Hospital Oneonta, NY

Mary Imogene Bassett Hospital

Mary Imogene Bassett Hospital in Cooperstown, NY publishes cash prices for 420 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 New York median for 373 of 416 procedures and above it for 29. By typical cash price it ranks #1 of 93 New York hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1 Atwell Rd, Cooperstown, NY 13326 Collected Sep 27, 2026 Source price file

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 4 actions for a hospital named Mary Imogene Bassett Hospital in Cooperstown, NY:

Jan 22, 2025 Warning notice
Feb 19, 2025 Case closed
Mar 19, 2025 Met requirements
Jun 4, 2025 Met requirements

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems. Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 X-Ray Ankle 3+ Vw	$29.15	$58.29	$11.50–$9.31	85% below	50%
Ankle X-ray, complete, 3 or more views CPT 73610 HC Ankle, Comp, Min 3 Views	$160.65	$595.00	$111.59–$88.05	19% below	73%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-Ray Ankle 3+ Vw	$29.15	$58.29	$11.16–$9.46	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Dop Art Ext 1-2 Levels Bil	$204.66	$758.00	$128.90–$98.17	24% below	73%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Esophagram	$78.73	$157.46	$133.84–$45.68	77% below	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Xr Esoph Scout Chst Sng Con	$264.01	$977.82	$108.42–$977.82	22% below	73%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Esophagram	$78.73	$157.46	$133.84–$80.07	—	50%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone Imaging, Whole Body	$216.52	$433.04	$32.68–$64.24	75% below	50%
Bone scan, whole body (nuclear medicine) CPT 78306 HC Bone Scan, Whole Body	$787.32	$2,916.00	$1,006.74–$988.74	8% below	73%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone Imaging, Whole Body	$216.52	$433.04	$218.43–$65.97	—	50%
Breast ultrasound, complete, one breast CPT 76641 US Breast Uni Real Time With Image Complete	$82.04	$164.08	$139.47–$83.93	74% below	50%
Breast ultrasound, complete, one breast CPT 76641 HC Ultrasound Breast Complete	$378.00	$1,400.00	$1,017.00–$988.38	20% above	73%
Breast ultrasound, complete, one breast inpatient CPT 76641 US Breast Uni Real Time With Image Complete	$82.04	$164.08	$139.47–$84.51	—	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 US Breast Uni Real Time With Image Limited	$67.59	$135.18	$114.90–$78.16	70% below	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC Ultrasound Breast Limited	$314.82	$1,166.00	$1,049.40–$991.10	41% above	73%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US Breast Uni Real Time With Image Limited	$67.59	$135.18	$114.90–$78.72	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio, Chest, Combo, Incl Image Proc	$230.52	$461.04	$114.93–$97.43	80% below	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angiography,Chest W&W/O Con	$1,385.64	$5,132.00	$1,000.53–$970.21	22% above	73%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio, Chest, Combo, Incl Image Proc	$230.52	$461.04	$114.93–$97.43	—	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Cta Hrt Cornry Art/Bypass Grfts Contrst 3d Post	$262.10	$524.20	$155.59–$92.47	75% below	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT Angio Hrt W/3d Image	$1,133.73	$4,199.00	$127.57–$79.22	10% above	73%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 Cta Hrt Cornry Art/Bypass Grfts Contrst 3d Post	$262.10	$524.20	$101.24–$98.50	—	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT Hrt W/O Dye W/Ca Test	$27.00	$100.00	$100.00–$93.00	83% below	73%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen & Pelvis W/O Contrast Material	$262.50	$525.00	$110.40–$93.02	75% below	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abd & Pelvis W/O Contrast	$1,480.14	$5,482.00	$1,168.48–$93.66	44% above	73%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen & Pelvis W/O Contrast Material	$262.50	$525.00	$110.40–$93.02	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen & Pelvis W/Contrast	$1,842.21	$6,823.00	$109.01–$6,823.00	18% above	73%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abdomen Pelvis Wwo Con	$2,235.87	$8,281.00	$138.11–$85.77	37% above	73%
CT scan of the abdomen with contrast CPT 74160 CT Scan of Abdomen Contrast	$197.93	$395.85	$336.47–$97.23	81% below	50%
CT scan of the abdomen with contrast CPT 74160 HC CT Abd W Contrast	$1,165.32	$4,316.00	$1,017.67–$997.91	15% above	73%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Scan of Abdomen Contrast	$197.93	$395.85	$207.26–$98.86	—	50%
CT scan of the abdomen without contrast CPT 74150 CT Scan,Abdomen,W/O Contrast	$123.38	$246.75	$209.74–$90.79	85% below	50%
CT scan of the abdomen without contrast CPT 74150 HC CT Abd W/O Contrast	$913.41	$3,383.00	$1,048.73–$967.35	15% above	73%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Scan,Abdomen,W/O Contrast	$123.38	$246.75	$133.92–$92.26	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Scan,Maxillofacial Area,W/O Contrast	$176.50	$353.00	$178.65–$66.46	75% below	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Maxillofacial W/Out Contrast	$929.07	$3,441.00	$106.34–$933.81	33% above	73%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Scan,Maxillofacial Area,W/O Contrast	$176.50	$353.00	$178.65–$66.46	—	50%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head/Brain WO Contrast	$834.57	$3,091.00	$106.34–$958.21	21% above	73%
CT scan of the head with contrast CPT 70460 HC CT Head/Brain W Contrast	$976.32	$3,616.00	$1,001.92–$995.10	11% above	73%
CT scan of the head without and with contrast CPT 70470 HC CT Head/Brain/W/O and W Contrast	$1,039.23	$3,849.00	$1,193.19–$932.15	at median	73%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Lumbar Spine, W/O Contrast	$1,007.64	$3,732.00	$1,001.52–$962.00	21% above	73%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Cervical Spine,W/O Contrast	$944.73	$3,499.00	$106.34–$924.48	11% above	73%
CT scan of the pelvis, with contrast dye CPT 72193 CT Scan of Pelvis Contrast	$193.42	$386.83	$328.81–$88.60	79% below	50%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W Contrast	$1,070.82	$3,966.00	$1,000.45–$981.75	19% above	73%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Scan of Pelvis Contrast	$193.42	$386.83	$203.10–$89.67	—	50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HC Duplex Extracranial Cmp Bil	$440.91	$1,633.00	$1,064.06–$919.76	20% below	73%
Chest X-ray, 2 views CPT 71046 Radiologic Exam Chest 2 Views	$26.60	$53.20	$10.10–$9.81	87% below	50%
Chest X-ray, 2 views CPT 71046 HC X-Ray Exam Chest 2 Views	$154.44	$572.00	$111.59–$9.41	23% below	73%
Chest X-ray, 2 views inpatient CPT 71046 Radiologic Exam Chest 2 Views	$26.60	$53.20	$10.10–$9.81	—	50%
Chest X-ray, single view CPT 71045 Radiologic Exam Chest Single View	$20.53	$41.05	$11.99–$9.32	89% below	50%
Chest X-ray, single view CPT 71045 HC X-Ray Exam Chest 1 View	$124.47	$461.00	$10.10–$98.34	33% below	73%
Chest X-ray, single view inpatient CPT 71045 Radiologic Exam Chest Single View	$20.53	$41.05	$11.37–$9.85	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US,Retroperit, B-Scan/Real Time,Complete	$86.24	$172.48	$146.61–$56.50	76% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US,Retroperit,Real Time,Complete	$409.32	$1,516.00	$1,047.48–$989.32	14% above	73%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US,Retroperit, B-Scan/Real Time,Complete	$86.24	$172.48	$115.13–$56.90	—	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dexa,Bone Density,Axial Skeleton	$40.00	$80.00	$12.92–$7.74	83% below	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC Bone Density Total Body	$223.56	$828.00	$101.00–$828.00	7% below	73%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Dexa,Bone Density,Axial Skeleton	$40.00	$80.00	$10.09–$9.57	—	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Dexa,Bone Density,Appendiculr Skeltn	$24.75	$49.49	$12.92–$7.74	83% below	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC Dexa Bone Density Peripheral	$109.82	$406.75	$102.18–$99.20	24% below	73%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Dexa,Bone Density,Appendiculr Skeltn	$24.75	$49.49	$10.09–$9.57	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US Preg+Detl Sngl1st Gest	$297.00	$1,100.00	$1,023.00–$990.00	43% below	73%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Scan,Thorax,W/O Contrast	$129.50	$259.00	$165.06–$89.67	84% below	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Thorax Diag WO Con	$1,007.64	$3,732.00	$106.34–$982.26	24% above	73%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Scan,Thorax,W/O Contrast	$129.50	$259.00	$165.06–$89.67	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Thorax Diag W Con	$1,228.23	$4,549.00	$1,003.00–$991.20	19% above	73%
Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic Mammography Computer-Aided Detcj Bi	$125.05	$250.10	$212.59–$76.12	—	50%
Diagnostic mammogram, both breasts CPT 77066 HC Mammo Diagnositc W Cad Bil	$204.66	$758.00	$101.40–$97.97	14% below	73%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Diagnostic Mammography Computer-Aided Detcj Bi	$125.05	$250.10	$212.59–$77.53	—	50%
Diagnostic mammogram, one breast CPT 77065 Diagnostic Mammography Computer-Aided Detcj Uni	$99.16	$198.31	$168.56–$61.98	63% below	50%
Diagnostic mammogram, one breast CPT 77065 HC Mammo Diagnositc W Cad Uni	$157.41	$583.00	$101.40–$97.97	41% below	73%
Diagnostic mammogram, one breast inpatient CPT 77065 Diagnostic Mammography Computer-Aided Detcj Uni	$99.16	$198.31	$168.56–$63.16	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC Arterial Duplex Lower Extrem.(Bilat.)	$431.44	$1,597.92	$1,041.20–$950.40	—	73%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Venous Duplex Scan Lower or Upper Extrem Bilat	$448.74	$1,662.00	$1,082.96–$950.40	—	73%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Tte W or WO Fol W Con Doppler	$688.35	$2,549.45	$1,001.31–$943.30	37% below	73%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary Syst Imaging Including Gallbladder	$237.82	$475.64	$28.48–$55.97	75% below	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC Hepatobiliary System Imaging	$629.91	$2,333.00	$104.78–$920.97	34% below	73%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepatobiliary Syst Imaging Including Gallbladder	$237.82	$475.64	$28.48–$56.37	—	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC Sleep Study,Unattended	$175.50	$650.00	$1,021.52–$988.60	46% below	73%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Polysomnography W/Cpap 6 Yrs or Older	$742.50	$2,750.00	$1,017.39–$990.82	66% below	73%
Knee X-ray, 3 views CPT 73562 X-Ray Knee 3 View	$32.05	$64.09	$10.05–$7.45	81% below	50%
Knee X-ray, 3 views CPT 73562 HC Knee 3 Views	$157.41	$583.00	$111.59–$9.41	6% below	73%
Knee X-ray, 3 views inpatient CPT 73562 X-Ray Knee 3 View	$32.05	$64.09	$10.21–$9.70	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Sono Abdomen Limited	$69.82	$139.64	$118.69–$44.59	77% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, Abdomen Limited	$393.66	$1,458.00	$1,025.76–$98.30	28% above	73%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Sono Abdomen Limited	$69.82	$139.64	$118.69–$93.98	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Computed Tomography Thorax Lw Dose Lng Ca Scr C-	$128.50	$257.00	$218.45–$82.57	69% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT Thor Lung Ca Scr WO Con	$784.89	$2,907.00	$1,004.66–$998.26	87% above	73%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Computed Tomography Thorax Lw Dose Lng Ca Scr C-	$128.50	$257.00	$218.45–$82.57	—	50%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast Without&With Contrast W/Cad Bilateral	$283.63	$567.26	$150.31–$89.31	—	50%
MRI of both breasts, without and then with contrast dye CPT 77049 HC Uc MRI Breast W WO Con Cad Bil	$927.99	$3,437.00	$1,065.47–$681.75	23% below	73%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI Breast Without&With Contrast W/Cad Bilateral	$283.63	$567.26	$102.95–$97.80	—	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Low Extrem Jnt WO Con	$1,322.73	$4,899.00	$1,001.32–$972.16	31% above	73%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI, Joint of Leg. Combo	$319.33	$638.66	$140.64–$83.52	83% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Low Extrm Jnt WO W Con	$1,637.55	$6,065.00	$1,010.00–$681.75	11% below	73%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI, Joint of Leg. Combo	$319.33	$638.66	$101.15–$99.22	—	50%
MRI of the abdomen without contrast CPT 74181 HC MRI Abdomen WO Contrast	$1,259.82	$4,666.00	$1,010.00–$681.75	23% above	73%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI, Abdomen, Combo	$279.64	$559.27	$143.45–$85.20	83% below	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI Abdomen WO W Contrast	$1,700.73	$6,299.00	$1,010.00–$681.75	3% above	73%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI, Abdomen, Combo	$279.64	$559.27	$101.20–$98.25	—	50%
MRI of the brain, no contrast dye CPT 70551 MRI Brain	$176.50	$353.00	$110.76–$96.07	82% below	50%
MRI of the brain, no contrast dye CPT 70551 HC MRI Brain W/O Contrast	$1,165.32	$4,316.00	$1,010.00–$994.43	17% above	73%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain	$176.50	$353.00	$102.51–$98.82	—	50%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain W/O Follwed by W/Contrast	$1,511.73	$5,599.00	$1,010.00–$681.75	6% below	73%
MRI of the lower back, no contrast dye CPT 72148 HC MRI Lumbar Spine W/O Contrast	$1,354.32	$5,016.00	$1,001.10–$982.03	27% above	73%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI Lumbar Spine Canal, W/WO Contrast	$1,669.14	$6,182.00	$1,010.00–$681.75	1% above	73%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI Thoracic Spine W/O Contrast	$1,322.73	$4,899.00	$1,007.50–$963.60	31% above	73%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI Cerv Spine Canal W/WO Contrast	$1,606.23	$5,949.00	$1,010.00–$681.75	at median	73%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI Cervical Spine Canal W/O Contrast	$1,322.73	$4,899.00	$1,010.00–$993.03	32% above	73%
MRI of the pelvis without and with contrast CPT 72197 MRI, Pelvis, Combo	$278.59	$557.17	$143.45–$85.20	82% below	50%
MRI of the pelvis without and with contrast CPT 72197 HC MRI Pelvis W/WO Contrast	$1,574.64	$5,832.00	$1,010.00–$681.75	2% above	73%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI, Pelvis, Combo	$278.59	$557.17	$101.20–$98.25	—	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI, Pelvis, W/O Contrast	$188.94	$377.88	$109.68–$95.12	81% below	50%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI Pelvis W/O Contrast	$1,259.82	$4,666.00	$1,005.95–$997.58	27% above	73%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI, Pelvis, W/O Contrast	$188.94	$377.88	$101.50–$97.38	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI Upp Extrem Jnt WO Contrast	$1,354.32	$5,016.00	$1,010.00–$989.00	13% above	73%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial Spect Multiple Studies	$344.39	$688.78	$100.50–$84.94	84% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC Myocar Perf Spect Wall Mult	$1,464.48	$5,424.00	$1,018.25–$999.21	34% below	73%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Myocardial Spect Multiple Studies	$344.39	$688.78	$100.50–$86.03	—	50%
OCT scan of the retina (optical coherence tomography) CPT 92134 Computerized Ophthalmic Imaging Retina	$35.00	$70.00	$10.87–$63.00	50% below	50%
OCT scan of the retina (optical coherence tomography) CPT 92134 HC Cptrzd Oph Dx Img Pst RTA	$136.57	$505.81	$156.80–$75.28	94% above	73%
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 Computerized Ophthalmic Imaging Retina	$35.00	$70.00	$10.87–$63.00	—	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Nuc Therapy Hyperthyroid Subsequent	$1,086.35	$2,172.70	$155.68–$92.26	71% below	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pet/CT Tumor Image Skull-Thigh	$2,015.55	$7,465.00	$1,458.59–$921.73	46% below	73%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Nuc Therapy Hyperthyroid Subsequent	$1,086.35	$2,172.70	$101.30–$98.41	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Sono Pelvis Limited	$38.69	$77.37	$15.28–$69.63	85% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US,Pelvic (Nonobstetric),Real Time,Limited	$256.77	$951.00	$106.34–$951.00	1% above	73%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Sono Pelvis Limited	$38.69	$77.37	$15.28–$69.63	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Echo,Pelvic (Nonobstetric)	$83.83	$167.65	$142.50–$52.26	77% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US,Pelvic (Nonobstetric),Real Time,Complete	$384.21	$1,423.00	$1,006.69–$98.30	6% above	73%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Echo,Pelvic (Nonobstetric)	$83.83	$167.65	$107.53–$53.04	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US,Preg Uter,Fetal & Mat, 2-3 Trimest	$107.71	$215.42	$183.11–$76.22	67% below	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US Preg=>14wk Sng 1st Ges	$419.67	$1,554.32	$1,012.79–$98.30	30% above	73%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US,Preg Uter,Fetal & Mat, 2-3 Trimest	$107.71	$215.42	$126.92–$76.97	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US, Preg Uter,Fetal & Mat,1st Trimest	$93.64	$187.28	$109.91–$76.97	70% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US Preg<14wk Sngl1st Gest	$381.39	$1,412.57	$1,049.40–$991.10	24% above	73%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US, Preg Uter,Fetal & Mat,1st Trimest	$93.64	$187.28	$109.91–$76.97	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US,Pregnant Uterus,Limited, 1/> Fetuses	$64.67	$129.34	$109.94–$78.48	79% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US Preg 1 or >Fetuses Ltd	$204.66	$758.00	$106.34–$758.00	34% below	73%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US,Pregnant Uterus,Limited, 1/> Fetuses	$64.67	$129.34	$109.94–$78.48	—	50%
Screening mammogram, both breasts both sides CPT 77067 Screening Mammography Bi 2-View Breast Inc Cad	$101.44	$202.88	$172.45–$58.14	—	50%
Screening mammogram, both breasts both sides CPT 77067 HC Scr Mammo Bi Incl Cad	$189.00	$700.00	$101.40–$97.97	—	73%
Screening mammogram, both breasts inpatient both sides CPT 77067 Screening Mammography Bi 2-View Breast Inc Cad	$101.44	$202.88	$172.45–$59.30	—	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-Ray Shoulder 2+ Vw	$27.33	$54.66	$10.05–$7.45	86% below	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC Shoulder Comp, Min 2 Views	$160.65	$595.00	$111.59–$9.41	20% below	73%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-Ray Shoulder 2+ Vw	$27.33	$54.66	$10.21–$9.70	—	50%
Sleep study in a lab (polysomnography) CPT 95810 HC Polysom >6yr W 4/> Param	$702.00	$2,600.00	$1,003.94–$937.74	67% below	73%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Swallowing Fcn,W/Cine &/or Video	$100.36	$200.71	$170.60–$40.73	70% below	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Xr Swallow Func Cine/Video Wcon	$251.91	$933.00	$12.12–$933.00	25% below	73%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Swallowing Fcn,W/Cine &/or Video	$100.36	$200.71	$170.60–$80.20	—	50%
Transvaginal pelvic ultrasound CPT 76830 Echography,Transvaginal	$95.08	$190.15	$109.35–$53.57	73% below	50%
Transvaginal pelvic ultrasound CPT 76830 HC Ultrasound Pelvis,Transvaginal	$362.07	$1,341.00	$1,005.75–$992.77	4% above	73%
Transvaginal pelvic ultrasound inpatient CPT 76830 Echography,Transvaginal	$95.08	$190.15	$109.35–$53.57	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 US,Pregnant Uterus,Transvaginal	$73.70	$147.39	$125.28–$57.71	73% below	50%
Transvaginal ultrasound during pregnancy CPT 76817 HC Transvaginal US, Obstetric	$251.91	$933.00	$106.34–$98.30	9% below	73%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US,Pregnant Uterus,Transvaginal	$73.70	$147.39	$125.28–$88.20	—	50%
Ultrasound of the abdomen, complete CPT 76700 US,Abdom,B-Scan &/or Real Time,Complete	$92.62	$185.23	$157.45–$61.45	78% below	50%
Ultrasound of the abdomen, complete CPT 76700 HC US, Abdom,B-Scan &/or Real Time,Complete	$472.50	$1,750.00	$106.34–$98.30	11% above	73%
Ultrasound of the abdomen, complete inpatient CPT 76700 US,Abdom,B-Scan &/or Real Time,Complete	$92.62	$185.23	$122.24–$63.16	—	50%
Ultrasound of the scrotum and testicles CPT 76870 Echo,Scrotum & Contents	$80.10	$160.19	$136.16–$48.42	77% below	50%
Ultrasound of the scrotum and testicles CPT 76870 HC Echo,Scrotum & Contents	$378.00	$1,400.00	$1,022.92–$98.30	7% above	73%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Echo,Scrotum & Contents	$80.10	$160.19	$136.16–$64.22	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US,Head/Neck Tissues,B-Scan/Real Time	$88.10	$176.20	$105.46–$43.63	72% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, Head/Neck Tissues,Real Time	$409.32	$1,516.00	$1,053.30–$987.83	31% above	73%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US,Head/Neck Tissues,B-Scan/Real Time	$88.10	$176.20	$105.46–$43.63	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radex GI Tract Upper W/WO Delayed Images W/O Kub	$98.62	$197.24	$167.65–$61.43	76% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Xr Ugi/Scout Abd Sng Con	$270.81	$1,003.00	$1,003.00–$968.03	35% below	73%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Radex GI Tract Upper W/WO Delayed Images W/O Kub	$98.62	$197.24	$100.45–$62.60	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Venous Duplex Scan Lower or Upper Extrem Unilat	$362.07	$1,341.00	$1,005.75–$999.83	4% above	73%
Wrist X-ray, complete, 3 or more views CPT 73110 X-Ray Wrist 3+ Vw	$32.30	$64.59	$10.40–$9.31	83% below	50%
Wrist X-ray, complete, 3 or more views CPT 73110 HC Wrist, Comp, Min 3 Views	$155.79	$577.00	$111.59–$88.05	19% below	73%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-Ray Wrist 3+ Vw	$32.30	$64.59	$10.40–$9.59	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-Ray Exam Hip Uni 2-3 Views	$179.55	$665.00	$111.59–$88.05	2% below	73%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Radex Hip Unilateral With Pelvis 2-3 Views	$37.07	$74.13	$11.94–$8.85	80% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Radex Hip Unilateral With Pelvis 2-3 Views	$37.07	$74.13	$10.12–$9.61	—	50%
X-ray of the abdomen, 1 view CPT 74018 Radiologic Exam Abdomen 1 View	$23.68	$47.35	$11.99–$9.68	88% below	50%
X-ray of the abdomen, 1 view CPT 74018 HC X-Ray Exam Abdomen 1 View	$135.54	$502.00	$10.10–$88.05	33% below	73%
X-ray of the abdomen, 1 view inpatient CPT 74018 Radiologic Exam Abdomen 1 View	$23.68	$47.35	$11.62–$9.85	—	50%
X-ray of the ankle, 2 views CPT 73600 X-Ray Ankle 2 Vw	$25.74	$51.47	$10.59–$8.56	84% below	50%
X-ray of the ankle, 2 views CPT 73600 HC Ankle Two Views	$117.99	$437.00	$10.10–$88.05	26% below	73%
X-ray of the ankle, 2 views inpatient CPT 73600 X-Ray Ankle 2 Vw	$25.74	$51.47	$10.44–$8.70	—	50%
X-ray of the finger(s), 2 or more views CPT 73140 X-Ray Exam of Finger(S)	$29.89	$59.77	$10.59–$9.17	81% below	50%
X-ray of the finger(s), 2 or more views CPT 73140 HC Finger, Min 2 Views	$154.44	$572.00	$10.23–$99.20	2% below	73%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-Ray Exam of Finger(S)	$29.89	$59.77	$10.43–$9.88	—	50%
X-ray of the foot, 2 views CPT 73620 X-Ray Foot 2 Vw	$22.34	$44.67	$10.15–$8.20	87% below	50%
X-ray of the foot, 2 views CPT 73620 HC Foot Two Views	$117.99	$437.00	$10.10–$88.05	29% below	73%
X-ray of the foot, 2 views inpatient CPT 73620 X-Ray Foot 2 Vw	$22.34	$44.67	$10.00–$9.84	—	50%
X-ray of the foot, complete, 3 or more views CPT 73630 X-Ray Foot 3+ Vw	$27.06	$54.11	$11.07–$8.94	85% below	50%
X-ray of the foot, complete, 3 or more views CPT 73630 HC Foot Comp, Min 3 Views	$163.89	$607.00	$111.59–$88.05	9% below	73%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-Ray Foot 3+ Vw	$27.06	$54.11	$10.73–$9.10	—	50%
X-ray of the hand, 3 or more views CPT 73130 X-Ray Hand 3+ Vw	$29.15	$58.29	$11.50–$9.31	86% below	50%
X-ray of the hand, 3 or more views CPT 73130 HC Hand Two Views	$154.44	$572.00	$111.59–$88.05	23% below	73%
X-ray of the hand, 3 or more views inpatient CPT 73130 X-Ray Hand 3+ Vw	$29.15	$58.29	$11.16–$9.46	—	50%
X-ray of the knee, 1 or 2 views CPT 73560 X-Ray Knee 1 or 2 View	$27.05	$54.09	$11.04–$8.92	85% below	50%
X-ray of the knee, 1 or 2 views CPT 73560 HC Knee 1 or 2 Views	$129.06	$478.00	$10.10–$99.96	30% below	73%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-Ray Knee 1 or 2 View	$27.05	$54.09	$10.70–$9.07	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-Ray Lumbar Spine 2/3 Vw	$31.57	$63.14	$11.94–$8.85	88% below	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Spine Lumbosacral 2 or 3 View	$165.24	$612.00	$106.34–$9.41	37% below	73%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-Ray Lumbar Spine 2/3 Vw	$31.57	$63.14	$10.12–$9.61	—	50%
X-ray of the lower back, 4 or more views CPT 72110 HC Spine Lumbosacral 4+ Views	$251.91	$933.00	$106.34–$933.00	9% below	73%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Spine Thoracic Two Views Her	$141.75	$525.00	$106.34–$9.41	30% below	73%
X-ray of the nasal bones, 3 or more views CPT 70160 X-Ray Nasal Bones	$30.20	$60.39	$11.50–$8.94	85% below	50%
X-ray of the nasal bones, 3 or more views CPT 70160 HC Nasal Bones 3+ Views	$162.82	$603.03	$111.59–$9.41	19% below	73%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-Ray Nasal Bones	$30.20	$60.39	$10.90–$9.46	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Radex Spine Cervical 2 or 3 Views	$31.32	$62.63	$11.94–$8.85	84% below	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Spine Cervical 2-3 Vws	$157.41	$583.00	$111.59–$9.41	22% below	73%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Radex Spine Cervical 2 or 3 Views	$31.32	$62.63	$10.12–$9.61	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC Pelvis 1 or 2 View	$149.58	$554.00	$106.34–$7.84	33% below	73%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-Ray Sacrum/Coccyx 2+ Vw	$25.75	$51.50	$11.50–$9.31	87% below	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Sacroiliac, Min 3 Views	$135.54	$502.00	$102.96–$99.96	33% below	73%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-Ray Sacrum/Coccyx 2+ Vw	$25.75	$51.50	$11.16–$9.46	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Transferase Alanine Aminot(Alt/Sgpt)	$25.08	$92.90	$10.16–$92.90	7% above	73%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC Transferase, Aspartate	$25.08	$92.90	$10.16–$92.90	at median	73%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC Acute Hepatitis Panel	$82.42	$305.25	$100.61–$98.66	52% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Assay of Glycated Protein	$4.68	$17.32	$11.29–$9.97	71% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allg Spec Ige Crude Xtrc Ea Ref	$12.14	$44.97	$12.59–$8.29	24% below	73%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Specific Ige Each Allergen	$12.14	$44.97	$12.59–$8.29	24% below	73%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODIES,IgG	$16.14	$59.79	$11.27–$7.80	66% below	73%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC Cyclic Citrullinated Peptide (CCP) Antibodies	$29.84	$110.53	$102.79–$99.48	36% below	73%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Antinuclear Ab S	$8.92	$33.03	$10.24–$9.99	80% below	73%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Antinuclear Antibodies	$41.19	$152.57	$10.50–$99.41	6% below	73%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Antinuclear Antibodies Aild	$41.20	$152.58	$10.50–$99.42	6% below	73%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Antinuclear Antibodies, HEp-2 Substrate, IgG, S REF	$41.20	$152.58	$10.50–$99.42	6% below	73%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Natriuretic Peptide	$57.62	$213.40	$122.47–$78.96	53% below	73%
Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel	$62.07	$229.89	$131.93–$9.89	at median	73%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV Surg Pathology Gross&Microscopic Exam	$56.34	$112.68	$101.41–$95.78	69% below	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Level IV Gross & Micro	$106.05	$392.78	$109.98–$98.15	41% below	73%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level IV Surg Pathology Gross&Microscopic Exam	$56.34	$112.68	$101.41–$95.78	—	50%
Blood culture for bacteria CPT 87040 HC Culture Bact Blood	$53.72	$198.97	$10.32–$9.88	23% below	73%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Venipuncture	$9.19	$34.02	$10.55–$9.82	42% below	73%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Lab Specimen Collection	$9.19	$34.02	$1.28–$9.82	42% below	73%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection Venous Blood Venipuncture	$11.00	$22.00	$11.09–$9.09	30% below	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection Venous Blood Venipuncture	$11.00	$22.00	$11.09–$9.43	—	50%
Blood glucose (sugar) test CPT 82947 HC Glucose,Quantitative Blood	$26.57	$98.40	$2.30–$98.40	48% above	73%
Blood lead test CPT 83655 HC Lead Heavymetals Screen	$5.63	$20.84	$10.54–$7.71	87% below	73%
Blood lead test CPT 83655 HC Lead -POCT	$5.63	$20.84	$10.54–$7.71	87% below	73%
Blood lead test CPT 83655 HC Lead, Capillary, w/ Demographics, B REF	$8.10	$30.00	$10.08–$9.89	81% below	73%
Blood lead test CPT 83655 HC Heavy Metals Scrn, Occ Exp, Ru	$47.05	$174.27	$10.54–$7.10	9% above	73%
Blood lead test CPT 83655 HC Heavy Metals, 24 Hr Urine	$47.05	$174.27	$10.54–$7.10	9% above	73%
Blood lead test CPT 83655 HC Lead,Venous, W/Demographics B Ref	$47.05	$174.27	$10.54–$7.10	9% above	73%
Blood lead test CPT 83655 HC Heavy Metals Screen	$47.05	$174.27	$10.54–$7.10	9% above	73%
Blood lead test CPT 83655 HC Assay of Lead Ref	$47.05	$174.27	$10.54–$7.10	9% above	73%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Gonadotropin Chorionic Qualitative	$15.93	$58.99	$16.52–$8.12	55% below	73%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Gonadotropin Chorionic Qual-Serum	$49.27	$182.47	$104.72–$8.12	39% above	73%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Arc Abo Type	$7.43	$27.50	$1.75–$9.90	95% below	73%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing Abo	$35.63	$131.96	$1.75–$99.66	77% below	73%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing Abo (Forward)	$35.63	$131.96	$1.75–$99.66	77% below	73%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-Reactive Protein	$26.44	$97.94	$27.42–$97.94	10% below	73%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C Diff Amplified Probe Ref	$31.05	$115.00	$103.50–$97.75	75% below	73%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C Diff Direct (Diasorin)	$40.35	$149.46	$101.59–$97.39	68% below	73%
C. difficile toxin gene test (stool PCR) CPT 87493 HC Infectious Agent Ag-C Diff Toxin	$100.19	$371.07	$103.90–$40.25	20% below	73%
CA 19-9 blood test (tumor marker) CPT 86301 HC Ca 19-19,Pancreatic Cyst Ref	$21.15	$78.34	$12.21–$78.34	72% below	73%
CA 19-9 blood test (tumor marker) CPT 86301 HC Cancer Antigen 19-9	$47.63	$176.42	$101.25–$65.28	37% below	73%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC Immunoassay-Tumor Ag Ca-125	$40.95	$151.68	$103.10–$98.83	50% below	73%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC Cancer Antigen 125, Serum	$40.95	$151.68	$103.10–$98.83	50% below	73%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC SARS-CoV-2 by PCR REF	$25.65	$95.00	$26.60–$95.00	78% below	73%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC SARS-CoV-2 by PCR (Quest - Res) REF	$35.10	$130.00	$102.14–$98.18	70% below	73%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC SARS-CoV-2 by PCR (Quest - Emp) REF	$35.10	$130.00	$102.14–$98.18	70% below	73%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Covid-19 Direct (Diasorin)	$49.53	$183.45	$105.28–$69.28	57% below	73%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID19-ID NOW - Community Testing	$57.90	$214.43	$123.06–$78.74	50% below	73%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID 19(ADSCIS) ref	$57.90	$214.43	$123.06–$78.74	50% below	73%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Covid19	$57.90	$214.43	$123.06–$78.74	50% below	73%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC C.Trach,Misc,Amplified Rna Ref	$51.77	$191.75	$110.05–$70.95	40% below	73%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chlamydia Trachomatis	$51.77	$191.75	$110.05–$70.95	40% below	73%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC C Trach Misc Amplified Rna	$51.77	$191.75	$110.05–$70.95	40% below	73%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid REF	$90.19	$334.02	$100.07–$98.20	24% above	73%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel(Cvp)	$90.19	$334.02	$100.07–$98.20	24% above	73%
Complete blood count (CBC) with differential CPT 85025 HC Blood Count Auto W/Auto Diff	$41.47	$153.61	$100.09–$88.42	at median	73%
Complete blood count (CBC), no differential CPT 85027 HC Blood Count Automated	$28.39	$105.15	$105.15–$97.79	8% below	73%
Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel	$97.04	$359.42	$10.10–$9.19	3% above	73%
D-dimer blood test (blood clot marker) CPT 85379 HC D-Dimer, P	$35.07	$129.90	$10.18–$98.10	5% below	73%
D-dimer blood test (blood clot marker) CPT 85379 HC Fibrin Deg Prob;D-Dimer Quant	$38.11	$141.15	$10.18–$99.02	3% above	73%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC Dehydroepiandrosterone (Dhea,Sulfate)	$10.79	$39.95	$12.38–$50.02	89% below	73%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC Dehydroepiandrosterone(Dhea,Sulfate)	$69.59	$257.73	$13.05–$95.36	28% below	73%
Estradiol blood test CPT 82670 HC Estradiol, Mass Spectrometry, S	$13.04	$48.29	$13.52–$62.87	87% below	73%
Estradiol blood test CPT 82670 HC Estradiol	$66.53	$246.39	$141.40–$91.16	34% below	73%
FSH (follicle-stimulating hormone) test CPT 83001 HC Gonadotropin Follicle Stimulating Horm	$79.05	$292.78	$10.91–$99.55	4% above	73%
Fecal calprotectin (stool inflammation test) CPT 83993 HC Calprotectin, Fecal	$62.91	$233.00	$11.39–$72.23	41% below	73%
Fecal calprotectin (stool inflammation test) CPT 83993 HC Calprotectin,Fecal	$90.74	$336.08	$100.69–$98.81	15% below	73%
Ferritin blood test (iron stores) CPT 82728 HC Ferritin-Serum	$55.67	$206.18	$11.86–$76.29	17% below	73%
Folate (folic acid) blood test CPT 82746 HC Folic Acid-Serum	$51.36	$190.24	$109.18–$8.83	16% below	73%
Free T3 thyroid hormone test CPT 84481 HC Triiodothyronine T3,Free	$12.39	$45.90	$10.91–$9.94	86% below	73%
Free T3 thyroid hormone test CPT 84481 HC T3 (Triiodothyronine), Free, Serum	$32.71	$121.13	$10.91–$96.90	63% below	73%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC Thyroxin Free	$63.19	$234.02	$10.80–$9.74	at median	73%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4 (Thyroxine), Free by Dialysis, Serum	$63.19	$234.02	$10.80–$9.74	at median	73%
Free testosterone test CPT 84402 HC Testosterone, Total, Bio, Free	$38.13	$141.24	$105.93–$99.08	59% below	73%
Free testosterone test CPT 84402 HC Testosterone Free	$38.13	$141.24	$105.93–$99.08	59% below	73%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC General Health Panel	$156.81	$580.77	$116.15–$580.77	at median	73%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose;Post Glucose Dose	$50.19	$185.90	$10.21–$9.50	136% above	73%
Glucose tolerance test, 3 samples CPT 82951 HC Glucose Tol Test 3 Spec	$68.95	$255.38	$11.20–$94.49	15% above	73%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.Gonorr,Misc,Amplified Rna Ref	$50.94	$188.66	$108.27–$69.80	49% below	73%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Iadna Neisseria Gonorrhoeae Amplified Probe Tq Cgrna	$50.94	$188.66	$108.27–$69.80	49% below	73%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Infectious Agent Detection;Ng;Amp Pro	$50.94	$188.66	$108.27–$69.80	49% below	73%
H. pylori antibody blood test CPT 86677 HC Antibody H Pylori Igg	$9.13	$33.81	$10.13–$9.94	83% below	73%
H. pylori antibody blood test CPT 86677 HC Antibody H Pylori Igm	$15.39	$57.00	$10.95–$8.82	71% below	73%
H. pylori antibody blood test CPT 86677 HC H. Pylori Ab Igg Igm Iga S	$15.39	$57.00	$10.95–$8.82	71% below	73%
H. pylori stool antigen test CPT 87338 HC Infectious Agent,Ag,H Pylori,Stool(Hpag)	$16.50	$61.11	$10.95–$8.39	74% below	73%
H. pylori stool antigen test CPT 87338 HC Infectious Agnet-Ag H Pylori Stool(Hpag)	$41.47	$153.61	$10.95–$9.73	34% below	73%
HIV-1 and HIV-2 antibody test CPT 86703 HC Antibody, Hiv-1 and Hiv-2,Single Assay	$38.92	$144.15	$104.84–$93.93	32% below	73%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Hiv-1 Ag W Hiv-1/2 Abs, Expidited	$24.39	$90.35	$18.67–$90.35	70% below	73%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Hiv-1 Ag W Hiv-1/2 Abs, Single	$28.67	$106.18	$106.18–$98.75	65% below	73%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Hiv-1/-2 Ag & Ab Screen, P	$28.67	$106.18	$106.18–$98.75	65% below	73%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC Human Papillomavirus High Risk	$50.66	$187.63	$107.68–$69.42	43% below	73%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Hemoglobin;Glycated	$30.34	$112.37	$10.00–$95.51	26% below	73%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Hemoglobin;Glycated POC	$30.34	$112.37	$10.00–$95.51	26% below	73%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Hepatitis B Surface Antibody, Qual/Quant, Serum	$9.20	$34.08	$10.02–$9.83	79% below	73%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Hepatitis B Surface Ab	$37.30	$138.14	$10.20–$96.91	13% below	73%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Hepatitis B Surface Antigen, Serum	$8.76	$32.46	$10.06–$9.82	77% below	73%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Infectious Agent(HEP B SURF AG)	$42.17	$156.18	$10.33–$89.90	13% above	73%
Hepatitis C antibody blood test (screening) CPT 86803 HC Hepatitis C Antibody W/ Reflex to Hcv Pcr, Serum	$59.57	$220.62	$10.10–$81.63	at median	73%
Hepatitis C antibody blood test (screening) CPT 86803 HC Hepatitis C Antibody	$59.57	$220.62	$10.10–$81.63	at median	73%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC Infectious Agent, Hep C Rna,Quant	$32.13	$119.00	$101.15–$96.39	76% below	73%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC Infectious Agent;Hep C Rna-Quant	$74.32	$275.26	$100.14–$99.09	44% below	73%
Herpes blood test, HSV-1 antibody CPT 86695 HC Torch Profile,Igg,S	$21.62	$80.09	$11.48–$80.09	45% below	73%
Herpes blood test, HSV-1 antibody CPT 86695 HC Hsv Types 1 and 2 Ab Igg	$21.62	$80.09	$11.48–$80.09	45% below	73%
Herpes blood test, HSV-2 antibody CPT 86696 HC Hsv Types 1 and 2 Ab Igg	$41.27	$152.86	$103.90–$99.60	31% below	73%
Herpes blood test, HSV-2 antibody CPT 86696 HC Torch Profile,Igg,S	$41.27	$152.86	$103.90–$99.60	31% below	73%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-Reactive Protein High Sensitivity	$22.27	$82.47	$10.35–$82.47	53% below	73%
Homocysteine blood test CPT 83090 HC Homocystine (Urine)	$25.00	$92.60	$15.60–$92.60	67% below	73%
Homocysteine blood test CPT 83090 HC Homocystine(Hcs/Mahcs)	$31.73	$117.52	$105.77–$99.89	59% below	73%
Insulin blood test CPT 83525 HC Insulin, Total	$32.29	$119.59	$101.64–$95.67	31% below	73%
Insulin blood test CPT 83525 HC Insulin, Total, S Ref	$32.29	$119.59	$101.65–$95.67	31% below	73%
Iron blood test (serum iron) CPT 83540 HC Ironliver Tissue	$23.40	$86.65	$10.16–$86.65	24% below	73%
Iron blood test (serum iron) CPT 83540 HC Assay of Iron (REF)	$30.34	$112.37	$10.16–$95.51	1% below	73%
Iron blood test (serum iron) CPT 83540 HC Iron	$30.34	$112.37	$10.16–$95.51	1% below	73%
Iron-binding capacity (TIBC) test CPT 83550 HC Iron Binding Capacity(Tibc)	$35.75	$132.39	$10.16–$99.98	14% below	73%
Iron-binding capacity (TIBC) test CPT 83550 HC Iron Binding Test (REF)	$35.75	$132.39	$10.16–$99.98	14% below	73%
Kidney function blood test panel CPT 80069 HC Renal Function Panel	$74.32	$275.25	$10.42–$99.09	13% above	73%
LH (luteinizing hormone) test CPT 83002 HC Gonadotropin Luteinizing Hormone	$77.16	$285.79	$10.87–$98.77	at median	73%
Lipase blood test (pancreas enzyme) CPT 83690 HC Lipase	$28.11	$104.12	$104.12–$96.83	17% below	73%
Liver function blood test panel CPT 80076 HC Hepatic Function Panel	$55.11	$204.12	$117.14–$9.89	26% below	73%
Lyme disease antibody test CPT 86618 HC Lyme Disease Serology, S Ref(Ticks)	$45.93	$170.10	$10.00–$97.91	at median	73%
Lyme disease antibody test CPT 86618 HC Lyme Disease Serology Eval	$45.93	$170.10	$10.00–$97.91	at median	73%
Lyme disease antibody test CPT 86618 HC Lyme Disease Antibodies (Igg/Igm)	$45.93	$170.10	$10.00–$97.91	at median	73%
Magnesium blood test CPT 83735 HC Magnesium	$21.71	$80.41	$10.16–$80.41	26% below	73%
Magnesium blood test CPT 83735 HC Magnesium(Sat24)	$21.71	$80.41	$10.16–$80.41	26% below	73%
Measles (rubeola) antibody test CPT 86765 HC Measles (Rubeola) Antibody Igg	$44.65	$165.37	$107.76–$95.19	2% below	73%
Measles (rubeola) antibody test CPT 86765 HC Rubeola Ab (Igm) Titer, If	$44.65	$165.37	$107.76–$95.19	2% below	73%
Mono test (heterophile antibody, Monospot) CPT 86308 HC Heterophile Ab,Screen	$37.58	$139.17	$10.27–$97.63	at median	73%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC Prostate Spec Ag Free Screening	$49.82	$184.53	$10.79–$68.28	16% below	73%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC Prostate Spec Ag Free Ref	$49.82	$184.53	$10.79–$68.28	16% below	73%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC Prostate Specific Antigen Free Monitoring	$49.82	$184.53	$10.79–$68.28	16% below	73%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Ag; Total,Screen	$49.69	$184.02	$10.79–$68.09	24% below	73%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Ag; Total,Monitoring	$49.69	$184.02	$10.79–$68.09	24% below	73%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Psa, Total Ref	$49.69	$184.02	$10.79–$68.09	24% below	73%
Pap test (liquid-based, automated screening with review) CPT 88175 HC Cytopath W/Auto Sc- Routine (Cerv or Vag)	$64.38	$238.44	$136.84–$88.22	at median	73%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Scrn Pap,Thinprep W/Reflx	$38.97	$144.33	$101.02–$99.57	47% below	73%
Parathyroid hormone (PTH) blood test CPT 83970 HC Parathyroid Hormone (Pth)	$59.11	$218.93	$125.64–$92.88	56% below	73%
Parathyroid hormone (PTH) blood test CPT 83970 HC Parathormone(Parathyroid Hormone)	$59.11	$218.93	$125.64–$92.88	56% below	73%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Lupus Anticoagulant Profile	$29.78	$110.31	$102.59–$99.28	at median	73%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time Partial	$29.78	$110.31	$102.59–$99.28	at median	73%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC Non-Invasive Prenatal Testing for Fetal Aneuploidy REF	$695.06	$2,574.30	$1,477.39–$952.49	28% below	73%
Progesterone blood test CPT 84144 HC Progesterone Serum	$85.73	$317.52	$101.61–$98.43	3% below	73%
Progesterone blood test CPT 84144 HC Progesterone	$85.73	$317.52	$101.61–$98.43	3% below	73%
Prolactin blood test CPT 84146 HC Prolactin	$65.69	$243.30	$11.37–$90.02	8% below	73%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time Fspt	$14.33	$53.08	$13.74–$8.89	24% below	73%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time - Ref	$24.22	$89.69	$2.31–$89.69	28% above	73%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time	$24.22	$89.69	$2.31–$89.69	28% above	73%
Prothrombin time (PT/INR) clotting test CPT 85610 HC POCT Pt/Inr Coagucheck	$24.22	$89.69	$2.31–$89.69	28% above	73%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$26.54	$53.08	$2.89–$47.77	40% above	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time	$26.54	$53.08	$3.48–$45.12	—	50%
Rapid flu test (influenza antigen) CPT 87804 HC Infectious Agent Ag - Flu	$22.32	$82.66	$14.41–$82.66	45% below	73%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Infectious Agentstrep Group A	$13.01	$48.19	$13.49–$8.52	67% below	73%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC POCT Rapid Strep A	$13.01	$48.19	$13.49–$8.52	67% below	73%
Rheumatoid factor (RF) test CPT 86431 HC Rheumatiod Factor Quant REF	$7.44	$27.54	$10.02–$9.91	73% below	73%
Rheumatoid factor (RF) test CPT 86431 HC Rheumatiod Factor Quantitative	$27.56	$102.06	$10.50–$94.92	at median	73%
Rubella antibody test (immunity check) CPT 86762 HC Rubella Ab, Igg, S	$8.64	$32.00	$10.24–$9.92	80% below	73%
Rubella antibody test (immunity check) CPT 86762 HC Rubella Antibody Ref	$25.05	$92.78	$12.53–$92.78	41% below	73%
Rubella antibody test (immunity check) CPT 86762 HC Rubella Ab Igg	$25.05	$92.78	$12.53–$92.78	41% below	73%
Rubella antibody test (immunity check) CPT 86762 HC Torch Profile,Igg,S	$25.05	$92.78	$12.53–$92.78	41% below	73%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC Sed Rate	$24.77	$91.75	$1.58–$91.75	at median	73%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC Semen Analysis Complete Lab	$25.47	$94.33	$10.72–$94.33	31% below	73%
Stool ova and parasites exam CPT 87177 HC Ova & Para Direct Smear Conc/Ident	$27.77	$102.87	$10.68–$95.67	28% below	73%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC - Blood, Occult Feces, Screening Triple Card	$24.22	$89.69	$1.91–$89.69	60% above	73%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Blood Occult Feces;Immunoassay (1-3)	$12.80	$47.42	$13.28–$9.33	72% below	73%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Vdrl, CSF	$20.48	$75.86	$2.50–$75.86	11% above	73%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Syphilis Test Qual (Rpr)	$20.48	$75.86	$2.50–$75.86	11% above	73%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB Test,Cell Mediated Immunity	$28.35	$105.00	$105.00–$97.65	81% below	73%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB Test Cell Mediated Immunity	$75.95	$281.28	$100.42–$98.50	49% below	73%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Testosterone,Total	$57.34	$212.37	$121.88–$78.58	34% below	73%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Testosterone, Total	$57.34	$212.37	$121.88–$78.58	34% below	73%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Testosterone,Total,Bio	$57.34	$212.37	$121.88–$78.58	34% below	73%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC Thyrogl Ab W Thyroid Perox Ab	$21.57	$79.90	$12.67–$8.54	57% below	73%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC Liver/Kidney Microsomal Ab	$21.57	$79.90	$12.67–$8.54	57% below	73%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC Thyroperoxidase Ab	$21.57	$79.90	$12.67–$8.54	57% below	73%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC Thyroid Peroxidase Antibody	$21.57	$79.90	$12.67–$8.54	57% below	73%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hormone	$73.21	$271.13	$10.91–$99.56	7% below	73%
Trichomonas test (NAAT) CPT 87661 HC Trichomonas Vaginalis;Amp Probe	$50.10	$185.56	$106.49–$68.66	32% below	73%
Trichomonas test (NAAT) CPT 87661 HC Trichomonas Vaginalis Amplif (Male) Ref	$50.10	$185.56	$106.49–$68.66	32% below	73%
Trichomonas test (NAAT) CPT 87661 HC Trichomonas Vaginalis Amplif Ref	$50.10	$185.56	$106.49–$68.66	32% below	73%
Trichomonas test (NAAT) CPT 87661 HC Trichomonas Vaginalis Amplif(Female) Ref	$50.10	$185.56	$106.49–$68.66	32% below	73%
Uric acid blood test CPT 84550 HC Uric Acid	$14.89	$55.15	$10.17–$9.72	37% below	73%
Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis Auto With Micro	$27.00	$100.00	$100.00–$93.00	8% below	73%
Urinalysis without microscope exam, automated CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy	$15.93	$31.85	$1.52–$28.67	6% below	50%
Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Auto W/O Micro	$18.37	$68.05	$1.32–$68.05	8% above	73%
Urinalysis without microscope exam, automated CPT 81003 HC POCT Perform Urine Dipstick	$18.37	$68.05	$1.32–$68.05	8% above	73%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy	$15.93	$31.85	$1.52–$28.67	—	50%
Urinalysis without microscope exam, manual CPT 81002 HC Urinalysis Non Auto W/O Micro	$8.60	$31.85	$1.50–$9.87	27% below	73%
Urine culture for bacteria, with colony count CPT 87086 HC Culture Bact Urine Quant	$38.13	$141.24	$10.89–$99.08	10% below	73%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test	$29.50	$58.99	$2.02–$8.50	5% below	50%
Urine pregnancy test, read by color change CPT 81025 HC POCT Perform Urine Pregnancy	$38.97	$144.33	$101.02–$99.57	25% above	73%
Urine pregnancy test, read by color change CPT 81025 HC Urine Preg Test Visual Color	$38.97	$144.33	$101.02–$99.57	25% above	73%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test	$29.50	$58.99	$2.02–$8.50	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 HC Cyanocobalamin Vit B	$36.46	$135.05	$101.29–$94.74	43% below	73%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Calcifediol(24-Oh Vit D-3)	$64.71	$239.65	$137.54–$88.67	27% below	73%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Vitamin D; 25 Hyrdoxy	$64.71	$239.65	$137.54–$88.67	27% below	73%
Zinc blood test CPT 84630 HC Iron Stain	$8.75	$32.41	$10.05–$9.91	75% below	73%
Zinc blood test CPT 84630 HC Zinc	$8.82	$32.66	$10.12–$9.91	75% below	73%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Hcg, Tumor Marker	$61.10	$226.29	$12.49–$83.73	at median	73%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Gonadrotropin Chorionic Quant	$61.10	$226.29	$12.49–$83.73	at median	73%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 Adenoidectomy Primary <Age 12	$350.50	$701.00	$175.70–$595.85	91% below	50%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 Adenoidectomy Primary <Age 12	$350.50	$701.00	$100.23–$630.90	—	50%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 Arthrd Ant Interbody Decompress Cervical Belw C2	$3,150.00	$6,300.00	$1,071.00–$672.10	74% below	50%
Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 Arthrd Ant Interbody Decompress Cervical Belw C2	$3,150.00	$6,300.00	$1,071.00–$676.52	—	50%
Appendectomy, open surgery CPT 44950 Appendectomy	$600.00	$1,200.00	$1,018.22–$997.99	62% below	50%
Appendectomy, open surgery inpatient CPT 44950 Appendectomy	$600.00	$1,200.00	$1,003.29–$997.99	—	50%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Arthrs Aided Ant Cruciate Ligm Rpr/Agmntj/Rcnstj	$2,200.00	$4,400.00	$1,333.05–$793.59	57% below	50%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 Arthrs Aided Ant Cruciate Ligm Rpr/Agmntj/Rcnstj	$2,200.00	$4,400.00	$1,040.88–$980.32	—	50%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 Surgical Arthroscopy Shoulder W/Rotator Cuff Rpr	$1,006.50	$2,013.00	$1,087.34–$869.87	79% below	50%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 Surgical Arthroscopy Shoulder W/Rotator Cuff Rpr	$1,006.50	$2,013.00	$1,001.18–$951.12	—	50%
Botox injections for chronic migraine CPT 64615 Chemodervate Facial/Trigem/Cerv Musc Migraine	$130.00	$260.00	$106.89–$98.15	63% below	50%
Botox injections for chronic migraine inpatient CPT 64615 Chemodervate Facial/Trigem/Cerv Musc Migraine	$130.00	$260.00	$106.89–$98.15	—	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Bx Breast W/Device 1st Lesion Stereotactic Guid	$399.54	$799.08	$1,018.83–$679.22	86% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC Bx Breast 1st Lesion Strtctc 711	$564.30	$2,090.00	$1,126.19–$647.90	81% below	73%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Bx Breast W/Device 1st Lesion Stereotactic Guid	$399.54	$799.08	$100.54–$997.32	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Cltx Dstl Fibular Fx Lat Malls W/O Manj	$258.50	$517.00	$128.64–$511.66	46% below	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Cltx Dstl Fibular Fx Lat Malls W/O Manj	$258.50	$517.00	$128.64–$511.66	—	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed Tx Metatarsal Fracture W/O Manipulation	$199.00	$398.00	$109.08–$89.52	50% below	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC Closed Treatment Metatarsal Fracture;W/O Manipulation Each	$300.51	$1,113.00	$1,001.70–$96.44	25% below	73%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed Tx Metatarsal Fracture W/O Manipulation	$199.00	$398.00	$140.90–$89.52	—	50%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Corrj Hlx Vlgs Bncty Sesmdc Dstl Metar Osteot	$770.00	$1,540.00	$1,309.00–$833.73	80% below	50%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 Corrj Hlx Vlgs Bncty Sesmdc Dstl Metar Osteot	$770.00	$1,540.00	$1,158.59–$891.05	—	50%
Bunion correction with removal of part of the big toe joint CPT 28292 Corrj Hlx Vlgs Bncty Sesmdc Rescj Prox Phlx Base	$643.00	$1,286.00	$1,093.10–$789.05	83% below	50%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 Corrj Hlx Vlgs Bncty Sesmdc Rescj Prox Phlx Base	$643.00	$1,286.00	$1,011.34–$957.72	—	50%
Cardiac catheterization with coronary angiogram CPT 93458 HC L Hrt Artery/Ventricle Angio	$3,447.24	$12,767.54	$10,852.41–$9,575.66	41% below	73%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Elective Arrhythmia External	$255.50	$511.00	$100.71–$95.67	74% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion Ext	$959.74	$3,554.59	$1,025.14–$995.29	3% below	73%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Elective Arrhythmia External	$255.50	$511.00	$100.71–$95.67	—	50%
Carpal tunnel release, open surgery CPT 64721 Neuroplasty &/Transpos Median Nrv Carpal Tunne	$630.00	$1,260.00	$1,040.22–$942.70	73% below	50%
Carpal tunnel release, open surgery inpatient CPT 64721 Neuroplasty &/Transpos Median Nrv Carpal Tunne	$630.00	$1,260.00	$1,040.22–$958.32	—	50%
Cataract surgery with lens implant CPT 66984 Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp	$1,575.00	$3,150.00	$1,061.02–$918.71	42% below	50%
Cataract surgery with lens implant inpatient CPT 66984 Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp	$1,575.00	$3,150.00	$1,002.43–$981.97	—	50%
Catheter ablation for atrial fibrillation CPT 93656 HC Comp Ep Evl Abltj Atr Fib	$11,643.52	$43,124.13	$13,368.48–$43,124.13	60% below	73%
Cervical biopsy CPT 57500 Biopsy Cervix Single/Mult/Excision of Lesion Spx	$122.15	$244.29	$101.45–$99.01	90% below	50%
Cervical biopsy inpatient CPT 57500 Biopsy Cervix Single/Mult/Excision of Lesion Spx	$122.15	$244.29	$102.58–$84.31	—	50%
Cesarean delivery, including prenatal and postpartum care CPT 59510 OB Antepartum Care Cesarean Dlvr & Postpartum	$2,165.50	$4,331.00	$110.52–$99.54	10% below	50%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 OB Antepartum Care Cesarean Dlvr & Postpartum	$2,165.50	$4,331.00	$1,948.09–$5,312.03	—	50%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circumcision Age >28 Days	$247.50	$495.00	$161.30–$420.75	90% below	50%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 Circumcision Age >28 Days	$247.50	$495.00	$157.48–$99.86	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision W/Clamp/Oth Dev W/Block	$228.00	$456.00	$102.09–$96.10	74% below	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision W/Clamp/Oth Dev W/Block	$228.00	$456.00	$10.14–$96.10	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Clsd Fx Colles' Smith Type	$57.51	$213.00	$100.55–$98.74	88% below	73%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Cltx Dstl Radial Fx/Epiphysl Sep W/O Manj	$321.00	$642.00	$117.76–$815.53	35% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Cltx Dstl Radial Fx/Epiphysl Sep W/O Manj	$321.00	$642.00	$117.76–$577.80	—	50%
Colonoscopy with polyp removal CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$577.50	$1,155.00	$1,020.00–$981.75	53% below	50%
Colonoscopy with polyp removal inpatient CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$577.50	$1,155.00	$1,039.50–$981.75	—	50%
Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy Single/Multiple	$489.00	$978.00	$161.40–$952.53	55% below	50%
Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy W/Biopsy Single/Multiple	$489.00	$978.00	$161.40–$929.30	—	50%
Colonoscopy, diagnostic CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$435.00	$870.00	$103.24–$804.79	61% below	50%
Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$435.00	$870.00	$103.24–$804.79	—	50%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colposcopy Cervix Bx Cervix & Endocrv Curretage	$137.50	$275.00	$101.88–$96.79	65% below	50%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Colposcopy Cervix Bx Cervix & Endocrv Curretage	$137.50	$275.00	$105.83–$73.73	—	50%
Complex cataract surgery with lens implant CPT 66982 Xcapsl Ctrc Rmvl Insj Io Lens Prosth Cplx WO Ecp	$975.50	$1,951.00	$1,006.61–$603.63	64% below	50%
Complex cataract surgery with lens implant inpatient CPT 66982 Xcapsl Ctrc Rmvl Insj Io Lens Prosth Cplx WO Ecp	$975.50	$1,951.00	$1,006.61–$968.18	—	50%
Coronary stent placement, one artery CPT 92928 HC Prq Card Stent W/Angio 1 Vsl	$3,945.89	$14,614.40	$10,960.80–$9,522.74	72% below	73%
Coronary stent placement, one artery CPT 92928 HC Prq Card Stent W/Angio 1 Vsl Des	$3,945.89	$14,614.40	$10,960.80–$9,522.74	72% below	73%
Cystoscopy with ureteral stent placement CPT 52332 Cysto W/Insert Ureteral Stent	$685.50	$1,371.00	$1,165.35–$874.01	83% below	50%
Cystoscopy with ureteral stent placement inpatient CPT 52332 Cysto W/Insert Ureteral Stent	$685.50	$1,371.00	$1,038.32–$998.13	—	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystourethroscopy	$185.50	$371.00	$108.96–$89.56	86% below	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC Cystourethroscopy	$297.00	$1,100.00	$845.94	78% below	73%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystourethroscopy	$185.50	$371.00	$100.82–$89.56	—	50%
D&C (dilation and curettage), not related to pregnancy CPT 58120 Dilation & Curettage Dx&/Ther Nonobstetric	$350.00	$700.00	$153.52–$787.50	90% below	50%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 Dilation & Curettage Dx&/Ther Nonobstetric	$350.00	$700.00	$153.52–$787.50	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruction Premalignant Lesion 1st	$70.00	$140.00	$107.09–$99.22	70% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destruction Premalignant Lesion 1st	$70.00	$140.00	$107.09–$99.22	—	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Tympanostomy General Anesthesia	$242.50	$485.00	$131.08–$618.38	86% below	50%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 Tympanostomy General Anesthesia	$242.50	$485.00	$101.00–$654.75	—	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Tympanostomy Local/Topical Anesthesia	$165.00	$330.00	$108.80–$93.81	81% below	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 Tympanostomy Local/Topical Anesthesia	$165.00	$330.00	$108.80–$93.81	—	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC Removal Impacted Cerumen Using Irrigation/Lavage,Unilateral	$16.20	$60.00	$21.60–$75.28	84% below	73%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Removal Impacted Cerumen Irrigation/Lvg Unilat	$17.58	$35.15	$109.01–$95.57	83% below	50%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Removal Impacted Cerumen Irrigation/Lvg Unilat	$17.58	$35.15	$12.21–$93.73	—	50%
Earwax removal with instruments, one ear CPT 69210 HC Rem Impacted Cerumen	$22.96	$85.02	$27.21–$75.28	82% below	73%
Earwax removal with instruments, one ear one side CPT 69210 Removal Impacted Cerumen Instrumentation Unilat	$44.00	$88.00	$100.94–$98.47	65% below	50%
Earwax removal with instruments, one ear inpatient one side CPT 69210 Removal Impacted Cerumen Instrumentation Unilat	$44.00	$88.00	$103.98–$98.47	—	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC Endometrial Biopsy	$64.80	$240.00	$254.96	85% below	73%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial Bx W/WO Endocervix Bx W/O Dilat Spx	$106.00	$212.00	$100.76–$98.76	76% below	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Endometrial Bx W/WO Endocervix Bx W/O Dilat Spx	$106.00	$212.00	$100.76–$99.34	—	50%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 Nasal/Sinus Ndsc W/Total Ethoidectomy	$925.00	$1,850.00	$1,179.38–$771.81	88% below	50%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 Nasal/Sinus Ndsc W/Total Ethoidectomy	$925.00	$1,850.00	$1,179.38–$771.81	—	50%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 Nasal/Sinus Endoscopy W/Maxillary Antrostomy	$600.00	$1,200.00	$1,020.00–$765.00	86% below	50%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 Nasal/Sinus Endoscopy W/Maxillary Antrostomy	$600.00	$1,200.00	$100.09–$810.00	—	50%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 Nsl/Sinus Ndsc Max Antrost W/Rmvl Tiss Max Sinus	$600.00	$1,200.00	$1,020.00–$765.00	92% below	50%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 Nsl/Sinus Ndsc Max Antrost W/Rmvl Tiss Max Sinus	$600.00	$1,200.00	$1,020.00–$810.00	—	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn	$268.50	$537.00	$146.72–$87.58	70% below	50%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn	$268.50	$537.00	$100.49–$95.47	—	50%
Eye injection into the vitreous (intravitreal injection) CPT 67028 Intravitreal Njx Pharmacologic Agt Spx	$604.50	$1,209.00	$102.77–$97.63	16% below	50%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 Intravitreal Njx Pharmacologic Agt Spx	$604.50	$1,209.00	$102.77–$97.63	—	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level	$259.00	$518.00	$102.23–$97.12	86% below	50%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level	$259.00	$518.00	$102.23–$97.12	—	50%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Rpr Aa Hernia 1st 3-10 Cm Reducible	$537.50	$1,075.00	$1,106.72–$964.60	93% below	50%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 Rpr Aa Hernia 1st 3-10 Cm Reducible	$537.50	$1,075.00	$100.42–$967.50	—	50%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 Rpr Aa Hernia 1st > 10 Cm Reducible	$722.50	$1,445.00	$1,040.98–$772.99	90% below	50%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 Rpr Aa Hernia 1st > 10 Cm Reducible	$722.50	$1,445.00	$1,019.93–$998.70	—	50%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Rpr Aa Hernia 1st < 3 Cm Reducible	$322.50	$645.00	$105.83–$92.27	92% below	50%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 Rpr Aa Hernia 1st < 3 Cm Reducible	$322.50	$645.00	$105.83–$92.27	—	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa if Pfrmd	$146.93	$293.86	$116.12–$97.48	86% below	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa if Pfrmd	$146.93	$293.86	$116.12–$90.13	—	50%
Gallbladder removal, laparoscopic CPT 47562 Laparoscopy Surg Cholecystectomy	$945.00	$1,890.00	$101.97–$971.90	54% below	50%
Gallbladder removal, laparoscopic inpatient CPT 47562 Laparoscopy Surg Cholecystectomy	$945.00	$1,890.00	$1,011.03–$971.90	—	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Laps Surg Cholecystectomy W/Cholangiography	$1,365.00	$2,730.00	$1,002.20–$984.64	79% below	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 Laps Surg Cholecystectomy W/Cholangiography	$1,365.00	$2,730.00	$1,002.20–$984.64	—	50%
Gallbladder removal, open surgery through a larger incision CPT 47600 Cholecystectomy	$1,100.00	$2,200.00	$1,077.98–$935.00	at median	50%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 Cholecystectomy	$1,100.00	$2,200.00	$1,022.95–$993.16	—	50%
Hammertoe correction surgery CPT 28285 Correction Hammertoe	$422.68	$845.35	$319.46–$718.55	89% below	50%
Hammertoe correction surgery inpatient CPT 28285 Correction Hammertoe	$422.68	$845.35	$161.15–$852.70	—	50%
Hemorrhoid banding (rubber band ligation) CPT 46221 Hemorrhoidectomy Internal Rubber Band Ligations	$224.53	$449.05	$103.57–$98.39	79% below	50%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 Hemorrhoidectomy Internal Rubber Band Ligations	$224.53	$449.05	$157.00–$82.68	—	50%
Hemorrhoidectomy (internal and external), one area CPT 46255 Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group	$498.00	$996.00	$155.94–$896.40	85% below	50%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group	$498.00	$996.00	$155.94–$896.40	—	50%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 Conv Prev Hip Tot Hip Arthrp W/WO Agrft/Algrft	$2,750.00	$5,500.00	$1,351.52–$935.00	4% below	50%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 Conv Prev Hip Tot Hip Arthrp W/WO Agrft/Algrft	$2,750.00	$5,500.00	$1,339.78–$990.00	—	50%
Hysterectomy through an abdominal incision (total) CPT 58150 Total Abdominal Hysterect W/WO Rmvl Tube Ovary	$1,350.00	$2,700.00	$1,007.63–$998.12	36% below	50%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 Total Abdominal Hysterect W/WO Rmvl Tube Ovary	$1,350.00	$2,700.00	$1,007.63–$998.12	—	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Cath/Inject Hysterosalpingogram	$378.00	$756.00	$101.48–$97.46	47% above	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Cath/Inject Hysterosalpingogram	$378.00	$756.00	$101.48–$97.46	—	50%
Hysteroscopy with endometrial ablation CPT 58563 Hysteroscopy Endometrial Ablation	$1,687.86	$3,375.71	$1,434.68–$391.55	71% below	50%
Hysteroscopy with endometrial ablation inpatient CPT 58563 Hysteroscopy Endometrial Ablation	$1,687.86	$3,375.71	$1,384.62–$391.55	—	50%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$400.00	$800.00	$1,147.50–$720.00	92% below	50%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$400.00	$800.00	$1,147.50–$720.00	—	50%
IUD insertion (the device itself billed separately) CPT 58300 Insertion Intrauterine Device Iud	$90.00	$180.00	$106.09–$81.00	63% below	50%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Insertion Intrauterine Device Iud	$90.00	$180.00	$106.09–$81.00	—	50%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D Abscess Simple	$65.41	$242.26	$251.83–$86.49	82% below	73%
Incision and drainage of a simple or single skin abscess CPT 10060 Drain Skin Abscess Simple	$99.29	$198.58	$100.56–$99.99	73% below	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drain Skin Abscess Simple	$99.29	$198.58	$100.56–$99.99	—	50%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$600.00	$1,200.00	$1,020.00–$954.00	85% below	50%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$600.00	$1,200.00	$1,020.00–$879.25	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inject Tendon Sheath/Ligament	$62.00	$124.00	$102.57–$95.50	85% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inject Tendon Sheath/Ligament	$62.00	$124.00	$102.57–$95.50	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US	$70.50	$141.00	$102.59–$95.18	81% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthocen/Aspir Inj Lg Joint	$118.30	$438.14	$140.20–$374.12	68% below	73%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US	$70.50	$141.00	$102.59–$98.70	—	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion Drug Delivery Implant	$98.00	$196.00	$109.19–$99.39	63% below	50%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insertion Drug Delivery Implant	$98.00	$196.00	$110.52–$99.39	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US	$55.50	$111.00	$108.55–$99.90	84% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US	$55.50	$111.00	$108.55–$99.90	—	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US	$49.00	$98.00	$104.22–$97.53	86% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthrocentesis,Aspiration & or Injection;Small Joint/Bursa	$141.03	$522.34	$109.18–$374.12	60% below	73%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US	$49.00	$98.00	$104.22–$94.44	—	50%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Arthroscopy Knee W/Meniscus Rpr Medial/Lateral	$1,325.00	$2,650.00	$1,085.81–$948.71	43% below	50%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 Arthroscopy Knee W/Meniscus Rpr Medial/Lateral	$1,325.00	$2,650.00	$1,007.45–$954.04	—	50%
Knee arthroscopy with meniscus trim CPT 29881 Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg	$1,235.00	$2,470.00	$1,049.75–$873.86	68% below	50%
Knee arthroscopy with meniscus trim inpatient CPT 29881 Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg	$1,235.00	$2,470.00	$1,049.75–$873.86	—	50%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Arthrs Knee W/Meniscectomy Med&Lat W/Shaving	$1,347.50	$2,695.00	$1,145.38–$906.64	23% below	50%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 Arthrs Knee W/Meniscectomy Med&Lat W/Shaving	$1,347.50	$2,695.00	$1,111.07–$957.06	—	50%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 Arthrs Knee Debridement/Shaving Artclr Crtlg	$1,109.00	$2,218.00	$1,000.47–$980.58	32% below	50%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 Arthrs Knee Debridement/Shaving Artclr Crtlg	$1,109.00	$2,218.00	$1,000.47–$985.79	—	50%
Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 Laps Gstr Rstcv Px W/Byp Roux-en-Y Limb <150 Cm	$1,584.50	$3,169.00	$1,394.76–$685.36	54% below	50%
Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 Laps Gstr Rstcv Px W/Byp Roux-en-Y Limb <150 Cm	$1,584.50	$3,169.00	$1,371.97–$978.48	—	50%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Laparoscopic Appendectomy	$545.00	$1,090.00	$1,004.91–$981.33	85% below	50%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 Laparoscopic Appendectomy	$545.00	$1,090.00	$1,004.91–$981.33	—	50%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 Laps Surg Esopg/Gstr Fundoplasty	$1,250.00	$2,500.00	$1,453.59–$866.01	62% below	50%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 Laps Surg Esopg/Gstr Fundoplasty	$1,250.00	$2,500.00	$1,025.48–$995.61	—	50%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 Laparoscopy W Total Hysterectomy Uterus 250 Gm/<	$876.50	$1,753.00	$1,101.53–$659.63	83% below	50%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 Laparoscopy W Total Hysterectomy Uterus 250 Gm/<	$876.50	$1,753.00	$1,003.16–$917.60	—	50%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Laps Total Hysterect 250 Gm/< W/Rmvl Tube/Ovary	$970.50	$1,941.00	$1,017.30–$966.44	83% below	50%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 Laps Total Hysterect 250 Gm/< W/Rmvl Tube/Ovary	$970.50	$1,941.00	$1,006.70–$966.44	—	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Laparoscopy Surg Rpr Initial Inguinal Hernia	$615.00	$1,230.00	$1,015.98–$887.26	53% below	50%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 Laparoscopy Surg Rpr Initial Inguinal Hernia	$615.00	$1,230.00	$1,015.98–$988.78	—	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Laps Surg Rpr Recurrent Inguinal Hernia	$504.50	$1,009.00	$1,156.67–$901.61	93% below	50%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 Laps Surg Rpr Recurrent Inguinal Hernia	$504.50	$1,009.00	$1,106.56–$950.69	—	50%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Laparoscopy W/Rmvl Adnexal Structures	$1,155.00	$2,310.00	$1,006.76–$997.91	60% below	50%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 Laparoscopy W/Rmvl Adnexal Structures	$1,155.00	$2,310.00	$1,006.76–$997.91	—	50%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy	$1,144.50	$2,289.00	$1,105.48–$884.38	70% below	50%
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy	$1,144.50	$2,289.00	$1,015.69–$964.91	—	50%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Post-Cataract Laser Surgery	$550.00	$1,100.00	$1,028.07–$990.00	16% below	50%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Post-Cataract Laser Surgery	$550.00	$1,100.00	$1,028.07–$990.00	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Lac Rep Int Scalp Tk Less Than 2.6	$172.87	$640.26	$101.17–$925.06	69% below	73%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Repair Intermediate S/a/T/E 2.5 Cm/<	$208.41	$416.82	$100.72–$98.80	63% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Repair Intermediate S/a/T/E 2.5 Cm/<	$208.41	$416.82	$120.62–$68.85	—	50%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn	$290.22	$580.43	$135.71–$80.97	79% below	50%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn	$290.22	$580.43	$100.02–$98.53	—	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inject Anes/Steroid Foramen Lumbar/Sacral W Img Guide ,1 Level	$291.50	$583.00	$103.53–$98.40	77% below	50%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inject Anes/Steroid Foramen Lumbar/Sacral W Img Guide ,1 Level	$291.50	$583.00	$100.90–$99.02	—	50%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Lamnotmy Incl W/Dcmprsn Nrv Root 1 Intrspc Lumbr	$1,650.00	$3,300.00	$1,051.88–$926.48	80% below	50%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 Lamnotmy Incl W/Dcmprsn Nrv Root 1 Intrspc Lumbr	$1,650.00	$3,300.00	$1,014.28–$973.71	—	50%
Lumbar laminectomy (spinal decompression), one level CPT 63047 Lam Facetectomy & Foramotomy 1 Vrt Sgm Lumbar	$2,021.50	$4,043.00	$1,030.97–$894.45	76% below	50%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 Lam Facetectomy & Foramotomy 1 Vrt Sgm Lumbar	$2,021.50	$4,043.00	$1,030.26–$978.75	—	50%
Lumbar spinal fusion (posterior), one level CPT 22612 Arthrodesis Posterior/Pstlat Tq 1ntrspc Lumbar	$2,493.50	$4,987.00	$1,059.74–$847.79	56% below	50%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 Arthrodesis Posterior/Pstlat Tq 1ntrspc Lumbar	$2,493.50	$4,987.00	$1,059.74–$953.55	—	50%
Lumpectomy (partial mastectomy) CPT 19301 Mastectomy Partial	$600.00	$1,200.00	$1,020.00–$895.48	60% below	50%
Lumpectomy (partial mastectomy) inpatient CPT 19301 Mastectomy Partial	$600.00	$1,200.00	$1,004.45–$965.56	—	50%
Mastectomy (total removal of the breast) CPT 19303 Mastectomy Simple Complete	$949.00	$1,898.00	$1,008.31–$967.46	57% below	50%
Mastectomy (total removal of the breast) inpatient CPT 19303 Mastectomy Simple Complete	$949.00	$1,898.00	$1,015.57–$967.46	—	50%
Miscarriage treatment with D&C, first trimester CPT 59820 Tx Missed Abortion First Trimester Surgical	$500.00	$1,000.00	$195.94–$900.00	87% below	50%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Tx Missed Abortion First Trimester Surgical	$500.00	$1,000.00	$195.94–$900.00	—	50%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 Mohs Micrographic H/N/H/F/G 1st Stage 5 Blocks	$591.00	$1,182.00	$1,004.70–$991.15	33% below	50%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 Mohs Micrographic H/N/H/F/G 1st Stage 5 Blocks	$591.00	$1,182.00	$1,004.70–$991.15	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc B9 Lesion Mrgn Xcp Sk Tg T/a/L 0.5 Cm/<	$101.22	$202.44	$101.54–$99.84	88% below	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc B9 Lesion Mrgn Xcp Sk Tg T/a/L 0.5 Cm/<	$101.22	$202.44	$101.57–$95.35	—	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc B9 Lesion Mrgn Xcp Sk Tg F/E/E/N/L/M 0.5cm/<	$125.00	$250.00	$100.96–$95.91	86% below	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Hchc Exc Skin Benig <5mm Face,Facial450	$338.85	$1,255.00	$1,066.75–$941.25	63% below	73%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Exc B9 Lesion Mrgn Xcp Sk Tg F/E/E/N/L/M 0.5cm/<	$125.00	$250.00	$100.96–$95.91	—	50%
Nail removal (partial or complete), one nail CPT 11730 HC Avulsion of Nail	$53.44	$197.94	$1,126.19–$925.06	81% below	73%
Nail removal (partial or complete), one nail CPT 11730 Removal of Nail Plate	$91.08	$182.15	$10.16–$91.67	68% below	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 Removal of Nail Plate	$91.08	$182.15	$102.29–$91.67	—	50%
Occipital nerve block (injection for headaches) CPT 64405 Injection Aa&/Strd Greater Occipital Nerve	$99.00	$198.00	$101.31–$97.48	75% below	50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Injection Aa&/Strd Greater Occipital Nerve	$99.00	$198.00	$102.57–$97.48	—	50%
Pacemaker implant (dual chamber) CPT 33208 HC Pacemaker Ins/Repl a/V	$3,829.49	$14,183.30	$10,465.33–$9,241.84	69% below	73%
Paracentesis with imaging guidance CPT 49083 Abdom Paracentesis Dx/Ther W/Imaging Guidance	$324.50	$649.00	$143.94–$85.43	74% below	50%
Paracentesis with imaging guidance CPT 49083 HC Abdominal Paracentesis W/Imaging	$645.59	$2,391.09	$1,126.19–$937.56	48% below	73%
Paracentesis with imaging guidance inpatient CPT 49083 Abdom Paracentesis Dx/Ther W/Imaging Guidance	$324.50	$649.00	$101.55–$98.59	—	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Excision Nail/Matrix	$124.20	$460.00	$101.44–$99.50	79% below	73%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal of Nail Bed	$179.50	$359.00	$100.73–$98.81	69% below	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal of Nail Bed	$179.50	$359.00	$100.73–$98.81	—	50%
Prostate biopsy CPT 55700 Biopsy of Prostate,Needle/Punch	$223.00	$446.00	$105.35–$66.66	90% below	50%
Prostate biopsy inpatient CPT 55700 Biopsy of Prostate,Needle/Punch	$223.00	$446.00	$105.35–$66.66	—	50%
Prostate removal (prostatectomy), laparoscopic CPT 55866 Laps Surg Prst8ect Rpbic Rad W/Nrv Sparing Robot	$1,720.00	$3,440.00	$1,212.02–$969.61	86% below	50%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 Laps Surg Prst8ect Rpbic Rad W/Nrv Sparing Robot	$1,720.00	$3,440.00	$1,059.76–$969.61	—	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Dstr Nrolytc Agnt Parverteb Fct Sngl Lmbr/Sacral	$465.50	$931.00	$1,187.03–$791.35	80% below	50%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Dstr Nrolytc Agnt Parverteb Fct Sngl Lmbr/Sacral	$465.50	$931.00	$1,042.56–$966.62	—	50%
Removal of a breast lump, open surgery CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion	$518.72	$1,037.44	$339.46–$881.82	88% below	50%
Removal of a breast lump, open surgery inpatient CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion	$518.72	$1,037.44	$1,032.43–$933.70	—	50%
Removal of a foreign object under the skin, simple CPT 10120 Incision & Removal Foreign Body Subq Tiss Simple	$119.41	$238.82	$100.56–$99.99	78% below	50%
Removal of a foreign object under the skin, simple CPT 10120 HC FB Rem Simple	$241.60	$894.83	$286.35–$506.36	56% below	73%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision & Removal Foreign Body Subq Tiss Simple	$119.41	$238.82	$101.50–$99.19	—	50%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 Total Thyroid Lobectomy Uni W/WO Isthmusectomy	$1,059.00	$2,118.00	$1,108.13–$964.21	85% below	50%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 Total Thyroid Lobectomy Uni W/WO Isthmusectomy	$1,059.00	$2,118.00	$1,030.53–$975.90	—	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colon ca scrn not hi rsk ind	$435.00	$870.00	$103.24–$805.13	60% below	50%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 Colon ca scrn not hi rsk ind	$435.00	$870.00	$103.24–$805.13	—	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colorectal scrn; hi risk ind	$435.00	$870.00	$148.47–$804.79	60% below	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 Colorectal scrn; hi risk ind	$435.00	$870.00	$148.47–$804.79	—	50%
Septoplasty to straighten the nasal septum CPT 30520 Septoplasty/Submucous Resecj W/WO Cartilage Grf	$797.50	$1,595.00	$1,064.00–$912.19	79% below	50%
Septoplasty to straighten the nasal septum inpatient CPT 30520 Septoplasty/Submucous Resecj W/WO Cartilage Grf	$797.50	$1,595.00	$1,064.00–$996.18	—	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy Xtrcorp Shock Wave	$962.50	$1,925.00	$1,636.25–$918.23	81% below	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Lithotripsy Xtrcorp Shock Wave	$962.50	$1,925.00	$1,019.22–$968.69	—	50%
Short arm cast (elbow to hand) CPT 29075 HC Cast App Forearem	$32.35	$119.80	$336.59–$50.40	90% below	73%
Short arm cast (elbow to hand) CPT 29075 Apply Forearm Cast	$74.50	$149.00	$100.13–$98.14	76% below	50%
Short arm cast (elbow to hand) inpatient CPT 29075 Apply Forearm Cast	$74.50	$149.00	$100.13–$98.14	—	50%
Short arm splint (forearm and hand) CPT 29125 Apply Forearm Splint,Static	$54.50	$109.00	$106.94–$98.10	71% below	50%
Short arm splint (forearm and hand) CPT 29125 HC Application Short Arm Static	$84.82	$314.15	$100.53–$163.37	54% below	73%
Short arm splint (forearm and hand) inpatient CPT 29125 Apply Forearm Splint,Static	$54.50	$109.00	$106.94–$98.10	—	50%
Short leg cast (below the knee) CPT 29405 HC Cast App Short Leg-Knee-Toe	$33.57	$124.35	$336.59–$61.15	90% below	73%
Short leg cast (below the knee) CPT 29405 Application Short Leg Cast Below Knee-Toe	$79.50	$159.00	$105.09–$98.57	76% below	50%
Short leg cast (below the knee) inpatient CPT 29405 Application Short Leg Cast Below Knee-Toe	$79.50	$159.00	$105.09–$94.11	—	50%
Short leg splint (calf to foot) CPT 29515 HC Application Short Leg Splint	$57.34	$212.37	$199.98–$75.82	70% below	73%
Short leg splint (calf to foot) CPT 29515 Apply Lower Leg Splint	$58.50	$117.00	$102.97–$99.45	70% below	50%
Short leg splint (calf to foot) inpatient CPT 29515 Apply Lower Leg Splint	$58.50	$117.00	$102.97–$99.45	—	50%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 Surgical Arthroscopy Shoulder Dstl Claviculc	$626.50	$1,253.00	$106.51–$934.34	63% below	50%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 Surgical Arthroscopy Shoulder Dstl Claviculc	$626.50	$1,253.00	$100.69–$991.15	—	50%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls	$1,210.00	$2,420.00	$137.71–$54.13	15% below	50%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls	$1,210.00	$2,420.00	$137.71–$54.13	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repr Superf Wnd Body <2.5cm	$129.00	$258.00	$100.97–$90.02	55% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Lac Rep Sim Trunk Less Than 2.6	$142.79	$528.86	$169.24–$251.83	50% below	73%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Repr Superf Wnd Body <2.5cm	$129.00	$258.00	$105.17–$90.02	—	50%
Skin biopsy, punch, one lesion CPT 11104 HC Punch Biopsy Skin Single Lesion	$93.15	$345.00	$106.95–$666.00	84% below	73%
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Skin Single Lesion	$120.50	$241.00	$102.43–$96.78	79% below	50%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy Skin Single Lesion	$120.50	$241.00	$102.43–$96.78	—	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Excision Mal Lesion Trunk/Arm/Leg 0.5 Cm/<	$156.29	$312.58	$167.16–$99.82	81% below	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Excision Mal Lesion Trunk/Arm/Leg 0.5 Cm/<	$156.29	$312.58	$108.77–$99.82	—	50%
Skin tag removal, up to 15 tags CPT 11200 Removal of Skin Tags	$73.50	$147.00	$103.44–$98.64	75% below	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of Skin Tags	$73.50	$147.00	$103.88–$99.71	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Puncture,Lumbar,Diagnostic	$150.00	$300.00	$100.48–$98.48	84% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Lumbar Puncture	$636.44	$2,357.18	$1,126.19–$925.06	33% below	73%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Puncture,Lumbar,Diagnostic	$150.00	$300.00	$100.48–$98.48	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Repr Sup Npterf Wnd Body 2.6-7.5	$131.00	$262.00	$105.17–$93.46	62% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Lac Rep Sim Trunk 2.6 - 7.5	$152.85	$566.10	$1,126.19–$925.06	56% below	73%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Repr Sup Npterf Wnd Body 2.6-7.5	$131.00	$262.00	$105.63–$93.46	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Repr Superf Wnd Face <2.5cm	$131.00	$262.00	$103.74–$93.92	57% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Lac Rep Sim Face Ear Less Than 2.5	$146.83	$543.81	$189.83–$251.83	52% below	73%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Repr Superf Wnd Face <2.5cm	$131.00	$262.00	$103.74–$93.92	—	50%
TURP (transurethral resection of the prostate) CPT 52601 Trurl Electrosurg Rescj Prostate Bleed Complete	$920.00	$1,840.00	$1,141.60–$995.11	85% below	50%
TURP (transurethral resection of the prostate) inpatient CPT 52601 Trurl Electrosurg Rescj Prostate Bleed Complete	$920.00	$1,840.00	$1,053.58–$997.72	—	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential Biopsy Skin Single Lesion	$102.00	$204.00	$113.00–$96.05	77% below	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangential Biopsy Skin Single Lesion	$102.00	$204.00	$112.22–$95.38	—	50%
Thoracentesis with imaging guidance CPT 32555 HC Aspirate Pleura W/Imaging	$467.48	$1,731.42	$1,126.19–$783.57	62% below	73%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis Needle/Cath Pleura W/Imaging	$575.00	$1,150.00	$100.81–$977.50	53% below	50%
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis Needle/Cath Pleura W/Imaging	$575.00	$1,150.00	$100.81–$977.50	—	50%
Tonsil and adenoid removal, age 12 or older CPT 42821 Tonsillectomy & Adenoidectomy Age 12/>	$436.00	$872.00	$250.53–$741.20	89% below	50%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 Tonsillectomy & Adenoidectomy Age 12/>	$436.00	$872.00	$148.06–$784.80	—	50%
Tonsil and adenoid removal, child under 12 CPT 42820 Tonsillectomy & Adenoidectomy <Age 12	$357.50	$715.00	$239.98–$607.75	95% below	50%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 Tonsillectomy & Adenoidectomy <Age 12	$357.50	$715.00	$141.04–$643.50	—	50%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Tonsillectomy Primary/Secondary Age 12/>	$385.00	$770.00	$210.81–$654.50	90% below	50%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 Tonsillectomy Primary/Secondary Age 12/>	$385.00	$770.00	$122.66–$693.00	—	50%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 Tonsillectomy Primary/Secondary <Age 12	$386.00	$772.00	$221.37–$656.20	94% below	50%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 Tonsillectomy Primary/Secondary <Age 12	$386.00	$772.00	$127.00–$694.80	—	50%
Total hip replacement CPT 27130 Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	$2,887.50	$5,775.00	$1,040.81–$981.75	28% below	50%
Total hip replacement inpatient CPT 27130 Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	$2,887.50	$5,775.00	$1,039.50–$981.75	—	50%
Total knee replacement CPT 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments	$2,520.00	$5,040.00	$1,039.32–$856.80	82% below	50%
Total knee replacement inpatient CPT 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments	$2,520.00	$5,040.00	$1,039.32–$856.80	—	50%
Total shoulder replacement CPT 23472 Arthroplasty Glenohumeral Joint Total Shoulder	$2,289.00	$4,578.00	$1,171.20–$972.83	48% below	50%
Total shoulder replacement inpatient CPT 23472 Arthroplasty Glenohumeral Joint Total Shoulder	$2,289.00	$4,578.00	$1,168.86–$972.83	—	50%
Total thyroid removal (thyroidectomy) CPT 60240 Thyroidectomy Total/Complete	$1,223.00	$2,446.00	$1,246.83–$929.76	77% below	50%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 Thyroidectomy Total/Complete	$1,223.00	$2,446.00	$1,006.20–$973.55	—	50%
Trigger finger release surgery CPT 26055 Tendon Sheath Incision	$521.50	$1,043.00	$140.00–$938.70	72% below	50%
Trigger finger release surgery inpatient CPT 26055 Tendon Sheath Incision	$521.50	$1,043.00	$140.00–$938.70	—	50%
Trigger point injections, 1 or 2 muscles CPT 20552 Inject Trigger Point, 1 or 2	$49.00	$98.00	$105.40–$91.40	86% below	50%
Trigger point injections, 1 or 2 muscles CPT 20552 HC Injection(S);Single or Mult Trigger Point(S),1 or 2 Muscles	$71.82	$266.00	$374.12–$81.68	79% below	73%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inject Trigger Point, 1 or 2	$49.00	$98.00	$18.18–$88.20	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC Bx Breast 1st Lesion US Imag	$267.30	$990.00	$2,053.46	90% below	73%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx Breast W/Device 1st Lesion Ultrasound Guid	$399.46	$798.92	$1,018.62–$679.08	86% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Bx Breast W/Device 1st Lesion Ultrasound Guid	$399.46	$798.92	$1,005.71–$997.12	—	50%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Egd Balloon Dilation Esophagus <30 Mm Diam	$325.00	$650.00	$1,165.92–$552.50	86% below	50%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 Egd Balloon Dilation Esophagus <30 Mm Diam	$325.00	$650.00	$1,165.92–$942.57	—	50%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd Transoral Biopsy Single/Multiple	$401.00	$802.00	$101.00–$852.20	65% below	50%
Upper endoscopy (EGD) with biopsy CPT 43239 HC Upper GI Endoscopy W/Biopsy	$776.45	$2,875.73	$1,188.24	32% below	73%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Egd Transoral Biopsy Single/Multiple	$401.00	$802.00	$101.00–$852.20	—	50%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Esophagogastroduodenoscopy Submucosal Injection	$317.65	$635.29	$111.70–$540.00	71% below	50%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 Esophagogastroduodenoscopy Submucosal Injection	$317.65	$635.29	$101.00–$628.19	—	50%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd Removal Tumor Polyp/Other Lesion Snare Tech	$425.00	$850.00	$104.09–$773.83	81% below	50%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 Egd Removal Tumor Polyp/Other Lesion Snare Tech	$425.00	$850.00	$104.09–$773.83	—	50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Egd Insert Guide Wire Dilator Passage Esophagus	$327.03	$654.06	$133.83–$555.95	71% below	50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 Egd Insert Guide Wire Dilator Passage Esophagus	$327.03	$654.06	$133.83–$90.27	—	50%
Upper endoscopy (EGD), diagnostic CPT 43235 HC Egd Diagnostic Brush Wash	$294.30	$1,090.00	$1,090.00–$981.00	73% below	73%
Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic	$329.00	$658.00	$107.92–$98.89	70% below	50%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic	$329.00	$658.00	$107.92–$98.89	—	50%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 Cysto W/Ureteroscopy W/Lithotripsy	$423.50	$847.00	$315.04–$719.95	93% below	50%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 Cysto W/Ureteroscopy W/Lithotripsy	$423.50	$847.00	$222.20–$762.30	—	50%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 Routine OB Care Vag Dlvry & Postpartum Care Vb	$1,952.50	$3,905.00	$2,037.73–$4,005.22	40% below	50%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 Routine OB Care Vag Dlvry & Postpartum Care Vb	$1,952.50	$3,905.00	$1,752.50–$4,005.22	—	50%
Vaginal delivery, including prenatal and postpartum care CPT 59400 OB Care Antepartum Vag Dlvr & Postpartum	$1,966.50	$3,933.00	$1,950.91–$4,793.22	38% below	50%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 OB Care Antepartum Vag Dlvr & Postpartum	$1,966.50	$3,933.00	$1,720.75–$4,793.22	—	50%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 Vasectomy Uni/Bi Spx W/Postop Semen Exams	$442.00	$884.00	$188.49–$751.40	—	50%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 Vasectomy Uni/Bi Spx W/Postop Semen Exams	$442.00	$884.00	$116.36–$795.60	—	50%
Vein ablation, radiofrequency, first vein CPT 36475 Endoven Abltj Incmptnt Vein Xtr Rf 1st Vein	$2,179.50	$4,359.00	$1,259.35–$431.29	42% below	50%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 Endoven Abltj Incmptnt Vein Xtr Rf 1st Vein	$2,179.50	$4,359.00	$1,259.35–$939.99	—	50%
Wart removal, up to 14 warts CPT 17110 Destruction Benign Lesions Up to 14	$96.00	$192.00	$102.78–$94.74	59% below	50%
Wart removal, up to 14 warts inpatient CPT 17110 Destruction Benign Lesions Up to 14	$96.00	$192.00	$101.49–$96.23	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement Subcutaneous Tissue 1st 20 Sq Cm/<	$101.64	$203.27	$100.12–$97.53	86% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride Skin Tissue	$179.82	$666.00	$1,126.19–$925.06	75% below	73%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement Subcutaneous Tissue 1st 20 Sq Cm/<	$101.64	$203.27	$100.12–$97.24	—	50%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 Optx Dstl Radl X-Artic Fx/Epiphysl Sep	$800.00	$1,600.00	$1,028.63–$680.00	65% below	50%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 Optx Dstl Radl X-Artic Fx/Epiphysl Sep	$800.00	$1,600.00	$1,002.28–$977.18	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion Cvru	$313.42	$1,160.81	$1,044.73–$986.69	57% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion 3 Units	$313.42	$1,160.81	$1,044.70–$986.69	57% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion 2 Units	$313.42	$1,160.81	$1,044.70–$986.69	57% below	73%
Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion - 1 Unit	$313.42	$1,160.81	$1,044.70–$986.69	57% below	73%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Aerogen Solo Nebulizer Tx	$67.50	$250.00	$143.48–$92.50	70% below	73%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Airway Inhalation Treat	$103.55	$383.50	$107.38–$70.00	54% below	73%
Chemotherapy IV infusion, first hour CPT 96413 HC Chemo Infusion Up to 1hr	$204.66	$758.00	$175.64–$758.00	65% below	73%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 Oph Svcs Medical Xm&Eval Compre New Pt 1/> Vst	$118.50	$237.00	$104.93–$99.68	48% below	50%
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 Oph Svcs Medical Xm&Eval Compre New Pt 1/> Vst	$118.50	$237.00	$104.93–$99.68	—	50%
Comprehensive eye exam, returning patient CPT 92014 HC Clinic Use Fee Oph	$40.36	$149.48	$101.60–$97.40	81% below	73%
Comprehensive eye exam, returning patient CPT 92014 HC Clinic Use Fee Oph..	$40.36	$149.48	$101.60–$97.40	81% below	73%
Comprehensive eye exam, returning patient CPT 92014 Oph Svcs Medical Xm&Eval Compre Est Pt 1/>Vst	$112.50	$225.00	$100.23–$84.62	47% below	50%
Comprehensive eye exam, returning patient inpatient CPT 92014 Oph Svcs Medical Xm&Eval Compre Est Pt 1/>Vst	$112.50	$225.00	$100.23–$84.62	—	50%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC Comprehensive Audiometry	$74.24	$274.97	$101.74–$95.03	70% below	73%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care, E/M 30-74 Minutes	$216.22	$432.44	$169.63–$84.68	86% below	50%
Critical care, first 30 to 74 minutes CPT 99291 HC Trauma Critical Care Emergency Room First 30-74 Minutes	$472.50	$1,750.00	$1,067.91–$925.06	69% below	73%
Critical care, first 30 to 74 minutes CPT 99291 HC Emergency Critical Care Without Trauma First 30-74 Minutes	$590.37	$2,186.57	$1,067.91–$925.06	62% below	73%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care, E/M 30-74 Minutes	$216.22	$432.44	$169.63–$84.68	—	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake & Drowsy	$235.06	$870.61	$182.00–$870.61	57% below	73%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Ecg 12 Lead Tracing Only	$72.09	$267.01	$10.23–$98.79	50% below	73%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER Visit No MD/Qhcp Req Obw	$38.07	$141.00	$105.75–$88.05	74% below	73%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Department Visit Limited/Minor Prob	$40.00	$80.00	$15.53–$9.31	72% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER Visit No MD/Qhcp Req	$87.96	$325.77	$100.99–$98.51	39% below	73%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Department Visit Limited/Minor Prob	$40.00	$80.00	$10.11–$9.31	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Department Visit Low/Moder Severity	$58.00	$116.00	$34.03–$98.60	81% below	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER Visit Straightforward	$141.12	$522.67	$1,126.19–$925.06	55% below	73%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER Visit Straightforward Obw	$141.12	$522.67	$1,126.19–$522.67	55% below	73%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Department Visit Low/Moder Severity	$58.00	$116.00	$104.40–$98.60	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Department Visit Moderate Severity	$86.50	$173.00	$147.05–$96.78	81% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER Visit Low Level Obw	$113.13	$419.00	$1,126.19–$419.00	75% below	73%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER Visit Low Level	$190.11	$704.11	$1,126.19–$925.06	58% below	73%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Department Visit Moderate Severity	$86.50	$173.00	$105.02–$99.77	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Department Visit High/Urgent Severity	$107.92	$215.84	$119.98–$98.57	84% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER Visit Moderate Level Obw	$179.82	$666.00	$1,126.19–$666.00	73% below	73%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER Visit Moderate Level	$274.04	$1,014.96	$1,014.90–$925.06	59% below	73%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Department Visit High/Urgent Severity	$107.92	$215.84	$101.69–$99.14	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Dept Visit High Severity&Threat Funcj	$163.62	$327.24	$142.82–$278.15	81% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER Visit High Level	$401.65	$1,487.61	$1,011.13–$925.06	53% below	73%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Dept Visit High Severity&Threat Funcj	$163.62	$327.24	$139.25–$67.19	—	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC Cardiovas Stres Test W Rx	$337.50	$1,250.00	$1,000.00–$982.13	42% below	73%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC Ekg Stress	$440.91	$1,633.00	$1,000.00–$944.00	24% below	73%
Eye exam, returning patient, intermediate CPT 92012 HC Eye Exam Clinic Use Fee	$31.45	$116.49	$102.65–$99.02	84% below	73%
Eye exam, returning patient, intermediate CPT 92012 HC Clinic Use Fee	$31.45	$116.49	$104.84–$99.02	84% below	73%
Eye exam, returning patient, intermediate CPT 92012 Oph Svcs Medical Xm&Eval Intermediate Est Pt	$70.50	$141.00	$117.89–$82.35	64% below	50%
Eye exam, returning patient, intermediate inpatient CPT 92012 Oph Svcs Medical Xm&Eval Intermediate Est Pt	$70.50	$141.00	$117.89–$82.35	—	50%
Family therapy with the patient, 50 minutes CPT 90847 HC Family Therapy With Patient	$23.52	$87.12	$109.38–$87.12	91% below	73%
Family therapy with the patient, 50 minutes CPT 90847 Family Psychotherapy W/Patient Present 50 Mins	$90.00	$180.00	$90.00	64% below	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Psychotherapy W/Patient Present 50 Mins	$90.00	$180.00	$90.00	—	50%
Family therapy without the patient, 50 minutes CPT 90846 HC Family Therapy Without Patient	$23.52	$87.12	$12.58–$87.12	91% below	73%
Family therapy without the patient, 50 minutes CPT 90846 Family Psychotherapy W/O Patient Present 50 Mins	$76.54	$153.08	$90.00	70% below	50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psychotherapy W/O Patient Present 50 Mins	$76.54	$153.08	$90.00	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC Hydration Up to 1hr	$120.24	$445.35	$124.70–$445.35	65% below	73%
IV infusion of a medicine, first hour CPT 96365 HC Intra Infus Up to 1hr	$127.21	$471.13	$131.92–$471.13	66% below	73%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Administration(Im)	$20.25	$75.00	$23.25–$90.20	76% below	73%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Ther/Proph/Dx Injec;Subcut/Intramusc	$30.90	$114.43	$102.99–$97.27	63% below	73%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection,Therap/Proph/Diagnost, Im or Subcut	$41.25	$82.50	$10.41–$93.50	51% below	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection,Therap/Proph/Diagnost, Im or Subcut	$41.25	$82.50	$11.40–$82.50	—	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC Psych Diagnostic Interview	$89.63	$331.95	$102.90–$8.96	59% below	73%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Diagnostic Evaluation	$148.00	$296.00	$120.00	32% below	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychiatric Diagnostic Evaluation	$148.00	$296.00	$120.00	—	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC Motor & Sens 7-8 Nrv Cndj Test.	$465.75	$1,725.00	$1,124.01–$869.06	5% above	73%
Neuromuscular re-education, 15 minutes CPT 97112 HC Neuromuscular Re-Education Each 15 Min	$36.05	$133.50	$100.13–$99.92	57% below	73%
New patient office visit, about 30 minutes CPT 99203 Office/Outpatient New Low Mdm 30-44 Minutes	$95.50	$191.00	$100.56–$99.74	51% below	50%
New patient office visit, about 30 minutes inpatient CPT 99203 Office/Outpatient New Low Mdm 30-44 Minutes	$95.50	$191.00	$102.47–$96.65	—	50%
New patient office visit, about 45 minutes CPT 99204 Office/Outpatient New Moderate Mdm 45-59 Minutes	$144.50	$289.00	$106.32–$73.25	50% below	50%
New patient office visit, about 45 minutes inpatient CPT 99204 Office/Outpatient New Moderate Mdm 45-59 Minutes	$144.50	$289.00	$106.32–$56.57	—	50%
New patient office visit, about 60 minutes CPT 99205 Office/Outpatient New High Mdm 60-74 Minutes	$182.50	$365.00	$144.56–$98.25	35% below	50%
New patient office visit, about 60 minutes inpatient CPT 99205 Office/Outpatient New High Mdm 60-74 Minutes	$182.50	$365.00	$144.56–$73.59	—	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office/Outpatient New Sf Mdm 15-29 Minutes	$67.00	$134.00	$105.41–$99.83	57% below	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office/Outpatient New Sf Mdm 15-29 Minutes	$67.00	$134.00	$105.41–$99.83	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC Mnt Nutrition Initl Ea15	$13.50	$50.00	$118.43–$50.00	76% below	73%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Medical Nutrition Assmt&Ivntj Indiv Each 15 Mi	$29.50	$59.00	$23.46–$58.05	48% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Medical Nutrition Assmt&Ivntj Indiv Each 15 Mi	$29.50	$59.00	$23.46–$58.05	—	50%
Occupational therapy evaluation, low complexity CPT 97165 HC Occupational Therapy Eval Low Complex	$52.75	$195.36	$100.20–$97.28	69% below	73%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Physical Therapy Eval High Complexity	$105.57	$391.00	$101.46–$99.62	63% below	73%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Physical Therapy Eval Low Complexity	$73.76	$273.19	$100.32–$99.56	59% below	73%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Physical Therapy Eval Mod Complexity	$76.04	$281.64	$100.55–$99.56	68% below	73%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Manual Ther Ea 15 Min	$36.18	$134.00	$100.07–$92.67	57% below	73%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Therapeutic Exercises Each 15 Min	$31.59	$117.00	$10.49–$99.90	61% below	73%
Preventive checkup, new patient aged 18–39 CPT 99385 HC Clinic Use Fee New 18-39	$32.19	$119.22	$100.85–$97.99	84% below	73%
Preventive checkup, new patient aged 18–39 CPT 99385 Initial Preventive Medicine New Pt Age 18-39yrs	$121.00	$242.00	$105.85–$65.52	40% below	50%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Initial Preventive Medicine New Pt Age 18-39yrs	$121.00	$242.00	$105.85–$37.20	—	50%
Preventive checkup, new patient aged 40–64 CPT 99386 HC Clinic Use Fee New 40-64	$35.41	$131.15	$100.85–$98.36	83% below	73%
Preventive checkup, new patient aged 40–64 CPT 99386 Initial Preventive Medicine New Patient 40-64yrs	$139.50	$279.00	$130.28–$93.96	33% below	50%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Initial Preventive Medicine New Patient 40-64yrs	$139.50	$279.00	$130.28–$93.96	—	50%
Preventive checkup, new patient aged 65 or older CPT 99387 HC Clinic Use Fee 65 & Over.	$35.41	$131.15	$10.82–$98.36	86% below	73%
Preventive checkup, new patient aged 65 or older CPT 99387 Initial Preventive Medicine New Patient 65yrs&>	$146.00	$292.00	$114.75–$97.54	42% below	50%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Initial Preventive Medicine New Patient 65yrs&>	$146.00	$292.00	$114.75–$97.54	—	50%
Preventive checkup, returning patient aged 18–39 CPT 99395 HC Clinic Use Fee Est 18-39	$28.95	$107.21	$100.85–$99.71	84% below	73%
Preventive checkup, returning patient aged 18–39 CPT 99395 Periodic Preventive Med Est Patient 18-39 Yrs	$110.50	$221.00	$101.02–$99.39	39% below	50%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Periodic Preventive Med Est Patient 18-39 Yrs	$110.50	$221.00	$101.02–$99.39	—	50%
Preventive checkup, returning patient aged 40–64 CPT 99396 HC Clinic Use Fee Est 40-64	$48.43	$179.38	$101.47–$66.37	75% below	73%
Preventive checkup, returning patient aged 40–64 CPT 99396 Periodic Preventive Med Est Patient 40-64yrs	$117.50	$235.00	$100.00–$99.82	39% below	50%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Periodic Preventive Med Est Patient 40-64yrs	$117.50	$235.00	$100.00–$99.82	—	50%
Preventive checkup, returning patient aged 65 or older CPT 99397 HC Clinic Use Fee Preventative	$49.96	$185.05	$104.68–$68.47	75% below	73%
Preventive checkup, returning patient aged 65 or older CPT 99397 Periodic Preventive Med Est Patient 65yrs& Older	$124.50	$249.00	$108.24–$98.85	37% below	50%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Periodic Preventive Med Est Patient 65yrs& Older	$124.50	$249.00	$116.10–$98.85	—	50%
Psychiatric evaluation with medical services CPT 90792 HC Psych Diag Eval W/Med Srvcs	$50.50	$187.05	$109.38–$57.99	82% below	73%
Psychiatric evaluation with medical services CPT 90792 Psychiatric Diagnostic Eval W/Medical Services	$165.50	$331.00	$120.00	41% below	50%
Psychiatric evaluation with medical services inpatient CPT 90792 Psychiatric Diagnostic Eval W/Medical Services	$165.50	$331.00	$120.00	—	50%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 HC Psycl Tst Eval Phys/Qhp 1st	$31.32	$116.00	$104.40–$98.60	91% below	73%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Psychological Tst Eval Svc Phys/Qhp First Hour	$110.00	$220.00	$104.00–$98.80	68% below	50%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 Psychological Tst Eval Svc Phys/Qhp First Hour	$110.00	$220.00	$151.84–$90.23	—	50%
Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy for Crisis Initial 60 Minutes	$150.00	$300.00	$90.00	37% below	50%
Psychotherapy for crisis, first 60 minutes CPT 90839 HC Psytx Crisis Initial 60 Min	$301.30	$1,115.92	$1,004.33–$948.53	27% above	73%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy W/Patient 30 Minutes	$64.50	$129.00	$48.00	67% below	50%
Psychotherapy session, 30 minutes CPT 90832 HC Psytx Pt&/Family 30 Min	$65.97	$244.33	$11.51–$75.74	67% below	73%
Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy W/Patient 30 Minutes	$64.50	$129.00	$48.00	—	50%
Psychotherapy session, 45 minutes CPT 90834 HC Psytx Pt&/Family 45 Min	$72.37	$268.04	$11.51–$83.09	72% below	73%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy W/Patient 45 Minutes	$85.00	$170.00	$90.00	67% below	50%
Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy W/Patient 45 Minutes	$85.00	$170.00	$90.00	—	50%
Psychotherapy session, 60 minutes CPT 90837 HC Psytx Pt&/Family 60 Min	$66.80	$247.42	$13.24–$76.70	77% below	73%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy W/Patient 60 Minutes	$125.00	$250.00	$90.00	58% below	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy W/Patient 60 Minutes	$125.00	$250.00	$90.00	—	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC Smoking Cessation 3-10	$10.22	$37.84	$10.60–$68.00	76% below	73%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco Use Cessation Intermediate 3-10 Minutes	$14.44	$28.87	$10.00–$9.62	66% below	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco Use Cessation Intermediate 3-10 Minutes	$14.44	$28.87	$10.00–$9.62	—	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Office O/P Est Vst High 40 Min	$33.75	$125.00	$106.25–$93.75	86% below	73%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office/Outpatient Established High Mdm 40-54 Min	$149.50	$299.00	$114.61–$79.75	36% below	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office/Outpatient Established High Mdm 40-54 Min	$149.50	$299.00	$114.61–$66.00	—	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Office O/P Est Visit Low 20min	$29.71	$110.05	$102.35–$99.05	83% below	73%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office/Outpatient Established Low Mdm 20-29 Min	$75.00	$150.00	$102.19–$92.92	56% below	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office/Outpatient Established Low Mdm 20-29 Min	$75.00	$150.00	$102.19–$92.92	—	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Office O/P Est Visit Mod 30min	$35.90	$132.98	$100.84–$99.74	81% below	73%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office/Outpatient Established Mod Mdm 30-39 Min	$106.00	$212.00	$100.58–$98.22	45% below	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office/Outpatient Established Mod Mdm 30-39 Min	$106.00	$212.00	$100.58–$98.22	—	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Office O/P Est Visit Sf 10 Min	$23.15	$85.75	$10.38–$90.05	82% below	73%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office/Outpatient Established Sf Mdm 10 Min	$46.50	$93.00	$11.36–$93.00	64% below	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office/Outpatient Established Sf Mdm 10 Min	$46.50	$93.00	$11.36–$93.00	—	50%
Speech and language evaluation CPT 92523 HC Speech Sound Lang Compehen	$105.36	$390.21	$1,019.74–$838.94	73% below	73%
Speech therapy session, individual CPT 92507 HC St Treatment Speech Individ	$66.15	$245.00	$100.05–$98.18	64% below	73%
Spirometry (breathing test) CPT 94010 HC Portable Pft/Bedside Screen	$62.10	$230.00	$149.87–$71.30	73% below	73%
Spirometry (breathing test) CPT 94010 HC Resp Mechanics	$102.57	$379.89	$117.77–$89.36	56% below	73%
Spirometry (breathing test) CPT 94010 HC Incentive Spirometry	$102.57	$379.89	$106.37–$379.89	56% below	73%
Spirometry (breathing test) CPT 94010 HC Nif Fvc Pf Peak Follow Up	$102.57	$379.89	$117.77–$85.10	56% below	73%
Spirometry (breathing test) CPT 94010 HC Peak Flow Test	$102.57	$379.89	$117.77–$85.10	56% below	73%
Spirometry (breathing test) CPT 94010 HC (Fvc) (Vt) (Ve) Peak Flow Ea	$102.57	$379.89	$106.37–$379.89	56% below	73%
Spirometry before and after a bronchodilator CPT 94060 HC Post Bronchodilator Pfl	$170.07	$629.89	$176.37–$629.89	55% below	73%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC Therapeutic Activity Each 15 Min	$28.67	$106.18	$106.18–$98.75	69% below	73%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Phelbotomy	$104.38	$386.59	$119.84–$97.85	51% below	73%
Visual field test, extended both sides CPT 92083 Extended Visual Field Xm Uni/Bi I&R	$49.21	$98.42	$16.26–$88.58	—	50%
Visual field test, extended CPT 92083 HC Visual Field Rm (Hks)	$204.85	$758.72	$128.90–$80.00	39% below	73%
Visual field test, extended inpatient both sides CPT 92083 Extended Visual Field Xm Uni/Bi I&R	$49.21	$98.42	$16.26–$88.58	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC Moderna 12+Yr Sarscov2 Vac 50 Mcg/0.5ml Im	$52.92	$196.00	$101.92–$90.55	75% below	73%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC Varicella Virus Vaccine Live (Pf) 1,350 Unit/0.5 Ml Subcutaneous Susp [14757]	$96.93	$359.00	$100.70–$99.77	54% below	73%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$7.56	$28.00	$10.00–$9.81	76% below	73%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC Flu Vacc Spl V Pf>=3yr Im	$7.56	$28.00	$10.00–$9.81	76% below	73%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Iiv3 Vacc Preservative Free 0.5 Ml Dosage Im Use	$14.00	$28.00	$109.06–$97.17	55% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Iiv3 Vacc Preservative Free 0.5 Ml Dosage Im Use	$14.00	$28.00	$19.60–$28.00	—	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC Human Papillomavirus Vaccine,9-Valent (Pf) 0.5 Ml Im Suspension [201121]	$156.60	$580.00	$140.28–$70.14	72% below	73%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9vhpv Vacc 2/3 Dose Sched Im Use	$264.50	$529.00	$370.30–$544.87	54% below	50%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 9vhpv Vacc 2/3 Dose Sched Im Use	$264.50	$529.00	$370.30–$544.87	—	50%
Hepatitis A vaccine, adult dose CPT 90632 HC Hepatitis a Virus Vaccine (Pf) 1,440 Elisa Unit/Ml Im Suspension [112019]	$40.77	$151.00	$102.63–$98.39	60% below	73%
Hepatitis A vaccine, adult dose CPT 90632 Hepa Vaccine Adult Dose for Intramuscular Use	$75.50	$151.00	$105.70–$155.53	27% below	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepa Vaccine Adult Dose for Intramuscular Use	$75.50	$151.00	$105.70–$155.53	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC Hepatitis B Virus Vaccine Recomb (Pf) 20 Mcg/Ml Intramuscular Syringe [111241]	$31.05	$115.00	$103.50–$97.75	62% below	73%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC Hepatitis B Vaccine 20 Mcg/1ml	$31.60	$117.02	$102.25–$99.47	61% below	73%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC Hepatitis B Virus Vaccine Recomb (Pf) 20 Mcg/Ml Intramuscular Susp [111321]	$34.02	$126.00	$103.50–$97.75	58% below	73%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepb Vaccine Adult 3 Dose Schedule for Im Use	$119.50	$239.00	$103.85–$88.27	47% above	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepb Vaccine Adult 3 Dose Schedule for Im Use	$119.50	$239.00	$103.85–$88.27	—	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$29.70	$110.00	$102.30–$99.00	73% below	73%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC Flu Vaccine Ts(65yr Up)(Pf)180 Mcg/0.5 Ml Intramuscular Syringe	$29.70	$110.00	$102.30–$99.00	73% below	73%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Iiv Vaccine Preserv Free Increased Ag Content Im	$55.00	$110.00	$103.07–$99.63	51% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Iiv Vaccine Preserv Free Increased Ag Content Im	$55.00	$110.00	$110.00–$93.50	—	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC Measles,Mumps,Rubella Vaccine Live(Pf) 1,000-12,500tcid50/0.5 Ml Sub-Q [10512]	$53.19	$197.00	$102.73–$96.67	51% below	73%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$66.64	$246.83	$141.66–$91.39	39% below	73%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles Mumps Rubella Virus Vaccine Live Subq	$89.50	$179.00	$125.30–$82.50	18% below	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Measles Mumps Rubella Virus Vaccine Live Subq	$89.50	$179.00	$125.30–$82.50	—	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC Meningoc Vac a,C,Y,W-135 Dip(Pf) 10 Mcg-5 Mcg/0.5 Ml Intramuscular Kit [101034]	$68.04	$252.00	$100.80–$92.53	65% below	73%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC Meningoc Vac a,C,Y,W-135 Dip (Pf) 4 Mcg/0.5 Ml Intramuscular Solution [40540]	$85.86	$318.00	$101.76–$98.58	56% below	73%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menacwyd/Menacwy-CRM Conj Vacc Grps Acwy Im Use	$159.00	$318.00	$216.30–$327.54	18% below	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menacwyd/Menacwy-CRM Conj Vacc Grps Acwy Im Use	$159.00	$318.00	$216.30–$327.54	—	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC Meningococcal B Vac,4-Cmp(Pf) 50mcg-50mcg-50mcg-25mcg/0.5ml Im Syringe [201637]	$108.00	$400.00	$100.37–$98.49	67% below	73%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Menb-4c Recombnt Prot & Outer Memb Vesic Vacc Im	$167.50	$335.00	$234.50–$345.05	49% below	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Menb-4c Recombnt Prot & Outer Memb Vesic Vacc Im	$167.50	$335.00	$234.50–$345.05	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC Pneumococcal 23 Polyvalent Vaccine 25 Mcg/0.5 Ml Injection Solution [11037]	$72.36	$268.00	$108.27–$88.86	49% below	73%
Rabies vaccine, one dose CPT 90675 HC Rabies Vaccine, Purified Chicken Embryo Cell (Pf) 2.5 Unit Im Susp [22120]	$199.26	$738.00	$206.64–$738.00	58% below	73%
Rabies vaccine, one dose CPT 90675 HC Rabies Vaccine,Human Diploid (Pf) 2.5 Unit Intramuscular Solution [11257]	$230.58	$854.00	$230.72–$854.00	52% below	73%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC Shingrix	$105.05	$389.06	$108.94–$82.10	62% below	73%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC Tetanus and Diphtheria Tox (Pf) 5 Lf Unit-2 Lf Unit/0.5 Ml Im Susp [112409]	$21.60	$80.00	$22.40–$80.00	61% below	73%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC Tetanus and Diphtheria Tox (Pf) 5 Lf Unit-2 Lf Unit/0.5 Ml Im Syringe [112408]	$22.14	$82.00	$22.40–$82.00	60% below	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC Diphth,Pertussis(Acel),Tetanus 2.5 Lf Unit-8 Mcg-5 Lf/0.5ml Im Syringe [191344]	$24.84	$92.00	$103.01–$97.28	56% below	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC Diphth,Pertussis(Acell),Tetanus 2.5 Lf Unit-8 Mcg-5 Lf/0.5 Ml Im Susp [191345]	$25.65	$95.00	$103.01–$97.28	54% below	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC Diphth,Pertus(Acel)Tetanus(Pf)2lf-(2.5-5-3-5mcg)-5 Lf/0.5 Ml Im Susp [41628]	$26.19	$97.00	$27.16–$97.00	53% below	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC Diphth,Pertus(Ac)Tetanus(Pf)2 Lf-(2.5-5-3-5mcg)-5 Lf/0.5 Ml Im Syringe [112534]	$26.19	$97.00	$103.01–$97.28	53% below	73%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap Vaccine 7 Yrs/> Im	$46.00	$92.00	$64.05–$94.76	18% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap Vaccine 7 Yrs/> Im	$46.00	$92.00	$64.05–$94.76	—	50%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 HC Typhoid VI Polysacch Vaccine 25 Mcg/0.5 Ml Intramuscular Syringe [14678]	$74.79	$277.00	$126.04–$91.43	72% below	73%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Imm Adm,Single or Combination	$11.88	$44.00	$12.32–$90.20	84% below	73%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Imm Adm,Single or Combination Endo	$19.76	$73.19	$10.40–$9.82	73% below	73%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immuniz Admin,1 Single/Comb Vac/Toxoid	$22.00	$44.00	$14.10–$44.00	70% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immuniz Admin,1 Single/Comb Vac/Toxoid	$22.00	$44.00	$14.10–$44.00	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Flu Vaccine Additional Adm	$5.07	$18.78	$10.78–$6.95	84% below	73%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Imm Adm,Single or Combination Endo	$5.07	$18.78	$1.24–$6.01	84% below	73%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Pneumonia Vaccine Adm Additional	$5.07	$18.78	$1.55–$6.95	84% below	73%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Imm Admeach Additional Vaccine	$5.13	$19.00	$10.15–$7.03	84% below	73%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immuniz,Admin,Each Addl	$9.50	$19.00	$10.02–$23.18	70% below	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immuniz,Admin,Each Addl	$9.50	$19.00	$11.97–$19.97	—	50%

Dental

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant CDT D4341 HC Periodontal Scaling & Root	$297.14	$1,100.52	$1,023.48–$990.47	68% below	73%
Dental implant, surgical placement CDT D6010 HC Odontics Endosteal Implant	$592.65	$2,195.00	$1,241.71–$680.45	45% below	73%
Porcelain crown CDT D2740 HC Crown Porcelain/Ceramic Substrate	$1,132.85	$4,195.74	$1,092.42–$886.66	5% above	73%
Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240 HC Impact Tooth Remov Comp Bony	$135.00	$500.00	$155.00–$540.75	83% below	73%
Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 HC Prophylaxis-Adult	$105.24	$389.77	$120.83–$91.35	31% below	73%
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 HC Extraction,Erupted Tooth Or	$204.28	$756.61	$120.97–$756.61	40% below	73%

Source file: https://rca.elevatepfs.com/ptapp/api/cdm/export/oneclick?recno=638791007d7220c77dfc6b49d7b49d68d4d69a772af088f9448b9759d927eebd