Little Falls Hospital
Little Falls Hospital in Little Falls, NY publishes cash prices for 393 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 363 of 390 procedures and above it for 14. By typical cash price it ranks #2 of 93 New York hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
140 Burwell Street, Little Falls NY 13365 Collected Sep 27, 2026 Source price file (315) 823-5261
Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 2 of 5 CCN 331311 · CMS hospital register
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Little Falls Hospital in Little Falls, NY:
- Jun 3, 2025 Met requirements
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 HC Ankle, Comp, Min 3 Views | $131.94 | $488.65 | $111.59–$88.05 | 34% below | 73% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Dop Art Ext 1-2 Levels Bil | $141.75 | $525.00 | $128.90–$98.17 | 47% below | 73% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Xr Esoph Scout Chst Sng Con | $104.55 | $387.21 | $108.42–$977.82 | 69% below | 73% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC Bone Scan, Whole Body | $365.06 | $1,352.08 | $1,006.74–$988.74 | 57% below | 73% |
| Breast ultrasound, complete, one breast CPT 76641 CAH Chg US Breast Uni Real Time With Image Complete | $44.30 | $164.08 | $111.53–$94.44 | 86% below | 73% |
| Breast ultrasound, complete, one breast CPT 76641 HC Ultrasound Breast Complete | $199.02 | $737.10 | $1,017.00–$988.38 | 37% below | 73% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 CAH Chg US Breast Uni Real Time With Image Limited | $36.50 | $135.18 | $101.39–$94.83 | 84% below | 73% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC Ultrasound Breast Limited | $160.98 | $596.22 | $1,049.40–$991.10 | 28% below | 73% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angiography,Chest W&W/O Con | $818.62 | $3,031.92 | $1,000.53–$970.21 | 28% below | 73% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CAH Chg CT Angio Hrt Cornry Art/Bypass Grfts Contrst 3d Post | $141.53 | $524.20 | $146.78–$524.20 | 86% below | 73% |
| 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 of the heart without contrast dye to measure coronary calcium CPT 75571 CAH Chg CT Heart W/O Contrast Quant Eval Coronary Calcium | $46.37 | $171.74 | $116.73–$98.85 | 71% below | 73% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abd & Pelvis W/O Contrast | $1,126.75 | $4,173.14 | $1,168.48–$93.66 | 9% above | 73% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen & Pelvis W/Contrast | $1,235.30 | $4,575.19 | $109.01–$6,823.00 | 21% below | 73% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abdomen Pelvis Wwo Con | $1,497.50 | $5,546.31 | $138.11–$85.77 | 8% below | 73% |
| CT scan of the abdomen with contrast CPT 74160 HC CT Abd W Contrast | $833.65 | $3,087.58 | $1,017.67–$997.91 | 18% below | 73% |
| CT scan of the abdomen without contrast CPT 74150 HC CT Abd W/O Contrast | $678.05 | $2,511.30 | $1,048.73–$967.35 | 15% below | 73% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Maxillofacial W/Out Contrast | $654.54 | $2,424.21 | $106.34–$933.81 | 6% below | 73% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head/Brain WO Contrast | $548.37 | $2,031.00 | $106.34–$958.21 | 21% below | 73% |
| CT scan of the head with contrast CPT 70460 HC CT Head/Brain W Contrast | $588.06 | $2,178.00 | $1,001.92–$995.10 | 33% below | 73% |
| CT scan of the head without and with contrast CPT 70470 HC CT Head/Brain/W/O and W Contrast | $762.67 | $2,824.70 | $1,193.19–$932.15 | 27% below | 73% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Lumbar Spine, W/O Contrast | $628.78 | $2,328.83 | $1,001.52–$962.00 | 25% below | 73% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Cervical Spine,W/O Contrast | $608.19 | $2,252.55 | $106.34–$924.48 | 29% below | 73% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W Contrast | $801.79 | $2,969.60 | $1,000.45–$981.75 | 11% below | 73% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HC Duplex Extracranial Cmp Bil | $431.44 | $1,597.92 | $1,064.06–$919.76 | 21% below | 73% |
| Chest X-ray, 2 views CPT 71046 HC X-Ray Exam Chest 2 Views | $112.05 | $415.00 | $111.59–$9.41 | 44% below | 73% |
| Chest X-ray, single view CPT 71045 HC X-Ray Exam Chest 1 View | $92.07 | $341.00 | $10.10–$98.34 | 50% below | 73% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US,Retroperit,Real Time,Complete | $314.25 | $1,163.90 | $1,047.48–$989.32 | 13% below | 73% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC Bone Density Total Body | $199.57 | $739.16 | $101.00–$828.00 | 17% below | 73% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC Dexa Bone Density Peripheral | $95.66 | $354.30 | $102.18–$99.20 | 34% below | 73% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 CAH PR US,Preg Uter,Fet & Mat,+ Detl Fet Exm | $75.56 | $279.86 | $101.81–$99.91 | 85% below | 73% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Thorax Diag WO Con | $573.75 | $2,125.00 | $106.34–$982.26 | 30% below | 73% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Thorax Diag W Con | $641.31 | $2,375.22 | $1,003.00–$991.20 | 38% below | 73% |
| Diagnostic mammogram, both breasts both sides CPT 77066 CAH Chg Diagnostic Mammography Computer-Aided Detcj Bi | $67.53 | $250.10 | $143.53–$92.54 | — | 73% |
| Diagnostic mammogram, both breasts CPT 77066 HC Mammo Diagnositc W Cad Bil | $186.77 | $691.74 | $101.40–$97.97 | 21% below | 73% |
| Diagnostic mammogram, one breast CPT 77065 CAH Chg Diagnostic Mammography Computer-Aided Detcj Uni | $53.54 | $198.31 | $113.81–$73.37 | 80% below | 73% |
| Diagnostic mammogram, one breast CPT 77065 HC Mammo Diagnositc W Cad Uni | $148.36 | $549.48 | $101.40–$97.97 | 44% below | 73% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 CAH PR Duplex Lo Extrem Art Bilat | $101.98 | $377.72 | $105.76–$377.72 | — | 73% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC Arterial Duplex Lower Extrem.(Bilat.) | $445.81 | $1,651.15 | $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 | $445.81 | $1,651.15 | $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 HC Hepatobiliary System Imaging | $432.00 | $1,600.01 | $104.78–$920.97 | 55% below | 73% |
| Knee X-ray, 3 views CPT 73562 HC Knee 3 Views | $128.04 | $474.22 | $111.59–$9.41 | 24% below | 73% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, Abdomen Limited | $276.96 | $1,025.76 | $1,025.76–$98.30 | 10% below | 73% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CAH Chg Computed Tomography Thorax Lw Dose Lng Ca Scr C- | $66.15 | $245.00 | $140.61–$90.65 | 84% below | 73% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT Thor Lung Ca Scr WO Con | $635.04 | $2,352.00 | $1,004.66–$998.26 | 51% above | 73% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Low Extrem Jnt WO Con | $937.44 | $3,472.00 | $1,001.32–$972.16 | 7% below | 73% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Low Extrm Jnt WO W Con | $1,175.85 | $4,355.00 | $1,010.00–$681.75 | 36% below | 73% |
| MRI of the abdomen without contrast CPT 74181 HC MRI Abdomen WO Contrast | $1,034.61 | $3,831.90 | $1,010.00–$681.75 | 1% above | 73% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI Abdomen WO W Contrast | $1,214.98 | $4,499.94 | $1,010.00–$681.75 | 26% below | 73% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain W/O Contrast | $913.26 | $3,382.43 | $1,010.00–$994.43 | 8% below | 73% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain W/O Follwed by W/Contrast | $1,215.27 | $4,501.00 | $1,010.00–$681.75 | 24% below | 73% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI Lumbar Spine W/O Contrast | $919.38 | $3,405.11 | $1,001.10–$982.03 | 14% below | 73% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI Lumbar Spine Canal, W/WO Contrast | $1,232.24 | $4,563.85 | $1,010.00–$681.75 | 25% below | 73% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI Thoracic Spine W/O Contrast | $788.40 | $2,920.00 | $1,007.50–$963.60 | 22% below | 73% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI Cerv Spine Canal W/WO Contrast | $1,278.17 | $4,733.95 | $1,010.00–$681.75 | 21% below | 73% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI Cervical Spine Canal W/O Contrast | $929.68 | $3,443.25 | $1,010.00–$993.03 | 7% below | 73% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI Pelvis W/WO Contrast | $1,175.85 | $4,355.00 | $1,010.00–$681.75 | 24% below | 73% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI Pelvis W/O Contrast | $868.86 | $3,218.00 | $1,005.95–$997.58 | 12% below | 73% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI Upp Extrem Jnt WO Contrast | $883.04 | $3,270.50 | $1,010.00–$989.00 | 27% below | 73% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC Myocar Perf Spect Wall Mult | $917.65 | $3,398.69 | $1,018.25–$999.21 | 58% below | 73% |
| OCT scan of the retina (optical coherence tomography) CPT 92134 CAH PR Computerized Ophthalmic Imaging Retina | $18.09 | $67.00 | $18.76–$67.00 | 74% below | 73% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 CAH Pet Imaging CT Attenuation Skull Base Mid-Thigh | $586.63 | $2,172.70 | $1,246.91–$797.82 | 84% below | 73% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US,Pelvic (Nonobstetric),Real Time,Limited | $242.72 | $898.96 | $106.34–$951.00 | 4% below | 73% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US,Pelvic (Nonobstetric),Real Time,Complete | $302.01 | $1,118.54 | $1,006.69–$98.30 | 17% below | 73% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 CAH US, OB >/= 14 Wks, Sngl Fetus | $58.16 | $215.42 | $123.63–$79.71 | 82% below | 73% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US Preg=>14wk Sng 1st Ges | $202.37 | $749.50 | $1,012.79–$98.30 | 37% below | 73% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 CAH US, OB < 14 Wks, Single Fetus | $50.57 | $187.28 | $107.48–$69.29 | 84% below | 73% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US Preg<14wk Sngl1st Gest | $192.51 | $713.00 | $1,049.40–$991.10 | 37% below | 73% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US Preg 1 or >Fetuses Ltd | $135.95 | $503.50 | $106.34–$758.00 | 56% below | 73% |
| Screening mammogram, both breasts both sides CPT 77067 CAH Chg Screening Mammography Bi 2-View Breast Inc Cad | $54.78 | $202.88 | $106.52–$94.37 | — | 73% |
| Screening mammogram, both breasts both sides CPT 77067 HC Scr Mammo Bi Incl Cad | $165.57 | $613.23 | $101.40–$97.97 | — | 73% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC Shoulder Comp, Min 2 Views | $127.21 | $471.13 | $111.59–$9.41 | 37% below | 73% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CAH PR Echo Tthrc R-T 2d W/WO M-Mode Rest&Strs Cont Ecg | $191.70 | $710.00 | $198.80–$710.00 | 83% below | 73% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 CAH PR Swallowing Fcn,W/Cine &/or Video | $54.19 | $200.71 | $115.19–$73.70 | 84% below | 73% |
| Transvaginal pelvic ultrasound CPT 76830 CAH PR Echography,Transvaginal | $51.34 | $190.15 | $109.13–$70.36 | 85% below | 73% |
| Transvaginal pelvic ultrasound CPT 76830 HC Ultrasound Pelvis,Transvaginal | $268.05 | $992.77 | $1,005.75–$992.77 | 23% below | 73% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC Transvaginal US, Obstetric | $167.87 | $621.73 | $106.34–$98.30 | 40% below | 73% |
| Ultrasound of the abdomen, complete CPT 76700 HC US, Abdom,B-Scan &/or Real Time,Complete | $425.03 | $1,574.20 | $106.34–$98.30 | at median | 73% |
| Ultrasound of the scrotum and testicles CPT 76870 HC Echo,Scrotum & Contents | $252.32 | $934.52 | $1,022.92–$98.30 | 28% below | 73% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, Head/Neck Tissues,Real Time | $214.05 | $792.77 | $1,053.30–$987.83 | 32% below | 73% |
| 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 | $317.59 | $1,176.27 | $1,005.75–$999.83 | 9% below | 73% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC Wrist, Comp, Min 3 Views | $113.06 | $418.74 | $111.59–$88.05 | 41% below | 73% |
| 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 | $165.89 | $614.42 | $111.59–$88.05 | 9% below | 73% |
| X-ray of the abdomen, 1 view CPT 74018 HC X-Ray Exam Abdomen 1 View | $112.73 | $417.52 | $10.10–$88.05 | 44% below | 73% |
| X-ray of the ankle, 2 views CPT 73600 HC Ankle Two Views | $104.78 | $388.08 | $10.10–$88.05 | 34% below | 73% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC Finger, Min 2 Views | $70.38 | $260.67 | $10.23–$99.20 | 55% below | 73% |
| X-ray of the foot, 2 views CPT 73620 HC Foot Two Views | $100.48 | $372.16 | $10.10–$88.05 | 40% below | 73% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC Foot Comp, Min 3 Views | $131.66 | $487.62 | $111.59–$88.05 | 27% below | 73% |
| X-ray of the hand, 3 or more views CPT 73130 HC Hand Two Views | $113.06 | $418.74 | $111.59–$88.05 | 44% below | 73% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC Knee 1 or 2 Views | $96.39 | $357.00 | $10.10–$99.96 | 47% below | 73% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Spine Lumbosacral 2 or 3 View | $145.02 | $537.11 | $106.34–$9.41 | 45% below | 73% |
| X-ray of the lower back, 4 or more views CPT 72110 HC Spine Lumbosacral 4+ Views | $232.60 | $861.47 | $106.34–$933.00 | 16% below | 73% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Spine Thoracic Two Views Her | $111.06 | $411.33 | $106.34–$9.41 | 45% below | 73% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC Nasal Bones 3+ Views | $110.16 | $408.00 | $111.59–$9.41 | 45% below | 73% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Spine Cervical 2-3 Vws | $129.17 | $478.41 | $111.59–$9.41 | 36% below | 73% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC Pelvis 1 or 2 View | $129.99 | $481.44 | $106.34–$7.84 | 41% below | 73% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Sacroiliac, Min 3 Views | $96.39 | $357.00 | $102.96–$99.96 | 52% below | 73% |
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 Allergen Specific Ige Each Allergen (Lfh) Lab700 | $7.83 | $29.00 | $16.69–$9.28 | 51% 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 CAH PR Surg Path,Level IV | $30.42 | $112.68 | $101.41–$95.78 | 83% below | 73% |
| 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% |
| 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 CAH PR Collection Venous Blood,Venipuncture Non-Mib | $5.94 | $22.00 | $12.63–$9.09 | 62% below | 73% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection Venous Blood Venipuncture | $7.00 | $13.99 | $11.09–$9.09 | 55% below | 50% |
| 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 inpatient CPT 36415 Collection Venous Blood Venipuncture | $7.00 | $13.99 | $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 CAH Assay of Lead | $5.63 | $20.84 | $11.96–$7.71 | 87% below | 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 Heavymetals Screen Ref | $7.86 | $29.10 | $12.11–$9.31 | 82% 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, 24 Hr Urine | $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 Heavy Metals Scrn, Occ Exp, Ru | $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 lead test CPT 83655 HC Lead,Venous, W/Demographics B 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% |
| 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 - 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 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 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 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% |
| 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% |
| 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 Panel(Cvp) | $90.19 | $334.02 | $100.07–$98.20 | 24% above | 73% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid REF | $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) | $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 | $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 | $13.15 | $48.70 | $10.91–$9.94 | 85% 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 Free | $22.75 | $84.25 | $14.94–$81.80 | 75% below | 73% |
| Free testosterone test CPT 84402 HC Testosterone, Total, Bio, 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 Infectious Agent Detection;Ng;Amp Pro | $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 N.Gonorr,Misc,Amplified Rna Ref | $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 antibody blood test CPT 86677 HC Helicobacter Pylori Ab | $37.05 | $137.24 | $10.95–$99.93 | 29% 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 | $23.48 | $86.97 | $104.84–$93.93 | 59% 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 CAH PR Glycosylated Hemoglobin Test | $23.07 | $85.46 | $23.93–$9.71 | 44% 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 | $59.57 | $220.62 | $10.10–$81.63 | at median | 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 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 Hsv Types 1 and 2 Ab Igg | $21.62 | $80.09 | $11.48–$80.09 | 45% 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-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 | $14.59 | $54.03 | $11.43–$8.71 | 69% 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 Iron | $30.34 | $112.37 | $10.16–$95.51 | 1% 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-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 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% |
| Lyme disease antibody test CPT 86618 HC Lyme Disease Serology, S Ref(Ticks) | $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 Antibody,Rubeola | $16.19 | $59.98 | $12.88–$58.23 | 64% 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 Specific Antigen Free Monitoring | $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 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, 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 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 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 Parathormone(Parathyroid Hormone) | $59.11 | $218.93 | $125.64–$92.88 | 56% below | 73% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC Parathyroid Hormone (Pth) | $59.11 | $218.93 | $125.64–$92.88 | 56% below | 73% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time Partial | $29.78 | $110.31 | $102.59–$99.28 | at median | 73% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Lupus Anticoagulant Profile | $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 Ref | $17.15 | $63.50 | $17.78–$57.15 | 76% 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 | $13.25 | $49.07 | $13.74–$8.89 | 30% below | 73% |
| Prothrombin time (PT/INR) clotting test CPT 85610 CAH Chg Prothrombin Time | $14.33 | $53.08 | $14.86–$8.89 | 24% below | 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 HC Prothrombin Time | $24.22 | $89.69 | $2.31–$89.69 | 28% above | 73% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time - Ref | $24.22 | $89.69 | $2.31–$89.69 | 28% above | 73% |
| 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 CAH Chg Iaadiadoo Streptococcus Group A | $11.15 | $41.29 | $11.56–$41.29 | 72% 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% |
| 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% |
| 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 Torch Profile,Igg,S | $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% |
| 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 | $24.52 | $90.80 | $10.72–$94.33 | 33% 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 Syphilis Test Qual (Rpr) | $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 Vdrl, CSF | $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 | $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 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 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 Thyrogl Ab W Thyroid Perox Ab | $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 Amplif(Female) 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 (Male) Ref | $50.10 | $185.56 | $106.49–$68.66 | 32% below | 73% |
| Trichomonas test (NAAT) CPT 87661 HC Trichomonas Vaginalis;Amp Probe | $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 with microscope exam, manual CPT 81000 HC Urinalysis,Non Auto W/Micro | $18.27 | $67.68 | $1.86–$9.00 | 69% above | 73% |
| Urinalysis without microscope exam, automated CPT 81003 CAH PR Urinalysis Auto W/O Micro | $8.60 | $31.85 | $10.19–$9.87 | 49% below | 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 CPT 81003 HC Urinalysis Auto W/O Micro | $18.37 | $68.05 | $1.32–$68.05 | 8% above | 73% |
| Urinalysis without microscope exam, manual CPT 81002 HC Urinalysis Non Auto W/O Micro | $9.21 | $34.10 | $1.50–$9.87 | 22% 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 CAH Chg Urine Pregnancy Test | $15.93 | $58.99 | $16.52–$8.61 | 49% below | 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 CPT 81025 HC POCT Perform Urine Pregnancy | $38.97 | $144.33 | $101.02–$99.57 | 25% above | 73% |
| 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 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 |
|---|---|---|---|---|---|
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 CAH PR Arthrodesis Ant Interbody Inc Discectomy, Cervical Below C2 | $1,620.00 | $6,000.00 | $1,680.00–$6,000.00 | 87% below | 73% |
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 CAH PR Appendectomy,Rupt Appendx+Abscess | $458.19 | $1,697.00 | $1,153.45–$976.79 | 41% below | 73% |
| Appendectomy, open surgery CPT 44950 CAH PR Appendectomy | $324.00 | $1,200.00 | $1,020.00–$960.00 | 80% below | 73% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 CAH PR Knee Scope,Aid Ant Cruciate Repair | $1,188.00 | $4,400.00 | $1,232.00–$4,400.00 | 77% below | 73% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 CAH PR Shldr Arthroscop,Surg,W/Rotat Cuff Repr | $543.51 | $2,013.00 | $1,155.26–$739.17 | 88% below | 73% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 CAH PR Nasal/Sinus Ndsc Surg W/Dilation Maxillary Sinus | $718.34 | $2,660.53 | $1,526.88–$976.95 | 91% below | 73% |
| Botox injections for chronic migraine CPT 64615 CAH PR Chemodervate Facial/Trigem/Cerv Musc Migraine | $70.20 | $260.00 | $149.21–$95.47 | 80% below | 73% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CAH PR Closed Rx Dist Fibula Fx | $139.59 | $517.00 | $144.76–$517.00 | 71% below | 73% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC Closed Treatment Metatarsal Fracture;W/O Manipulation Each | $81.37 | $301.36 | $1,001.70–$96.44 | 80% below | 73% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CAH PR Closed Rx Metatarsal Fx | $107.46 | $398.00 | $111.44–$398.00 | 73% below | 73% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CAH PR Corrj Hallux Valgus W/Sesmdc W/Dist Metar Osteot | $415.80 | $1,540.00 | $1,046.74–$886.42 | 89% below | 73% |
| Bunion correction with removal of part of the big toe joint CPT 28292 CAH PR Corrj Hallux Valgus W/Sesmdc W/Rescj Prox Phal | $347.22 | $1,286.00 | $1,010.41–$971.19 | 91% below | 73% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CAH PR Cardioversion Elective Arrhythmia External | $137.97 | $511.00 | $143.08–$511.00 | 86% below | 73% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion Ext | $959.74 | $3,554.59 | $1,025.14–$995.29 | 3% below | 73% |
| Carpal tunnel release, open surgery CPT 64721 CAH PR Revise Median N/Carpal Tunnel Surg | $324.00 | $1,200.00 | $1,020.00–$960.00 | 86% below | 73% |
| Cataract surgery with lens implant CPT 66984 CAH PR Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp | $810.00 | $3,000.00 | $1,008.00–$988.80 | 70% below | 73% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 CAH PR Full Rout Obste Care,Cesarean Deliv | $1,045.71 | $3,873.00 | $1,084.44–$3,873.00 | 57% below | 73% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CAH PR Circumcision W/Regional Block | $123.12 | $456.00 | $127.68–$456.00 | 86% below | 73% |
| Circumcision, surgical, older than a newborn CPT 54160 CAH PR Circumcision,Other,<28 D/O | $120.96 | $448.00 | $125.44–$448.00 | 87% below | 73% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Clsd Fx Colles' Smith Type | $92.34 | $341.99 | $100.55–$98.74 | 81% below | 73% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CAH PR Closed Rx Dist Rad/Ulna Fx | $173.34 | $642.00 | $179.76–$642.00 | 65% below | 73% |
| Colonoscopy with endoscopic ultrasound CPT 45391 CAH PR Colsc Flx W/Ndsc US Xm Rctm Et Al Lmtd&Adj Strux | $147.42 | $546.00 | $152.88–$546.00 | 89% below | 73% |
| Colonoscopy with polyp removal CPT 45385 CAH PR Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $297.00 | $1,100.00 | $1,100.00–$990.00 | 76% below | 73% |
| Colonoscopy with tissue sample CPT 45380 CAH PR Colonoscopy W/Biopsy Single/Multiple | $251.37 | $931.00 | $260.68–$931.00 | 77% below | 73% |
| Colonoscopy, diagnostic CPT 45378 CAH PR Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $223.83 | $829.00 | $232.12–$829.00 | 80% below | 73% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 CAH PR Colposcopy,Cervix W/Adj Vag,W/Loop Bx | $270.00 | $1,000.00 | $1,000.00–$900.00 | 93% below | 73% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 CAH PR Colposc,Cervix W/Adj Vag,W/Bx & Curretag | $74.25 | $275.00 | $100.05–$98.18 | 81% below | 73% |
| Complex cataract surgery with lens implant CPT 66982 CAH PR Xcapsl Ctrc Rmvl Insj Io Lens Prosth Cplx WO Ecp | $526.77 | $1,951.00 | $1,119.68–$716.41 | 80% below | 73% |
| Cystoscopy with ureteral stent placement CPT 52332 CAH PR Cystoscopy,Insert Ureteral Stent | $352.62 | $1,306.00 | $1,026.12–$986.29 | 91% below | 73% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CAH PR Cystourethroscopy | $95.31 | $353.00 | $101.81–$98.84 | 93% below | 73% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC Destroy Benign/Prem Lg Lesion | $21.08 | $78.09 | $168.78–$78.09 | 91% below | 73% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 CAH PR Destruc Premalignant, First Lesion | $35.37 | $131.00 | $102.93–$98.93 | 85% below | 73% |
| 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) with local anesthesia, one ear CPT 69433 CAH PR Create Eardrum Opening,Local Anesth | $89.10 | $330.00 | $102.30–$99.79 | 90% below | 73% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC Ear Irrigation. | $21.08 | $78.09 | $21.87–$925.06 | 79% 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 one side CPT 69209 HC Removal Impacted Cerumen Using Irrigation/Lavage,Unilateral | $18.36 | $68.00 | $18.60–$75.60 | 82% below | 73% |
| 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 | $100.69–$85.02 | 82% below | 73% |
| Earwax removal with instruments, one ear one side CPT 69210 CAH PR Removal Impacted Cerumen Instrumentation Unilat | $23.76 | $88.00 | $24.64–$88.00 | 81% 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 CAH PR Biopsy of Uterus Lining | $57.24 | $212.00 | $121.67–$78.44 | 87% below | 73% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 CAH PR Nasal/Sinus Ndsc W/Total Ethoidectomy | $499.50 | $1,850.00 | $1,061.72–$679.32 | 93% below | 73% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 CAH PR Nasal/Sinus Ndsc W/Rmvl Tiss From Frontal Sinus | $432.00 | $1,600.00 | $1,087.52–$920.96 | 94% below | 73% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 CAH PR Nasal Scopy,Open Maxill Sinus | $324.00 | $1,200.00 | $1,020.00–$960.00 | 93% below | 73% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 CAH PR Nasal Scopy,Rmv Tiss Maxill Sinus | $324.00 | $1,200.00 | $1,020.00–$960.00 | 96% below | 73% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CAH PR Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn | $144.99 | $537.00 | $150.36–$537.00 | 84% below | 73% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 CAH PR Inject Intravitreal Pharmcologic | $310.77 | $1,151.00 | $1,035.90–$978.35 | 57% below | 73% |
| Gallbladder removal, laparoscopic CPT 47562 CAH PR Lap,Cholecystectomy | $486.00 | $1,800.00 | $1,033.02–$660.96 | 76% below | 73% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 CAH PR Lap,Cholecystectomy/Graph | $702.00 | $2,600.00 | $1,492.14–$954.72 | 89% below | 73% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 CAH PR Removal Gallbladder | $594.00 | $2,200.00 | $1,262.58–$807.84 | 46% below | 73% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 CAH PR Hemorrhoidectomy Internal Rubber Band Ligations | $121.24 | $449.05 | $125.73–$449.05 | 89% below | 73% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 CAH PR Hemorrhoidectomy,Int/Ext,1 Column/Group | $268.92 | $996.00 | $278.88–$996.00 | 92% below | 73% |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 CAH PR Conv Prev Hip Surg to Tot Hip Arthroplas | $1,485.00 | $5,500.00 | $1,540.00–$5,500.00 | 48% below | 73% |
| Hysterectomy through an abdominal incision (total) CPT 58150 CAH PR Total Abdom Hysterectomy | $729.00 | $2,700.00 | $1,549.53–$991.44 | 65% below | 73% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CAH PR Cath/Inject Hysterosalpingogram | $204.12 | $756.00 | $211.68–$756.00 | 21% below | 73% |
| Hysteroscopy with endometrial ablation CPT 58563 CAH PR Hysteroscopy,W/Endometrial Ablation | $911.44 | $3,375.71 | $1,011.36–$992.46 | 84% below | 73% |
| IUD insertion (the device itself billed separately) CPT 58300 CAH PR Insert Intrauterine Device | $48.60 | $180.00 | $103.30–$66.10 | 80% below | 73% |
| Incision and drainage of a simple or single skin abscess CPT 10060 CAH PR Drain Skin Abscess Simple | $53.62 | $198.58 | $113.97–$73.47 | 85% below | 73% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D Abscess Simple | $65.41 | $242.26 | $139.03–$89.64 | 82% below | 73% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 CAH PR Repair Ing Hernia,5+Y/O,Reducibl | $324.00 | $1,200.00 | $1,020.00–$960.00 | 92% below | 73% |
| 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 | $122.68–$438.14 | 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 CAH PR Insertion Drug Delivery Implant | $52.92 | $196.00 | $112.48–$71.97 | 80% below | 73% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Introduction or Removal Intermediate Join or Bursa | $40.77 | $151.00 | $100.06–$94.50 | 88% below | 73% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthrocentesis,Aspiration & or Injection;Small Joint/Bursa | $137.70 | $510.00 | $105.77–$522.34 | 61% below | 73% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 CAH PR Knee Scope,Med or Lat Menis Repair | $715.50 | $2,650.00 | $1,520.84–$973.08 | 69% below | 73% |
| Knee arthroscopy with meniscus trim CPT 29881 CAH PR Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg | $666.90 | $2,470.00 | $1,417.53–$906.98 | 83% below | 73% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 CAH PR Arthrs Knee W/Meniscectomy Med&Lat W/Shaving | $727.65 | $2,695.00 | $1,546.66–$989.60 | 58% below | 73% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 CAH PR Knee Scope,Shave Articular Cart | $598.86 | $2,218.00 | $1,272.91–$814.45 | 63% below | 73% |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 CAH PR Lap Gastric Bypass/Roux-en-Y | $855.63 | $3,169.00 | $1,014.08–$982.39 | 75% below | 73% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 CAH PR Lap,Esophagogast Fundoplasty | $675.00 | $2,500.00 | $1,434.75–$918.00 | 79% below | 73% |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 CAH PR Laparoscopy W Tot Hysterect Uterus 250 Gram or Less | $473.31 | $1,753.00 | $1,006.05–$643.70 | 91% below | 73% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 CAH PR Laparoscopy W Tot Hysterectuterus <=250 Gram W Tube/Ovary | $524.07 | $1,941.00 | $1,113.94–$712.74 | 91% below | 73% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 CAH PR Lap,Inguinal Hernia Repr,Initial | $328.59 | $1,217.00 | $1,034.45–$973.60 | 75% below | 73% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 CAH PR Lap,Inguinal Hernia Repr,Recur | $272.43 | $1,009.00 | $1,009.00–$908.10 | 96% below | 73% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 CAH PR Lap,Rmv Adnexal Structure | $594.00 | $2,200.00 | $1,262.58–$807.84 | 79% below | 73% |
| Laparoscopic sleeve gastrectomy for weight loss CPT 43775 CAH PR Lap, Gast Restrict Proc, Longitudinal Gastrectomy | $618.03 | $2,289.00 | $1,313.66–$840.52 | 84% below | 73% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 CAH PR Discission,2nd Cataract,Laser | $297.00 | $1,100.00 | $1,100.00–$990.00 | 54% below | 73% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 CAH PR Layr Clos Wnd Trunk,Arm,Leg <2.5 Cm | $112.54 | $416.82 | $116.71–$416.82 | 80% below | 73% |
| 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% |
| Lower-back epidural injection, with imaging guidance CPT 62323 CAH PR Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $156.72 | $580.43 | $162.52–$580.43 | 89% below | 73% |
| Lower-back epidural injection, without imaging guidance CPT 62322 CAH PR Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $136.89 | $507.00 | $141.96–$507.00 | 88% below | 73% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CAH PR Inject Anes/Steroid Foramen Lumbar/Sacral W Img Guide ,1 Level | $157.41 | $583.00 | $163.24–$583.00 | 88% below | 73% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 CAH PR Lamnotmy Incl W/Dcmprsn Nrv Root 1 Intrspc Lumbr | $891.00 | $3,300.00 | $1,023.00–$997.92 | 89% below | 73% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 CAH Laminec/Facetect/Foramin,Lumbar 1 Seg | $1,039.50 | $3,850.00 | $1,078.00–$3,850.00 | 88% below | 73% |
| Lumbar spinal fusion (posterior), one level CPT 22612 CAH PR Arthrodesis Posterior/Pstlat Tq 1ntrspc Lumbar | $1,346.49 | $4,987.00 | $1,396.36–$4,987.00 | 76% below | 73% |
| Lumpectomy (partial mastectomy) CPT 19301 CAH PR Mastectomy, Partial | $324.00 | $1,200.00 | $1,020.00–$960.00 | 79% below | 73% |
| Mastectomy (total removal of the breast) CPT 19303 CAH PR Mastectomy, Simple, Complete | $488.16 | $1,808.00 | $1,037.61–$663.90 | 78% below | 73% |
| Miscarriage treatment with D&C, first trimester CPT 59820 CAH PR Surg Rx Missed Abortn,1st Tri | $270.00 | $1,000.00 | $1,000.00–$900.00 | 93% below | 73% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 CAH PR Mohs, 1 Stage, Head/Neck/Hand/Feet/Gential | $304.02 | $1,126.00 | $1,013.40–$957.10 | 65% below | 73% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 CAH PR Exc Skin Benig <5mm Trunk,Arm,Leg | $54.66 | $202.44 | $116.18–$74.34 | 94% below | 73% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 CAH PR Exc Skin Benig <5mm Face,Facial | $67.50 | $250.00 | $143.48–$91.80 | 93% below | 73% |
| Nail removal (partial or complete), one nail CPT 11730 CAH PR Removal of Nail Plate | $49.18 | $182.15 | $104.54–$67.40 | 83% below | 73% |
| Nail removal (partial or complete), one nail CPT 11730 HC Avulsion of Nail | $58.32 | $216.00 | $1,126.19–$925.06 | 79% 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 CAH PR Injection Aa&/Strd Greater Occipital Nerve | $53.46 | $198.00 | $113.63–$72.71 | 86% below | 73% |
| Paracentesis with imaging guidance CPT 49083 CAH PR Abdom Paracentesis Dx/Ther W Imaging Guidance | $166.86 | $618.00 | $173.04–$618.00 | 87% below | 73% |
| Partial knee replacement (one compartment) CPT 27446 CAH PR Plasty Knee,Med or Lat Compartmt | $815.94 | $3,022.00 | $1,015.39–$996.05 | 91% below | 73% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 CAH PR Removal of Nail Bed | $96.93 | $359.00 | $100.52–$359.00 | 83% below | 73% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Excision Nail/Matrix | $171.36 | $634.67 | $101.44–$99.50 | 70% 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 removal (prostatectomy), laparoscopic CPT 55866 CAH PR Lap,Prostatectomy,Radical,W/Nerve Spare,Incl Robotic | $928.80 | $3,440.00 | $1,011.36–$992.10 | 92% below | 73% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 CAH PR Dstr Nrolytc Agnt Parverteb Fct Sngl Lmbr/Sacral | $239.49 | $887.00 | $248.36–$887.00 | 90% below | 73% |
| Removal of a breast lump, open surgery CPT 19120 CAH PR Removal of Breast Lesion | $280.11 | $1,037.44 | $1,037.44–$933.70 | 93% below | 73% |
| Removal of a foreign object under the skin, simple CPT 10120 CAH PR Remove Foreign Body Simple | $64.48 | $238.82 | $137.06–$87.69 | 88% below | 73% |
| Removal of a foreign object under the skin, simple CPT 10120 HC FB Rem Simple | $241.60 | $894.83 | $250.55–$894.83 | 56% below | 73% |
| Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 CAH PR Thyroid Lobectomy,Unilat | $571.86 | $2,118.00 | $1,215.52–$777.73 | 92% below | 73% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 CAH PR Colon Ca Scrn Not Hi Rsk Ind | $223.83 | $829.00 | $232.12–$829.00 | 79% below | 73% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 CAH PR Colorectal Scrn; Hi Risk Ind | $223.83 | $829.00 | $232.12–$829.00 | 79% below | 73% |
| Septoplasty to straighten the nasal septum CPT 30520 CAH PR Repair of Nasal Septum | $430.65 | $1,595.00 | $1,084.12–$918.08 | 89% below | 73% |
| Short arm cast (elbow to hand) CPT 29075 CAH PR Apply Forearm Cast | $40.23 | $149.00 | $101.28–$85.76 | 87% below | 73% |
| Short arm cast (elbow to hand) CPT 29075 HC Cast App Forearem | $85.81 | $317.82 | $101.70–$98.52 | 73% below | 73% |
| Short arm splint (forearm and hand) CPT 29125 CAH PR Apply Forearm Splint,Static | $29.43 | $109.00 | $109.00–$98.10 | 84% below | 73% |
| Short arm splint (forearm and hand) CPT 29125 HC Application Short Arm Static | $84.82 | $314.15 | $100.53–$97.39 | 54% below | 73% |
| Short leg cast (below the knee) CPT 29405 CAH PR Apply Short Leg Cast | $42.93 | $159.00 | $108.07–$91.52 | 87% below | 73% |
| Short leg cast (below the knee) CPT 29405 HC Cast App Short Leg-Knee-Toe | $70.20 | $260.00 | $105.70–$93.26 | 79% below | 73% |
| Short leg splint (calf to foot) CPT 29515 CAH PR Apply Lower Leg Splint | $31.59 | $117.00 | $105.30–$99.45 | 84% below | 73% |
| Short leg splint (calf to foot) CPT 29515 HC Application Short Leg Splint | $57.34 | $212.37 | $121.88–$77.98 | 70% below | 73% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 CAH PR Shldr Arthroscop,Surg,Dis Claviculectomy | $338.31 | $1,253.00 | $1,002.40–$984.48 | 80% below | 73% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 CAH PR Shoulder Scope Bone Shaving | $653.40 | $2,420.00 | $1,388.84–$888.62 | 54% below | 73% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 CAH PR Repr Superf Wnd Body <2.5cm | $66.42 | $246.00 | $141.18–$90.33 | 77% below | 73% |
| 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 | $148.08–$528.86 | 50% below | 73% |
| Skin biopsy, punch, one lesion CPT 11104 CAH PR Punch Biopsy Skin Single Lesion | $65.07 | $241.00 | $138.31–$89.17 | 89% below | 73% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 CAH PR Exc Skin Malig <5mm Trunk,Arm,Leg | $84.40 | $312.58 | $100.03–$96.90 | 90% below | 73% |
| Skin tag removal, up to 15 tags CPT 11200 CAH PR Removal of Skin Tags, Up to 15 | $39.69 | $147.00 | $102.89–$99.92 | 86% below | 73% |
| 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% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 CAH PR Repr Sup Npterf Wnd Body 2.6-7.5 | $70.74 | $262.00 | $150.36–$96.21 | 80% below | 73% |
| 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 | $159.54 | $590.90 | $1,126.19–$925.06 | 54% below | 73% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 CAH PR Repr Superf Wnd Face <2.5cm | $70.74 | $262.00 | $150.36–$96.21 | 77% below | 73% |
| 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 | $170.82 | $632.67 | $168.58–$632.67 | 44% below | 73% |
| TURP (transurethral resection of the prostate) CPT 52601 CAH PR Transurethral Elec-Surg Prostatectom | $496.80 | $1,840.00 | $1,055.98–$675.65 | 92% below | 73% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 CAH PR Tangential Biopsy Skin Single Lesion | $51.84 | $192.00 | $110.19–$70.50 | 89% below | 73% |
| Thoracentesis with imaging guidance CPT 32555 CAH PR Thoracentesis Needle/Cath Pleura W/Imaging | $310.50 | $1,150.00 | $1,035.00–$977.50 | 75% below | 73% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 CAH PR Removal of Tonsils,12+ Y/O | $207.90 | $770.00 | $215.60–$770.00 | 95% below | 73% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 CAH Removal of Tonsils,<12 Y/O | $208.44 | $772.00 | $216.16–$772.00 | 97% below | 73% |
| Total hip replacement CPT 27130 CAH PR Total Hip Arthroplasty | $1,485.00 | $5,500.00 | $1,540.00–$5,500.00 | 63% below | 73% |
| Total knee replacement CPT 27447 CAH PR Total Knee Arthroplasty | $1,296.00 | $4,800.00 | $1,344.00–$4,800.00 | 91% below | 73% |
| Total shoulder replacement CPT 23472 CAH PR Reconstr Total Shoulder Implant | $1,177.20 | $4,360.00 | $1,220.80–$4,360.00 | 73% below | 73% |
| Total thyroid removal (thyroidectomy) CPT 60240 CAH PR Thyroidectomy | $660.42 | $2,446.00 | $1,403.76–$898.17 | 88% below | 73% |
| Trigger finger release surgery CPT 26055 CAH PR Incise Finger Tendon Sheath | $281.61 | $1,043.00 | $1,043.00–$938.70 | 85% below | 73% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Injection(S);Single or Mult Trigger Point(S),1 or 2 Muscles | $37.35 | $138.33 | $110.66–$84.02 | 89% below | 73% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 CAH PR Lap,Tubal Cautery | $378.00 | $1,400.00 | $1,050.00–$982.10 | 91% below | 73% |
| Upper endoscopy (EGD) with biopsy CPT 43239 CAH PR Egd Transoral Biopsy Single/Multiple | $206.28 | $764.00 | $213.92–$764.00 | 82% below | 73% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 CAH PR Esophagogastroduodenoscopy Submucosal Injection | $171.53 | $635.29 | $177.88–$635.29 | 85% below | 73% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 CAH PR Egd Removal Tumor Polyp/Other Lesion Snare Tech | $229.50 | $850.00 | $238.00–$850.00 | 90% below | 73% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 CAH PR Egd Insert Guide Wire Dilator Passage Esophagus | $176.60 | $654.06 | $183.14–$654.06 | 84% below | 73% |
| Upper endoscopy (EGD), diagnostic CPT 43235 CAH PR Esophagogastroduodenoscopy Transoral Diagnostic | $169.29 | $627.00 | $175.56–$627.00 | 85% below | 73% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 CAH PR Rout OB Care,Vag Deliv,Prev C-Sec | $988.47 | $3,661.00 | $1,025.08–$3,661.00 | 70% below | 73% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 CAH PR Full Rout Obste Care,Vaginal Deliv | $940.41 | $3,483.00 | $1,004.50–$975.24 | 70% below | 73% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 CAH PR Removal of Sperm Duct(S) | $238.68 | $884.00 | $247.52–$884.00 | 89% below | 73% |
| Vein ablation, radiofrequency, first vein CPT 36475 CAH PR Endovenous Rf, 1st Vein | $1,120.77 | $4,151.00 | $1,162.28–$4,151.00 | 70% below | 73% |
| Wart removal, up to 14 warts CPT 17110 HC Dest Benign/Pm Les;1st | $25.93 | $96.04 | $104.00–$98.18 | 89% below | 73% |
| Wart removal, up to 14 warts CPT 17110 CAH PR Destruction Benign Lesions Up to 14 | $49.41 | $183.00 | $105.02–$67.71 | 79% below | 73% |
| 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 CAH PR Debridement, Skin, Sub-Q Tissue,=<20 Sq Cm | $54.88 | $203.27 | $116.66–$75.21 | 92% below | 73% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride Skin Tissue | $206.34 | $764.24 | $1,126.19–$925.06 | 71% below | 73% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 CAH PR Open Rx Distal Radius Fx, Extra-Articular | $432.00 | $1,600.00 | $1,087.52–$920.96 | 81% below | 73% |
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 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 | $169.37 | $627.30 | $175.64–$758.00 | 71% below | 73% |
| Comprehensive eye exam by an eye doctor, new patient CPT 92004 CAH PR Eye Exam, New Patient,Comprehesv | $62.10 | $230.00 | $132.00–$84.46 | 73% below | 73% |
| Comprehensive eye exam, returning patient CPT 92014 CAH PR Eye Exam, Est Patient,Comprehesv | $56.97 | $211.00 | $121.09–$77.48 | 73% below | 73% |
| Critical care, first 30 to 74 minutes CPT 99291 HC Trauma Critical Care Emergency Room First 30-74 Minutes | $543.78 | $2,014.00 | $1,067.91–$925.06 | 65% 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% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 CAH PR Eeg,W/Awake & Drowsy Record | $162.15 | $600.55 | $168.15–$600.55 | 70% below | 73% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake & Drowsy | $175.50 | $650.00 | $182.00–$870.61 | 68% 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 | $87.96 | $325.77 | $100.99–$98.51 | 39% below | 73% |
| 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 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 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 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% |
| 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 | $337.50 | $1,250.00 | $1,000.00–$944.00 | 42% below | 73% |
| Eye exam, returning patient, intermediate CPT 92012 CAH PR Eye Exam Established Pt | $36.72 | $136.00 | $102.00–$95.40 | 81% below | 73% |
| Family therapy with the patient, 50 minutes CPT 90847 CAH PR Family Psychotherapy W/Patient Present 50 Mins | $48.60 | $180.00 | $103.30–$66.10 | 81% below | 73% |
| Family therapy without the patient, 50 minutes CPT 90846 CAH PR Family Psychotherapy W/O Patient Present 50 Mins | $41.33 | $153.08 | $104.05–$88.11 | 84% below | 73% |
| 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 CAH PR Injection,Therap/Proph/Diagnost, Im or Subcut | $22.28 | $82.50 | $23.10–$82.50 | 74% below | 73% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection,Therap/Proph/Diagnost, Im or Subcut | $22.82 | $45.64 | $10.41–$93.50 | 73% below | 50% |
| 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 inpatient CPT 96372 Injection,Therap/Proph/Diagnost, Im or Subcut | $22.82 | $45.64 | $11.40–$82.50 | — | 50% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 CAH PR Psychiatric Diagnostic Evaluation | $63.72 | $236.00 | $135.44–$86.66 | 71% below | 73% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 CAH PR Motor &/Sens 7-8 Nrv Cndj Preconf Eltrode Limb | $74.89 | $277.38 | $100.91–$99.02 | 83% below | 73% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Neuromuscular Re-Education Each 15 Min | $39.69 | $147.00 | $100.13–$99.92 | 53% below | 73% |
| New patient office visit, about 30 minutes CPT 99203 CAH PR Office/Outpatient New Low Mdm 30-44 Minutes | $48.60 | $180.00 | $103.30–$66.60 | 75% 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 CAH PR Office/Outpatient New Moderate Mdm 45-59 Minutes | $73.44 | $272.00 | $100.64–$99.88 | 74% below | 73% |
| 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 CAH PR Office/Outpatient New High Mdm 60-74 Minutes | $92.34 | $342.00 | $100.55–$98.63 | 67% below | 73% |
| 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 CAH PR Office/Outpatient New Sf Mdm 15-29 Minutes | $34.02 | $126.00 | $100.80–$99.00 | 78% below | 73% |
| 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 | $15.17 | $56.18 | $11.51–$88.31 | 73% below | 73% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 CAH PR Med Nutr Ther, 1st, Indiv, Ea 15 Min | $15.93 | $59.00 | $16.52–$59.00 | 72% below | 73% |
| Occupational therapy evaluation, low complexity CPT 97165 HC Occupational Therapy Eval Low Complex | $68.04 | $252.00 | $100.20–$97.28 | 60% below | 73% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Physical Therapy Eval High Complexity | $82.08 | $304.00 | $101.46–$99.62 | 71% 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 | $43.47 | $161.00 | $100.07–$92.67 | 48% below | 73% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Therapeutic Exercises Each 15 Min | $34.29 | $127.00 | $10.49–$99.90 | 58% below | 73% |
| Preventive checkup, new patient aged 18–39 CPT 99385 CAH PR Preventive Visit,New,18-39 | $23.22 | $86.00 | $24.08–$86.00 | 88% below | 73% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC Clinic Use Fee New 18-39 | $74.57 | $276.17 | $100.85–$97.99 | 63% 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 CAH PR Preventive Visit,New,40-64 | $29.97 | $111.00 | $111.00–$99.90 | 86% below | 73% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC Clinic Use Fee New 40-64 | $74.57 | $276.17 | $100.85–$98.36 | 64% 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 CAH PR Preventive Visit,New,65 & Over | $78.84 | $292.00 | $100.27–$99.98 | 68% 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 CAH PR Preventive Visit,Est,18-39 | $56.70 | $210.00 | $120.52–$77.70 | 69% 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 CAH PR Preventive Visit,Est,40-64 | $60.48 | $224.00 | $128.55–$82.88 | 69% 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 CAH PR Preventive Visit,Est,65 & Over | $23.49 | $87.00 | $24.36–$87.00 | 88% below | 73% |
| 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 CAH PR Psychiatric Diagnostic Eval W/Medical Services | $67.77 | $251.00 | $144.05–$92.17 | 76% below | 73% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 CAH PR Psychological Tst Eval Svc Phys/Qhp First Hour | $59.40 | $220.00 | $126.26–$80.78 | 83% below | 73% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 CAH PR Psychotherapy for Crisis Initial 60 Minutes | $81.00 | $300.00 | $100.80–$98.88 | 66% below | 73% |
| Psychotherapy session, 30 minutes CPT 90832 CAH PR Psychotherapy W/Patient 30 Minutes | $28.08 | $104.00 | $104.00–$93.60 | 86% below | 73% |
| Psychotherapy session, 45 minutes CPT 90834 CAH PR Psychotherapy W/Patient 45 Minutes | $41.04 | $152.00 | $103.31–$87.49 | 84% below | 73% |
| Psychotherapy session, 60 minutes CPT 90837 CAH PR Psychotherapy W/Patient 60 Minutes | $60.75 | $225.00 | $129.13–$82.62 | 79% below | 73% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 CAH PR Tobacco Use Cessation Intermediate 3-10 Minutes | $7.79 | $28.87 | $10.11–$9.98 | 82% below | 73% |
| 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 CAH PR Office/Outpatient Established High Mdm 40-54 Min | $74.79 | $277.00 | $100.77–$98.89 | 68% below | 73% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Office O/P Est Vst High 40 Min | $94.81 | $351.16 | $101.27–$98.32 | 60% 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 CAH PR Office/Outpatient Established Low Mdm 20-29 Min | $37.80 | $140.00 | $105.00–$98.21 | 78% 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 CAH PR Office/Outpatient Established Mod Mdm 30-39 Min | $54.00 | $200.00 | $114.78–$74.00 | 72% below | 73% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Office O/P Est Visit Mod 30min | $62.87 | $232.86 | $100.84–$99.74 | 67% 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 CAH PR Office/Outpatient Established Sf Mdm 10-19 Min | $23.22 | $86.00 | $24.08–$86.00 | 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% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC Office Consult- Mod-High Sev | $21.68 | $80.30 | $22.48–$80.30 | 93% below | 73% |
| Speech and language evaluation CPT 92523 CAH PR Eval Speech Sound Product Language Comprehension | $99.09 | $367.00 | $102.76–$367.00 | 75% below | 73% |
| 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 | $74.25 | $275.00 | $100.05–$98.18 | 59% below | 73% |
| Spirometry (breathing test) CPT 94010 HC Nif Fvc Pf Peak Follow Up | $62.10 | $230.00 | $117.77–$85.10 | 73% below | 73% |
| Spirometry (breathing test) CPT 94010 HC Peak Flow Test | $62.10 | $230.00 | $117.77–$85.10 | 73% below | 73% |
| Spirometry (breathing test) CPT 94010 HC Resp Mechanics | $65.21 | $241.50 | $117.77–$89.36 | 72% 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 (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 | $45.90 | $170.00 | $119.84–$97.85 | 78% below | 73% |
| Visual field test, extended CPT 92083 CAH PR Visual Field Exam,Extended | $26.57 | $98.42 | $27.56–$98.42 | 92% below | 73% |
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% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID VACC 2025-26 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE | $154.71 | $573.00 | $114.60–$773.55 | 28% below | 73% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC Varicella Virus Vaccine Live (Pf) 1,350 Unit/0.5 Ml Subcutaneous Susp [14757] | $89.91 | $333.00 | $100.70–$99.77 | 57% below | 73% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Var Vaccine Live for Subcutaneous Use | $144.13 | $288.25 | $201.78–$342.99 | 32% below | 50% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Var Vaccine Live for Subcutaneous Use | $144.13 | $288.25 | $201.78–$342.99 | — | 50% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC Flu Vacc Spl V Pf>=3yr Im | $4.86 | $18.00 | $10.00–$9.81 | 84% 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 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] | $142.83 | $529.00 | $140.28–$70.14 | 75% below | 73% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9vhpv Vacc 2/3 Dose Sched Im Use | $272.44 | $544.87 | $370.30–$544.87 | 52% below | 50% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 9vhpv Vacc 2/3 Dose Sched Im Use | $272.44 | $544.87 | $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 | $76.37 | $152.73 | $105.70–$155.53 | 26% below | 50% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepa Vaccine Adult Dose for Intramuscular Use | $76.37 | $152.73 | $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 Virus Vaccine Recomb (Pf) 20 Mcg/Ml Intramuscular Susp [111321] | $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 Hepb Vaccine Adult 3 Dose Schedule for Im Use | $51.93 | $103.85 | $103.85–$88.27 | 36% below | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepb Vaccine Adult 3 Dose Schedule for Im Use | $51.93 | $103.85 | $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 Measles Mumps Rubella Virus Vaccine Live Subq | $41.25 | $82.50 | $125.30–$82.50 | 62% below | 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] | $48.33 | $179.00 | $102.73–$96.67 | 56% 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 | $66.69 | $247.00 | $141.66–$91.39 | 39% below | 73% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Measles Mumps Rubella Virus Vaccine Live Subq | $41.25 | $82.50 | $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 | $154.50 | $309.00 | $216.30–$327.54 | 21% below | 50% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menacwyd/Menacwy-CRM Conj Vacc Grps Acwy Im Use | $154.50 | $309.00 | $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] | $90.45 | $335.00 | $100.37–$98.49 | 73% below | 73% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Menb-4c Recombnt Prot & Outer Memb Vesic Vacc Im | $172.53 | $345.05 | $234.50–$345.05 | 48% below | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Menb-4c Recombnt Prot & Outer Memb Vesic Vacc Im | $172.53 | $345.05 | $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] | $65.34 | $242.00 | $108.27–$88.86 | 54% below | 73% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Ppsv23 Vaccine 2 Yrs or Older for Subq/Im Use | $110.07 | $220.13 | $133.47–$220.13 | 22% below | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Ppsv23 Vaccine 2 Yrs or Older for Subq/Im Use | $110.07 | $220.13 | $154.09–$220.13 | — | 50% |
| 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] | $222.48 | $824.00 | $230.72–$854.00 | 54% below | 73% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC Shingrix | $105.05 | $389.06 | $108.94–$82.10 | 62% below | 73% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Hzv Zoster Vacc Recombinant Adjuvanted Im Use | $195.00 | $390.00 | $331.50–$390.00 | 29% below | 50% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Hzv Zoster Vacc Recombinant Adjuvanted Im Use | $195.00 | $390.00 | $331.50–$390.00 | — | 50% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Td Vaccine Prsrv Free 7 Yrs or Older for Im Use | $21.23 | $42.45 | $29.72–$82.40 | 62% below | 50% |
| 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] | $21.60 | $80.00 | $22.40–$82.00 | 61% below | 73% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Td Vaccine Prsrv Free 7 Yrs or Older for Im Use | $21.23 | $42.45 | $29.72–$82.40 | — | 50% |
| 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] | $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(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,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 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 Tdap Vaccine 7 Yrs/> Im | $45.75 | $91.50 | $64.05–$94.76 | 19% below | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap Vaccine 7 Yrs/> Im | $45.75 | $91.50 | $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] | $67.23 | $249.00 | $126.04–$91.43 | 75% below | 73% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $113.13 | $419.00 | $117.32–$419.00 | 58% 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 HC Pneumonia Vaccine Adm | $19.76 | $73.19 | $20.49–$74.55 | 73% below | 73% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Flu Vaccine Adm | $19.76 | $73.19 | $12.09–$73.19 | 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 Immunization Administration- Pneumococcal Vaccine | $3.98 | $14.74 | $1.24–$8.48 | 88% 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 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 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% |