Geneva General Hospital
Geneva General Hospital in Geneva, NY publishes cash prices for 271 common procedures listed here, from its own machine-readable price file updated Aug 27, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the New York median for 261 of 269 procedures and above it for 6. By typical cash price it ranks #8 of 93 New York hospitals and #1 of 9 hospitals in the Rochester, NY area, cheapest first. Click a procedure to compare it with other hospitals nearby.
196 -198 North Street, Geneva, NY 14456 Collected Sep 27, 2026 Source price file (315) 787-4175
Acute care hospital Emergency department CMS star rating 2 of 5 CCN 330058 · 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 4 actions for a hospital named Geneva General Hospital in Geneva, NY:
- Feb 20, 2025 Warning notice
- Mar 12, 2025 Case closed
- Apr 15, 2026 Warning notice
- Jul 17, 2026 Case closed
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.
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 ANKLE 3 VIEWS | $125.04 | $312.58 | $99.94–$265.69 | 37% below | 60% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE 3 VIEWS | $125.04 | $312.58 | — | — | 60% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPPER/LOW EXT ART, SINGLE | $138.20 | $345.48 | $152.80–$366.61 | 49% below | 60% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPPER/LOW EXT ART, SINGLE | $138.20 | $345.48 | — | — | 60% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 SINGLE CONTRAST ESOPHOGRAM | $252.80 | $631.99 | $201.43–$537.19 | 25% below | 60% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 SINGLE CONTRAST ESOPHOGRAM | $252.80 | $631.99 | — | — | 60% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN | $570.62 | $1,426.53 | $459.11–$1,212.55 | 33% below | 60% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE SCAN | $570.62 | $1,426.53 | — | — | 60% |
| Breast ultrasound, complete, one breast CPT 76641 BREAST SCAN COMPLETE | $151.01 | $377.52 | $120.06–$320.89 | 52% below | 60% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 BREAST SCAN COMPLETE | $151.01 | $377.52 | — | — | 60% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED | $117.50 | $293.73 | $99.94–$249.67 | 47% below | 60% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 BREAST SCAN LIMITED | $125.04 | $312.58 | $99.94–$265.69 | 44% below | 60% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST LIMITED | $117.50 | $293.73 | — | — | 60% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 BREAST SCAN LIMITED | $125.04 | $312.58 | — | — | 60% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST | $252.80 | $631.99 | $201.43–$537.19 | 78% below | 60% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST | $252.80 | $631.99 | — | — | 60% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CALCIUM SCORING | $117.50 | $293.73 | $99.94–$249.67 | 27% below | 60% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CALCIUM SCORING | $117.50 | $293.73 | — | — | 60% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS UNENHANCED | $343.26 | $858.13 | $274.02–$729.41 | 67% below | 60% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS UNENHANCED | $343.26 | $858.13 | — | — | 60% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS ENHANCED | $626.13 | $1,565.31 | $400.65–$1,330.51 | 60% below | 60% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS ENHANCED | $626.13 | $1,565.31 | — | — | 60% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS COMBO | $507.14 | $1,267.84 | $400.65–$1,077.66 | 69% below | 60% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS COMBO | $507.14 | $1,267.84 | — | — | 60% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN ENHANCED | $252.80 | $631.99 | $201.43–$537.19 | 75% below | 60% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN ENHANCED | $252.80 | $631.99 | — | — | 60% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN UNENHANCED | $151.01 | $377.52 | $120.06–$320.89 | 81% below | 60% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN UNENHANCED | $151.01 | $377.52 | — | — | 60% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLO FACIAL UNENHANCED | $151.01 | $377.52 | $120.06–$320.89 | 78% below | 60% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLO FACIAL UNENHANCED | $151.01 | $377.52 | — | — | 60% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN UNENHANCED | $151.01 | $377.52 | $120.06–$320.89 | 78% below | 60% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN UNENHANCED | $151.01 | $377.52 | — | — | 60% |
| CT scan of the head with contrast CPT 70460 CT BRAIN ENHANCED | $252.80 | $631.99 | $201.43–$537.19 | 71% below | 60% |
| CT scan of the head with contrast inpatient CPT 70460 CT BRAIN ENHANCED | $252.80 | $631.99 | — | — | 60% |
| CT scan of the head without and with contrast CPT 70470 CT BRAIN COMBINED | $212.07 | $530.16 | $201.43–$483.31 | 80% below | 60% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN COMBINED | $212.07 | $530.16 | — | — | 60% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LS SPINE UNENHANCED | $151.01 | $377.52 | $120.06–$320.89 | 82% below | 60% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LS SPINE UNENHANCED | $151.01 | $377.52 | — | — | 60% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE UNENHANCED | $151.01 | $377.52 | $120.06–$320.89 | 82% below | 60% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE UNENHANCED | $151.01 | $377.52 | — | — | 60% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS ENHANCED | $252.80 | $631.99 | $201.43–$537.19 | 72% below | 60% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS ENHANCED | $252.80 | $631.99 | — | — | 60% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID IMAGE DUPLEX | $274.62 | $686.53 | $274.02–$657.46 | 50% below | 60% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID IMAGE/DUPLEX | $343.26 | $858.13 | $274.02–$729.41 | 37% below | 60% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID IMAGE DUPLEX | $274.62 | $686.53 | — | — | 60% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID IMAGE/DUPLEX | $343.26 | $858.13 | — | — | 60% |
| Chest X-ray, 2 views CPT 71046 CHEST TWO VIEWS | $103.90 | $259.74 | $99.94–$239.79 | 49% below | 60% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST TWO VIEWS | $103.90 | $259.74 | — | — | 60% |
| Chest X-ray, single view CPT 71045 CHEST X-RAY, 1 VIEW FRONTAL | $125.04 | $312.58 | $99.94–$265.69 | 33% below | 60% |
| Chest X-ray, single view inpatient CPT 71045 CHEST X-RAY, 1 VIEW FRONTAL | $125.04 | $312.58 | — | — | 60% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RENAL SCAN | $133.43 | $333.57 | $120.06–$288.07 | 63% below | 60% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RETRER PER US COMPLT RMAL:AR | $151.01 | $377.52 | $120.06–$320.89 | 58% below | 60% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 RENAL SCAN | $133.43 | $333.57 | — | — | 60% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 RETRER PER US COMPLT RMAL:AR | $151.01 | $377.52 | — | — | 60% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA BONE DENSITY STUDY | $151.01 | $377.52 | $120.06–$320.89 | 37% below | 60% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA BONE DENSITY STUDY | $151.01 | $377.52 | — | — | 60% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY/PERIPHERAL | $99.14 | $247.83 | $99.94–$239.79 | 31% below | 60% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY/PERIPHERAL | $99.14 | $247.83 | — | — | 60% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX UNENHANCED | $151.01 | $377.52 | $120.06–$320.89 | 81% below | 60% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX UNENHANCED | $151.01 | $377.52 | — | — | 60% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX ENHANCED | $252.80 | $631.99 | $201.43–$537.19 | 76% below | 60% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX ENHANCED | $252.80 | $631.99 | — | — | 60% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAPHY BILATERAL-SSMH | $137.63 | $344.07 | $138.10–$331.36 | — | 60% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAPHY BILATERAL | $137.63 | $344.07 | $138.10–$331.36 | — | 60% |
| Diagnostic mammogram, both breasts CPT 77066 MAMMOGRAM BILATRAL MODIFIER GH | $137.63 | $344.07 | $138.10–$331.36 | 42% below | 60% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMOGRAPHY BILATERAL-SSMH | $137.63 | $344.07 | — | — | 60% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMOGRAPHY BILATERAL | $137.63 | $344.07 | — | — | 60% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMOGRAM BILATRAL MODIFIER GH | $137.63 | $344.07 | — | — | 60% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAPHY UNILATERAL | $107.93 | $269.82 | $109.06–$261.68 | 59% below | 60% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAPHY UNILATERAL-SSMH | $107.93 | $269.82 | $109.06–$261.68 | 59% below | 60% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAPHY UNILATERAL | $107.93 | $269.82 | — | — | 60% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAPHY UNILATERAL-SSMH | $107.93 | $269.82 | — | — | 60% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LOWER ARTERIAL BILATERAL | $274.62 | $686.53 | $274.02–$657.46 | — | 60% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LOWER ARTERIAL BILATERAL | $274.62 | $686.53 | — | — | 60% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 BILATERAL VENOUS EXTREMITY | $343.26 | $858.13 | $274.02–$729.41 | — | 60% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 BILATERAL VENOUS EXTREMITY | $343.26 | $858.13 | — | — | 60% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO - COMPLETE TC | $883.06 | $2,207.65 | $627.51–$1,876.50 | 19% below | 60% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO - COMPLETE TC | $883.06 | $2,207.65 | — | — | 60% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HIDA SCAN | $570.62 | $1,426.53 | $459.11–$1,212.55 | 40% below | 60% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HIDA SCAN | $570.62 | $1,426.53 | — | — | 60% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY W/CPAP | $1,444.73 | $3,611.82 | $986.20–$3,070.05 | 34% below | 60% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY W/CPAP | $1,444.73 | $3,611.82 | — | — | 60% |
| Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS | $125.04 | $312.58 | $99.94–$265.69 | 26% below | 60% |
| Knee X-ray, 3 views inpatient CPT 73562 KNEE 3 VIEWS | $125.04 | $312.58 | — | — | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 UPPER ABDOMEN LTD | $133.43 | $333.57 | $120.06–$288.07 | 57% below | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN | $142.16 | $355.38 | $120.06–$302.07 | 54% below | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 UPPER ABDOMEN US LTD | $151.01 | $377.52 | $120.06–$320.89 | 51% below | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 UPPER ABDOMEN LTD | $133.43 | $333.57 | — | — | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN | $142.16 | $355.38 | — | — | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 UPPER ABDOMEN US LTD | $151.01 | $377.52 | — | — | 60% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX CANCER SCR | $151.01 | $377.52 | $120.06–$320.89 | 64% below | 60% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX CANCER SCR | $151.01 | $377.52 | — | — | 60% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 JOINT LOWER EXT W/O CONTRAST | $343.26 | $858.13 | $274.02–$729.41 | 66% below | 60% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 JOINT LOWER EXT W/O CONTRAST | $343.26 | $858.13 | — | — | 60% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W | $447.24 | $1,118.08 | $400.65–$961.31 | 76% below | 60% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI JOINT LWR EXTR W/O&W | $447.24 | $1,118.08 | — | — | 60% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN | $280.17 | $700.41 | $274.02–$657.46 | 73% below | 60% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN | $280.17 | $700.41 | — | — | 60% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/0&W DYE | $507.14 | $1,267.84 | $400.65–$1,077.66 | 69% below | 60% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/0&W DYE | $507.14 | $1,267.84 | — | — | 60% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN | $343.26 | $858.13 | $274.02–$729.41 | 65% below | 60% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN | $343.26 | $858.13 | — | — | 60% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN C & S CONTRAST | $507.14 | $1,267.84 | $400.65–$1,077.66 | 68% below | 60% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN C & S CONTRAST | $507.14 | $1,267.84 | — | — | 60% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE | $343.26 | $858.13 | $274.02–$729.41 | 68% below | 60% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE | $343.26 | $858.13 | — | — | 60% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR C & S CONTRAST | $507.14 | $1,267.84 | $400.65–$1,077.66 | 69% below | 60% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR C & S CONTRAST | $507.14 | $1,267.84 | — | — | 60% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE | $280.17 | $700.41 | $274.02–$657.46 | 72% below | 60% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE | $280.17 | $700.41 | — | — | 60% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL C & S CONTRAST | $507.14 | $1,267.84 | $400.65–$1,077.66 | 69% below | 60% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL C & S CONTRAST | $507.14 | $1,267.84 | — | — | 60% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE | $343.26 | $858.13 | $274.02–$729.41 | 66% below | 60% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE | $343.26 | $858.13 | — | — | 60% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O&W DYE | $447.24 | $1,118.08 | $400.65–$961.31 | 71% below | 60% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O&W DYE | $447.24 | $1,118.08 | — | — | 60% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE | $274.62 | $686.53 | $274.02–$657.46 | 72% below | 60% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O DYE | $274.62 | $686.53 | — | — | 60% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXTREM JTS | $274.62 | $686.53 | $274.02–$657.46 | 77% below | 60% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXTREM JTS | $274.62 | $686.53 | — | — | 60% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT, MULT TC | $1,623.52 | $4,058.79 | $1,486.80–$3,567.36 | 26% below | 60% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HT MUSCLE IMAGE SPECT, MULT TC | $1,623.52 | $4,058.79 | — | — | 60% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED | $142.16 | $355.38 | $120.06–$302.07 | 44% below | 60% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIC US LTD | $151.01 | $377.52 | $120.06–$320.89 | 41% below | 60% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIC SCAN LTD | $151.01 | $377.52 | $120.06–$320.89 | 41% below | 60% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED | $142.16 | $355.38 | — | — | 60% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIC US LTD | $151.01 | $377.52 | — | — | 60% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIC SCAN LTD | $151.01 | $377.52 | — | — | 60% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC SCAN | $151.01 | $377.52 | $120.06–$320.89 | 58% below | 60% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC US COMPLETE | $151.01 | $377.52 | $120.06–$320.89 | 58% below | 60% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIC US COMPLETE | $151.01 | $377.52 | — | — | 60% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIC SCAN | $151.01 | $377.52 | — | — | 60% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB COMPLETE REALTIME | $151.01 | $377.52 | $120.06–$320.89 | 53% below | 60% |
| Pregnancy ultrasound after 14 weeks, one baby one side CPT 76805 OB US COMPLETE RT | $133.43 | $333.57 | $120.06–$288.07 | 59% below | 60% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB COMPLETE REALTIME | $151.01 | $377.52 | — | — | 60% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient one side CPT 76805 OB US COMPLETE RT | $133.43 | $333.57 | — | — | 60% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US FIRST TRIMESTER | $151.01 | $377.52 | $120.06–$320.89 | 51% below | 60% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB FIRST TRIMESTER | $151.01 | $377.52 | $120.06–$320.89 | 51% below | 60% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB FIRST TRIMESTER | $151.01 | $377.52 | — | — | 60% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US FIRST TRIMESTER | $151.01 | $377.52 | — | — | 60% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB LIMITED | $133.43 | $333.57 | $120.06–$288.07 | 57% below | 60% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S) | $142.16 | $355.38 | $120.06–$302.07 | 54% below | 60% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED | $151.01 | $377.52 | $120.06–$320.89 | 51% below | 60% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB LIMITED | $133.43 | $333.57 | — | — | 60% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETUS(S) | $142.16 | $355.38 | — | — | 60% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED | $151.01 | $377.52 | — | — | 60% |
| Screening mammogram, both breasts CPT 77067 MAMMOGRAPHY SCREENING | $101.96 | $254.88 | $111.10–$266.58 | 56% below | 60% |
| Screening mammogram, both breasts CPT 77067 MAMMO SCREENING | $114.12 | $285.30 | $111.10–$266.58 | 51% below | 60% |
| Screening mammogram, both breasts CPT 77067 MAMMOGRAPHY SCREENING (SSMH) | $114.12 | $285.30 | $111.10–$266.58 | 51% below | 60% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMOGRAPHY SCREENING | $101.96 | $254.88 | — | — | 60% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMOGRAPHY SCREENING (SSMH) | $114.12 | $285.30 | — | — | 60% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO SCREENING | $114.12 | $285.30 | — | — | 60% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 RADIOLOGIC EXAM; SHOULDER | $125.04 | $312.58 | $99.94–$265.69 | 38% below | 60% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RADIOLOGIC EXAM; SHOULDER | $125.04 | $312.58 | — | — | 60% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY | $1,444.73 | $3,611.82 | $986.20–$3,070.05 | 31% below | 60% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY | $1,444.73 | $3,611.82 | — | — | 60% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO - COMPLETE TC | $778.61 | $1,946.51 | $627.51–$1,654.53 | 31% below | 60% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS ECHO - COMPLETE TC | $778.61 | $1,946.51 | — | — | 60% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 CONTRAST SWALLW FUNC ESOPH W/V | $252.80 | $631.99 | $201.43–$537.19 | 25% below | 60% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 CONTRAST SWALLW FUNC ESOPH W/V | $252.80 | $631.99 | — | — | 60% |
| Transvaginal pelvic ultrasound CPT 76830 TRANS VAGINAL US | $151.01 | $377.52 | $120.06–$320.89 | 57% below | 60% |
| Transvaginal pelvic ultrasound CPT 76830 TRANS VAGINAL ULTRASOUND | $151.01 | $377.52 | $120.06–$320.89 | 57% below | 60% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 TRANS VAGINAL US | $151.01 | $377.52 | — | — | 60% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 TRANS VAGINAL ULTRASOUND | $151.01 | $377.52 | — | — | 60% |
| Transvaginal ultrasound during pregnancy CPT 76817 OB TRANSVAGINAL | $133.43 | $333.57 | $120.06–$288.07 | 52% below | 60% |
| Transvaginal ultrasound during pregnancy CPT 76817 OB TRANSVAGINAL US | $151.01 | $377.52 | $120.06–$320.89 | 46% below | 60% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 OB TRANSVAGINAL | $133.43 | $333.57 | — | — | 60% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 OB TRANSVAGINAL US | $151.01 | $377.52 | — | — | 60% |
| Ultrasound of the abdomen, complete CPT 76700 UPPER ABDOMEN COMPLETE | $133.43 | $333.57 | $120.06–$288.07 | 69% below | 60% |
| Ultrasound of the abdomen, complete CPT 76700 UPPER ABDOMEN US COMPLETE | $151.01 | $377.52 | $120.06–$320.89 | 64% below | 60% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 UPPER ABDOMEN COMPLETE | $133.43 | $333.57 | — | — | 60% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 UPPER ABDOMEN US COMPLETE | $151.01 | $377.52 | — | — | 60% |
| Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND OF SCROTUM | $133.43 | $333.57 | $120.06–$288.07 | 62% below | 60% |
| Ultrasound of the scrotum and testicles CPT 76870 TESTICULAR US | $151.01 | $377.52 | $120.06–$320.89 | 57% below | 60% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 ULTRASOUND OF SCROTUM | $133.43 | $333.57 | — | — | 60% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 TESTICULAR US | $151.01 | $377.52 | — | — | 60% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ST HEAD AND NECK | $133.43 | $333.57 | $120.06–$288.07 | 57% below | 60% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK | $142.16 | $355.38 | $120.06–$302.07 | 55% below | 60% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ST HEAD & NECK US | $151.01 | $377.52 | $120.06–$320.89 | 52% below | 60% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ST HEAD AND NECK | $133.43 | $333.57 | — | — | 60% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK | $142.16 | $355.38 | — | — | 60% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ST HEAD & NECK US | $151.01 | $377.52 | — | — | 60% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 SINGLE CONTRAST UPPER GI W/SCT | $252.80 | $631.99 | $201.43–$537.19 | 40% below | 60% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 SINGLE CONTRAST UPPER GI W/SCT | $252.80 | $631.99 | — | — | 60% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 EXTREMITY VENOUS UNILATERAL | $151.01 | $377.52 | $120.06–$320.89 | 57% below | 60% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 EXTREMITY VENOUS UNILATERAL | $151.01 | $377.52 | — | — | 60% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST MIN 3 VWS | $125.04 | $312.58 | $99.94–$265.69 | 35% below | 60% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST MIN 3 VWS | $125.04 | $312.58 | — | — | 60% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP UNI 2 VIEWS | $125.04 | $312.58 | $99.94–$265.69 | 32% below | 60% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP UNI 2 VIEWS WITH PELVIS | $125.04 | $312.58 | $99.94–$265.69 | 32% below | 60% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP UNI 2 VIEWS | $125.04 | $312.58 | — | — | 60% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP UNI 2 VIEWS WITH PELVIS | $125.04 | $312.58 | — | — | 60% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN X-RAY, SINGLE VIEW | $125.04 | $312.58 | $99.94–$265.69 | 38% below | 60% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN X-RAY, SINGLE VIEW | $125.04 | $312.58 | — | — | 60% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VIEWS | $125.04 | $312.58 | $99.94–$265.69 | 21% below | 60% |
| X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2 VIEWS | $125.04 | $312.58 | — | — | 60% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGER (S) MIN 2 VIEWS | $125.04 | $312.58 | $99.94–$265.69 | 21% below | 60% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER (S) MIN 2 VIEWS | $125.04 | $312.58 | — | — | 60% |
| X-ray of the foot, 2 views CPT 73620 FOOT 2 VIEWS | $125.04 | $312.58 | $99.94–$265.69 | 25% below | 60% |
| X-ray of the foot, 2 views inpatient CPT 73620 FOOT 2 VIEWS | $125.04 | $312.58 | — | — | 60% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT MIN 3 VWS | $125.04 | $312.58 | $99.94–$265.69 | 30% below | 60% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT MIN 3 VWS | $125.04 | $312.58 | — | — | 60% |
| X-ray of the hand, 3 or more views CPT 73130 HAND MIN 3 VWS | $125.04 | $312.58 | $99.94–$265.69 | 38% below | 60% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND MIN 3 VWS | $125.04 | $312.58 | — | — | 60% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1 OR 2 VIEWS | $125.04 | $312.58 | $99.94–$265.69 | 32% below | 60% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 1 OR 2 VIEWS | $125.04 | $312.58 | — | — | 60% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBOSACRAL 2OR3VIE | $151.01 | $377.52 | $120.06–$320.89 | 43% below | 60% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBOSACRAL 2OR3VIE | $151.01 | $377.52 | — | — | 60% |
| X-ray of the lower back, 4 or more views CPT 72110 SPINE L/S 4+MORE VIEWS | $151.01 | $377.52 | $120.06–$320.89 | 45% below | 60% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE L/S 4+MORE VIEWS | $151.01 | $377.52 | — | — | 60% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THORACIC 2 VIEWS | $151.01 | $377.52 | $120.06–$320.89 | 25% below | 60% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE THORACIC 2 VIEWS | $151.01 | $377.52 | — | — | 60% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3 VWS | $125.04 | $312.58 | $99.94–$265.69 | 38% below | 60% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MIN 3 VWS | $125.04 | $312.58 | — | — | 60% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 2OR3 VIEWS | $125.04 | $312.58 | $99.94–$265.69 | 38% below | 60% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 2OR3 VIEWS | $125.04 | $312.58 | — | — | 60% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VIEWS | $151.01 | $377.52 | $120.06–$320.89 | 32% below | 60% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 OR 2 VIEWS | $151.01 | $377.52 | — | — | 60% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX MIN 2 VWS | $125.04 | $312.58 | $99.94–$265.69 | 38% below | 60% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM/COCCYX MIN 2 VWS | $125.04 | $312.58 | — | — | 60% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 (RL)TRANSFERASE ALANINE AMINO | $6.36 | $15.90 | $4.88–$13.52 | 73% below | 60% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT | $6.36 | $15.90 | $4.88–$13.52 | 73% below | 60% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT | $6.36 | $15.90 | — | — | 60% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 (RL)TRANSFERASE ALANINE AMINO | $6.36 | $15.90 | — | — | 60% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT | $6.22 | $15.54 | $4.77–$13.21 | 75% below | 60% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT | $6.22 | $15.54 | — | — | 60% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 (RL)ACUTE HEPATITIS EVALUATION | $57.16 | $142.89 | $43.82–$121.46 | 67% below | 60% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 (RL)ACUTE HEPATITIS EVALUATION | $57.16 | $142.89 | — | — | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 (RL)NORTHEAST REG TEST PANEL | $6.27 | $15.66 | $4.80–$13.31 | 61% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 (RL) ALLG SPEC IGE CRUDE EACH | $6.27 | $15.66 | $4.80–$13.31 | 61% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 (UR) RAST QUEEN PALM T72 | $8.32 | $20.80 | $4.80–$17.68 | 48% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 (RL) PEDIATRIC FOOD PANEL X4 | $25.06 | $62.64 | $4.80–$53.24 | 57% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 (RL) MYCOTOX PROFILE X5 | $31.32 | $78.30 | $4.80–$66.56 | 96% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 (RL) ALLERGEN MOLD PANEL X6 | $37.59 | $93.96 | $4.80–$79.87 | 135% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 (RL) ALLERGEN FOOD PANEL X10 | $62.64 | $156.60 | $4.80–$133.11 | 292% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 (RL)ALLERGY NORTHEAST PNL X22 | $137.81 | $344.52 | $4.80–$292.84 | 761% above | 60% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 (RL) ALLG SPEC IGE CRUDE EACH | $6.27 | $15.66 | — | — | 60% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 (RL)NORTHEAST REG TEST PANEL | $6.27 | $15.66 | — | — | 60% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 (UR) RAST QUEEN PALM T72 | $8.32 | $20.80 | — | — | 60% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 (RL) PEDIATRIC FOOD PANEL X4 | $25.06 | $62.64 | — | — | 60% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 (RL) MYCOTOX PROFILE X5 | $31.32 | $78.30 | — | — | 60% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 (RL) ALLERGEN MOLD PANEL X6 | $37.59 | $93.96 | — | — | 60% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 (RL) ALLERGEN FOOD PANEL X10 | $62.64 | $156.60 | — | — | 60% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 (RL)ALLERGY NORTHEAST PNL X22 | $137.81 | $344.52 | — | — | 60% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 (UR) CYCLIC CITRULLINE PEPTID | $15.54 | $38.85 | $11.91–$33.02 | 67% below | 60% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 (UR) CYCLIC CITRULLINE PEPTID | $15.54 | $38.85 | — | — | 60% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 (UR) ANTINUCLEAR ANTIBODY ANA | $14.51 | $36.27 | $11.12–$30.83 | 67% below | 60% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 (UR) ANTINUCLEAR ANTIBODIES | $14.51 | $36.27 | $11.12–$30.83 | 67% below | 60% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA | $14.51 | $36.27 | $11.12–$30.83 | 67% below | 60% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 (UR) ANTINUCLEAR ANTIBODY ANA | $14.51 | $36.27 | — | — | 60% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA | $14.51 | $36.27 | — | — | 60% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 (UR) ANTINUCLEAR ANTIBODIES | $14.51 | $36.27 | — | — | 60% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP - NATRIURETIC PEPTIDE | $47.12 | $117.78 | $36.12–$100.11 | 62% below | 60% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP - NATRIURETIC PEPTIDE | $47.12 | $117.78 | — | — | 60% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $10.16 | $25.38 | $7.78–$21.57 | 84% below | 60% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $10.16 | $25.38 | — | — | 60% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV GROSS/MICRO PC | $34.10 | $85.25 | $48.34–$100.12 | 81% below | 60% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK PC | $38.66 | $96.63 | $48.34–$100.12 | 79% below | 60% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV GROSS/MICRO | $60.90 | $152.25 | $59.85–$143.59 | 66% below | 60% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK | $60.90 | $152.25 | $59.85–$143.59 | 66% below | 60% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV GROSS/MICRO PC | $34.10 | $85.25 | $48.34–$100.12 | — | 60% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK PC | $38.66 | $96.63 | $48.34–$100.12 | — | 60% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV GROSS/MICRO | $60.90 | $152.25 | — | — | 60% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK | $60.90 | $152.25 | — | — | 60% |
| Blood culture for bacteria CPT 87040 CULTURE BACTERIAL BLOOD | $12.39 | $30.96 | $9.49–$26.32 | 82% below | 60% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BACTERIAL BLOOD | $12.39 | $30.96 | — | — | 60% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE-ROUTINE | $10.91 | $27.27 | $8.59–$23.18 | 31% below | 60% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE-ROUTINE | $10.91 | $27.27 | — | — | 60% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $4.72 | $11.79 | $3.62–$10.02 | 74% below | 60% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE | $4.72 | $11.79 | — | — | 60% |
| Blood lead test CPT 83655 LEAD #V48 | $14.54 | $36.33 | $11.14–$30.88 | 66% below | 60% |
| Blood lead test CPT 83655 (UR) LEAD | $14.54 | $36.33 | $11.14–$30.88 | 66% below | 60% |
| Blood lead test CPT 83655 LEAD URMC | $14.54 | $36.33 | $11.14–$30.88 | 66% below | 60% |
| Blood lead test inpatient CPT 83655 LEAD #V48 | $14.54 | $36.33 | — | — | 60% |
| Blood lead test inpatient CPT 83655 LEAD URMC | $14.54 | $36.33 | — | — | 60% |
| Blood lead test inpatient CPT 83655 (UR) LEAD | $14.54 | $36.33 | — | — | 60% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BHCG, QUAL | $9.03 | $22.56 | $6.92–$19.18 | 75% below | 60% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 BHCG, QUAL | $9.03 | $22.56 | — | — | 60% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 REF LAB ABO | $146.06 | $365.13 | $152.80–$366.61 | 4% below | 60% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOODTYPING ABO | $183.05 | $457.61 | $152.80–$388.97 | 20% above | 60% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 REF LAB ABO | $146.06 | $365.13 | — | — | 60% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOODTYPING ABO | $183.05 | $457.61 | — | — | 60% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP QUANTITATIVE | $6.22 | $15.54 | $4.77–$13.21 | 79% below | 60% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 UR-CRP QUANTITATIVE IBD | $6.22 | $15.54 | $4.77–$13.21 | 79% below | 60% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 UR-CRP QUANTITATIVE IBD | $6.22 | $15.54 | — | — | 60% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP QUANTITATIVE | $6.22 | $15.54 | — | — | 60% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE | $44.73 | $111.81 | $34.29–$95.04 | 64% below | 60% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE | $44.73 | $111.81 | — | — | 60% |
| CA 19-9 blood test (tumor marker) CPT 86301 (RL) IMMUNOASSAY TUMOR CA 19-9 | $24.98 | $62.43 | $19.15–$53.07 | 67% below | 60% |
| CA 19-9 blood test (tumor marker) CPT 86301 (UR) CA 19-9, BODY FLUID | $24.98 | $62.43 | $19.15–$53.07 | 67% below | 60% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 (UR) CA 19-9, BODY FLUID | $24.98 | $62.43 | — | — | 60% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 (RL) IMMUNOASSAY TUMOR CA 19-9 | $24.98 | $62.43 | — | — | 60% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 (RL) IMMUNOASSAY TUMOR CA 125 | $24.98 | $62.43 | $19.15–$53.07 | 70% below | 60% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 (UR) OVARIAN CANCER MONITORING | $24.98 | $62.43 | $19.15–$53.07 | 70% below | 60% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 (RL) IMMUNOASSAY TUMOR CA 125 | $24.98 | $62.43 | — | — | 60% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 (UR) OVARIAN CANCER MONITORING | $24.98 | $62.43 | — | — | 60% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 (RL) COVID-19 TESTING | $61.58 | $153.93 | $47.21–$130.84 | 47% below | 60% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 (RL) COVID-19 TESTING | $61.58 | $153.93 | — | — | 60% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 (RL)CHYLMD TRACH DNA AMP PROBE | $42.11 | $105.27 | $32.28–$89.48 | 51% below | 60% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 IN HOUSE- CHYLMD TRACH DNA AMP | $42.11 | $105.27 | $32.28–$89.48 | 51% below | 60% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 (RL)CHYLMD TRACH DNA AMP PROBE | $42.11 | $105.27 | — | — | 60% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 IN HOUSE- CHYLMD TRACH DNA AMP | $42.11 | $105.27 | — | — | 60% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE | $13.39 | $33.47 | $12.32–$29.56 | 82% below | 60% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 (UR) LIPID PANEL | $16.07 | $40.17 | $12.32–$34.14 | 78% below | 60% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE | $13.39 | $33.47 | — | — | 60% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 (UR) LIPID PANEL | $16.07 | $40.17 | — | — | 60% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/COMPLETE AUTOMATED DIFF | $9.33 | $23.31 | $7.15–$19.81 | 78% below | 60% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/COMPLETE AUTOMATED DIFF | $9.33 | $23.31 | — | — | 60% |
| Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFF | $7.77 | $19.41 | $5.95–$16.50 | 75% below | 60% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFF | $7.77 | $19.41 | — | — | 60% |
| D-dimer blood test (blood clot marker) CPT 85379 D DIMER | $12.22 | $30.54 | $9.37–$25.96 | 67% below | 60% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER | $12.22 | $30.54 | — | — | 60% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 (UR) DHEA-SULFATE LEVEL | $26.68 | $66.69 | $20.45–$56.69 | 72% below | 60% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 (UR) DHEA-SULFATE LEVEL | $26.68 | $66.69 | — | — | 60% |
| Estradiol blood test CPT 82670 (RL) ESTRADIOL | $33.53 | $83.82 | $25.70–$71.25 | 67% below | 60% |
| Estradiol blood test CPT 82670 (UR) EASTRADIOL FREE LC/MS X2 | $67.06 | $167.64 | $25.70–$142.49 | 34% below | 60% |
| Estradiol blood test inpatient CPT 82670 (RL) ESTRADIOL | $33.53 | $83.82 | — | — | 60% |
| Estradiol blood test inpatient CPT 82670 (UR) EASTRADIOL FREE LC/MS X2 | $67.06 | $167.64 | — | — | 60% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $22.30 | $55.74 | $17.09–$47.38 | 71% below | 60% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH | $22.30 | $55.74 | — | — | 60% |
| Fecal calprotectin (stool inflammation test) CPT 83993 (RL) CALPROTECTIN, FECAL | $23.56 | $58.89 | $18.06–$50.06 | 78% below | 60% |
| Fecal calprotectin (stool inflammation test) CPT 83993 (RL) ASSAY CALPROTECTIN FECAL | $23.56 | $58.89 | $18.06–$50.06 | 78% below | 60% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL | $26.80 | $67.00 | $18.06–$56.95 | 75% below | 60% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 (RL) CALPROTECTIN, FECAL | $23.56 | $58.89 | — | — | 60% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 (RL) ASSAY CALPROTECTIN FECAL | $23.56 | $58.89 | — | — | 60% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL | $26.80 | $67.00 | — | — | 60% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $16.36 | $40.89 | $12.54–$34.76 | 76% below | 60% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $16.36 | $40.89 | — | — | 60% |
| Folate (folic acid) blood test CPT 82746 FOLATE | $17.64 | $44.10 | $13.52–$37.49 | 71% below | 60% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE | $17.64 | $44.10 | — | — | 60% |
| Free T3 thyroid hormone test CPT 84481 (UR) TRIIODOTHYRONINE T3 FREE | $20.33 | $50.82 | $15.58–$43.20 | 77% below | 60% |
| Free T3 thyroid hormone test inpatient CPT 84481 (UR) TRIIODOTHYRONINE T3 FREE | $20.33 | $50.82 | — | — | 60% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 (US) T4 FREE | $10.83 | $27.06 | $8.30–$23.00 | 83% below | 60% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE, FREE | $10.83 | $27.06 | $8.30–$23.00 | 83% below | 60% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE, FREE | $10.83 | $27.06 | — | — | 60% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 (US) T4 FREE | $10.83 | $27.06 | — | — | 60% |
| Free testosterone test CPT 84402 (UR) TESTOSTERONE FREE | $30.57 | $76.41 | $23.43–$64.95 | 67% below | 60% |
| Free testosterone test inpatient CPT 84402 (UR) TESTOSTERONE FREE | $30.57 | $76.41 | — | — | 60% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLU SCREENNG PRENATL 1 HR | $5.70 | $14.25 | $4.37–$12.11 | 73% below | 60% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLU SCREENNG PRENATL 1 HR | $5.70 | $14.25 | — | — | 60% |
| Glucose tolerance test, 3 samples CPT 82951 LACTOSE TOLERANCE | $15.45 | $38.61 | $11.84–$32.82 | 74% below | 60% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPEC | $15.45 | $38.61 | $11.84–$32.82 | 74% below | 60% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 LACTOSE TOLERANCE | $15.45 | $38.61 | — | — | 60% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 SPEC | $15.45 | $38.61 | — | — | 60% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 IN HOUSE-GONORRHOEAE DNA AMP | $42.11 | $105.27 | $32.28–$89.48 | 58% below | 60% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 (UR)N.GONORRHOEAE DNA AMP PROB | $42.11 | $105.27 | $32.28–$89.48 | 58% below | 60% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 IN HOUSE-GONORRHOEAE DNA AMP | $42.11 | $105.27 | — | — | 60% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 (UR)N.GONORRHOEAE DNA AMP PROB | $42.11 | $105.27 | — | — | 60% |
| H. pylori antibody blood test CPT 86677 (RL) HELICOBACTER PYLORI AB | $20.22 | $50.55 | $15.50–$42.97 | 61% below | 60% |
| H. pylori antibody blood test CPT 86677 (UR)H PYLORI AB IGG,A,M (X3) | $60.66 | $151.65 | $15.50–$128.90 | 16% above | 60% |
| H. pylori antibody blood test inpatient CPT 86677 (RL) HELICOBACTER PYLORI AB | $20.22 | $50.55 | — | — | 60% |
| H. pylori antibody blood test inpatient CPT 86677 (UR)H PYLORI AB IGG,A,M (X3) | $60.66 | $151.65 | — | — | 60% |
| H. pylori stool antigen test CPT 87338 (UR)HELICOBACTER PYLORI STOOL | $17.26 | $43.14 | $13.23–$36.67 | 72% below | 60% |
| H. pylori stool antigen test inpatient CPT 87338 (UR)HELICOBACTER PYLORI STOOL | $17.26 | $43.14 | — | — | 60% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 (RL)HIV1 QUANT&REVERSE TRANSCP | $102.12 | $255.30 | $78.29–$217.01 | 56% below | 60% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QUANT., PLASMA | $102.12 | $255.30 | $78.29–$217.01 | 56% below | 60% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QUANT., PLASMA | $102.12 | $255.30 | — | — | 60% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 (RL)HIV1 QUANT&REVERSE TRANSCP | $102.12 | $255.30 | — | — | 60% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 AB, SINGLE RESULT | $16.46 | $41.13 | $12.61–$34.96 | 71% below | 60% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV-2 AB, SINGLE RESULT | $16.46 | $41.13 | — | — | 60% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 (RL) HIV AG/AB,4TH GEN | $28.90 | $72.24 | $22.15–$61.40 | 65% below | 60% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 (RL) HIV-1 AG W/HIV-1/2 AB | $28.90 | $72.24 | $22.15–$61.40 | 65% below | 60% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 (RL) HIV 4TH GENERATION | $28.90 | $72.24 | $22.15–$61.40 | 65% below | 60% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 (RL) HIV-1 AG W/HIV-1/2 AB | $28.90 | $72.24 | — | — | 60% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 (RL) HIV 4TH GENERATION | $28.90 | $72.24 | — | — | 60% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 (RL) HIV AG/AB,4TH GEN | $28.90 | $72.24 | — | — | 60% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV II, DNA HIGH RISK | $42.11 | $105.27 | $32.28–$89.48 | 53% below | 60% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV WITHOUT GENOTYPING | $42.11 | $105.27 | $32.28–$89.48 | 53% below | 60% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV WITHOUT GENOTYPING | $42.11 | $105.27 | — | — | 60% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV II, DNA HIGH RISK | $42.11 | $105.27 | — | — | 60% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 (UR) HEMOGLOBIN GLYCOSYLATED | $11.66 | $29.13 | $8.93–$24.76 | 72% below | 60% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 (UR) HEMOGLOBIN GLYCOSYLATED | $11.66 | $29.13 | — | — | 60% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 (RL) HEP B SURFACE ANTIBODY | $12.89 | $32.22 | $9.88–$27.39 | 70% below | 60% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 (UR) HBV/HCV PROFILE VIII | $12.89 | $32.22 | $9.88–$27.39 | 70% below | 60% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 (RL) HEP B SURFACE ANTIBODY | $12.89 | $32.22 | — | — | 60% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 (UR) HBV/HCV PROFILE VIII | $12.89 | $32.22 | — | — | 60% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 (UR) HEP B SURFACE ANTIGEN | $12.40 | $30.99 | $9.50–$26.34 | 67% below | 60% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 (UR) HEP B SURFACE ANTIGEN | $12.40 | $30.99 | — | — | 60% |
| Hepatitis C antibody blood test (screening) CPT 86803 (RL) HEPATITIS C VIRUS AB | $17.13 | $42.81 | $13.13–$36.39 | 71% below | 60% |
| Hepatitis C antibody blood test (screening) CPT 86803 (RL) HEPATITIS C ANTIBODY | $17.13 | $42.81 | $13.13–$36.39 | 71% below | 60% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 (RL) HEPATITIS C VIRUS AB | $17.13 | $42.81 | — | — | 60% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 (RL) HEPATITIS C ANTIBODY | $17.13 | $42.81 | — | — | 60% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 (UR) HEP C REVRS TRNSCRPJ | $51.41 | $128.52 | $39.41–$109.24 | 61% below | 60% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 (UR) HEP C REVRS TRNSCRPJ | $51.41 | $128.52 | — | — | 60% |
| Herpes blood test, HSV-1 antibody CPT 86695 (RL) HERPES SIMPLEX VRS TYPE 1 | $15.83 | $39.57 | $12.13–$33.63 | 60% below | 60% |
| Herpes blood test, HSV-1 antibody CPT 86695 (UR) HERPES SIMPLEX VRS TYPE 1 | $15.83 | $39.57 | $12.13–$33.63 | 60% below | 60% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 (UR) HERPES SIMPLEX VRS TYPE 1 | $15.83 | $39.57 | — | — | 60% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 (RL) HERPES SIMPLEX VRS TYPE 1 | $15.83 | $39.57 | — | — | 60% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY,HERPES SIMPLEX,TYPE 2 | $23.22 | $58.05 | $17.80–$49.34 | 61% below | 60% |
| Herpes blood test, HSV-2 antibody CPT 86696 (UR) HERPES SIMPLEX VRS TYPE 2 | $23.22 | $58.05 | $17.80–$49.34 | 61% below | 60% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 (UR) HERPES SIMPLEX VRS TYPE 2 | $23.22 | $58.05 | — | — | 60% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY,HERPES SIMPLEX,TYPE 2 | $23.22 | $58.05 | — | — | 60% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN, HIGH SENS | $15.54 | $38.85 | $11.91–$33.02 | 67% below | 60% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN, HIGH SENS | $15.54 | $38.85 | — | — | 60% |
| Homocysteine blood test CPT 83090 (UR) HOMOCYSTEINE ASSAY | $21.51 | $53.76 | $16.49–$45.70 | 72% below | 60% |
| Homocysteine blood test inpatient CPT 83090 (UR) HOMOCYSTEINE ASSAY | $21.51 | $53.76 | — | — | 60% |
| Insulin blood test CPT 83525 INSULIN TEST | $13.72 | $34.29 | $10.52–$29.15 | 71% below | 60% |
| Insulin blood test CPT 83525 (UR) ASSAY OF INSULIN TOTAL | $13.72 | $34.29 | $10.52–$29.15 | 71% below | 60% |
| Insulin blood test inpatient CPT 83525 INSULIN TEST | $13.72 | $34.29 | — | — | 60% |
| Insulin blood test inpatient CPT 83525 (UR) ASSAY OF INSULIN TOTAL | $13.72 | $34.29 | — | — | 60% |
| Iron blood test (serum iron) CPT 83540 TOTAL IRON | $7.77 | $19.41 | $5.95–$16.50 | 75% below | 60% |
| Iron blood test (serum iron) inpatient CPT 83540 TOTAL IRON | $7.77 | $19.41 | — | — | 60% |
| Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING | $10.49 | $26.22 | $8.04–$22.29 | 75% below | 60% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING | $10.49 | $26.22 | — | — | 60% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $10.42 | $26.04 | $7.99–$22.13 | 84% below | 60% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $10.42 | $26.04 | — | — | 60% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZIN HORMONE | $22.23 | $55.56 | $17.04–$47.23 | 71% below | 60% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZIN HORMONE | $22.23 | $55.56 | — | — | 60% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $8.27 | $20.67 | $6.34–$17.57 | 76% below | 60% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $8.27 | $20.67 | — | — | 60% |
| Lyme disease antibody test CPT 86618 (RL) AB BORRELIA BURGDORFERI | $20.44 | $51.09 | $15.67–$43.43 | 55% below | 60% |
| Lyme disease antibody test CPT 86618 (UR) LYME DISEASE C6 AB | $20.44 | $51.09 | $15.67–$43.43 | 55% below | 60% |
| Lyme disease antibody test CPT 86618 (RL)BORRELIA BURGDORFERI PANEL | $20.44 | $51.09 | $15.67–$43.43 | 55% below | 60% |
| Lyme disease antibody test CPT 86618 (RL) AB BORRELIA BURGDORFER X2 | $40.88 | $102.18 | $15.67–$86.85 | 11% below | 60% |
| Lyme disease antibody test inpatient CPT 86618 (UR) LYME DISEASE C6 AB | $20.44 | $51.09 | — | — | 60% |
| Lyme disease antibody test inpatient CPT 86618 (RL) AB BORRELIA BURGDORFERI | $20.44 | $51.09 | — | — | 60% |
| Lyme disease antibody test inpatient CPT 86618 (RL)BORRELIA BURGDORFERI PANEL | $20.44 | $51.09 | — | — | 60% |
| Lyme disease antibody test inpatient CPT 86618 (RL) AB BORRELIA BURGDORFER X2 | $40.88 | $102.18 | — | — | 60% |
| Magnesium blood test CPT 83735 (UR) ASSAY OF MAGNESIUM | $8.04 | $20.10 | $6.16–$17.09 | 72% below | 60% |
| Magnesium blood test CPT 83735 MAGNESIUM,RBC | $8.04 | $20.10 | $6.16–$17.09 | 72% below | 60% |
| Magnesium blood test CPT 83735 MAGNESIUM | $8.04 | $20.10 | $6.16–$17.09 | 72% below | 60% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM,RBC | $8.04 | $20.10 | — | — | 60% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $8.04 | $20.10 | — | — | 60% |
| Magnesium blood test inpatient CPT 83735 (UR) ASSAY OF MAGNESIUM | $8.04 | $20.10 | — | — | 60% |
| Measles (rubeola) antibody test CPT 86765 *RUBEOLA | $12.28 | $30.70 | $11.85–$28.43 | 73% below | 60% |
| Measles (rubeola) antibody test CPT 86765 (UR) RUBEOLA ANTIBODY | $15.46 | $38.64 | $11.85–$32.84 | 66% below | 60% |
| Measles (rubeola) antibody test inpatient CPT 86765 *RUBEOLA | $12.28 | $30.70 | — | — | 60% |
| Measles (rubeola) antibody test inpatient CPT 86765 (UR) RUBEOLA ANTIBODY | $15.46 | $38.64 | — | — | 60% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPLTILE SCREENING | $6.22 | $15.54 | $4.77–$13.21 | 83% below | 60% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPLTILE SCREENING | $6.22 | $15.54 | — | — | 60% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 (UR) ASSAY OF PSA FREE | $22.07 | $55.17 | $16.92–$46.89 | 63% below | 60% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 (UR) ASSAY OF PSA FREE | $22.07 | $55.17 | — | — | 60% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 (RL) ASSAY OF PSA TOTAL | $22.07 | $55.17 | $16.92–$46.89 | 66% below | 60% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 (UR)PSA POST PROSTATECTOMY | $22.07 | $55.17 | $16.92–$46.89 | 66% below | 60% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 (UR)PSA POST PROSTATECTOMY | $22.07 | $55.17 | — | — | 60% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 (RL) ASSAY OF PSA TOTAL | $22.07 | $55.17 | — | — | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN LAYER PAP DIAGNOSTIC | $24.32 | $60.78 | $18.64–$51.66 | 67% below | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN LAYER PAP SCREENING | $24.32 | $60.78 | $18.64–$51.66 | 67% below | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOLOGY PAP THIN-LAYER SCREEN | $24.32 | $60.78 | $18.64–$51.66 | 67% below | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOLOGY PAP DIAGNOSTIC | $28.29 | $70.72 | $18.64–$60.11 | 61% below | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN LAYER PAP DIAGNOSTIC | $24.32 | $60.78 | — | — | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN LAYER PAP SCREENING | $24.32 | $60.78 | — | — | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOLOGY PAP THIN-LAYER SCREEN | $24.32 | $60.78 | — | — | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOLOGY PAP DIAGNOSTIC | $28.29 | $70.72 | — | — | 60% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE-PARATHYROID HORM | $49.54 | $123.84 | $37.98–$105.26 | 63% below | 60% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE-PARATHYROID HORM | $49.54 | $123.84 | — | — | 60% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTI | $7.22 | $18.03 | $5.53–$15.33 | 76% below | 60% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTI | $7.22 | $18.03 | — | — | 60% |
| Progesterone blood test CPT 84144 (UR) PROGESTRONE ASSAY | $25.04 | $62.58 | $19.19–$53.19 | 72% below | 60% |
| Progesterone blood test inpatient CPT 84144 (UR) PROGESTRONE ASSAY | $25.04 | $62.58 | — | — | 60% |
| Prolactin blood test CPT 84146 (UR) ASSAY OF PROLACTIN | $23.26 | $58.14 | $17.83–$49.42 | 67% below | 60% |
| Prolactin blood test inpatient CPT 84146 (UR) ASSAY OF PROLACTIN | $23.26 | $58.14 | — | — | 60% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $5.15 | $12.87 | $3.95–$10.94 | 73% below | 60% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $5.15 | $12.87 | — | — | 60% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP A ASSAY W/OPTIC | $19.84 | $49.59 | $15.21–$42.15 | 50% below | 60% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP A ASSAY W/OPTIC | $19.84 | $49.59 | — | — | 60% |
| Rheumatoid factor (RF) test CPT 86431 (UR) RHEUMATOID FACTOR QUANT | $6.81 | $17.01 | $5.22–$14.46 | 75% below | 60% |
| Rheumatoid factor (RF) test inpatient CPT 86431 (UR) RHEUMATOID FACTOR QUANT | $6.81 | $17.01 | — | — | 60% |
| Rubella antibody test (immunity check) CPT 86762 (UR) RUBELLA ANTIBODY | $17.27 | $43.17 | $13.24–$36.69 | 59% below | 60% |
| Rubella antibody test (immunity check) inpatient CPT 86762 (UR) RUBELLA ANTIBODY | $17.27 | $43.17 | — | — | 60% |
| Stool ova and parasites exam CPT 87177 (RL) OVA AND PARASITE SMEAR | $10.68 | $26.70 | $8.19–$22.70 | 72% below | 60% |
| Stool ova and parasites exam CPT 87177 TICK IDENTIFICATION | $13.20 | $33.00 | $8.19–$28.05 | 66% below | 60% |
| Stool ova and parasites exam inpatient CPT 87177 (RL) OVA AND PARASITE SMEAR | $10.68 | $26.70 | — | — | 60% |
| Stool ova and parasites exam inpatient CPT 87177 TICK IDENTIFICATION | $13.20 | $33.00 | — | — | 60% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD, FECES (GUAIAC) | $5.26 | $13.14 | $4.03–$11.17 | 65% below | 60% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD, FECES (GUAIAC) | $5.26 | $13.14 | — | — | 60% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 (UR) ASSAY TEST BLOOD FECAL | $19.11 | $47.76 | $14.65–$40.60 | 58% below | 60% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 (UR) ASSAY TEST BLOOD FECAL | $19.11 | $47.76 | — | — | 60% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 (UR) LISTERIA AB, CSF | $4.40 | $11.00 | $3.93–$9.43 | 76% below | 60% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR WITH REFLEX | $4.87 | $12.17 | $3.93–$10.34 | 74% below | 60% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SEROLOGY | $5.13 | $12.81 | $3.93–$10.89 | 72% below | 60% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 (UR) LISTERIA AB, CSF | $4.40 | $11.00 | — | — | 60% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR WITH REFLEX | $4.87 | $12.17 | — | — | 60% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR SEROLOGY | $5.13 | $12.81 | — | — | 60% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 (UR) TUBERCULOSIS QUANTIFERON | $74.38 | $185.94 | $57.02–$158.05 | 50% below | 60% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 (UR) TUBERCULOSIS QUANTIFERON | $74.38 | $185.94 | — | — | 60% |
| Testosterone blood test, total (not free testosterone) CPT 84403 (UR) TESTOSTERONE TOTAL | $30.98 | $77.43 | $23.75–$65.82 | 64% below | 60% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 (UR) TESTOSTERONE TOTAL | $30.98 | $77.43 | — | — | 60% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 (UR) THYROID PEROXIDASE AB | $17.46 | $43.65 | $13.39–$37.10 | 65% below | 60% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THYROID MICROSOMALAB | $17.46 | $43.65 | $13.39–$37.10 | 65% below | 60% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 (RL) MICROSOMAL ANTIBDY EACH | $17.46 | $43.65 | $13.39–$37.10 | 65% below | 60% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 (RL) ANMTILIVER CYTOSOL AB | $17.46 | $43.65 | $13.39–$37.10 | 65% below | 60% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-LIVER KIDNY MICROSOMAL AB | $17.46 | $43.65 | $13.39–$37.10 | 65% below | 60% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-THYROID MICROSOMALAB | $17.46 | $43.65 | — | — | 60% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-LIVER KIDNY MICROSOMAL AB | $17.46 | $43.65 | — | — | 60% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 (RL) MICROSOMAL ANTIBDY EACH | $17.46 | $43.65 | — | — | 60% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 (RL) ANMTILIVER CYTOSOL AB | $17.46 | $43.65 | — | — | 60% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 (UR) THYROID PEROXIDASE AB | $17.46 | $43.65 | — | — | 60% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 (RL) THYROID STIMULATING HORMO | $20.16 | $50.40 | $15.46–$42.84 | 74% below | 60% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $20.16 | $50.40 | $15.46–$42.84 | 74% below | 60% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $20.16 | $50.40 | — | — | 60% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 (RL) THYROID STIMULATING HORMO | $20.16 | $50.40 | — | — | 60% |
| Trichomonas test (NAAT) CPT 87661 (UR)TRICHOMONIASIS VAGINALIS | $42.11 | $105.27 | $32.28–$89.48 | 43% below | 60% |
| Trichomonas test (NAAT) inpatient CPT 87661 (UR)TRICHOMONIASIS VAGINALIS | $42.11 | $105.27 | — | — | 60% |
| Uric acid blood test CPT 84550 URIC ACID | $5.43 | $13.56 | $4.16–$11.53 | 77% below | 60% |
| Uric acid blood test inpatient CPT 84550 URIC ACID | $5.43 | $13.56 | — | — | 60% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS & MICROSCOPIC | $4.83 | $12.06 | $3.70–$10.25 | 55% below | 60% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS & MICROSCOPIC | $4.83 | $12.06 | — | — | 60% |
| Urinalysis without microscope exam, manual CPT 81002 SINGLE COMPONENT EXAM | $4.18 | $10.44 | $3.20–$8.87 | 65% below | 60% |
| Urinalysis without microscope exam, manual CPT 81002 MANUAL DIPSTICK W/O MICROSCOPY | $4.18 | $10.44 | $3.20–$8.87 | 65% below | 60% |
| Urinalysis without microscope exam, manual CPT 81002 SPECIFIC GRAVITY | $4.18 | $10.44 | $3.20–$8.87 | 65% below | 60% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 SPECIFIC GRAVITY | $4.18 | $10.44 | — | — | 60% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 SINGLE COMPONENT EXAM | $4.18 | $10.44 | — | — | 60% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 MANUAL DIPSTICK W/O MICROSCOPY | $4.18 | $10.44 | — | — | 60% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE | $9.69 | $24.21 | $7.42–$20.58 | 77% below | 60% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE | $9.69 | $24.21 | — | — | 60% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST, URINE | $10.34 | $25.83 | $2.90–$21.96 | 67% below | 60% |
| Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST, URINE | $10.34 | $25.83 | — | — | 60% |
| Vitamin B12 (cobalamin) blood test CPT 82607 B 12 | $18.10 | $45.24 | $13.87–$38.45 | 72% below | 60% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B 12 | $18.10 | $45.24 | — | — | 60% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 (UR)VITAMIN D 25 HYDROXY | $35.52 | $88.80 | $27.23–$75.48 | 60% below | 60% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALCIFEDIOL (25-OH VIT D-3) | $35.52 | $88.80 | $27.23–$75.48 | 60% below | 60% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 (UR)VITAMIN D 25 HYDROXY | $35.52 | $88.80 | — | — | 60% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CALCIFEDIOL (25-OH VIT D-3) | $35.52 | $88.80 | — | — | 60% |
| Zinc blood test CPT 84630 (RL) ASSAY OF ZINC | $13.67 | $34.17 | $10.48–$29.04 | 60% below | 60% |
| Zinc blood test CPT 84630 RBC ZINC | $15.40 | $38.48 | $10.48–$32.71 | 55% below | 60% |
| Zinc blood test inpatient CPT 84630 (RL) ASSAY OF ZINC | $13.67 | $34.17 | — | — | 60% |
| Zinc blood test inpatient CPT 84630 RBC ZINC | $15.40 | $38.48 | — | — | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE | $18.06 | $45.15 | $13.85–$38.38 | 70% below | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 (UR)CHORIONIC GONADOTROPIN TES | $18.06 | $45.15 | $13.85–$38.38 | 70% below | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 (RL)GONADOTROPIC CHORIONIC QNT | $18.06 | $45.15 | $13.85–$38.38 | 70% below | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 (RL)GONADOTROPIC CHORIONIC QNT | $18.06 | $45.15 | — | — | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE | $18.06 | $45.15 | — | — | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 (UR)CHORIONIC GONADOTROPIN TES | $18.06 | $45.15 | — | — | 60% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 STEREO BREAST BX 1ST LESION | $2,300.80 | $5,751.99 | $1,896.73–$4,889.19 | 21% below | 60% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 STEREO BREAST BX 1ST LESION | $2,300.80 | $5,751.99 | — | — | 60% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED RX LATERAL MALLEOLUS PC | $277.58 | $693.94 | $128.64–$412.66 | 42% below | 60% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED RX LATERAL MALLEOLUS | $340.64 | $851.59 | $283.28–$723.85 | 29% below | 60% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED RX LATERAL MALLEOLUS PC | $277.58 | $693.94 | $128.64–$412.66 | — | 60% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED RX LATERAL MALLEOLUS | $340.64 | $851.59 | — | — | 60% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED RX METATAR FX WO MAN PC | $198.18 | $495.43 | $89.52–$294.19 | 51% below | 60% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED RX METATAR FX WO MAN | $340.64 | $851.59 | $283.28–$723.85 | 15% below | 60% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED RX METATAR FX WO MAN PC | $198.18 | $495.43 | $89.52–$294.19 | — | 60% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED RX METATAR FX WO MAN | $340.64 | $851.59 | — | — | 60% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION | $688.48 | $1,721.19 | $759.04–$1,821.21 | 31% below | 60% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION | $688.48 | $1,721.19 | — | — | 60% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED RX COLLES FX PC | $317.09 | $792.71 | $117.76–$467.48 | 36% below | 60% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED RX COLLES | $340.64 | $851.59 | $283.28–$723.85 | 31% below | 60% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED RX COLLES FX PC | $317.09 | $792.71 | $117.76–$467.48 | — | 60% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED RX COLLES | $340.64 | $851.59 | — | — | 60% |
| Complex cataract surgery with lens implant CPT 66982 CATARACT PROC LENS&CAPSULAR RN | $2,545.04 | $6,362.58 | $2,650.35–$6,359.12 | 6% below | 60% |
| Complex cataract surgery with lens implant inpatient CPT 66982 CATARACT PROC LENS&CAPSULAR RN | $2,545.04 | $6,362.58 | — | — | 60% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMN UNI PC | $13.66 | $34.13 | $15.09–$21.88 | 86% below | 60% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN UNI | $84.35 | $210.87 | $67.75–$179.24 | 16% below | 60% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL IMPACTED CERUMN UNI PC | $13.66 | $34.13 | $15.09–$21.88 | — | 60% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL IMPACTED CERUMEN UNI | $84.35 | $210.87 | — | — | 60% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE CERUMEN PC | $33.14 | $82.85 | $18.08–$45.10 | 73% below | 60% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE CERUMEN | $68.22 | $170.55 | $67.75–$162.55 | 45% below | 60% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE CERUMEN PC | $33.14 | $82.85 | $18.08–$45.10 | — | 60% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE CERUMEN | $68.22 | $170.55 | — | — | 60% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT G JNT L/S 1 LEV | $1,008.88 | $2,522.19 | $1,015.75–$2,437.13 | 44% below | 60% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT G JNT L/S 1 LEV | $1,008.88 | $2,522.19 | — | — | 60% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ PROC HYSTERO | $68.42 | $171.03 | $138.53–$497.22 | 73% below | 60% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ PRO C HYSTERO | $68.42 | $171.03 | $138.53–$497.22 | 73% below | 60% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJ PROC HYSTERO | $68.42 | $171.03 | — | — | 60% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJ PRO C HYSTERO | $68.42 | $171.03 | — | — | 60% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D SQ ABCS-SIMPLE PC | $100.21 | $250.51 | $43.67–$149.13 | 72% below | 60% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I/D SUBCUTANEOUS ABSCESS | $282.14 | $705.33 | $230.41–$599.53 | 22% below | 60% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D SUBCUTANEOUS ABSCESS | $282.16 | $705.40 | $230.41–$599.59 | 22% below | 60% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SQ ABCS-SIMPLE PC | $100.21 | $250.51 | $43.67–$149.13 | — | 60% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I/D SUBCUTANEOUS ABSCESS | $282.14 | $705.33 | — | — | 60% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SUBCUTANEOUS ABSCESS | $282.16 | $705.40 | — | — | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION | $419.19 | $1,047.96 | $352.51–$890.77 | 15% above | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ MAJOR JOINT | $419.19 | $1,047.96 | $352.51–$890.77 | 15% above | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 LARGE JOINT ASPIRATION | $419.19 | $1,047.96 | $352.51–$890.77 | 15% above | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION AND/OR INJECTION | $419.19 | $1,047.96 | — | — | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ MAJOR JOINT | $419.19 | $1,047.96 | — | — | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 LARGE JOINT ASPIRATION | $419.19 | $1,047.96 | — | — | 60% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INTERMEDIATE JOINT INJ/ASP | $419.19 | $1,047.96 | $352.51–$890.77 | 20% above | 60% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INTERMEDIATE JOINT INJ/ASP | $419.19 | $1,047.96 | — | — | 60% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASP/INJ SMALL JOINT PC | $35.10 | $87.75 | $19.66–$49.69 | 90% below | 60% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 SMALL JT ASPIR/INJECT | $419.19 | $1,047.96 | $352.51–$890.77 | 20% above | 60% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASP/INJ SMALL JOINT PC | $35.10 | $87.75 | $19.66–$49.69 | — | 60% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 SMALL JT ASPIR/INJECT | $419.19 | $1,047.96 | — | — | 60% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC REP LAY 2.5 SATE PC | $150.68 | $376.68 | $68.85–$210.26 | 73% below | 60% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC REP LAY 2.5 SATE | $567.29 | $1,418.22 | $466.85–$1,205.49 | 2% above | 60% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC REP LAY 2.5 SATE PC | $150.68 | $376.68 | $68.85–$210.26 | — | 60% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC REP LAY 2.5 SATE | $567.29 | $1,418.22 | — | — | 60% |
| Lower-back epidural injection, with imaging guidance CPT 62323 EPIDURAL BLOCK W GUIDE | $983.40 | $2,458.50 | $810.65–$2,089.73 | 30% below | 60% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 EPIDURAL BLOCK W GUIDE | $983.40 | $2,458.50 | — | — | 60% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 LUM/SAC EPI SNGL INIT INJ | $1,264.24 | $3,160.60 | $1,015.75–$2,686.51 | at median | 60% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 LUM/SAC EPI SNGL INIT INJ | $1,264.24 | $3,160.60 | — | — | 60% |
| Nail removal (partial or complete), one nail CPT 11730 NAIL AVULSION REPAIR PC | $54.86 | $137.15 | $29.03–$74.94 | 81% below | 60% |
| Nail removal (partial or complete), one nail CPT 11730 NAIL AVULSION REPAIR | $282.14 | $705.33 | $230.41–$599.53 | at median | 60% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL AVULSION REPAIR PC | $54.86 | $137.15 | $29.03–$74.94 | — | 60% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL AVULSION REPAIR | $282.14 | $705.33 | — | — | 60% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTISIS W/IMAGING | $970.75 | $2,426.87 | $1,041.60–$2,499.16 | 22% below | 60% |
| Paracentesis with imaging guidance CPT 49083 PARACENTESIS W GUIDANCE IR | $1,331.37 | $3,328.41 | $1,041.60–$2,829.15 | 7% above | 60% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTISIS W/IMAGING | $970.75 | $2,426.87 | — | — | 60% |
| Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS W GUIDANCE IR | $1,331.37 | $3,328.41 | — | — | 60% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC INGROWN NAIL PC | $99.78 | $249.43 | $83.01–$142.69 | 83% below | 60% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC INGROWN NAIL | $567.29 | $1,418.22 | $466.85–$1,205.49 | 2% below | 60% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC INGROWN NAIL PC | $99.78 | $249.43 | $83.01–$142.69 | — | 60% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC INGROWN NAIL | $567.29 | $1,418.22 | — | — | 60% |
| Prostate biopsy CPT 55700 NB PROSTATE | $2,194.38 | $5,485.95 | $4,443.62–$4,663.06 | 5% below | 60% |
| Prostate biopsy inpatient CPT 55700 NB PROSTATE | $2,194.38 | $5,485.95 | — | — | 60% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVE SQ FB-SIMPLE PC | $101.84 | $254.58 | $43.22–$147.55 | 82% below | 60% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVE SQ FB-SIMPLE | $567.29 | $1,418.22 | $466.85–$1,205.49 | 2% above | 60% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE SQ FB-SIMPLE PC | $101.84 | $254.58 | $43.22–$147.55 | — | 60% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE SQ FB-SIMPLE | $567.29 | $1,418.22 | — | — | 60% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST PC | $60.04 | $150.08 | $29.60–$86.90 | 81% below | 60% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST | $273.03 | $682.56 | $321.20–$770.68 | 13% below | 60% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF FOREARM CAST PC | $60.04 | $150.08 | $29.60–$86.90 | — | 60% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF FOREARM CAST | $273.03 | $682.56 | — | — | 60% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT PC | $37.88 | $94.69 | $19.96–$56.17 | 80% below | 60% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT | $183.05 | $457.61 | $152.80–$388.97 | 1% below | 60% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT PC | $37.88 | $94.69 | $19.96–$56.17 | — | 60% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT | $183.05 | $457.61 | — | — | 60% |
| Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT PC | $48.96 | $122.38 | $23.71–$69.35 | 75% below | 60% |
| Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT | $224.07 | $560.17 | $186.62–$476.14 | 17% above | 60% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT PC | $48.96 | $122.38 | $23.71–$69.35 | — | 60% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT | $224.07 | $560.17 | — | — | 60% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC REP SIM 2.5 SNATG PC | $41.16 | $102.88 | $42.60–$61.77 | 86% below | 60% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIM SUPRFICIAL WOUND REP 2.5CM | $282.14 | $705.33 | $230.41–$599.53 | 1% below | 60% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC REP SIM 2.5 SNATG PC | $41.16 | $102.88 | $42.60–$61.77 | — | 60% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIM SUPRFICIAL WOUND REP 2.5CM | $282.14 | $705.33 | — | — | 60% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN | $567.29 | $1,418.22 | $466.85–$1,205.49 | at median | 60% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN | $567.29 | $1,418.22 | — | — | 60% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE | $983.40 | $2,458.50 | $810.65–$2,089.73 | 4% above | 60% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE | $983.40 | $2,458.50 | — | — | 60% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC REP SIM 2.6-7.5 SNATG PC | $54.04 | $135.08 | $53.61–$81.11 | 84% below | 60% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC REP SIM 2.6-7.5 SNATG | $282.16 | $705.40 | $230.41–$599.59 | 18% below | 60% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC REP SIM 2.6-7.5 SNATG PC | $54.04 | $135.08 | $53.61–$81.11 | — | 60% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC REP SIM 2.6-7.5 SNATG | $282.16 | $705.40 | — | — | 60% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC REP SIM 2.5 FEENL PC | $51.25 | $128.11 | $49.60–$76.47 | 83% below | 60% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC REP SIM 2.5 FEENL | $282.16 | $705.40 | $230.41–$599.59 | 7% below | 60% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC REP SIM 2.5 FEENL PC | $51.25 | $128.11 | $49.60–$76.47 | — | 60% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC REP SIM 2.5 FEENL | $282.16 | $705.40 | — | — | 60% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/GUIDANCE | $877.95 | $2,194.87 | $720.41–$1,865.64 | 29% below | 60% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/GUIDANCE | $877.95 | $2,194.87 | — | — | 60% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ.TRIGGER PTS 1-2 MUSCLES PC | $37.08 | $92.70 | $18.18–$51.17 | 89% below | 60% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINTS 1-2 MUSCLES | $419.19 | $1,047.96 | $352.51–$890.77 | 20% above | 60% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ.TRIGGER PTS 1OR2 MUSCLES | $419.19 | $1,047.96 | $352.51–$890.77 | 20% above | 60% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ.TRIGGER PTS 1-2 MUSCLES PC | $37.08 | $92.70 | $18.18–$51.17 | — | 60% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINTS 1-2 MUSCLES | $419.19 | $1,047.96 | — | — | 60% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ.TRIGGER PTS 1OR2 MUSCLES | $419.19 | $1,047.96 | — | — | 60% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US BREAST BX- 1ST LESION | $2,300.80 | $5,751.98 | $1,896.73–$4,889.18 | 17% below | 60% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US BREAST BX- 1ST LESION | $2,300.80 | $5,751.98 | — | — | 60% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE | $524.19 | $1,310.46 | $1,041.60–$2,499.16 | 54% below | 60% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY SINGLE/MULTIPLE | $524.19 | $1,310.46 | — | — | 60% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD BIOPSY SINGLE/MUTI FLEXIBL | $524.19 | $1,310.46 | $1,041.60–$2,499.16 | 53% below | 60% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD BIOPSY SINGLE/MUTI FLEXIBL | $524.19 | $1,310.46 | — | — | 60% |
| Vein ablation, radiofrequency, first vein CPT 36475 RADIO FREQ VEIN ABLATION 1STVN | $3,508.36 | $8,770.89 | $3,626.12–$8,700.32 | 6% below | 60% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 RADIO FREQ VEIN ABLATION 1STVN | $3,508.36 | $8,770.89 | — | — | 60% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SKIN SQ 1ST 20SQ CM PC | $58.90 | $147.25 | $23.16–$84.03 | 92% below | 60% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SKIN SQ 1ST 20SQCM | $567.29 | $1,418.22 | $466.85–$1,205.49 | 21% below | 60% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SKIN SQ 1ST 20SQ CM PC | $58.90 | $147.25 | $23.16–$84.03 | — | 60% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SKIN SQ 1ST 20SQCM | $567.29 | $1,418.22 | — | — | 60% |
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 TRANSFUSION, BLOOD OR BLD COMP | $464.03 | $1,160.07 | $506.65–$1,215.64 | 37% below | 60% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION,BLOOD OR BLD COMP | $464.03 | $1,160.07 | $506.65–$1,215.64 | 37% below | 60% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION, BLOOD OR BLD COMP | $464.03 | $1,160.07 | — | — | 60% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION,BLOOD OR BLD COMP | $464.03 | $1,160.07 | — | — | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB TREATMENT | $230.37 | $575.91 | $251.48–$603.38 | 3% above | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRES OR NON PRES INH TX MDI | $288.82 | $722.05 | $251.48–$613.74 | 29% above | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRES / NONPRES INH TX SVN IPPB | $329.22 | $823.04 | $251.48–$699.58 | 47% above | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT | $334.03 | $835.07 | $251.48–$709.81 | 49% above | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB TREATMENT | $230.37 | $575.91 | — | — | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRES OR NON PRES INH TX MDI | $288.82 | $722.05 | — | — | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRES / NONPRES INH TX SVN IPPB | $329.22 | $823.04 | — | — | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT | $334.03 | $835.07 | — | — | 60% |
| Chemotherapy IV infusion, first hour CPT 96413 IV INFUSION-CHEMO 1ST HR | $471.02 | $1,177.53 | $379.33–$1,000.90 | 20% below | 60% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INFUSION-CHEMO 1ST HR | $471.02 | $1,177.53 | — | — | 60% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74MIN PC | $200.62 | $501.53 | $84.68–$295.71 | 87% below | 60% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74MIN | $1,196.54 | $2,991.33 | $948.63–$2,542.63 | 22% below | 60% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 30-74MIN PC | $200.62 | $501.53 | $84.68–$295.71 | — | 60% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 30-74MIN | $1,196.54 | $2,991.33 | — | — | 60% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY | $318.71 | $796.77 | $247.97–$677.25 | 42% below | 60% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY | $318.71 | $796.77 | — | — | 60% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING | $68.22 | $170.55 | $67.75–$162.55 | 53% below | 60% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING | $68.22 | $170.55 | — | — | 60% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT NO QHP PRESENT PC | $21.56 | $53.88 | $8.04–$15.88 | 85% below | 60% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT NO QHP PRESENT | $125.04 | $312.58 | $96.84–$265.69 | 14% below | 60% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SUTURE REMOVAL- ED NO QHP | $125.04 | $312.58 | $96.84–$265.69 | 14% below | 60% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED VISIT NO QHP PRESENT PC | $21.56 | $53.88 | $8.04–$15.88 | — | 60% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED VISIT NO QHP PRESENT | $125.04 | $312.58 | — | — | 60% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 SUTURE REMOVAL- ED NO QHP | $125.04 | $312.58 | — | — | 60% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT STRAIGHTFORWARD PC | $56.76 | $141.88 | $15.11–$58.04 | 82% below | 60% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT STRAIGHTFORWARD | $224.88 | $562.19 | $176.33–$477.86 | 28% below | 60% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED VISIT STRAIGHTFORWARD PC | $56.76 | $141.88 | $15.11–$58.04 | — | 60% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED VISIT STRAIGHTFORWARD | $224.88 | $562.19 | — | — | 60% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT LOW LEVEL PC | $65.82 | $164.55 | $24.41–$98.80 | 86% below | 60% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT LOW LEVEL | $347.32 | $868.30 | $313.49–$752.18 | 24% below | 60% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED VISIT LOW LEVEL PC | $65.82 | $164.55 | $24.41–$98.80 | — | 60% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED VISIT LOW LEVEL | $347.32 | $868.30 | — | — | 60% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT MODERATE LEVEL PC | $112.20 | $280.49 | $45.02–$168.14 | 83% below | 60% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT MODERATE LEVEL | $801.21 | $2,003.01 | $479.19–$1,702.56 | 20% above | 60% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED VISIT MODERATE LEVEL PC | $112.20 | $280.49 | $45.02–$168.14 | — | 60% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED VISIT MODERATE LEVEL | $801.21 | $2,003.01 | — | — | 60% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT HIGH LEVEL PC | $162.66 | $406.63 | $67.19–$243.63 | 81% below | 60% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT HIGH LEVEL | $1,153.58 | $2,883.93 | $683.92–$2,451.34 | 35% above | 60% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED VISIT HIGH LEVEL PC | $162.66 | $406.63 | $67.19–$243.63 | — | 60% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED VISIT HIGH LEVEL | $1,153.58 | $2,883.93 | — | — | 60% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST ECG | $442.20 | $1,105.50 | $247.97–$939.68 | 23% below | 60% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST ECG | $442.20 | $1,105.50 | — | — | 60% |
| Family therapy with the patient, 50 minutes CPT 90847 SED-FAMLY GRP PSYTHRPY W PT PC | $100.10 | $250.23 | $88.58–$145.42 | 60% below | 60% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCH-THERPY W PT PC | $100.10 | $250.23 | $88.58–$145.42 | 60% below | 60% |
| Family therapy with the patient, 50 minutes CPT 90847 SED-FAMILY PSYCH-THERPY W PT | $165.81 | $414.51 | $203.84–$489.08 | 34% below | 60% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTHRPY W/PT NPP | $165.81 | $414.51 | $203.84–$489.08 | 34% below | 60% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTHRPY W/PT PSY | $165.81 | $414.51 | $203.84–$489.08 | 34% below | 60% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCH-THERPY W PT | $165.81 | $414.51 | $203.84–$489.08 | 34% below | 60% |
| Family therapy with the patient, 50 minutes CPT 90847 SED-FMLY PSYTHRPY W/PT NPP | $165.81 | $414.51 | $203.84–$489.08 | 34% below | 60% |
| Family therapy with the patient, 50 minutes CPT 90847 SED-FMLY PSYTHRPY W/PT PSY | $165.81 | $414.51 | $203.84–$489.08 | 34% below | 60% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 SED-FAMLY GRP PSYTHRPY W PT PC | $100.10 | $250.23 | $88.58–$145.42 | — | 60% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCH-THERPY W PT PC | $100.10 | $250.23 | $88.58–$145.42 | — | 60% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 SED-FAMILY PSYCH-THERPY W PT | $165.81 | $414.51 | — | — | 60% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTHRPY W/PT PSY | $165.81 | $414.51 | — | — | 60% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTHRPY W/PT NPP | $165.81 | $414.51 | — | — | 60% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 SED-FMLY PSYTHRPY W/PT NPP | $165.81 | $414.51 | — | — | 60% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 SED-FMLY PSYTHRPY W/PT PSY | $165.81 | $414.51 | — | — | 60% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCH-THERPY W PT | $165.81 | $414.51 | — | — | 60% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY GRP PSYCTHERPY WO PT PC | $96.30 | $240.75 | $85.96–$139.20 | 62% below | 60% |
| Family therapy without the patient, 50 minutes CPT 90846 SED-FAM GRPTHRPY W/O PT 30M PC | $96.30 | $240.75 | $85.96–$139.20 | 62% below | 60% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY GRP PSYTHRPY W/O PT PSY | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY GRP PSYTHRPY W/O PT NPP | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Family therapy without the patient, 50 minutes CPT 90846 SED-FMLY GRP W/O PT 30MIN PSY | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Family therapy without the patient, 50 minutes CPT 90846 SED-FAMILY GRPTHRPY W/O PT 30M | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Family therapy without the patient, 50 minutes CPT 90846 SED-FMLY GRP W/O PT 30MIN NPP | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY GRP PSYCH-THERPY W/O PT | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY GRP PSYCTHERPY WO PT PC | $96.30 | $240.75 | $85.96–$139.20 | — | 60% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 SED-FAM GRPTHRPY W/O PT 30M PC | $96.30 | $240.75 | $85.96–$139.20 | — | 60% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 SED-FMLY GRP W/O PT 30MIN NPP | $165.81 | $414.51 | — | — | 60% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY GRP PSYCH-THERPY W/O PT | $165.81 | $414.51 | — | — | 60% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 SED-FAMILY GRPTHRPY W/O PT 30M | $165.81 | $414.51 | — | — | 60% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY GRP PSYTHRPY W/O PT PSY | $165.81 | $414.51 | — | — | 60% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY GRP PSYTHRPY W/O PT NPP | $165.81 | $414.51 | — | — | 60% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 SED-FMLY GRP W/O PT 30MIN PSY | $165.81 | $414.51 | — | — | 60% |
| Group psychotherapy session CPT 90853 SED-GROUP PSY THERPY 60MIN PC | $24.88 | $62.18 | $21.47–$34.29 | 83% below | 60% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY 60MIN PC | $24.88 | $62.18 | $21.47–$34.29 | 83% below | 60% |
| Group psychotherapy session CPT 90853 SED-GRP PSYTHRPY 60MIN PSY | $86.31 | $215.76 | $116.67–$279.93 | 42% below | 60% |
| Group psychotherapy session CPT 90853 GRP PSYCHOTHRPY 60MIN PSY | $86.32 | $215.79 | $116.67–$279.93 | 42% below | 60% |
| Group psychotherapy session CPT 90853 GRP PSYCHOTHRPY 60MIN NPP | $86.32 | $215.79 | $116.67–$279.93 | 42% below | 60% |
| Group psychotherapy session CPT 90853 SED-GROUP PSYCH THRPY 60MIN | $86.32 | $215.79 | $116.67–$279.93 | 42% below | 60% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY 60MIN | $86.32 | $215.79 | $116.67–$279.93 | 42% below | 60% |
| Group psychotherapy session CPT 90853 SED-GRP PSYTHRPY 60MIN NPP | $86.32 | $215.79 | $116.67–$279.93 | 42% below | 60% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY 60MIN PC | $24.88 | $62.18 | $21.47–$34.29 | — | 60% |
| Group psychotherapy session inpatient CPT 90853 SED-GROUP PSY THERPY 60MIN PC | $24.88 | $62.18 | $21.47–$34.29 | — | 60% |
| Group psychotherapy session inpatient CPT 90853 SED-GRP PSYTHRPY 60MIN PSY | $86.31 | $215.76 | — | — | 60% |
| Group psychotherapy session inpatient CPT 90853 GRP PSYCHOTHRPY 60MIN NPP | $86.32 | $215.79 | — | — | 60% |
| Group psychotherapy session inpatient CPT 90853 SED-GRP PSYTHRPY 60MIN NPP | $86.32 | $215.79 | — | — | 60% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY 60MIN | $86.32 | $215.79 | — | — | 60% |
| Group psychotherapy session inpatient CPT 90853 SED-GROUP PSYCH THRPY 60MIN | $86.32 | $215.79 | — | — | 60% |
| Group psychotherapy session inpatient CPT 90853 GRP PSYCHOTHRPY 60MIN PSY | $86.32 | $215.79 | — | — | 60% |
| Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 HOLTER MONITOR 24H: GROUP PC | $70.44 | $176.08 | $68.68–$99.59 | 67% below | 60% |
| Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 HOLTER MONITOR 24H: GROUP PC | $70.44 | $176.08 | $68.68–$99.59 | — | 60% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INIT 31M-1HR | $250.72 | $626.79 | $244.27–$586.09 | 28% below | 60% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INIT 31M-1HR | $250.72 | $626.79 | — | — | 60% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY INITIAL HR | $250.72 | $626.79 | $244.27–$586.09 | 33% below | 60% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY INITIAL HR | $250.72 | $626.79 | — | — | 60% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 SED-INJ T/P/D SC OR IM W/E&M | $76.78 | $191.94 | $12.02–$198.39 | 9% below | 60% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION ADMIN T/P/D SC OR IM | $76.78 | $191.94 | $12.02–$198.39 | 9% below | 60% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION ADMIN T/P/D SC OR IN | $101.07 | $252.66 | $12.02–$214.76 | 20% above | 60% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION ADMIN T/P/D SC OR IM | $76.78 | $191.94 | — | — | 60% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 SED-INJ T/P/D SC OR IM W/E&M | $76.78 | $191.94 | — | — | 60% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION ADMIN T/P/D SC OR IN | $101.07 | $252.66 | — | — | 60% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 JAIL INIT ASSESS DX INTERVW PC | $152.20 | $380.50 | $107.67–$211.32 | 30% below | 60% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 SED-INIT ASSES DX INTVW EXM PC | $152.20 | $380.50 | $107.67–$211.32 | 30% below | 60% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 SED-INIT ASSES DX INTERVW EXM | $165.81 | $414.51 | $203.84–$489.08 | 23% below | 60% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 JAIL INIT ASSESS DX INTERVIEW | $165.81 | $414.51 | $203.84–$489.08 | 23% below | 60% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 SED-INIT ASSES DX INT EXM NPP | $165.81 | $414.51 | $203.84–$489.08 | 23% below | 60% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 SED-INIT ASSES DX INT EXM PSY | $165.81 | $414.51 | $203.84–$489.08 | 23% below | 60% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 INIT ASSESS DX INTVIEW EXM NPP | $165.81 | $414.51 | $203.84–$489.08 | 23% below | 60% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 INIT ASSESS DX INTVIEW EXM PSY | $165.81 | $414.51 | $203.84–$489.08 | 23% below | 60% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 INIT ASSEMENT DX INVW EXAM PC | $172.04 | $430.08 | $107.67–$211.32 | 21% below | 60% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 INIT ASSESSMENT DX INTVIEW EXM | $228.16 | $570.39 | $203.84–$489.08 | 5% above | 60% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 JAIL INIT ASSESS DX INTERVW PC | $152.20 | $380.50 | $107.67–$211.32 | — | 60% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 SED-INIT ASSES DX INTVW EXM PC | $152.20 | $380.50 | $107.67–$211.32 | — | 60% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 INIT ASSESS DX INTVIEW EXM NPP | $165.81 | $414.51 | — | — | 60% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 SED-INIT ASSES DX INTERVW EXM | $165.81 | $414.51 | — | — | 60% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 INIT ASSESS DX INTVIEW EXM PSY | $165.81 | $414.51 | — | — | 60% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 JAIL INIT ASSESS DX INTERVIEW | $165.81 | $414.51 | — | — | 60% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 SED-INIT ASSES DX INT EXM NPP | $165.81 | $414.51 | — | — | 60% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 SED-INIT ASSES DX INT EXM PSY | $165.81 | $414.51 | — | — | 60% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 INIT ASSEMENT DX INVW EXAM PC | $172.04 | $430.08 | $107.67–$211.32 | — | 60% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 INIT ASSESSMENT DX INTVIEW EXM | $228.16 | $570.39 | — | — | 60% |
| Neuromuscular re-education, 15 minutes CPT 97112 (H) NEUROMUSCULAR TX 15 MIN | $42.04 | $105.09 | $29.30–$89.33 | 50% below | 60% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR TX 15 MIN | $42.04 | $105.09 | $29.30–$89.33 | 50% below | 60% |
| Neuromuscular re-education, 15 minutes CPT 97112 (H) BALANCE POSTURE 15 MIN | $42.04 | $105.09 | $29.30–$89.33 | 50% below | 60% |
| Neuromuscular re-education, 15 minutes CPT 97112 BALANCE POSTURE 15 MIN | $42.04 | $105.09 | $29.30–$89.33 | 50% below | 60% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 BALANCE POSTURE 15 MIN | $42.04 | $105.09 | — | — | 60% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR TX 15 MIN | $42.04 | $105.09 | — | — | 60% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 (H) BALANCE POSTURE 15 MIN | $42.04 | $105.09 | — | — | 60% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 (H) NEUROMUSCULAR TX 15 MIN | $42.04 | $105.09 | — | — | 60% |
| New patient office visit, about 30 minutes CPT 99203 OP VISIT-LEVEL 3-NEW PC | $81.94 | $204.85 | $34.04–$114.03 | 58% below | 60% |
| New patient office visit, about 30 minutes CPT 99203 SED-NEW OP VISIT-LEVEL 3 PC | $81.94 | $204.85 | $34.04–$114.03 | 58% below | 60% |
| New patient office visit, about 30 minutes CPT 99203 OP VISIT-LEVEL 3-NEW | $183.00 | $457.50 | $104.00–$388.88 | 7% below | 60% |
| New patient office visit, about 30 minutes CPT 99203 SED-NEW OP VISIT-LEVEL 3 | $183.00 | $457.50 | $104.00–$388.88 | 7% below | 60% |
| New patient office visit, about 30 minutes inpatient CPT 99203 SED-NEW OP VISIT-LEVEL 3 PC | $81.94 | $204.85 | $34.04–$114.03 | — | 60% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OP VISIT-LEVEL 3-NEW PC | $81.94 | $204.85 | $34.04–$114.03 | — | 60% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OP VISIT-LEVEL 3-NEW | $183.00 | $457.50 | — | — | 60% |
| New patient office visit, about 30 minutes inpatient CPT 99203 SED-NEW OP VISIT-LEVEL 3 | $183.00 | $457.50 | — | — | 60% |
| New patient office visit, about 45 minutes CPT 99204 OP VISIT-LEVEL 4-NEW PC | $132.92 | $332.28 | $56.57–$185.73 | 54% below | 60% |
| New patient office visit, about 45 minutes CPT 99204 SED-NEW OP VISIT-LEVEL 4 PC | $132.92 | $332.28 | $56.57–$185.73 | 54% below | 60% |
| New patient office visit, about 45 minutes CPT 99204 SED-NEW OP VISIT-LEVEL 4 | $183.00 | $457.50 | $157.18–$388.88 | 36% below | 60% |
| New patient office visit, about 45 minutes CPT 99204 OP VISIT-LEVEL 4 NEW | $183.00 | $457.50 | $157.18–$388.88 | 36% below | 60% |
| New patient office visit, about 45 minutes CPT 99204 OP VISIT-LEVEL 4-NEW | $183.00 | $457.50 | $157.18–$388.88 | 36% below | 60% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OP VISIT-LEVEL 4-NEW PC | $132.92 | $332.28 | $56.57–$185.73 | — | 60% |
| New patient office visit, about 45 minutes inpatient CPT 99204 SED-NEW OP VISIT-LEVEL 4 PC | $132.92 | $332.28 | $56.57–$185.73 | — | 60% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OP VISIT-LEVEL 4-NEW | $183.00 | $457.50 | — | — | 60% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OP VISIT-LEVEL 4 NEW | $183.00 | $457.50 | — | — | 60% |
| New patient office visit, about 45 minutes inpatient CPT 99204 SED-NEW OP VISIT-LEVEL 4 | $183.00 | $457.50 | — | — | 60% |
| New patient office visit, about 60 minutes CPT 99205 OP VISIT-LEVEL 5-NEW PC | $169.06 | $422.63 | $73.59–$252.50 | 40% below | 60% |
| New patient office visit, about 60 minutes CPT 99205 SED-NEW OP VISIT-LEVEL 5 PC | $180.34 | $450.85 | $73.59–$252.50 | 36% below | 60% |
| New patient office visit, about 60 minutes CPT 99205 OP VISIT-LEVEL 5-NEW | $183.00 | $457.50 | $209.62–$502.95 | 35% below | 60% |
| New patient office visit, about 60 minutes CPT 99205 SED-NEW OP VISIT-LEVEL 5 | $183.00 | $457.50 | $209.62–$502.95 | 35% below | 60% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OP VISIT-LEVEL 5-NEW PC | $169.06 | $422.63 | $73.59–$252.50 | — | 60% |
| New patient office visit, about 60 minutes inpatient CPT 99205 SED-NEW OP VISIT-LEVEL 5 PC | $180.34 | $450.85 | $73.59–$252.50 | — | 60% |
| New patient office visit, about 60 minutes inpatient CPT 99205 SED-NEW OP VISIT-LEVEL 5 | $183.00 | $457.50 | — | — | 60% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OP VISIT-LEVEL 5-NEW | $183.00 | $457.50 | — | — | 60% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 SED-NEW OP VISIT-LEVEL 2 PC | $48.08 | $120.20 | $22.18–$66.03 | 69% below | 60% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP VISIT-LEVEL 2-NEW PC | $48.08 | $120.20 | $22.18–$66.03 | 69% below | 60% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 SED-NEW OP VISIT-LEVEL 2 | $183.00 | $457.50 | $66.58–$388.88 | 16% above | 60% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP VISIT-LEVEL 2-NEW | $183.00 | $457.50 | $66.58–$388.88 | 16% above | 60% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 SED-NEW OP VISIT-LEVEL 2 PC | $48.08 | $120.20 | $22.18–$66.03 | — | 60% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OP VISIT-LEVEL 2-NEW PC | $48.08 | $120.20 | $22.18–$66.03 | — | 60% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 SED-NEW OP VISIT-LEVEL 2 | $183.00 | $457.50 | — | — | 60% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OP VISIT-LEVEL 2-NEW | $183.00 | $457.50 | — | — | 60% |
| Occupational therapy evaluation, low complexity CPT 97165 TELEHEALTH OT EVAL LOW COMP | $120.47 | $301.17 | $90.16–$255.99 | 30% below | 60% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMP | $120.47 | $301.17 | $90.16–$255.99 | 30% below | 60% |
| Occupational therapy evaluation, low complexity CPT 97165 (H) OT EVAL LOW COMP | $120.47 | $301.17 | $90.16–$255.99 | 30% below | 60% |
| Occupational therapy evaluation, low complexity CPT 97165 TELEHEALTH OT EVAL MED COMP | $120.47 | $301.17 | $90.16–$255.99 | 30% below | 60% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMP | $120.47 | $301.17 | — | — | 60% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 (H) OT EVAL LOW COMP | $120.47 | $301.17 | — | — | 60% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEHEALTH OT EVAL MED COMP | $120.47 | $301.17 | — | — | 60% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEHEALTH OT EVAL LOW COMP | $120.47 | $301.17 | — | — | 60% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 TELEHEALTH PT EVAL HIGH COMP | $119.68 | $299.19 | $87.82–$254.31 | 58% below | 60% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 (H) PT EVAL HIGH COMP | $119.68 | $299.19 | $87.82–$254.31 | 58% below | 60% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMP - JCFLH | $119.68 | $299.19 | $87.82–$254.31 | 58% below | 60% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMP | $119.68 | $299.19 | $87.82–$254.31 | 58% below | 60% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMP - JCFLH | $119.68 | $299.19 | — | — | 60% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 (H) PT EVAL HIGH COMP | $119.68 | $299.19 | — | — | 60% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEHEALTH PT EVAL HIGH COMP | $119.68 | $299.19 | — | — | 60% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMP | $119.68 | $299.19 | — | — | 60% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMP | $114.33 | $285.81 | $87.82–$242.94 | 36% below | 60% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 TELEHEALTH PT EVAL LOW COMP | $119.68 | $299.19 | $87.82–$254.31 | 34% below | 60% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMP - JCFLH | $119.68 | $299.19 | $87.82–$254.31 | 34% below | 60% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 (H) PT EVAL LOW COMP | $119.68 | $299.19 | $87.82–$254.31 | 34% below | 60% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMP | $114.33 | $285.81 | — | — | 60% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMP - JCFLH | $119.68 | $299.19 | — | — | 60% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEHEALTH PT EVAL LOW COMP | $119.68 | $299.19 | — | — | 60% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 (H) PT EVAL LOW COMP | $119.68 | $299.19 | — | — | 60% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MED COMP - JCFLH | $119.68 | $299.19 | $87.82–$254.31 | 50% below | 60% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MED COMP | $119.68 | $299.19 | $87.82–$254.31 | 50% below | 60% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 TELEHEALTH PT EVAL MED COMP | $119.68 | $299.19 | $87.82–$254.31 | 50% below | 60% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 (H) PT EVAL MED COMP | $119.68 | $299.19 | $87.82–$254.31 | 50% below | 60% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MED COMP - JCFLH | $119.68 | $299.19 | — | — | 60% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEHEALTH PT EVAL MED COMP | $119.68 | $299.19 | — | — | 60% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MED COMP | $119.68 | $299.19 | — | — | 60% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 (H) PT EVAL MED COMP | $119.68 | $299.19 | — | — | 60% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MYOFASCIAL RELEASE 15 MIN | $31.71 | $79.26 | $24.81–$67.37 | 62% below | 60% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 (H) JOINT MOBILIZATION 15 MIN | $33.64 | $84.09 | $24.81–$71.48 | 60% below | 60% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY MOBS 15 MIN | $33.64 | $84.09 | $24.81–$71.48 | 60% below | 60% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 (H) MANUAL THERAPY MOBS 15MIN | $33.64 | $84.09 | $24.81–$71.48 | 60% below | 60% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 JOINT MOBILIZATION 15 MIN | $33.64 | $84.09 | $24.81–$71.48 | 60% below | 60% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 (H) MYOFASCIAL RELEASE 15 MIN | $33.64 | $84.09 | $24.81–$71.48 | 60% below | 60% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MYOFASCIAL RELEASE 15 MIN | $31.71 | $79.26 | — | — | 60% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 (H) MANUAL THERAPY MOBS 15MIN | $33.64 | $84.09 | — | — | 60% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 JOINT MOBILIZATION 15 MIN | $33.64 | $84.09 | — | — | 60% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY MOBS 15 MIN | $33.64 | $84.09 | — | — | 60% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 (H) MYOFASCIAL RELEASE 15 MIN | $33.64 | $84.09 | — | — | 60% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 (H) JOINT MOBILIZATION 15 MIN | $33.64 | $84.09 | — | — | 60% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE 15 MIN | $33.59 | $83.97 | $26.01–$71.37 | 59% below | 60% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HAND THERAPY 15 MIN | $36.57 | $91.41 | $26.01–$77.70 | 55% below | 60% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 (H) HAND THERAPY 15 MIN | $36.57 | $91.41 | $26.01–$77.70 | 55% below | 60% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 (H) THERAPEUTIC EXERCISE 15MIN | $36.57 | $91.41 | $26.01–$77.70 | 55% below | 60% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROC-15MIN-JCFLH | $36.57 | $91.41 | $26.01–$77.70 | 55% below | 60% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE 15 MIN | $33.59 | $83.97 | — | — | 60% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HAND THERAPY 15 MIN | $36.57 | $91.41 | — | — | 60% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROC-15MIN-JCFLH | $36.57 | $91.41 | — | — | 60% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 (H) THERAPEUTIC EXERCISE 15MIN | $36.57 | $91.41 | — | — | 60% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 (H) HAND THERAPY 15 MIN | $36.57 | $91.41 | — | — | 60% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN PC | $125.98 | $314.95 | $127.10–$184.30 | 47% below | 60% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN | $228.16 | $570.39 | $203.84–$489.08 | 4% below | 60% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYTX CRISIS INITIAL 60 MIN PC | $125.98 | $314.95 | $127.10–$184.30 | — | 60% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYTX CRISIS INITIAL 60 MIN | $228.16 | $570.39 | — | — | 60% |
| Psychotherapy session, 30 minutes CPT 90832 SED-INDV PSYCH THRPY 30MIN PC | $67.92 | $169.80 | $53.25–$97.76 | 66% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 INDV PSYCH-THERAPY 20MIN PC | $67.92 | $169.80 | $53.25–$97.76 | 66% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 SED-INDV PSYCH THRPY 20MIN PC | $67.92 | $169.80 | $53.25–$97.76 | 66% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 INDIV PSYCH-THERAPY 30MIN PC | $67.92 | $169.80 | $53.25–$97.76 | 66% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 JAIL IND PSYCHOTHERPY-30MIN PC | $67.92 | $169.80 | $53.25–$97.76 | 66% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 SED-INDIV THRPY 30MIN | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 JAIL IND PSYCHOTHERAPY 30MIN | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 SED-INDV PSYTHRPY 20 MIN NPP | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 SED-INDV PSYTHRPY 20MIN NPP | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 SED-INDV PSYTHRPY 20MIN PSY | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 SED-INDV PSYCH THRPY 20MIN | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 INDV PSYTHRPY 20MIN NPP | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 INDV PSY THRPY 20MIN PSY | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 INDV PSYCH-THRPY 20MIN | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 SED-INDIV PSYTHRPY 30MIN NPP | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 SED-INDIV PSYTHRPY 30MIN PSY | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 INDIV PSYTHRPY 30MIN NPP | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 INDIV PSYTHRPY 30MIN PSY | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 SED-INDIV PSYCH THRPY 30MIN | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 INDIV PSYCH-THERAPY 30MIN | $165.81 | $414.51 | $203.84–$489.08 | 16% below | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 INDIV PSYCH-THERAPY 30MIN PC | $67.92 | $169.80 | $53.25–$97.76 | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 SED-INDV PSYCH THRPY 30MIN PC | $67.92 | $169.80 | $53.25–$97.76 | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 JAIL IND PSYCHOTHERPY-30MIN PC | $67.92 | $169.80 | $53.25–$97.76 | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 INDV PSYCH-THERAPY 20MIN PC | $67.92 | $169.80 | $53.25–$97.76 | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 SED-INDV PSYCH THRPY 20MIN PC | $67.92 | $169.80 | $53.25–$97.76 | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 JAIL IND PSYCHOTHERAPY 30MIN | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 SED-INDV PSYTHRPY 20 MIN NPP | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 INDIV PSYTHRPY 30MIN PSY | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 SED-INDIV PSYCH THRPY 30MIN | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 INDIV PSYCH-THERAPY 30MIN | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 INDIV PSYTHRPY 30MIN NPP | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 SED-INDIV PSYTHRPY 30MIN PSY | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 SED-INDIV PSYTHRPY 30MIN NPP | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 INDV PSYCH-THRPY 20MIN | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 INDV PSY THRPY 20MIN PSY | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 INDV PSYTHRPY 20MIN NPP | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 SED-INDV PSYCH THRPY 20MIN | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 SED-INDV PSYTHRPY 20MIN PSY | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 SED-INDV PSYTHRPY 20MIN NPP | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 SED-INDIV THRPY 30MIN | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 45 minutes CPT 90834 SED-INDIV PSYCHTHRPY 45MIN PC | $89.44 | $223.60 | $71.09–$129.28 | 65% below | 60% |
| Psychotherapy session, 45 minutes CPT 90834 JAIL IND PSYCHOTHERPY-45MIN PC | $89.44 | $223.60 | $71.09–$129.28 | 65% below | 60% |
| Psychotherapy session, 45 minutes CPT 90834 INDIV PSYCH-THERAPY 45MIN PC | $89.44 | $223.60 | $71.09–$129.28 | 65% below | 60% |
| Psychotherapy session, 45 minutes CPT 90834 SED-INDIV PSYCH THRPY 45MIN | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Psychotherapy session, 45 minutes CPT 90834 INDIV PSYTHRPY 45MIN PSY | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Psychotherapy session, 45 minutes CPT 90834 SED-INDIV PSYTHRPY 45MIN PSY | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Psychotherapy session, 45 minutes CPT 90834 SED-INDIV PSYTHRPY 45MIN NPP | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Psychotherapy session, 45 minutes CPT 90834 JAIL IND PSYCHOTHERAPY-45MIN | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Psychotherapy session, 45 minutes CPT 90834 INDIV PSYCH-THERAPY 45MIN | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Psychotherapy session, 45 minutes CPT 90834 INDIV PSYTHRPY 45MIN NPP | $165.81 | $414.51 | $203.84–$489.08 | 35% below | 60% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 INDIV PSYCH-THERAPY 45MIN PC | $89.44 | $223.60 | $71.09–$129.28 | — | 60% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 SED-INDIV PSYCHTHRPY 45MIN PC | $89.44 | $223.60 | $71.09–$129.28 | — | 60% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 JAIL IND PSYCHOTHERPY-45MIN PC | $89.44 | $223.60 | $71.09–$129.28 | — | 60% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 INDIV PSYCH-THERAPY 45MIN | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 SED-INDIV PSYTHRPY 45MIN PSY | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 JAIL IND PSYCHOTHERAPY-45MIN | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 SED-INDIV PSYTHRPY 45MIN NPP | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 INDIV PSYTHRPY 45MIN NPP | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 INDIV PSYTHRPY 45MIN PSY | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 SED-INDIV PSYCH THRPY 45MIN | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 60 minutes CPT 90837 JAIL IND PSYCHOTHERAPY 60M PC | $131.30 | $328.23 | $106.12–$190.82 | 55% below | 60% |
| Psychotherapy session, 60 minutes CPT 90837 INDIV PSYCH THRPY 60MIN PC | $131.30 | $328.23 | $106.12–$190.82 | 55% below | 60% |
| Psychotherapy session, 60 minutes CPT 90837 INDIV PSYCH THRPY 60 MIN | $165.81 | $414.51 | $203.84–$489.08 | 44% below | 60% |
| Psychotherapy session, 60 minutes CPT 90837 INDIV PSY THRPY 60MIN PSY | $165.81 | $414.51 | $203.84–$489.08 | 44% below | 60% |
| Psychotherapy session, 60 minutes CPT 90837 INDIV PSYCH THRPY 60MIN NPP | $165.81 | $414.51 | $203.84–$489.08 | 44% below | 60% |
| Psychotherapy session, 60 minutes CPT 90837 JAIL IND PSYCHOTHERAPY 60MIN | $165.81 | $414.51 | $203.84–$489.08 | 44% below | 60% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 INDIV PSYCH THRPY 60MIN PC | $131.30 | $328.23 | $106.12–$190.82 | — | 60% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 JAIL IND PSYCHOTHERAPY 60M PC | $131.30 | $328.23 | $106.12–$190.82 | — | 60% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 INDIV PSYCH THRPY 60 MIN | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 INDIV PSYCH THRPY 60MIN NPP | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 INDIV PSY THRPY 60MIN PSY | $165.81 | $414.51 | — | — | 60% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 JAIL IND PSYCHOTHERAPY 60MIN | $165.81 | $414.51 | — | — | 60% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 INDV SMK/TOBAC COUNSL 3-10M PC | $12.24 | $30.60 | $24.79–$103.24 | 71% below | 60% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SED-INDV SMOK CESS 3-10M PC | $12.24 | $30.60 | $24.79–$103.24 | 71% below | 60% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 INDV SMOKE/TOBAC COUNSEL 3-10M | $33.78 | $84.45 | $43.03–$103.24 | 20% below | 60% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SED-INDV SMOK CESS 3-10MIN | $33.78 | $84.45 | $43.03–$103.24 | 20% below | 60% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 INDV SMK/TOBAC COUNSL 3-10M PC | $12.24 | $30.60 | — | — | 60% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SED-INDV SMOK CESS 3-10M PC | $12.24 | $30.60 | — | — | 60% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 INDV SMOKE/TOBAC COUNSEL 3-10M | $33.78 | $84.45 | — | — | 60% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SED-INDV SMOK CESS 3-10MIN | $33.78 | $84.45 | — | — | 60% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT-LEVEL 5-EST PC | $134.02 | $335.05 | $48.89–$201.09 | 43% below | 60% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 SED-OP VISIT-LEVEL 5 PC | $143.34 | $358.35 | $48.89–$201.09 | 39% below | 60% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 SED-OP VISIT-LEVEL 5 | $183.00 | $457.50 | $170.86–$409.94 | 22% below | 60% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT-LEVEL 5-EST | $183.00 | $457.50 | $170.86–$409.94 | 22% below | 60% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 SED-OP VISIT LEVEL 5 | $183.00 | $457.50 | $170.86–$409.94 | 22% below | 60% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP VISIT-LEVEL 5-EST PC | $134.02 | $335.05 | $48.89–$201.09 | — | 60% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SED-OP VISIT-LEVEL 5 PC | $143.34 | $358.35 | $48.89–$201.09 | — | 60% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SED-OP VISIT LEVEL 5 | $183.00 | $457.50 | — | — | 60% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SED-OP VISIT-LEVEL 5 | $183.00 | $457.50 | — | — | 60% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP VISIT-LEVEL 5-EST | $183.00 | $457.50 | — | — | 60% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT-LEVEL 3-EST PC | $61.54 | $153.84 | $21.76–$91.93 | 64% below | 60% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 SED-OP VISIT-LEVEL 3 PC | $65.78 | $164.43 | $21.76–$91.93 | 61% below | 60% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT-LEVEL 3-EST | $183.00 | $457.50 | $84.51–$388.88 | 8% above | 60% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 SED-OP VISIT-LEVEL 3 | $183.00 | $457.50 | $84.51–$388.88 | 8% above | 60% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP VISIT-LEVEL 3-EST PC | $61.54 | $153.84 | $21.76–$91.93 | — | 60% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SED-OP VISIT-LEVEL 3 PC | $65.78 | $164.43 | $21.76–$91.93 | — | 60% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SED-OP VISIT-LEVEL 3 | $183.00 | $457.50 | — | — | 60% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP VISIT-LEVEL 3-EST | $183.00 | $457.50 | — | — | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT-LEVEL 4-EST PC | $90.58 | $226.44 | $34.03–$135.63 | 53% below | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SED-OP VISIT LEVEL 4 PC | $96.68 | $241.68 | $34.03–$135.63 | 50% below | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT-LEVEL 4-EST | $183.00 | $457.50 | $120.41–$388.88 | 5% below | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SED-OP VISIT-LEVEL 4 | $183.00 | $457.50 | $120.41–$388.88 | 5% below | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SED-OP VISIT LEVEL 4 | $183.00 | $457.50 | $120.41–$388.88 | 5% below | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP VISIT-LEVEL 4-EST PC | $90.58 | $226.44 | $34.03–$135.63 | — | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SED-OP VISIT LEVEL 4 PC | $96.68 | $241.68 | $34.03–$135.63 | — | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SED-OP VISIT LEVEL 4 | $183.00 | $457.50 | — | — | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP VISIT-LEVEL 4-EST | $183.00 | $457.50 | — | — | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SED-OP VISIT-LEVEL 4 | $183.00 | $457.50 | — | — | 60% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SED-OP VISIT-LEVEL 2 PC | $35.64 | $89.08 | $11.47–$49.18 | 72% below | 60% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT-LEVEL 2-EST PC | $35.64 | $89.08 | $11.47–$49.18 | 72% below | 60% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT-LEVEL 2-EST | $183.00 | $457.50 | $52.58–$388.88 | 42% above | 60% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SED-OP VISIT-LEVEL 2 | $183.00 | $457.50 | $52.58–$388.88 | 42% above | 60% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP VISIT-LEVEL 2-EST PC | $35.64 | $89.08 | $11.47–$49.18 | — | 60% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SED-OP VISIT-LEVEL 2 PC | $35.64 | $89.08 | $11.47–$49.18 | — | 60% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SED-OP VISIT-LEVEL 2 | $183.00 | $457.50 | — | — | 60% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP VISIT-LEVEL 2-EST | $183.00 | $457.50 | — | — | 60% |
| Speech and language evaluation CPT 92523 (H)SPEECH SOUND LANG COMPREHEN | $271.48 | $678.69 | $203.75–$576.89 | 31% below | 60% |
| Speech and language evaluation CPT 92523 TELEHEALTH ST SOUND LANG COMP | $271.48 | $678.69 | $203.75–$576.89 | 31% below | 60% |
| Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN | $271.48 | $678.69 | $203.75–$576.89 | 31% below | 60% |
| Speech and language evaluation inpatient CPT 92523 (H)SPEECH SOUND LANG COMPREHEN | $271.48 | $678.69 | — | — | 60% |
| Speech and language evaluation inpatient CPT 92523 TELEHEALTH ST SOUND LANG COMP | $271.48 | $678.69 | — | — | 60% |
| Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN | $271.48 | $678.69 | — | — | 60% |
| Speech therapy session, individual CPT 92507 (H) SPEECH/LANG PATH TX | $94.88 | $237.18 | $68.48–$201.60 | 48% below | 60% |
| Speech therapy session, individual CPT 92507 SPEECH/LANG PATH TX | $94.88 | $237.18 | $68.48–$201.60 | 48% below | 60% |
| Speech therapy session, individual CPT 92507 AUGMENTATIVE COM TX | $94.88 | $237.18 | $68.48–$201.60 | 48% below | 60% |
| Speech therapy session, individual inpatient CPT 92507 (H) SPEECH/LANG PATH TX | $94.88 | $237.18 | — | — | 60% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH/LANG PATH TX | $94.88 | $237.18 | — | — | 60% |
| Speech therapy session, individual inpatient CPT 92507 AUGMENTATIVE COM TX | $94.88 | $237.18 | — | — | 60% |
| Spirometry (breathing test) CPT 94010 PFT BASIC SPIROMETRY | $222.18 | $555.45 | $247.97–$594.97 | 4% below | 60% |
| Spirometry (breathing test) inpatient CPT 94010 PFT BASIC SPIROMETRY | $222.18 | $555.45 | — | — | 60% |
| Spirometry before and after a bronchodilator CPT 94060 PFT B & A DILATOR | $442.20 | $1,105.49 | $428.54–$1,028.22 | 18% above | 60% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PFT B & A DILATOR | $442.20 | $1,105.49 | — | — | 60% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIV-DIRECT-15MIN | $46.86 | $117.15 | $31.25–$99.58 | 50% below | 60% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 (H) THERAPEUTIC ACTIVITY 15MIN | $46.86 | $117.15 | $31.25–$99.58 | 50% below | 60% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY 15 MIN | $46.86 | $117.15 | $31.25–$99.58 | 50% below | 60% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 (H) FUNCTIONAL SKILLS 15 MIN | $46.86 | $117.15 | $31.25–$99.58 | 50% below | 60% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPUTIC ACTIVITY 15 MIN | $46.86 | $117.15 | $31.25–$99.58 | 50% below | 60% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 FUNCTIONAL SKILLS 15 MIN | $46.86 | $117.15 | $31.25–$99.58 | 50% below | 60% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY 15 MIN | $46.86 | $117.15 | — | — | 60% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIV-DIRECT-15MIN | $46.86 | $117.15 | — | — | 60% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 (H) THERAPEUTIC ACTIVITY 15MIN | $46.86 | $117.15 | — | — | 60% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 FUNCTIONAL SKILLS 15 MIN | $46.86 | $117.15 | — | — | 60% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 (H) FUNCTIONAL SKILLS 15 MIN | $46.86 | $117.15 | — | — | 60% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPUTIC ACTIVITY 15 MIN | $46.86 | $117.15 | — | — | 60% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 (MRNA) VACCINE (MODER | $131.84 | $329.59 | $148.72–$356.83 | 39% below | 60% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19(MRNA) VACCINE 2023-24 | $166.35 | $415.87 | $148.72–$356.83 | 23% below | 60% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 (MRNA) VACCINE (MODER | $131.84 | $329.59 | — | — | 60% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19(MRNA) VACCINE 2023-24 | $166.35 | $415.87 | — | — | 60% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE, SINGLE .5ML | $26.69 | $66.71 | $11.40–$56.70 | 14% below | 60% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE, SINGLE .5ML | $26.69 | $66.71 | — | — | 60% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE INAC | $63.89 | $159.71 | $129.37–$135.76 | 38% below | 60% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE INAC | $63.89 | $159.71 | — | — | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECO | $46.23 | $115.56 | $69.13–$165.88 | 43% below | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECO | $46.23 | $115.56 | — | — | 60% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE | $61.86 | $154.64 | $125.26–$131.44 | 43% below | 60% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE | $61.86 | $154.64 | — | — | 60% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGA | $264.98 | $662.43 | $313.72–$752.73 | 38% below | 60% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ | $264.98 | $662.43 | $313.72–$752.73 | 38% below | 60% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ | $264.98 | $662.43 | — | — | 60% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGA | $264.98 | $662.43 | — | — | 60% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC POLYVALENT | $122.55 | $306.38 | $39.31–$294.62 | 14% below | 60% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX-23 | $152.16 | $380.39 | $39.31–$323.33 | 7% above | 60% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC POLYVALENT | $122.55 | $306.38 | — | — | 60% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX-23 | $152.16 | $380.39 | — | — | 60% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE HUMAN DIPL CELL | $316.86 | $792.13 | $305.42–$732.81 | 34% below | 60% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE HUMAN DIPL CELL | $316.86 | $792.13 | — | — | 60% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VACCINE RECOMBINANT ADJ | $154.74 | $386.83 | $127.26–$328.81 | 43% below | 60% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VACCINE RECOMBINANT ADJ | $154.74 | $386.83 | — | — | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH/TETANUS/ACEL. PERTUSSIS | $37.50 | $93.74 | $75.93–$79.68 | 33% below | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH/TETANUS/ACEL. PERTUSSIS | $37.50 | $93.74 | — | — | 60% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMIN 1ST IMMUNIZATION | $76.78 | $191.94 | $82.69–$198.39 | 3% above | 60% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMIN 1ST IMMUNIZATION | $76.78 | $191.94 | — | — | 60% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINE ADMIN EACH ADDITIONAL | $15.04 | $37.59 | $14.17–$33.99 | 53% below | 60% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINE ADMIN EACH ADDIT'L | $15.04 | $37.59 | $14.17–$33.99 | 53% below | 60% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINE ADMIN EACH ADDITIONAL | $15.04 | $37.59 | — | — | 60% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINE ADMIN EACH ADDIT'L | $15.04 | $37.59 | — | — | 60% |