460.00	$575.00	$173.00–$575.00	114% above	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Remove Lesion, Face/lid/ear/nose/lip <.5 Cm	$286.00	$358.00	$107.00–$358.00	22% below	20%
Nail removal (partial or complete), one nail CPT 11730 Nail Plate Avulsion; 1st Charge	$600.00	$750.00	$225.00–$750.00	47% above	20%
Paracentesis with imaging guidance CPT 49083 49083 Abdominal Paracentesis (Diagnostic Or Therapeutic); With Image Guidance	$642.00	$802.00	$241.00–$802.00	9% below	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Excision Of Nail And Nail Matrix, Partial Or Complete (Eg. Ingrown Or Deformed Nail) For Perma	$1,142.00	$1,427.00	$428.00–$1,427.00	25% above	20%
Removal of a foreign object under the skin, simple CPT 10120 Inc & Rem Fb Skin; Simple Charge	$986.00	$1,232.00	$370.00–$1,232.00	100% above	20%
Short arm cast (elbow to hand) CPT 29075 29075 Application Of Short Arm Cast (Elbow To Finger)	$655.00	$819.00	$246.00–$819.00	62% above	20%
Short arm splint (forearm and hand) CPT 29125 Application Of Short Arm Splint Charge	$382.00	$478.00	$143.00–$478.00	72% above	20%
Short leg cast (below the knee) CPT 29405 29405-application Of Short Leg Cast (Below Knee To Toes)	$246.00	$308.00	$92.00–$308.00	32% below	20%
Short leg splint (calf to foot) CPT 29515 Application Of Short Leg Splint Charge	$450.00	$563.00	$169.00–$563.00	32% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Simple Suture 2.5 Or Less.	$602.00	$752.00	$226.00–$752.00	51% above	20%
Skin biopsy, punch, one lesion CPT 11104 11104 Punch Biopsy Of Skin (Including Simple Closure, When Performed) Single Lesion	$186.00	$232.00	$70.00–$232.00	19% below	20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; Excised Diameter 0.5 Cm Or Less	$401.00	$501.00	$150.00–$501.00	50% above	20%
Skin tag removal, up to 15 tags CPT 11200 Removal Of Skin Tags, Mult Fibrocutaneous Tags, Any Area; Up To & W/15 Lesions Charge	$186.00	$233.00	$70.00–$233.00	6% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Charge Gch	$1,639.00	$2,049.00	$615.00–$2,049.00	94% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 Simple Suture 2.6-7.5cm.	$638.00	$797.00	$239.00–$797.00	20% above	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Simple Suture < 2.5	$644.00	$805.00	$242.00–$805.00	40% above	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangential Biopsy Of Skin (E.g. Shave, Scoop, Saucerize, Curette) Single Lesion	$148.00	$185.00	$56.00–$185.00	4% above	20%
Thoracentesis with imaging guidance CPT 32555 32555 Thoracentesis With Imaging Guidance	$1,250.00	$1,562.00	$469.00–$1,562.00	1% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 Injection(s); Single Or Multiple Trigger Point(s), 1 Or 2 Muscle(s) Ed	$650.00	$812.00	$244.00–$812.00	13% above	20%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 55250 Vasectomy,unilateral Or Bilateral Including Postopeative Semen Examinations	$3,070.00	$3,838.00	$1,151.00–$3,838.00	—	20%
Wart removal, up to 14 warts CPT 17110 Destruction (Eg, Laser Surgery), Benign Lesions; Up To 14 Lesions	$242.00	$303.00	$91.00–$303.00	51% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement,subcutaneous Tissue (Incl Epidermis And Dermis) First 20 Sqcm Or Less	$379.00	$474.00	$142.00–$474.00	at median	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Vermont	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion Charge	$921.00	$1,151.00	$345.00–$1,151.00	37% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pressurized Or Nonpressurized Inhalation Treatment For Acute Airway Obstruction Charge	$39.00	$49.00	$15.00–$49.00	80% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Updraft Charge	$127.00	$159.00	$48.00–$159.00	35% below	20%
Critical care, first 30 to 74 minutes CPT 99291 99291 Critical Care Fct Charge	$1,750.00	$2,187.00	$656.00–$2,187.00	at median	20%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Electrocardiogram, routine, with interpretation and report	$314.00	$392.00	$118.00–$392.00	92% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005-electrocardiogram, Routine Ecg With At Least 12 Leads	$286.00	$357.00	$107.00–$357.00	74% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg Gcho	$286.00	$357.00	$107.00–$357.00	74% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ecg 12-lead Acquisition	$286.00	$357.00	$107.00–$357.00	74% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 Ekg 12 Lead, Tracing Only Charge	$286.00	$357.00	$107.00–$357.00	74% above	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 Level 1 Fct Charge	$267.00	$334.00	$100.00–$334.00	at median	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 Level 2 Fct Charge	$430.00	$538.00	$161.00–$538.00	3% above	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 Level 3 Fct Charge	$731.00	$914.00	$274.00–$914.00	at median	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 Level 4 Fct Charge	$1,142.00	$1,428.00	$428.00–$1,428.00	18% above	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 Level 5 Fct Charge	$1,651.00	$2,064.00	$619.00–$2,064.00	22% above	20%
Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy, including patient, 50 min	$234.00	$293.00	$88.00–$293.00	14% above	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 Hydration, First Hour Fct Charge	$165.00	$206.00	$62.00–$206.00	28% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration Inf 1st Hr Charge	$184.00	$230.00	$69.00–$230.00	19% below	20%
IV infusion of a medicine, first hour CPT 96365 Iv Infusion 1st Hour Charge	$269.00	$336.00	$101.00–$336.00	14% below	20%
IV push of a medicine, first drug CPT 96374 Ivp Initial Charge	$121.00	$151.00	$45.00–$151.00	49% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-octreotide Intramuscular Administration	$34.00	$42.00	$13.00–$42.00	40% below	19%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-uzedy Administration Subcutaneous Injection	$34.00	$42.00	$13.00–$42.00	40% below	19%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 (Brixadi) Therapeutic; Prophylactic, Or Diagnostic Injection: Subcutaneous Or Intramuscular	$34.00	$42.00	$13.00–$42.00	40% below	19%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-(emgality)therapeutic,prophylactic Injection Administration	$34.00	$42.00	$13.00–$42.00	40% below	19%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Im Or Sq Injection-gcho	$34.00	$42.00	$13.00–$42.00	40% below	19%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Lanreotide Acetate Sq Administration	$34.00	$42.00	$13.00–$42.00	40% below	19%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Therapeutic, Prophylactic, Or Diagnostic Injection; Subcutaneous Or Intramuscular	$34.00	$42.00	$13.00–$42.00	40% below	19%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection-im/subq Charge	$121.00	$151.00	$45.00–$151.00	113% above	20%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791-psychiatric Diagnostic Evaluation	$297.00	$371.00	$111.00–$371.00	49% above	20%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Charges	$95.00	$119.00	$36.00–$119.00	26% below	20%
Neuromuscular re-education, 15 minutes CPT 97112 97112 Neuromuscular Re Ed	$104.00	$130.00	$39.00–$130.00	19% below	20%
Neuromuscular re-education, 15 minutes CPT 97112 Zzneuromuscular Reeducation Charges	$136.00	$170.00	$51.00–$170.00	6% above	20%
New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit, 30 min	$459.00	$574.00	$172.00–$574.00	134% above	20%
New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit, 45 min	$698.00	$873.00	$262.00–$873.00	178% above	20%
New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit, 60 min	$434.00	$542.00	$163.00–$542.00	40% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office Otpt Visit Eval Mgmnt Of New Pt. Phys Spends 15-29 Mins Face To Face With Pt And Or Fam	$153.00	$191.00	$57.00–$191.00	1% above	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 Face-toface Behavioral Counseling For Obesity, Group(2-10), 30 Minutes	$53.00	$66.00	$20.00–$66.00	5% below	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 Medical Nutrition Therapy Initial Assessment , Face To Face Each 15 Minutes	$55.00	$69.00	$21.00–$69.00	2% below	20%
Occupational therapy evaluation, low complexity CPT 97165 Ot Low Complex Units	$193.00	$241.00	$72.00–$241.00	36% below	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt High Complex Units	$358.00	$448.00	$134.00–$448.00	11% above	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Low Complex Units	$193.00	$241.00	$72.00–$241.00	35% below	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Moderate Complex Units	$269.00	$336.00	$101.00–$336.00	10% below	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Manual Therapy Units	$93.00	$116.00	$35.00–$116.00	28% below	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charge Units	$95.00	$119.00	$36.00–$119.00	26% below	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Stm/mfr/jt Mob/mld	$95.00	$119.00	$36.00–$119.00	26% below	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 Manual Therapy 1 Or More	$104.00	$130.00	$39.00–$130.00	19% below	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Zzmanual Therapy Charge Units	$155.00	$194.00	$58.00–$194.00	21% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Physical therapy, therapeutic exercise	$108.00	$135.00	$41.00–$135.00	14% below	20%
Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventative medicine evaluation (18-39 years)	$426.00	$533.00	$160.00–$533.00	159% above	20%
Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventative medicine evaluation (40-64 years)	$505.00	$631.00	$189.00–$631.00	148% above	20%
Preventive checkup, new patient aged 65 or older CPT 99387 Preventive Medicine 65+ Years New99387	$480.00	$600.00	$180.00–$600.00	189% above	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 Periodic Comp (18-39 Years Of Age) Preventive Med Reevaluation Mgmnt For Patients	$350.00	$438.00	$131.00–$438.00	210% above	20%
Preventive checkup, returning patient aged 40–64 CPT 99396 99396 Periodic Comp (40 -64 Years Of Age) Preventive Med Reevaluation Mgmnt For Patients	$387.00	$484.00	$145.00–$484.00	198% above	20%
Preventive checkup, returning patient aged 65 or older CPT 99397 Comp Preventive Med Reevaland Mgmnt Of An Individual Interventions, Estab Pt, 65 Yrs And Older	$426.00	$533.00	$160.00–$533.00	212% above	20%
Psychiatric evaluation with medical services CPT 90792 Psychiatric Diagnostic Interview Examination	$344.00	$430.00	$129.00–$430.00	44% above	20%
Psychotherapy for crisis, first 60 minutes CPT 90839 90839 Crisis, First 60 Minutes	$312.00	$390.00	$117.00–$390.00	—	20%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 min	$146.00	$183.00	$55.00–$183.00	29% above	20%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 min	$191.00	$239.00	$72.00–$239.00	37% above	20%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 min	$271.00	$339.00	$102.00–$339.00	20% above	20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406 Smoking And Tobacco Use Cessation Counseling Visit, Intermediate > 3 Up To 8 Minutes	$31.00	$39.00	$12.00–$39.00	9% above	21%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Oupatiient Visit- Level V	$307.00	$384.00	$115.00–$384.00	7% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office Or Otpt Visit Eval Mgmnt Of Est Pt.physician Spend 40-54min Face To Face With Pt And Or Fam	$614.00	$767.00	$230.00–$767.00	115% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office Or Otpt Visit Eval Mgmnt Of Est Pt.physician Spend 20-29 Min Face To Face With Pt And Or Fam`	$162.00	$203.00	$61.00–$203.00	at median	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Outpatient Visit -Level Iii	$216.00	$270.00	$81.00–$270.00	33% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Outpatient Visit -Level Iv	$294.00	$367.00	$110.00–$367.00	39% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office Or Otpt Visit Eval Mgmnt Of Est Pt.physician Spend 30-39 Min Face To Face With Pt And Or Fam	$459.00	$574.00	$172.00–$574.00	116% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212-office O/p Est Sf 10-19 Min	$95.00	$119.00	$36.00–$119.00	14% below	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Outpatient Visit -Level Ii	$131.00	$164.00	$49.00–$164.00	19% above	20%
Speech and language evaluation CPT 92523 Slp Sound Prod W/ Lang Comp Eval Units	$476.00	$595.00	$179.00–$595.00	24% above	20%
Speech therapy session, individual CPT 92507 Tx Of Speech/lang/voice/comm/auditory Chg Medicaid	$358.00	$447.00	$134.00–$447.00	1% above	20%
Spirometry (breathing test) CPT 94010 Pulmonary Function Test Charge	$250.00	$312.00	$94.00–$312.00	20% below	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 Functional Activities Charges	$95.00	$119.00	$36.00–$119.00	16% below	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 Pt Therapeutic Activity	$95.00	$119.00	$36.00–$119.00	16% below	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charges	$95.00	$119.00	$36.00–$119.00	16% below	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Exercise Charges	$95.00	$119.00	$36.00–$119.00	16% below	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 97530 Kinetic Therapy	$104.00	$130.00	$39.00–$130.00	8% below	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 Zztherapeutic Activities Charge	$146.00	$182.00	$55.00–$182.00	30% above	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy, Therapeutic (Separate Procedure)	$238.00	$298.00	$89.00–$298.00	8% above	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Vermont	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Medication Charge	$120.00	$150.00	$45.00–$150.00	at median	20%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 91322 Moderna Spikevax 65+	$240.00	$300.00	$90.00–$300.00	8% above	20%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 91320-pfizer 65 Years Or Older	$124.00	$155.00	$47.00–$155.00	8% above	20%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza Virus Vaccine, Split Virus, Preservative Free, For Im Use	$40.00	$50.00	$15.00–$50.00	8% above	20%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Cl Influenza Vaccine	$48.00	$60.00	$18.00–$60.00	30% above	20%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 90656 Trivalent Medication Charge	$48.00	$60.00	$18.00–$60.00	30% above	20%
Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Vaccine, Adult Dosage, For Intramuscular Use	$124.00	$155.00	$47.00–$155.00	48% above	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine, Adult Dosage, For Intramuscular Use	$95.00	$119.00	$36.00–$119.00	at median	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Medication Charge	$95.00	$119.00	$36.00–$119.00	at median	20%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 90662 Flu Vacc Prsv Free Inc Antig	$120.00	$150.00	$45.00–$150.00	18% above	20%
Nasal spray flu vaccine, live (FluMist) CPT 90660 Medication Charge	$34.00	$43.00	$13.00–$43.00	—	21%
Nasal spray flu vaccine, live (FluMist) CPT 90660 Influenza Virus Vaccine, Live, For Intranasal Use	$36.00	$45.00	$14.00–$45.00	—	20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Medication Charge	$277.00	$346.00	$104.00–$346.00	11% above	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 90677 Prevnar 20 Vaccine 65 Years Or Older	$264.00	$330.00	$99.00–$330.00	46% below	20%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 90684-capvaxive 0.5 Ml Pneumococcal Conjugate Vaccine , 21 Valent (Pcv 21) For Im Use	$560.00	$700.00	$210.00–$700.00	at median	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Medication Charge	$202.00	$252.00	$76.00–$252.00	70% above	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal 23-valent Adult Vaccine Poc	$202.00	$252.00	$76.00–$252.00	70% above	20%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 90679â ( Arexvy)respiratory Syncytial Virus Vaccine, Pref, Recombinant, Subunit, Adjuvanted, For Intr	$280.00	$350.00	$105.00–$350.00	31% below	20%
Rabies vaccine, one dose CPT 90675 Rabies Vaccine, For Intramuscular Use	$504.00	$630.00	$189.00–$630.00	20% above	20%
Rabies vaccine, one dose CPT 90675 Immunization, Rabies Im Charge	$726.00	$907.00	$272.00–$907.00	73% above	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus And Diphtheria Toxoids(td) Adsorbed, Preserv Free, Admin 7yrs+ Old,intramuscular Use	$64.00	$80.00	$24.00–$80.00	49% above	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Medication Charge	$64.00	$80.00	$24.00–$80.00	49% above	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap, When Administered To Individuals 7 Years Or Older, For Intramuscular Use	$79.00	$99.00	$30.00–$99.00	41% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471-arexvy Im Administration	$34.00	$42.00	$13.00–$42.00	29% below	19%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Charge	$34.00	$42.00	$13.00–$42.00	29% below	19%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pneumococcal 23-valent Vaccine	$34.00	$42.00	$13.00–$42.00	29% below	19%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immunization Administration; 1 Vaccine, Single Or Combination Vaccine/toxoid (90471 Vaccine)	$34.00	$43.00	$13.00–$43.00	29% below	21%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Each Additional Vaccine, Single Or Combination Vaccine/toxoid	$34.00	$42.00	$13.00–$42.00	12% above	19%
Yellow fever vaccine, live CPT 90717 Travel: Yellow Fever Vaccine Yf-vax (90717)	$230.00	$287.00	$86.00–$287.00	—	20%
Yellow fever vaccine, live CPT 90717 Yellow Fever Vaccine Subq Orderset	$250.00	$313.00	$94.00–$313.00	—	20%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://secure.claraprice.net/price-transparency/5f6520a384/machine-readable/030343282_grace-cottage-hospital_standardcharges.json