Hospital

Sidney Health Center

Sidney Health Center in Sidney, MT publishes cash prices for 423 common procedures listed here, from its own machine-readable price file updated Apr 30, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Montana median for 317 of 397 procedures and above it for 57. By typical cash price it ranks #1 of 14 Montana hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

216 14th Ave SW, Sidney, MT 59270 Collected Sep 27, 2026 Source price file (406) 488-2100

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 3 of 5 CCN 271344 · 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 3 actions for a hospital named Sidney Health Center in Sidney, MT:

Jan 28, 2026 Warning notice
May 5, 2026 Corrective action plan requested
Jun 22, 2026 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. 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 Montana	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 PFR 73610 ANKLE MIN 3 VWS	$34.06	$55.00	$33.56–$63.00	83% below	38%
Ankle X-ray, complete, 3 or more views CPT 73610 RAD EXAM ANKLE MIN 3 VWS	$150.47	$243.00	$218.70–$243.00	26% below	38%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 PFR 73610 ANKLE MIN 3 VWS	$34.06	$55.00	$33.56–$63.00	—	38%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 RAD EXAM ANKLE MIN 3 VWS	$150.47	$243.00	$221.13–$243.00	—	38%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 LIMITED BILAT PHYSIOLOGIC STUDIES EXT ART 1-2 LVLS	$146.76	$237.00	$215.67–$237.00	—	38%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 LIMITED BILAT PHYSIOLOGIC STUDIES EXT ART 1-2 LVLS	$146.76	$237.00	$215.67–$237.00	—	38%
Barium swallow (esophagus X-ray with contrast) CPT 74220 PFR 74220 ESOPHAGRAM	$47.68	$77.00	$73.15–$166.46	87% below	38%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RAD EXAM ESOPHAGUS	$110.84	$179.00	$161.10–$179.00	70% below	38%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 PFR 74220 ESOPHAGRAM	$47.68	$77.00	$73.15–$166.46	—	38%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RAD EXAM ESOPHAGUS	$110.84	$179.00	$162.89–$179.00	—	38%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE AND OR JNT IMG WHOLE BODY	$618.59	$999.00	$899.10–$999.00	46% below	38%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE AND OR JNT IMG WHOLE BODY	$618.59	$999.00	$909.09–$999.00	—	38%
Breast ultrasound, complete, one breast one side CPT 76641 PFR 76641 US UNILATERAL BREAST COMPLETE	$121.37	$196.00	$94.22–$186.20	62% below	38%
Breast ultrasound, complete, one breast one side CPT 76641 US UNILATERAL BREAST COMPLETE	$200.63	$324.00	$291.60–$324.00	36% below	38%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 PFR 76641 US UNILATERAL BREAST COMPLETE	$121.37	$196.00	$94.22–$186.20	—	38%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US UNILATERAL BREAST COMPLETE	$200.63	$324.00	$294.84–$324.00	—	38%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 PFR 76642 US UNILATERAL BREAST LIMITED	$111.46	$180.00	$78.21–$171.00	57% below	38%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US UNILATERAL BREAST LIMITED	$175.24	$283.00	$254.70–$283.00	33% below	38%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 PFR 76642 US UNILATERAL BREAST LIMITED	$111.46	$180.00	$78.21–$171.00	—	38%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US UNILATERAL BREAST LIMITED	$175.24	$283.00	$257.53–$283.00	—	38%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 PFR 71275 CTA CHEST WO W CONT	$247.68	$400.00	$264.49–$496.50	89% below	38%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST WCONT +WO IF PERF	$1,426.64	$2,304.00	$2,073.60–$2,304.00	38% below	38%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 PFR 71275 CTA CHEST WO W CONT	$247.68	$400.00	$264.49–$496.50	—	38%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST WCONT +WO IF PERF	$1,426.64	$2,304.00	$2,096.64–$2,304.00	—	38%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 PFR 74176 CT ABD PELVIS WO CONT	$351.71	$568.00	$172.12–$539.60	85% below	38%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PELVIS WO CONTRAST	$751.71	$1,214.00	$1,092.60–$1,214.00	69% below	38%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 PFR 74176 CT ABD PELVIS WO CONT	$351.71	$568.00	$172.12–$539.60	—	38%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD PELVIS WO CONTRAST	$751.71	$1,214.00	$1,104.74–$1,214.00	—	38%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 PFR 74177 CT ABD PELVIS W CONT	$344.90	$557.00	$282.96–$531.18	88% below	38%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PELVIS W CONTRAST	$1,219.21	$1,969.00	$1,772.10–$1,969.00	59% below	38%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 PFR 74177 CT ABD PELVIS W CONT	$344.90	$557.00	$282.96–$531.18	—	38%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD PELVIS W CONTRAST	$1,219.21	$1,969.00	$1,791.79–$1,969.00	—	38%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 PFR 74178 CT ABD PEL WO&W CONT	$316.42	$511.00	$316.83–$594.76	91% below	38%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD PELVIS WO THEN W CONT	$1,292.89	$2,088.00	$1,879.20–$2,088.00	62% below	38%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 PFR 74178 CT ABD PEL WO&W CONT	$316.42	$511.00	$316.83–$594.76	—	38%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD PELVIS WO THEN W CONT	$1,292.89	$2,088.00	$1,900.08–$2,088.00	—	38%
CT scan of the abdomen with contrast CPT 74160 PFR 74160 CT ABDOMEN W CONT	$261.93	$423.00	$216.15–$405.76	85% below	38%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST	$926.33	$1,496.00	$1,346.40–$1,496.00	49% below	38%
CT scan of the abdomen with contrast inpatient CPT 74160 PFR 74160 CT ABDOMEN W CONT	$261.93	$423.00	$216.15–$405.76	—	38%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST	$926.33	$1,496.00	$1,361.36–$1,496.00	—	38%
CT scan of the abdomen without contrast CPT 74150 PFR 74150 CT ABDOMEN WO CONT	$242.73	$392.00	$127.78–$372.40	84% below	38%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST	$738.71	$1,193.00	$1,073.70–$1,193.00	53% below	38%
CT scan of the abdomen without contrast inpatient CPT 74150 PFR 74150 CT ABDOMEN WO CONT	$242.73	$392.00	$127.78–$372.40	—	38%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST	$738.71	$1,193.00	$1,085.63–$1,193.00	—	38%
CT scan of the face and sinuses, no contrast dye CPT 70486 PFR 70486 CT MAXILLOFACIAL WO CONT	$209.91	$339.00	$120.08–$322.05	83% below	38%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONT	$656.98	$1,061.00	$954.90–$1,061.00	47% below	38%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 PFR 70486 CT MAXILLOFACIAL WO CONT	$209.91	$339.00	$120.08–$322.05	—	38%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONT	$656.98	$1,061.00	$965.51–$1,061.00	—	38%
CT scan of the head or brain, no contrast dye CPT 70450 PFR 70450 CT HEAD WO CONTRAST	$200.01	$323.00	$100.07–$306.85	86% below	38%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$743.04	$1,200.00	$1,080.00–$1,200.00	49% below	38%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 PFR 70450 CT HEAD WO CONTRAST	$200.01	$323.00	$100.07–$306.85	—	38%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST	$743.04	$1,200.00	$1,092.00–$1,200.00	—	38%
CT scan of the head with contrast CPT 70460 PFR 70460 CT HEAD W CONTRA	$227.87	$368.00	$139.17–$349.60	86% below	38%
CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST	$499.70	$807.00	$726.30–$807.00	69% below	38%
CT scan of the head with contrast inpatient CPT 70460 PFR 70460 CT HEAD W CONTRA	$227.87	$368.00	$139.17–$349.60	—	38%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST	$499.70	$807.00	$734.37–$807.00	—	38%
CT scan of the head without and with contrast CPT 70470 PFR 70470 CT HEAD WO THEN W	$271.83	$439.00	$162.57–$417.05	87% below	38%
CT scan of the head without and with contrast CPT 70470 CT HEAD WO THEN W CONTRAST	$898.46	$1,451.00	$1,305.90–$1,451.00	57% below	38%
CT scan of the head without and with contrast inpatient CPT 70470 PFR 70470 CT HEAD WO THEN W	$271.83	$439.00	$162.57–$417.05	—	38%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WO THEN W CONTRAST	$898.46	$1,451.00	$1,320.41–$1,451.00	—	38%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 PFR 72131 CT LUMB SPINE WO CONT	$235.30	$380.00	$121.31–$361.00	85% below	38%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONT	$764.72	$1,235.00	$1,111.50–$1,235.00	52% below	38%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 PFR 72131 CT LUMB SPINE WO CONT	$235.30	$380.00	$121.31–$361.00	—	38%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONT	$764.72	$1,235.00	$1,123.85–$1,235.00	—	38%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 PFR 72125 CT CERV SPINE WO CON	$235.30	$380.00	$121.93–$361.00	84% below	38%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTRAST	$751.71	$1,214.00	$1,092.60–$1,214.00	50% below	38%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 PFR 72125 CT CERV SPINE WO CON	$235.30	$380.00	$121.93–$361.00	—	38%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CONTRAST	$751.71	$1,214.00	$1,104.74–$1,214.00	—	38%
CT scan of the pelvis, with contrast dye CPT 72193 PFR 72193 CT PELVIS W CONTRAST	$225.39	$364.00	$212.45–$398.82	88% below	38%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST	$707.75	$1,143.00	$1,028.70–$1,143.00	62% below	38%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 PFR 72193 CT PELVIS W CONTRAST	$225.39	$364.00	$212.45–$398.82	—	38%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST	$707.75	$1,143.00	$1,040.13–$1,143.00	—	38%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX SCAN EXTRACRANIAL ARTERIES COMP BILAT STUDY	$274.93	$444.00	$404.04–$444.00	—	38%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUP CAROTID BILAT	$468.74	$757.00	$688.87–$757.00	—	38%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUPLEX SCAN EXTRACRANIAL ARTERIES COMP BILAT STUDY	$274.93	$444.00	$404.04–$444.00	—	38%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUP CAROTID BILAT	$468.74	$757.00	$688.87–$757.00	—	38%
Chest X-ray, 2 views CPT 71046 PFR 71046 RAD EXAM CHEST 2 VWS	$40.87	$66.00	$31.10–$62.70	82% below	38%
Chest X-ray, 2 views CPT 71046 RAD EXAM CHEST 2 VWS	$143.66	$232.00	$208.80–$232.00	36% below	38%
Chest X-ray, 2 views inpatient CPT 71046 PFR 71046 RAD EXAM CHEST 2 VWS	$40.87	$66.00	$31.10–$62.70	—	38%
Chest X-ray, 2 views inpatient CPT 71046 RAD EXAM CHEST 2 VWS	$143.66	$232.00	$211.12–$232.00	—	38%
Chest X-ray, single view CPT 71045 PFR 71045 RAD EXAM CHEST SINGLE VW	$34.06	$55.00	$24.02–$52.25	81% below	38%
Chest X-ray, single view CPT 71045 RAD EXAM CHEST SINGLE VW	$100.32	$162.00	$145.80–$162.00	45% below	38%
Chest X-ray, single view inpatient CPT 71045 PFR 71045 RAD EXAM CHEST SINGLE VW	$34.06	$55.00	$24.02–$52.25	—	38%
Chest X-ray, single view inpatient CPT 71045 RAD EXAM CHEST SINGLE VW	$100.32	$162.00	$147.42–$162.00	—	38%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 PFR 76770 US RETROPERITONEUM	$83.60	$135.00	$99.45–$186.69	83% below	38%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEUM	$175.86	$284.00	$255.60–$284.00	64% below	38%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 PFR 76770 US RETROPERITONEUM	$83.60	$135.00	$99.45–$186.69	—	38%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEUM	$175.86	$284.00	$258.44–$284.00	—	38%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 PFR 77080 DXA SCAN AXIAL SKELET	$46.44	$75.00	$36.33–$71.25	86% below	38%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY DEXA AXIAL SKELET	$260.69	$421.00	$378.90–$421.00	22% below	38%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 PFR 77080 DXA SCAN AXIAL SKELET	$46.44	$75.00	$36.33–$71.25	—	38%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY DEXA AXIAL SKELET	$260.69	$421.00	$383.11–$421.00	—	38%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY DEXA APPEND SKEL	$63.78	$103.00	$92.70–$103.00	54% below	38%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENSITY DEXA APPEND SKEL	$63.78	$103.00	$93.73–$103.00	—	38%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PG UTR TRNSABD SG	$163.47	$264.00	$237.60–$264.00	59% below	38%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 PFR 76811 US PG UTR TRNSABD SG	$190.72	$308.00	$163.80–$307.50	52% below	38%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PG UTR TRNSABD SG	$163.47	$264.00	$240.24–$264.00	—	38%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 PFR 76811 US PG UTR TRNSABD SG	$190.72	$308.00	$163.80–$307.50	—	38%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 PFR 71250 CT THORAX DIAGNOSTIC WO CONTRAST	$248.30	$401.00	$124.70–$380.95	83% below	38%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DIAGNOSTIC WO CONTRAST	$789.48	$1,275.00	$1,147.50–$1,275.00	46% below	38%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 PFR 71250 CT THORAX DIAGNOSTIC WO CONTRAST	$248.30	$401.00	$124.70–$380.95	—	38%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DIAGNOSTIC WO CONTRAST	$789.48	$1,275.00	$1,160.25–$1,275.00	—	38%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 PFR 71260 CT THORAX DIAGNOSTIC WITH CONTRAST	$284.84	$460.00	$156.41–$437.00	85% below	38%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DIAGNOSTIC WITH CONTRAST	$933.76	$1,508.00	$1,357.20–$1,508.00	50% below	38%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 PFR 71260 CT THORAX DIAGNOSTIC WITH CONTRAST	$284.84	$460.00	$156.41–$437.00	—	38%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX DIAGNOSTIC WITH CONTRAST	$933.76	$1,508.00	$1,372.28–$1,508.00	—	38%
Diagnostic mammogram, both breasts both sides CPT 77066 PFR 77066 MAMMO DX BILAT INCL CAD	$95.36	$154.00	$146.25–$274.55	—	38%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DX BILAT INCL CAD	$341.18	$551.00	$495.90–$551.00	—	38%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 PFR 77066 MAMMO DX BILAT INCL CAD	$95.36	$154.00	$146.25–$274.55	—	38%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DX BILAT INCL CAD	$341.18	$551.00	$501.41–$551.00	—	38%
Diagnostic mammogram, one breast one side CPT 77065 PFR 77065 MAMMO DX UNILAT INCL CAD	$77.40	$125.00	$116.08–$217.91	69% below	38%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT INCL CAD	$285.46	$461.00	$414.90–$461.00	15% above	38%
Diagnostic mammogram, one breast inpatient one side CPT 77065 PFR 77065 MAMMO DX UNILAT INCL CAD	$77.40	$125.00	$116.08–$217.91	—	38%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX UNILAT INCL CAD	$285.46	$461.00	$419.51–$461.00	—	38%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 PFR 93925 DUPX ARTER LWR EXT BI	$85.45	$138.00	$131.10–$409.22	—	38%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX SCAN LWR EXTREMITY ARTERIES ARTERIAL BYPASS GRFTS COMP BILAT	$87.31	$141.00	$128.31–$141.00	—	38%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX ART LOWER EXT CMPL BILAT	$493.51	$797.00	$725.27–$797.00	—	38%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 PFR 93925 DUPX ARTER LWR EXT BI	$85.45	$138.00	$131.10–$409.22	—	38%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUPLEX SCAN LWR EXTREMITY ARTERIES ARTERIAL BYPASS GRFTS COMP BILAT	$87.31	$141.00	$128.31–$141.00	—	38%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUPLEX ART LOWER EXT CMPL BILAT	$493.51	$797.00	$725.27–$797.00	—	38%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 PFR 93970 DUPX VENOUS EXTREM BI	$107.75	$174.00	$165.30–$319.63	—	38%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX SCAN VEINS EXTREMITY COMP BILAT STUDY	$393.82	$636.00	$578.76–$636.00	—	38%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX VENOUS EXT CMPL BILAT	$577.72	$933.00	$849.03–$933.00	—	38%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 PFR 93970 DUPX VENOUS EXTREM BI	$107.75	$174.00	$165.30–$319.63	—	38%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX SCAN VEINS EXTREMITY COMP BILAT STUDY	$393.82	$636.00	$578.76–$636.00	—	38%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX VENOUS EXT CMPL BILAT	$577.72	$933.00	$849.03–$933.00	—	38%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO (2D) COMPLETE W DOPPLER & COLOR	$370.91	$599.00	$545.09–$599.00	74% below	38%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO (2D) COMPLETE W DOPPLER & COLOR	$370.91	$599.00	$545.09–$599.00	—	38%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY IMG INCL GALLBLADDER	$776.48	$1,254.00	$1,128.60–$1,254.00	27% below	38%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY IMG INCL GALLBLADDER	$776.48	$1,254.00	$1,141.14–$1,254.00	—	38%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATTENDED	$209.29	$338.00	$307.58–$338.00	at median	38%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 UNATTENDED SLEEP STUDY 95806	$323.85	$523.00	$475.93–$523.00	55% above	38%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATTENDED	$209.29	$338.00	$307.58–$338.00	—	38%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 UNATTENDED SLEEP STUDY 95806	$323.85	$523.00	$475.93–$523.00	—	38%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PF 95811 POLYSOM SLEEP STUDY W CPAP M26	$355.43	$574.00	$545.30–$1,138.66	85% below	38%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PF 95811 PSG (SLEEP STAGE)4+W	$359.14	$580.00	$527.80–$580.00	85% below	38%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG CPAP BIPAP 4+ PARAMETERS	$2,115.19	$3,416.00	$3,108.56–$3,416.00	12% below	38%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PF 95811 POLYSOM SLEEP STUDY W CPAP M26	$355.43	$574.00	$545.30–$1,138.66	—	38%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PF 95811 PSG (SLEEP STAGE)4+W	$359.14	$580.00	$527.80–$580.00	—	38%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG CPAP BIPAP 4+ PARAMETERS	$2,115.19	$3,416.00	$3,108.56–$3,416.00	—	38%
Knee X-ray, 3 views CPT 73562 PFR 73562 KNEE 3 VIEWS	$35.30	$57.00	$37.56–$70.52	81% below	38%
Knee X-ray, 3 views CPT 73562 RAD EXAM KNEE 3 VWS	$150.47	$243.00	$218.70–$243.00	21% below	38%
Knee X-ray, 3 views inpatient CPT 73562 PFR 73562 KNEE 3 VIEWS	$35.30	$57.00	$37.56–$70.52	—	38%
Knee X-ray, 3 views inpatient CPT 73562 RAD EXAM KNEE 3 VWS	$150.47	$243.00	$221.13–$243.00	—	38%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 PFR 76705 US ABD LIMITED	$80.50	$130.00	$80.05–$150.28	79% below	38%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LIMITED	$217.96	$352.00	$316.80–$352.00	44% below	38%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 PFR 76705 US ABD LIMITED	$80.50	$130.00	$80.05–$150.28	—	38%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LIMITED	$217.96	$352.00	$320.32–$352.00	—	38%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 PFR 71271 CT THORAX LUNG CANCER SCR C-	$111.46	$180.00	$129.01–$242.18	76% below	38%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LW DOSE LUNG CA SCR NO CONTRAST	$227.87	$368.00	$331.20–$368.00	50% below	38%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 PFR 71271 CT THORAX LUNG CANCER SCR C-	$111.46	$180.00	$129.01–$242.18	—	38%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LW DOSE LUNG CA SCR NO CONTRAST	$227.87	$368.00	$334.88–$368.00	—	38%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 PFR 77049 MRI BREAST WO AND W CONTRAST INC CAD WHEN PERFORMED BILATERAL	$352.33	$569.00	$320.52–$601.70	—	38%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST BILAT WO AND W CONT INC CAD	$917.04	$1,481.00	$1,332.90–$1,481.00	—	38%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 PFR 77049 MRI BREAST WO AND W CONTRAST INC CAD WHEN PERFORMED BILATERAL	$352.33	$569.00	$320.52–$601.70	—	38%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST BILAT WO AND W CONT INC CAD	$917.04	$1,481.00	$1,347.71–$1,481.00	—	38%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 PFR 73721 MRI LO EXT JT WO	$358.52	$579.00	$190.59–$550.05	80% below	38%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXT JT WO CONTRAST	$877.41	$1,417.00	$1,275.30–$1,417.00	52% below	38%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 PFR 73721 MRI LO EXT JT WO	$358.52	$579.00	$190.59–$550.05	—	38%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXT JT WO CONTRAST	$877.41	$1,417.00	$1,289.47–$1,417.00	—	38%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 PFR 73723 MRI LO EXT JT WO W	$450.78	$728.00	$359.32–$691.60	85% below	38%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXT JT WO THEN W CONT	$1,556.05	$2,513.00	$2,261.70–$2,513.00	47% below	38%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 PFR 73723 MRI LO EXT JT WO W	$450.78	$728.00	$359.32–$691.60	—	38%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXT JT WO THEN W CONT	$1,556.05	$2,513.00	$2,286.83–$2,513.00	—	38%
MRI of the abdomen without contrast CPT 74181 PFR 74181 MRI ABDOMEN WO CONT	$307.75	$497.00	$183.20–$472.15	85% below	38%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST	$1,123.85	$1,815.00	$1,633.50–$1,815.00	44% below	38%
MRI of the abdomen without contrast inpatient CPT 74181 PFR 74181 MRI ABDOMEN WO CONT	$307.75	$497.00	$183.20–$472.15	—	38%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST	$1,123.85	$1,815.00	$1,651.65–$1,815.00	—	38%
MRI of the abdomen, without and then with contrast dye CPT 74183 PFR 74183 MRI ABDOM WO W CON	$601.25	$971.00	$316.52–$922.45	81% below	38%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO THEN W CONT	$2,071.85	$3,346.00	$3,011.40–$3,346.00	35% below	38%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 PFR 74183 MRI ABDOM WO W CON	$601.25	$971.00	$316.52–$922.45	—	38%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO THEN W CONT	$2,071.85	$3,346.00	$3,044.86–$3,346.00	—	38%
MRI of the brain, no contrast dye CPT 70551 PFR 70551 MRI BRAIN WO CONTRAST	$448.92	$725.00	$184.12–$688.75	77% below	38%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST	$1,013.02	$1,636.00	$1,472.40–$1,636.00	49% below	38%
MRI of the brain, no contrast dye inpatient CPT 70551 PFR 70551 MRI BRAIN WO CONTRAST	$448.92	$725.00	$184.12–$688.75	—	38%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST	$1,013.02	$1,636.00	$1,488.76–$1,636.00	—	38%
MRI of the brain, with and without contrast dye CPT 70553 PFR 70553 MRI BRAIN WO W CONT	$796.92	$1,287.00	$298.97–$1,222.65	76% below	38%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO THEN W CONT	$1,925.10	$3,109.00	$2,798.10–$3,109.00	41% below	38%
MRI of the brain, with and without contrast dye inpatient CPT 70553 PFR 70553 MRI BRAIN WO W CONT	$796.92	$1,287.00	$298.97–$1,222.65	—	38%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO THEN W CONT	$1,925.10	$3,109.00	$2,829.19–$3,109.00	—	38%
MRI of the lower back, no contrast dye CPT 72148 PFR 72148 MRI L SPINE WO CONT	$424.78	$686.00	$179.20–$651.70	79% below	38%
MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE WO CONTRAST	$876.79	$1,416.00	$1,274.40–$1,416.00	57% below	38%
MRI of the lower back, no contrast dye inpatient CPT 72148 PFR 72148 MRI L SPINE WO CONT	$424.78	$686.00	$179.20–$651.70	—	38%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L SPINE WO CONTRAST	$876.79	$1,416.00	$1,288.56–$1,416.00	—	38%
MRI of the lower back, without and then with contrast dye CPT 72158 PFR 72158 MRI L SPINE WO W CON	$733.76	$1,185.00	$299.28–$1,125.75	75% below	38%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L SPINE WO THEN W CONT	$1,735.62	$2,803.00	$2,522.70–$2,803.00	41% below	38%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 PFR 72158 MRI L SPINE WO W CON	$733.76	$1,185.00	$299.28–$1,125.75	—	38%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L SPINE WO THEN W CONT	$1,735.62	$2,803.00	$2,550.73–$2,803.00	—	38%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 PFR 72146 MRI THOR SPINE WO CON	$445.21	$719.00	$178.89–$683.05	78% below	38%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE WO CONTRAST	$957.91	$1,547.00	$1,392.30–$1,547.00	53% below	38%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 PFR 72146 MRI THOR SPINE WO CON	$445.21	$719.00	$178.89–$683.05	—	38%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T SPINE WO CONTRAST	$957.91	$1,547.00	$1,407.77–$1,547.00	—	38%
MRI of the neck (cervical spine) without and with contrast CPT 72156 PFR 72156 MRI C-SPINE WO W CON	$776.48	$1,254.00	$299.89–$1,191.30	73% below	38%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C SPINE WO THEN W CONT	$1,965.96	$3,175.00	$2,857.50–$3,175.00	32% below	38%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 PFR 72156 MRI C-SPINE WO W CON	$776.48	$1,254.00	$299.89–$1,191.30	—	38%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C SPINE WO THEN W CONT	$1,965.96	$3,175.00	$2,889.25–$3,175.00	—	38%
MRI of the neck (cervical spine), no contrast dye CPT 72141 PFR 72141 MRI C-SPINE WO CONT	$412.39	$666.00	$178.58–$632.70	79% below	38%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C SPINE WO CONTRAST	$889.18	$1,436.00	$1,292.40–$1,436.00	55% below	38%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 PFR 72141 MRI C-SPINE WO CONT	$412.39	$666.00	$178.58–$632.70	—	38%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C SPINE WO CONTRAST	$889.18	$1,436.00	$1,306.76–$1,436.00	—	38%
MRI of the pelvis without and with contrast CPT 72197 PFR 72197 MRI PELVIS WO W CONT	$596.91	$964.00	$315.29–$915.80	81% below	38%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO THEN W CONT	$2,057.61	$3,323.00	$2,990.70–$3,323.00	34% below	38%
MRI of the pelvis without and with contrast inpatient CPT 72197 PFR 72197 MRI PELVIS WO W CONT	$596.91	$964.00	$315.29–$915.80	—	38%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO THEN W CONT	$2,057.61	$3,323.00	$3,023.93–$3,323.00	—	38%
MRI of the pelvis, no contrast dye CPT 72195 PFR 72195 MRI PELVIS WO CONT	$286.08	$462.00	$213.68–$438.90	87% below	38%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST	$1,181.44	$1,908.00	$1,717.20–$1,908.00	48% below	38%
MRI of the pelvis, no contrast dye inpatient CPT 72195 PFR 72195 MRI PELVIS WO CONT	$286.08	$462.00	$213.68–$438.90	—	38%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST	$1,181.44	$1,908.00	$1,736.28–$1,908.00	—	38%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 PFR 73221 MRI UP EXT JT WO	$393.82	$636.00	$190.90–$604.20	80% below	38%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXT JT WO CONTRAST	$993.82	$1,605.00	$1,444.50–$1,605.00	49% below	38%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 PFR 73221 MRI UP EXT JT WO	$393.82	$636.00	$190.90–$604.20	—	38%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXT JT WO CONTRAST	$993.82	$1,605.00	$1,460.55–$1,605.00	—	38%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIAL SPECT MULT STDY	$1,026.02	$1,657.00	$1,491.30–$1,657.00	51% below	38%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARDIAL SPECT MULT STDY	$1,026.02	$1,657.00	$1,507.87–$1,657.00	—	38%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT SKULL BASE TO MID THIGH	$2,956.07	$4,774.00	$4,296.60–$4,774.00	39% below	38%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET CT SKULL BASE TO MID THIGH	$2,956.07	$4,774.00	$4,344.34–$4,774.00	—	38%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PFR 76857 US PELVIS NON OB LTD	$66.26	$107.00	$46.19–$101.65	79% below	38%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PFR 76857 US FOLLICULAR SCAN	$104.65	$169.00	$46.19–$160.55	67% below	38%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED	$220.44	$356.00	$320.40–$356.00	30% below	38%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PFR 76857 US PELVIS NON OB LTD	$66.26	$107.00	$46.19–$101.65	—	38%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PFR 76857 US FOLLICULAR SCAN	$104.65	$169.00	$46.19–$160.55	—	38%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED	$220.44	$356.00	$323.96–$356.00	—	38%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PFR 76856 US PELVIC COMPLETE	$129.42	$209.00	$96.68–$198.55	73% below	38%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE	$317.04	$512.00	$460.80–$512.00	34% below	38%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PFR 76856 US PELVIC COMPLETE	$129.42	$209.00	$96.68–$198.55	—	38%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE	$317.04	$512.00	$465.92–$512.00	—	38%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 PFR 76805 US PREG>14 WKS SGL	$136.23	$220.00	$123.78–$232.36	77% below	38%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTER RLTIME WIMAGE DOC FETAL & MATERNL 1ST TRIMST TRANSABDM S	$222.92	$360.00	$327.60–$360.00	63% below	38%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PG UTR 2-3TRI SGL 1ST	$261.31	$422.00	$379.80–$422.00	56% below	38%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 PFR 76805 US PREG>14 WKS SGL	$136.23	$220.00	$123.78–$232.36	—	38%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTER RLTIME WIMAGE DOC FETAL & MATERNL 1ST TRIMST TRANSABDM S	$222.92	$360.00	$327.60–$360.00	—	38%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PG UTR 2-3TRI SGL 1ST	$261.31	$422.00	$384.02–$422.00	—	38%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT	$158.52	$256.00	$232.96–$256.00	70% below	38%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 PFR 76801 US PREG <14W SGL	$159.76	$258.00	$107.46–$245.10	70% below	38%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTER 1ST TRI SGL	$220.44	$356.00	$320.40–$356.00	59% below	38%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT	$158.52	$256.00	$232.96–$256.00	—	38%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 PFR 76801 US PREG <14W SGL	$159.76	$258.00	$107.46–$245.10	—	38%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTER 1ST TRI SGL	$220.44	$356.00	$323.96–$356.00	—	38%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 PFR 76815 US PREGNANCY LTD	$122.61	$198.00	$74.51–$188.10	65% below	38%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB REAL TIME LTD	$210.53	$340.00	$306.00–$340.00	40% below	38%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 PFR 76815 US PREGNANCY LTD	$122.61	$198.00	$74.51–$188.10	—	38%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB REAL TIME LTD	$210.53	$340.00	$309.40–$340.00	—	38%
Screening mammogram, both breasts both sides CPT 77067 PFR 77067 MAMMO SCREEN BILAT INCL CAD	$76.79	$124.00	$117.80–$222.53	—	38%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD	$304.65	$492.00	$442.80–$492.00	—	38%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52	$47.06	$76.00	$68.40–$76.00	83% below	38%
Screening mammogram, both breasts one side CPT 77067 PFR 77067 MAMMO SCREEN UNILAT INCL CAD	$65.02	$105.00	$99.75–$222.53	77% below	38%
Screening mammogram, both breasts inpatient both sides CPT 77067 PFR 77067 MAMMO SCREEN BILAT INCL CAD	$76.79	$124.00	$117.80–$222.53	—	38%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD	$304.65	$492.00	$447.72–$492.00	—	38%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52	$47.06	$76.00	$69.16–$76.00	—	38%
Screening mammogram, both breasts inpatient one side CPT 77067 PFR 77067 MAMMO SCREEN UNILAT INCL CAD	$65.02	$105.00	$99.75–$222.53	—	38%
Shoulder X-ray, complete, 2 or more views CPT 73030 PFR 73030 SHOULDER COMP MIN2VWS	$27.25	$44.00	$32.02–$60.11	88% below	38%
Shoulder X-ray, complete, 2 or more views CPT 73030 RAD EXAM SHOULDER COMPL MIN 2 VWS	$139.32	$225.00	$202.50–$225.00	38% below	38%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 PFR 73030 SHOULDER COMP MIN2VWS	$27.25	$44.00	$32.02–$60.11	—	38%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RAD EXAM SHOULDER COMPL MIN 2 VWS	$139.32	$225.00	$204.75–$225.00	—	38%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY SLEEP STAGING W4+ ADDL PARAMETERS ATTENDED	$319.51	$516.00	$469.56–$516.00	86% below	38%
Sleep study in a lab (polysomnography) CPT 95810 PF 95810 PSG 4+ PARAMETERS M26	$326.32	$527.00	$500.65–$1,087.22	85% below	38%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY PARTIAL 95810 M52	$1,896.00	$3,062.00	$2,786.42–$3,062.00	16% below	38%
Sleep study in a lab (polysomnography) CPT 95810 PSG 4+ PARAMETERS	$1,896.00	$3,062.00	$2,786.42–$3,062.00	16% below	38%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY SLEEP STAGING W4+ ADDL PARAMETERS ATTENDED	$319.51	$516.00	$469.56–$516.00	—	38%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PF 95810 PSG 4+ PARAMETERS M26	$326.32	$527.00	$500.65–$1,087.22	—	38%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STUDY PARTIAL 95810 M52	$1,896.00	$3,062.00	$2,786.42–$3,062.00	—	38%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG 4+ PARAMETERS	$1,896.00	$3,062.00	$2,786.42–$3,062.00	—	38%
Swallow study (modified barium swallow, video X-ray) CPT 74230 PFR 74230 RAD SWALLOWING FUNC CINERAD OR VIDEORAD	$52.64	$85.00	$80.75–$210.97	88% below	38%
Swallow study (modified barium swallow, video X-ray) CPT 74230 RAD SWALLOWING FUNC W CINERAD OR VIDEORAD	$200.01	$323.00	$290.70–$323.00	54% below	38%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 PFR 74230 RAD SWALLOWING FUNC CINERAD OR VIDEORAD	$52.64	$85.00	$80.75–$210.97	—	38%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RAD SWALLOWING FUNC W CINERAD OR VIDEORAD	$200.01	$323.00	$293.93–$323.00	—	38%
Transvaginal pelvic ultrasound CPT 76830 PFR 76830 US TRANSVAGINAL	$77.40	$125.00	$108.69–$204.03	82% below	38%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$282.98	$457.00	$411.30–$457.00	35% below	38%
Transvaginal pelvic ultrasound inpatient CPT 76830 PFR 76830 US TRANSVAGINAL	$77.40	$125.00	$108.69–$204.03	—	38%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$282.98	$457.00	$415.87–$457.00	—	38%
Transvaginal ultrasound during pregnancy CPT 76817 PFR 76817 US PREG TRANSVAGINAL	$149.23	$241.00	$84.67–$228.95	65% below	38%
Transvaginal ultrasound during pregnancy CPT 76817 US PG UTR TRANSVAG	$227.25	$367.00	$330.30–$367.00	46% below	38%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 PFR 76817 US PREG TRANSVAGINAL	$149.23	$241.00	$84.67–$228.95	—	38%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PG UTR TRANSVAG	$227.25	$367.00	$333.97–$367.00	—	38%
Ultrasound of the abdomen, complete CPT 76700 PFR 76700 US ABD COMPLETE	$133.13	$215.00	$106.53–$204.25	75% below	38%
Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE	$265.64	$429.00	$386.10–$429.00	50% below	38%
Ultrasound of the abdomen, complete inpatient CPT 76700 PFR 76700 US ABD COMPLETE	$133.13	$215.00	$106.53–$204.25	—	38%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD COMPLETE	$265.64	$429.00	$390.39–$429.00	—	38%
Ultrasound of the scrotum and testicles CPT 76870 PFR 76870 US SCROTUM	$121.99	$197.00	$92.06–$187.15	74% below	38%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$298.46	$482.00	$433.80–$482.00	36% below	38%
Ultrasound of the scrotum and testicles inpatient CPT 76870 PFR 76870 US SCROTUM	$121.99	$197.00	$92.06–$187.15	—	38%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$298.46	$482.00	$438.62–$482.00	—	38%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 PFR 76536 US THYROID PARATHYROI	$77.40	$125.00	$100.99–$189.58	82% below	38%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD NECK	$251.40	$406.00	$365.40–$406.00	42% below	38%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 PFR 76536 US THYROID PARATHYROI	$77.40	$125.00	$100.99–$189.58	—	38%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD NECK	$251.40	$406.00	$369.46–$406.00	—	38%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 PFR 74240 RADIOLOGIC EXAM UPPER GI TRACT W SCOUT SGL CNTRST	$119.51	$193.00	$111.46–$209.24	74% below	38%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RAD EXAM GI UPPER W WO DELAYED IMG WO KUB	$228.49	$369.00	$332.10–$369.00	51% below	38%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 PFR 74240 RADIOLOGIC EXAM UPPER GI TRACT W SCOUT SGL CNTRST	$119.51	$193.00	$111.46–$209.24	—	38%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RAD EXAM GI UPPER W WO DELAYED IMG WO KUB	$228.49	$369.00	$335.79–$369.00	—	38%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 PFR 93971 DUPX VENOUS EXTREM UN	$75.55	$122.00	$109.00–$204.61	89% below	38%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX SCAN VEINS EXTREMITY UNILAT LIMITED STUDY	$76.79	$124.00	$112.84–$124.00	89% below	38%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX VENOUS EXT LTD UNILAT	$391.96	$633.00	$576.03–$633.00	45% below	38%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX VENOUS EXT LTD UNILAT 52 MOD	$402.48	$650.00	$591.50–$650.00	43% below	38%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 PFR 93971 DUPX VENOUS EXTREM UN	$75.55	$122.00	$109.00–$204.61	—	38%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX SCAN VEINS EXTREMITY UNILAT LIMITED STUDY	$76.79	$124.00	$112.84–$124.00	—	38%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX VENOUS EXT LTD UNILAT	$391.96	$633.00	$576.03–$633.00	—	38%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX VENOUS EXT LTD UNILAT 52 MOD	$402.48	$650.00	$591.50–$650.00	—	38%
Wrist X-ray, complete, 3 or more views CPT 73110 PFR 73110 WRIST COMP 3 VIEWS	$33.44	$54.00	$38.18–$71.67	85% below	38%
Wrist X-ray, complete, 3 or more views CPT 73110 RAD EXAM WRIST COMPL MIN 3 VWS	$143.04	$231.00	$207.90–$231.00	36% below	38%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 PFR 73110 WRIST COMP 3 VIEWS	$33.44	$54.00	$38.18–$71.67	—	38%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 RAD EXAM WRIST COMPL MIN 3 VWS	$143.04	$231.00	$210.21–$231.00	—	38%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 PFR 73502 HIP UNILATERAL 2-3 VWS	$32.20	$52.00	$44.03–$82.65	83% below	38%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RAD EXAM HIP UNILAT W PELV WHEN PERF 2 OR 3 VWS	$115.18	$186.00	$167.40–$186.00	40% below	38%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 PFR 73502 HIP UNILATERAL 2-3 VWS	$32.20	$52.00	$44.03–$82.65	—	38%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RAD EXAM HIP UNILAT W PELV WHEN PERF 2 OR 3 VWS	$115.18	$186.00	$169.26–$186.00	—	38%
X-ray of the abdomen, 1 view CPT 74018 PFR 74018 RAD EXAM ABDOMEN 1 VW	$40.87	$66.00	$27.71–$62.70	77% below	38%
X-ray of the abdomen, 1 view CPT 74018 RAD EXAM ABDOMEN 1 VW	$97.22	$157.00	$141.30–$157.00	46% below	38%
X-ray of the abdomen, 1 view inpatient CPT 74018 PFR 74018 RAD EXAM ABDOMEN 1 VW	$40.87	$66.00	$27.71–$62.70	—	38%
X-ray of the abdomen, 1 view inpatient CPT 74018 RAD EXAM ABDOMEN 1 VW	$97.22	$157.00	$142.87–$157.00	—	38%
X-ray of the ankle, 2 views CPT 73600 PFR 73600 ANKLE 2 VIEWS	$30.96	$50.00	$29.56–$55.49	83% below	38%
X-ray of the ankle, 2 views CPT 73600 RAD EXAM ANKLE 2 VWS	$112.08	$181.00	$162.90–$181.00	37% below	38%
X-ray of the ankle, 2 views inpatient CPT 73600 PFR 73600 ANKLE 2 VIEWS	$30.96	$50.00	$29.56–$55.49	—	38%
X-ray of the ankle, 2 views inpatient CPT 73600 RAD EXAM ANKLE 2 VWS	$112.08	$181.00	$164.71–$181.00	—	38%
X-ray of the finger(s), 2 or more views CPT 73140 PFR 73140 FINGER 2 VIEWS	$27.25	$44.00	$35.41–$66.47	85% below	38%
X-ray of the finger(s), 2 or more views CPT 73140 RAD EXAM FINGER(S) MIN 2 VWS	$98.46	$159.00	$143.10–$159.00	45% below	38%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 PFR 73140 FINGER 2 VIEWS	$27.25	$44.00	$35.41–$66.47	—	38%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 RAD EXAM FINGER(S) MIN 2 VWS	$98.46	$159.00	$144.69–$159.00	—	38%
X-ray of the foot, 2 views CPT 73620 PFR 73620 FOOT 2 VIEWS	$30.96	$50.00	$26.17–$49.13	81% below	38%
X-ray of the foot, 2 views CPT 73620 RAD EXAM FOOT 2 VWS	$134.37	$217.00	$195.30–$217.00	16% below	38%
X-ray of the foot, 2 views inpatient CPT 73620 PFR 73620 FOOT 2 VIEWS	$30.96	$50.00	$26.17–$49.13	—	38%
X-ray of the foot, 2 views inpatient CPT 73620 RAD EXAM FOOT 2 VWS	$134.37	$217.00	$197.47–$217.00	—	38%
X-ray of the foot, complete, 3 or more views CPT 73630 PFR 73630 FOOT COMP 3 VIEWS	$33.44	$54.00	$31.41–$58.96	82% below	38%
X-ray of the foot, complete, 3 or more views CPT 73630 RAD EXAM FOOT MIN 3 VWS	$137.47	$222.00	$199.80–$222.00	28% below	38%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 PFR 73630 FOOT COMP 3 VIEWS	$33.44	$54.00	$31.41–$58.96	—	38%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 RAD EXAM FOOT MIN 3 VWS	$137.47	$222.00	$202.02–$222.00	—	38%
X-ray of the hand, 3 or more views CPT 73130 PFR 73130 HAND 3 VIEWS	$70.59	$114.00	$34.48–$108.30	69% below	38%
X-ray of the hand, 3 or more views CPT 73130 RAD EXAM HAND MIN 3 VWS	$139.32	$225.00	$202.50–$225.00	38% below	38%
X-ray of the hand, 3 or more views inpatient CPT 73130 PFR 73130 HAND 3 VIEWS	$70.59	$114.00	$34.48–$108.30	—	38%
X-ray of the hand, 3 or more views inpatient CPT 73130 RAD EXAM HAND MIN 3 VWS	$139.32	$225.00	$204.75–$225.00	—	38%
X-ray of the knee, 1 or 2 views CPT 73560 PFR 73560 KNEE 1 OR 2 VWS BIL	$33.44	$54.00	$31.41–$58.96	81% below	38%
X-ray of the knee, 1 or 2 views CPT 73560 RAD EXAM KNEE 1 OR 2 VWS	$117.65	$190.00	$171.00–$190.00	33% below	38%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 PFR 73560 KNEE 1 OR 2 VWS BIL	$33.44	$54.00	$31.41–$58.96	—	38%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 RAD EXAM KNEE 1 OR 2 VWS	$117.65	$190.00	$172.90–$190.00	—	38%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 PFR 72100 SPINE LUMBOSACRAL2-3V	$34.06	$55.00	$36.64–$68.78	87% below	38%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RAD EXAM SPINE LUMB 2 OR 3 VWS	$150.47	$243.00	$218.70–$243.00	42% below	38%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 PFR 72100 SPINE LUMBOSACRAL2-3V	$34.06	$55.00	$36.64–$68.78	—	38%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RAD EXAM SPINE LUMB 2 OR 3 VWS	$150.47	$243.00	$221.13–$243.00	—	38%
X-ray of the lower back, 4 or more views CPT 72110 PFR 72110 SPINE LUMBOSAC MIN4VW	$63.16	$102.00	$48.03–$96.90	80% below	38%
X-ray of the lower back, 4 or more views CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS	$293.51	$474.00	$426.60–$474.00	7% below	38%
X-ray of the lower back, 4 or more views inpatient CPT 72110 PFR 72110 SPINE LUMBOSAC MIN4VW	$63.16	$102.00	$48.03–$96.90	—	38%
X-ray of the lower back, 4 or more views inpatient CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS	$293.51	$474.00	$431.34–$474.00	—	38%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 PFR 72070 SPINE THORACIC 2VWS	$40.87	$66.00	$30.48–$62.70	83% below	38%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 RAD EXAM SPINE THOR 2 VWS	$146.14	$236.00	$212.40–$236.00	40% below	38%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 PFR 72070 SPINE THORACIC 2VWS	$40.87	$66.00	$30.48–$62.70	—	38%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 RAD EXAM SPINE THOR 2 VWS	$146.14	$236.00	$214.76–$236.00	—	38%
X-ray of the nasal bones, 3 or more views CPT 70160 PFR 70160 NASAL BONES MIN 3 VWS	$27.25	$44.00	$34.79–$65.31	88% below	38%
X-ray of the nasal bones, 3 or more views CPT 70160 RAD EXAM NASAL BONES COMPL MIN 3 VWS	$138.09	$223.00	$200.70–$223.00	38% below	38%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 PFR 70160 NASAL BONES MIN 3 VWS	$27.25	$44.00	$34.79–$65.31	—	38%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 RAD EXAM NASAL BONES COMPL MIN 3 VWS	$138.09	$223.00	$202.93–$223.00	—	38%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 PFR 72040 SPINE CERVICAL <3 VWS	$42.73	$69.00	$36.64–$68.78	82% below	38%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RAD EXAM SPINE CERV 2 OR 3 VWS	$134.99	$218.00	$196.20–$218.00	45% below	38%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 PFR 72040 SPINE CERVICAL <3 VWS	$42.73	$69.00	$36.64–$68.78	—	38%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RAD EXAM SPINE CERV 2 OR 3 VWS	$134.99	$218.00	$198.38–$218.00	—	38%
X-ray of the pelvis, 1 or 2 views CPT 72170 PFR 72170 PELVIS AP	$42.11	$68.00	$25.86–$64.60	81% below	38%
X-ray of the pelvis, 1 or 2 views CPT 72170 RAD EXAM PELVIS 1 OR 2 VWS	$125.70	$203.00	$182.70–$203.00	43% below	38%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PFR 72170 PELVIS AP	$42.11	$68.00	$25.86–$64.60	—	38%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD EXAM PELVIS 1 OR 2 VWS	$125.70	$203.00	$184.73–$203.00	—	38%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 PFR 72220 SACRUM & COCCYX	$36.54	$59.00	$30.17–$56.64	85% below	38%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RAD EXAM SACRUM COCCYX MIN 2 VWS	$84.22	$136.00	$122.40–$136.00	66% below	38%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 PFR 72220 SACRUM & COCCYX	$36.54	$59.00	$30.17–$56.64	—	38%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RAD EXAM SACRUM COCCYX MIN 2 VWS	$84.22	$136.00	$123.76–$136.00	—	38%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Montana	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE AMINO ALT SGPT 84460	$30.35	$49.00	$44.59–$49.00	16% below	38%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALANINE AMINO ALT SGPT 84460	$30.35	$49.00	$44.59–$49.00	—	38%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST 84450	$39.63	$64.00	$58.24–$64.00	10% below	38%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST 84450	$39.63	$64.00	$58.24–$64.00	—	38%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL 80074	$178.95	$289.00	$262.99–$289.00	10% below	38%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL 80074	$178.95	$289.00	$262.99–$289.00	—	38%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERG WATERMELON SO 86003.942	$27.87	$45.00	$40.95–$45.00	15% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERG BASIL SO 86003.948	$27.87	$45.00	$40.95–$45.00	15% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ON PANEL 86003	$27.87	$45.00	$40.95–$45.00	15% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 ALERGEN SPEC IGE QNT SO 86003	$27.87	$45.00	$40.95–$45.00	15% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERG KIWI SO 86003.924	$27.87	$45.00	$40.95–$45.00	15% below	38%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERG KIWI SO 86003.924	$27.87	$45.00	$40.95–$45.00	—	38%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERG BASIL SO 86003.948	$27.87	$45.00	$40.95–$45.00	—	38%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERG WATERMELON SO 86003.942	$27.87	$45.00	$40.95–$45.00	—	38%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ON PANEL 86003	$27.87	$45.00	$40.95–$45.00	—	38%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALERGEN SPEC IGE QNT SO 86003	$27.87	$45.00	$40.95–$45.00	—	38%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITR PEP AB(CCP) 86200	$78.02	$126.00	$114.66–$126.00	14% below	38%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITR PEP AB(CCP) 86200	$78.02	$126.00	$114.66–$126.00	—	38%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY SCRE86038	$74.31	$120.00	$109.20–$120.00	9% above	38%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY SCRE86038	$74.31	$120.00	$109.20–$120.00	—	38%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE 83880	$123.84	$200.00	$182.00–$200.00	29% below	38%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE 83880	$123.84	$200.00	$182.00–$200.00	—	38%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL 80048	$71.83	$116.00	$105.56–$116.00	16% below	38%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL 80048	$71.83	$116.00	$105.56–$116.00	—	38%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH LEVEL IV 88305	$55.73	$90.00	$81.90–$90.00	74% below	38%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATH LEVEL IV 88305	$55.73	$90.00	$81.90–$90.00	—	38%
Blood culture for bacteria CPT 87040 CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES 87040	$86.69	$140.00	$127.40–$140.00	47% below	38%
Blood culture for bacteria inpatient CPT 87040 CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES 87040	$86.69	$140.00	$127.40–$140.00	—	38%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION VENOUS BLOOD VENIPUNCTURE	$17.96	$29.00	$26.39–$29.00	15% below	38%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE 36415	$21.68	$35.00	$31.85–$35.00	2% above	38%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION VENOUS BLOOD VENIPUNCTURE	$17.96	$29.00	$26.39–$29.00	—	38%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE 36415	$21.68	$35.00	$31.85–$35.00	—	38%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT BLOOD (EXCEPT REAGENT STRIP)	$34.68	$56.00	$50.96–$56.00	at median	38%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT BLOOD (EXCEPT REAGENT STRIP) 82947	$37.16	$60.00	$54.60–$60.00	7% above	38%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT BLOOD (EXCEPT REAGENT STRIP)	$34.68	$56.00	$50.96–$56.00	—	38%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT BLOOD (EXCEPT REAGENT STRIP) 82947	$37.16	$60.00	$54.60–$60.00	—	38%
Blood lead test CPT 83655 LEAD	$38.40	$62.00	$56.42–$62.00	24% below	38%
Blood lead test CPT 83655 LEAD 83655	$39.63	$64.00	$58.24–$64.00	22% below	38%
Blood lead test CPT 83655 LEAD BLOOD 83655.900	$39.63	$64.00	$58.24–$64.00	22% below	38%
Blood lead test inpatient CPT 83655 LEAD	$38.40	$62.00	$56.42–$62.00	—	38%
Blood lead test inpatient CPT 83655 LEAD BLOOD 83655.900	$39.63	$64.00	$58.24–$64.00	—	38%
Blood lead test inpatient CPT 83655 LEAD 83655	$39.63	$64.00	$58.24–$64.00	—	38%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL 84703	$37.78	$61.00	$55.51–$61.00	23% below	38%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL 84703	$37.78	$61.00	$55.51–$61.00	—	38%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO 86900	$84.22	$136.00	$123.76–$136.00	21% below	38%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO 86900	$84.22	$136.00	$123.76–$136.00	—	38%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN QUANT 86140	$48.92	$79.00	$71.89–$79.00	4% above	38%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN QUANT 86140	$48.92	$79.00	$71.89–$79.00	—	38%
C. difficile toxin gene test (stool PCR) CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE	$141.18	$228.00	$207.48–$228.00	17% below	38%
C. difficile toxin gene test (stool PCR) CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE 87493	$150.47	$243.00	$221.13–$243.00	12% below	38%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE	$141.18	$228.00	$207.48–$228.00	—	38%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE 87493	$150.47	$243.00	$221.13–$243.00	—	38%
CA 19-9 blood test (tumor marker) CPT 86301 CDMR CA 19-9PANCREATIC CANCER86301	$144.90	$234.00	$212.94–$234.00	18% above	38%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CDMR CA 19-9PANCREATIC CANCER86301	$144.90	$234.00	$212.94–$234.00	—	38%
CA-125 blood test (ovarian cancer marker) CPT 86304 CDMR CA 125 86304	$154.80	$250.00	$227.50–$250.00	26% above	38%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CDMR CA 125 86304	$154.80	$250.00	$227.50–$250.00	—	38%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CDMR SARS-COV-2 COVID-19 AMP PRB 87635	$131.89	$213.00	$193.83–$213.00	at median	38%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CDMR SARS-COV-2 COVID-19 AMP PRB 87635	$131.89	$213.00	$193.83–$213.00	—	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA NUCLEIC ACID DETECTION 87491.901	$28.49	$46.00	$41.86–$46.00	63% below	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS OCULAR PERITONEAL NAA 87491.900	$28.49	$46.00	$41.86–$46.00	63% below	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECT AGNT NUCLEIC ACID DNA RNA CHLAMYDIA TRACH AMPLIF PROBE 87491	$122.61	$198.00	$180.18–$198.00	58% above	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA NUCLEIC ACID DETECTION 87491.901	$28.49	$46.00	$41.86–$46.00	—	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS OCULAR PERITONEAL NAA 87491.900	$28.49	$46.00	$41.86–$46.00	—	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INFECT AGNT NUCLEIC ACID DNA RNA CHLAMYDIA TRACH AMPLIF PROBE 87491	$122.61	$198.00	$180.18–$198.00	—	38%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL 80061	$73.69	$119.00	$108.29–$119.00	2% below	38%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL 80061	$73.69	$119.00	$108.29–$119.00	—	38%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC 85025	$61.31	$99.00	$90.09–$99.00	13% above	38%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC 85025	$61.31	$99.00	$90.09–$99.00	—	38%
Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT COMPLETE AUTOMATED 85027	$28.49	$46.00	$41.86–$46.00	41% below	38%
Complete blood count (CBC), no differential inpatient CPT 85027 BLOOD COUNT COMPLETE AUTOMATED 85027	$28.49	$46.00	$41.86–$46.00	—	38%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL 80053	$92.88	$150.00	$136.50–$150.00	10% below	38%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL 80053	$92.88	$150.00	$136.50–$150.00	—	38%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION PRODUCTS D-DIMER QUANT 85379	$32.20	$52.00	$47.32–$52.00	69% below	38%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION PRODUCTS D-DIMER QUANT 85379	$32.20	$52.00	$47.32–$52.00	—	38%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE 82627	$144.90	$234.00	$212.94–$234.00	14% above	38%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE WITH TANNER STAGES 82627.900	$144.90	$234.00	$212.94–$234.00	14% above	38%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE WITH TANNER STAGES 82627.900	$144.90	$234.00	$212.94–$234.00	—	38%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE 82627	$144.90	$234.00	$212.94–$234.00	—	38%
Estradiol blood test CPT 82670 ESTRADIOL TOTAL 82670	$147.37	$238.00	$216.58–$238.00	10% above	38%
Estradiol blood test inpatient CPT 82670 ESTRADIOL TOTAL 82670	$147.37	$238.00	$216.58–$238.00	—	38%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN FOLLICLE STIMULATING HORMONE (FSH) 83001	$157.90	$255.00	$232.05–$255.00	25% above	38%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN FOLLICLE STIMULATING HORMONE (FSH) 83001	$157.90	$255.00	$232.05–$255.00	—	38%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN 83993	$155.42	$251.00	$228.41–$251.00	47% below	38%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN 83993	$155.42	$251.00	$228.41–$251.00	—	38%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN 82728	$61.92	$100.00	$91.00–$100.00	33% below	38%
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN 82728	$61.92	$100.00	$91.00–$100.00	—	38%
Folate (folic acid) blood test CPT 82746 FOLATE	$50.16	$81.00	$73.71–$81.00	46% below	38%
Folate (folic acid) blood test CPT 82746 FOLATE 82746	$52.02	$84.00	$76.44–$84.00	44% below	38%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$50.16	$81.00	$73.71–$81.00	—	38%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE 82746	$52.02	$84.00	$76.44–$84.00	—	38%
Free T3 thyroid hormone test CPT 84481 T3 FREE 84481	$143.66	$232.00	$211.12–$232.00	17% above	38%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE 84481	$143.66	$232.00	$211.12–$232.00	—	38%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE 84439	$32.20	$52.00	$47.32–$52.00	47% below	38%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 BY EQ DIALYSIS SO 84439.900	$32.20	$52.00	$47.32–$52.00	47% below	38%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE 84439	$32.20	$52.00	$47.32–$52.00	—	38%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 BY EQ DIALYSIS SO 84439.900	$32.20	$52.00	$47.32–$52.00	—	38%
Free testosterone test CPT 84402 TESTOSTERONE FREE MEASURED 84402.901	$216.11	$349.00	$317.59–$349.00	55% above	38%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE MEASURED 84402.901	$216.11	$349.00	$317.59–$349.00	—	38%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$282.36	$456.00	$414.96–$456.00	2% above	38%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$282.36	$456.00	$414.96–$456.00	—	38%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE 82950	$51.40	$83.00	$75.53–$83.00	17% below	38%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOSE DOSE 82950	$51.40	$83.00	$75.53–$83.00	—	38%
Glucose tolerance test, 3 samples CPT 82951 GLUC TOL 3 SPEC & DOSE 82951	$94.74	$153.00	$139.23–$153.00	14% below	38%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUC TOL 3 SPEC & DOSE 82951	$94.74	$153.00	$139.23–$153.00	—	38%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE NUCLEIC ACID DETECT 87591.901	$58.21	$94.00	$85.54–$94.00	26% below	38%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECT AGNT NUCLEIC ACID DNA RNA NEISSERIA GONORRHOEAE AMPLIF PROBE 87591	$131.28	$212.00	$192.92–$212.00	68% above	38%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE NUCLEIC ACID DETECT 87591.901	$58.21	$94.00	$85.54–$94.00	—	38%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECT AGNT NUCLEIC ACID DNA RNA NEISSERIA GONORRHOEAE AMPLIF PROBE 87591	$131.28	$212.00	$192.92–$212.00	—	38%
H. pylori antibody blood test CPT 86677 H PYLORI IGM	$120.13	$194.00	$176.54–$194.00	12% above	38%
H. pylori antibody blood test CPT 86677 H PYLORI IGG 86677	$120.13	$194.00	$176.54–$194.00	12% above	38%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGM	$120.13	$194.00	$176.54–$194.00	—	38%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGG 86677	$120.13	$194.00	$176.54–$194.00	—	38%
H. pylori stool antigen test CPT 87338 H PYLORI AG STOOL 87338	$166.57	$269.00	$244.79–$269.00	75% above	38%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI AG STOOL 87338	$166.57	$269.00	$244.79–$269.00	—	38%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA PCR QNT 87536	$382.67	$618.00	$562.38–$618.00	47% above	38%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 RNA PCR QNT 87536	$382.67	$618.00	$562.38–$618.00	—	38%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1 HIV-2 ANTIBODY 86703	$58.21	$94.00	$85.54–$94.00	29% below	38%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 & 2 RAPID 86703	$58.21	$94.00	$85.54–$94.00	29% below	38%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 & 2 RAPID 86703	$58.21	$94.00	$85.54–$94.00	—	38%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1 HIV-2 ANTIBODY 86703	$58.21	$94.00	$85.54–$94.00	—	38%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG WHIV-1 & HIV-2 AB 87389/G0475	$96.60	$156.00	$141.96–$156.00	6% above	38%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG WHIV-1 & HIV-2 AB 87389/G0475	$96.60	$156.00	$141.96–$156.00	—	38%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$32.82	$53.00	$48.23–$53.00	42% below	38%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C 83036	$35.30	$57.00	$51.87–$57.00	37% below	38%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$32.82	$53.00	$48.23–$53.00	—	38%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C 83036	$35.30	$57.00	$51.87–$57.00	—	38%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB) 86706	$37.16	$60.00	$54.60–$60.00	51% below	38%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB) 86706	$37.16	$60.00	$54.60–$60.00	—	38%
Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECT AGNT ATGN DETECT IA HEPATITIS B SURFACE ANTIGEN 87340	$56.35	$91.00	$82.81–$91.00	9% below	38%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 INFECT AGNT ATGN DETECT IA HEPATITIS B SURFACE ANTIGEN 87340	$56.35	$91.00	$82.81–$91.00	—	38%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY 86803	$45.83	$74.00	$67.34–$74.00	60% below	38%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY 86803	$45.83	$74.00	$67.34–$74.00	—	38%
Hepatitis C viral load (HCV RNA) test CPT 87522 INFECT AGNT DETECT NUC ACID HEP C QUANT 87522	$544.28	$879.00	$799.89–$879.00	7% above	38%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 INFECT AGNT DETECT NUC ACID HEP C QUANT 87522	$544.28	$879.00	$799.89–$879.00	—	38%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLX VIR1 IGG 86695	$82.98	$134.00	$121.94–$134.00	9% above	38%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLX VIR1 IGG 86695	$82.98	$134.00	$121.94–$134.00	—	38%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SMPLX VIR 2 IGG 86696	$130.66	$211.00	$192.01–$211.00	30% above	38%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SMPLX VIR 2 IGG 86696	$130.66	$211.00	$192.01–$211.00	—	38%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HISEN 86141	$53.88	$87.00	$79.17–$87.00	23% below	38%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HISEN 86141	$53.88	$87.00	$79.17–$87.00	—	38%
Homocysteine blood test CPT 83090 CDMR HOMOCYSTINE 83090	$157.28	$254.00	$231.14–$254.00	36% above	38%
Homocysteine blood test inpatient CPT 83090 CDMR HOMOCYSTINE 83090	$157.28	$254.00	$231.14–$254.00	—	38%
Insulin blood test CPT 83525 INSULIN LEVEL 83525	$97.22	$157.00	$142.87–$157.00	2% below	38%
Insulin blood test inpatient CPT 83525 INSULIN LEVEL 83525	$97.22	$157.00	$142.87–$157.00	—	38%
Iron blood test (serum iron) CPT 83540 IRON 83540	$37.16	$60.00	$54.60–$60.00	2% below	38%
Iron blood test (serum iron) inpatient CPT 83540 IRON 83540	$37.16	$60.00	$54.60–$60.00	—	38%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY 83550	$46.44	$75.00	$68.25–$75.00	2% above	38%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY 83550	$46.44	$75.00	$68.25–$75.00	—	38%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL 80069	$47.06	$76.00	$69.16–$76.00	55% below	38%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL 80069	$47.06	$76.00	$69.16–$76.00	—	38%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN LUTEINIZING HORMONE (LH) 83002	$157.90	$255.00	$232.05–$255.00	35% above	38%
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN LUTEINIZING HORMONE (LH) 83002	$157.90	$255.00	$232.05–$255.00	—	38%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE 83690	$46.44	$75.00	$68.25–$75.00	24% below	38%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE 83690	$46.44	$75.00	$68.25–$75.00	—	38%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL 80076	$69.97	$113.00	$102.83–$113.00	9% below	38%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL 80076	$69.97	$113.00	$102.83–$113.00	—	38%
Lyme disease antibody test CPT 86618 LYMES TOTAL 86618	$105.27	$170.00	$154.70–$170.00	15% below	38%
Lyme disease antibody test inpatient CPT 86618 LYMES TOTAL 86618	$105.27	$170.00	$154.70–$170.00	—	38%
Magnesium blood test CPT 83735 MAGNESIUM FECES 83735.901	$46.44	$75.00	$68.25–$75.00	23% below	38%
Magnesium blood test CPT 83735 MAGNESIUM 83735	$46.44	$75.00	$68.25–$75.00	23% below	38%
Magnesium blood test inpatient CPT 83735 MAGNESIUM 83735	$46.44	$75.00	$68.25–$75.00	—	38%
Magnesium blood test inpatient CPT 83735 MAGNESIUM FECES 83735.901	$46.44	$75.00	$68.25–$75.00	—	38%
Measles (rubeola) antibody test CPT 86765 MEASLES VIRUS RUBEOLA AB IGG 86765.902	$73.07	$118.00	$107.38–$118.00	76% above	38%
Measles (rubeola) antibody test CPT 86765 ANTIBODY RUBEOLA 86765	$73.07	$118.00	$107.38–$118.00	76% above	38%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES VIRUS RUBEOLA AB IGG 86765.902	$73.07	$118.00	$107.38–$118.00	—	38%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY RUBEOLA 86765	$73.07	$118.00	$107.38–$118.00	—	38%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSCREEN 86308	$35.92	$58.00	$52.78–$58.00	29% below	38%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSCREEN 86308	$35.92	$58.00	$52.78–$58.00	—	38%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL 80055	$210.53	$340.00	$309.40–$340.00	17% below	38%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL 80055	$210.53	$340.00	$309.40–$340.00	—	38%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE 84154	$84.84	$137.00	$124.67–$137.00	at median	38%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE 84154	$84.84	$137.00	$124.67–$137.00	—	38%
PSA (prostate-specific antigen) blood test, total CPT 84153 CDMR ASSAY OF PSA TOTAL 84153	$58.21	$94.00	$85.54–$94.00	48% below	38%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CDMR ASSAY OF PSA TOTAL 84153	$58.21	$94.00	$85.54–$94.00	—	38%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTO CERV THN MAN 88142	$73.69	$119.00	$108.29–$119.00	15% below	38%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTO CERV THN MAN 88142	$73.69	$119.00	$108.29–$119.00	—	38%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT 83970	$145.52	$235.00	$213.85–$235.00	28% below	38%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT 83970	$145.52	$235.00	$213.85–$235.00	—	38%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730	$55.73	$90.00	$81.90–$90.00	at median	38%
Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAG PANEL PTT 85730.900	$55.73	$90.00	$81.90–$90.00	at median	38%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730	$55.73	$90.00	$81.90–$90.00	—	38%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAG PANEL PTT 85730.900	$55.73	$90.00	$81.90–$90.00	—	38%
Progesterone blood test CPT 84144 PROGESTERONE 84144	$114.56	$185.00	$168.35–$185.00	22% below	38%
Progesterone blood test inpatient CPT 84144 PROGESTERONE 84144	$114.56	$185.00	$168.35–$185.00	—	38%
Prolactin blood test CPT 84146 PROLACTIN 84146	$144.90	$234.00	$212.94–$234.00	11% above	38%
Prolactin blood test inpatient CPT 84146 PROLACTIN 84146	$144.90	$234.00	$212.94–$234.00	—	38%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT)	$14.25	$23.00	$20.93–$23.00	60% below	38%
Prothrombin time (PT/INR) clotting test CPT 85610 PT INR FINGERSTICK-QW 85610	$14.87	$24.00	$21.84–$24.00	59% below	38%
Prothrombin time (PT/INR) clotting test CPT 85610 LUPUS ANTICOAG PANEL PT 85610.900	$24.77	$40.00	$36.40–$40.00	31% below	38%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME 85610	$24.77	$40.00	$36.40–$40.00	31% below	38%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME - PROTIME CLINIC 85610	$24.77	$40.00	$36.40–$40.00	31% below	38%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT)	$14.25	$23.00	$20.93–$23.00	—	38%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT INR FINGERSTICK-QW 85610	$14.87	$24.00	$21.84–$24.00	—	38%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LUPUS ANTICOAG PANEL PT 85610.900	$24.77	$40.00	$36.40–$40.00	—	38%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME 85610	$24.77	$40.00	$36.40–$40.00	—	38%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME - PROTIME CLINIC 85610	$24.77	$40.00	$36.40–$40.00	—	38%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCR PRESUMP DIRECT OPTICAL OBS 80305	$53.26	$86.00	$78.26–$86.00	29% below	38%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCR PRESUMP DIRECT OPTICAL OBS 80305	$53.26	$86.00	$78.26–$86.00	—	38%
Rapid flu test (influenza antigen) CPT 87804 INFECTIOUS AGENT IMMUNOASSAY DIRECT OBSERVATION INFLUENZA	$33.44	$54.00	$49.14–$54.00	44% below	38%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A B DIRECT 87804	$34.68	$56.00	$50.96–$56.00	42% below	38%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFECTIOUS AGENT IMMUNOASSAY DIRECT OBSERVATION INFLUENZA	$33.44	$54.00	$49.14–$54.00	—	38%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A B DIRECT 87804	$34.68	$56.00	$50.96–$56.00	—	38%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP ONLY	$30.96	$50.00	$45.50–$50.00	52% below	38%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 INFECTIOUS AGENT IMMUNOASSAY DIRECT OBSERVATION STREPOCOCCUS GROUP A	$37.16	$60.00	$54.60–$60.00	42% below	38%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RPD GROUP A STREP SCREEN 87880	$38.40	$62.00	$56.42–$62.00	40% below	38%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP ONLY	$30.96	$50.00	$45.50–$50.00	—	38%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 INFECTIOUS AGENT IMMUNOASSAY DIRECT OBSERVATION STREPOCOCCUS GROUP A	$37.16	$60.00	$54.60–$60.00	—	38%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RPD GROUP A STREP SCREEN 87880	$38.40	$62.00	$56.42–$62.00	—	38%
Rheumatoid factor (RF) test CPT 86431 RA FACTOR QUANT 86431	$26.63	$43.00	$39.13–$43.00	38% below	38%
Rheumatoid factor (RF) test inpatient CPT 86431 RA FACTOR QUANT 86431	$26.63	$43.00	$39.13–$43.00	—	38%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY RUBELLA 86762	$86.07	$139.00	$126.49–$139.00	51% above	38%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY RUBELLA 86762	$86.07	$139.00	$126.49–$139.00	—	38%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE RBC AUTOMATED 85652	$27.87	$45.00	$40.95–$45.00	43% below	38%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE RBC AUTOMATED 85652	$27.87	$45.00	$40.95–$45.00	—	38%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS COMPLETE 89320	$108.36	$175.00	$159.25–$175.00	32% below	38%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS COMPLETE 89320	$108.36	$175.00	$159.25–$175.00	—	38%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES 87177	$75.55	$122.00	$111.02–$122.00	4% above	38%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES 87177	$75.55	$122.00	$111.02–$122.00	—	38%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER 82270	$6.20	$10.00	$9.10–$10.00	63% below	38%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER 82270	$6.20	$10.00	$9.10–$10.00	—	38%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 CDMR BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3	$31.58	$51.00	$46.41–$51.00	46% below	38%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLD OCLT FCL HGB DETRM-QW82274	$32.82	$53.00	$48.23–$53.00	44% below	38%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 CDMR OCCULT BLOOD CRC SCREEN (FIT IMMUNOCHEMICAL) G0328 82274.006	$34.06	$55.00	$50.05–$55.00	42% below	38%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 CDMR BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 82274	$34.06	$55.00	$50.05–$55.00	42% below	38%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 CDMR BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3	$31.58	$51.00	$46.41–$51.00	—	38%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLD OCLT FCL HGB DETRM-QW82274	$32.82	$53.00	$48.23–$53.00	—	38%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 CDMR BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 82274	$34.06	$55.00	$50.05–$55.00	—	38%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 CDMR OCCULT BLOOD CRC SCREEN (FIT IMMUNOCHEMICAL) G0328 82274.006	$34.06	$55.00	$50.05–$55.00	—	38%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL 86592	$32.82	$53.00	$48.23–$53.00	38% below	38%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL 86592	$32.82	$53.00	$48.23–$53.00	—	38%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 M. TUBER. QUANTIFERON	$164.71	$266.00	$242.06–$266.00	3% above	38%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 M. TUBER. QUANTIFERON	$164.71	$266.00	$242.06–$266.00	—	38%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL 84403.900	$20.44	$33.00	$30.03–$33.00	85% below	38%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TESTOSTERONE TOTAL 84403	$138.71	$224.00	$203.84–$224.00	at median	38%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL MEASURED 84403.902	$138.71	$224.00	$203.84–$224.00	at median	38%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL 84403.900	$20.44	$33.00	$30.03–$33.00	—	38%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL MEASURED 84403.902	$138.71	$224.00	$203.84–$224.00	—	38%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TESTOSTERONE TOTAL 84403	$138.71	$224.00	$203.84–$224.00	—	38%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOME T1 AB SERUM 86376.900	$90.41	$146.00	$132.86–$146.00	10% above	38%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE AB	$90.41	$146.00	$132.86–$146.00	10% above	38%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTITHYROID AB ANTI TPO 86376	$105.27	$170.00	$154.70–$170.00	29% above	38%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROPEROXIDASE AB	$90.41	$146.00	$132.86–$146.00	—	38%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOME T1 AB SERUM 86376.900	$90.41	$146.00	$132.86–$146.00	—	38%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTITHYROID AB ANTI TPO 86376	$105.27	$170.00	$154.70–$170.00	—	38%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH) 84443	$60.07	$97.00	$88.27–$97.00	21% below	38%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH) 84443	$60.07	$97.00	$88.27–$97.00	—	38%
Trichomonas test (NAAT) CPT 87661 NUCLEIC ACID TRICHOMON AMP 87661	$53.88	$87.00	$79.17–$87.00	at median	38%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS BY NUCLEIC ACID DETECTION 87661	$147.37	$238.00	$216.58–$238.00	174% above	38%
Trichomonas test (NAAT) inpatient CPT 87661 NUCLEIC ACID TRICHOMON AMP 87661	$53.88	$87.00	$79.17–$87.00	—	38%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS BY NUCLEIC ACID DETECTION 87661	$147.37	$238.00	$216.58–$238.00	—	38%
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID 84550	$17.96	$29.00	$26.39–$29.00	61% below	38%
Uric acid blood test inpatient CPT 84550 ASSAY OF BLOOD/URIC ACID 84550	$17.96	$29.00	$26.39–$29.00	—	38%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE	$18.58	$30.00	$27.30–$30.00	65% below	38%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE 81001	$28.49	$46.00	$41.86–$46.00	46% below	38%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE	$18.58	$30.00	$27.30–$30.00	—	38%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE 81001	$28.49	$46.00	$41.86–$46.00	—	38%
Urinalysis with microscope exam, manual CPT 81000 UA NON-AUTOMATED W MICROS81000	$8.67	$14.00	$12.74–$14.00	60% below	38%
Urinalysis with microscope exam, manual inpatient CPT 81000 UA NON-AUTOMATED W MICROS81000	$8.67	$14.00	$12.74–$14.00	—	38%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS MACROSCOPIC	$12.39	$20.00	$18.20–$20.00	61% below	38%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS-DIPSTICK ONLY 81003	$13.63	$22.00	$20.02–$22.00	57% below	38%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS MACROSCOPIC	$12.39	$20.00	$18.20–$20.00	—	38%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS-DIPSTICK ONLY 81003	$13.63	$22.00	$20.02–$22.00	—	38%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS DIP STICK TABLET REAGENT NON-AUTOMATED WO MICROSCOPY	$13.01	$21.00	$19.11–$21.00	19% below	38%
Urinalysis without microscope exam, manual CPT 81002 CLINITEST DIPSTICK TABLET81002	$18.58	$30.00	$27.30–$30.00	16% above	38%
Urinalysis without microscope exam, manual CPT 81002 OB UA DIPSTK NONAU W/O MICRO 81002	$18.58	$30.00	$27.30–$30.00	16% above	38%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS DIP STICK TABLET REAGENT NON-AUTOMATED WO MICROSCOPY	$13.01	$21.00	$19.11–$21.00	—	38%
Urinalysis without microscope exam, manual inpatient CPT 81002 CLINITEST DIPSTICK TABLET81002	$18.58	$30.00	$27.30–$30.00	—	38%
Urinalysis without microscope exam, manual inpatient CPT 81002 OB UA DIPSTK NONAU W/O MICRO 81002	$18.58	$30.00	$27.30–$30.00	—	38%
Urine culture for bacteria, with colony count CPT 87086 CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE 87086	$74.31	$120.00	$109.20–$120.00	at median	38%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE 87086	$74.31	$120.00	$109.20–$120.00	—	38%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$22.92	$37.00	$33.67–$37.00	39% below	38%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST 81025	$39.01	$63.00	$57.33–$63.00	4% above	38%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$22.92	$37.00	$33.67–$37.00	—	38%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST 81025	$39.01	$63.00	$57.33–$63.00	—	38%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN VITAMIN B-12 82607	$80.50	$130.00	$118.30–$130.00	15% below	38%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN VITAMIN B-12 82607	$80.50	$130.00	$118.30–$130.00	—	38%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CDMR VITAMIN D 25 HYDROXY 82306	$87.31	$141.00	$128.31–$141.00	4% below	38%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CDMR VITAMIN D 25 HYDROXY 82306	$87.31	$141.00	$128.31–$141.00	—	38%
Zinc blood test CPT 84630 ZINC 84630.900	$66.88	$108.00	$98.28–$108.00	18% below	38%
Zinc blood test inpatient CPT 84630 ZINC 84630.900	$66.88	$108.00	$98.28–$108.00	—	38%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC HCG QUANTITATIVE 84702	$129.42	$209.00	$190.19–$209.00	15% above	38%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIONIC HCG QUANTITATIVE 84702	$129.42	$209.00	$190.19–$209.00	—	38%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Montana	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 ADENOIDECTOMY PRIME < AGE 12	$642.73	$1,038.00	$944.58–$1,038.00	8% above	38%
Adenoid removal (adenoidectomy), child under 12 CPT 42830 PF 42830 ADENOIDECTOMY UNDER 12	$642.73	$1,038.00	$201.06–$986.10	8% above	38%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ADENOIDECTOMY PRIME < AGE 12	$642.73	$1,038.00	$944.58–$1,038.00	—	38%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 PF 42830 ADENOIDECTOMY UNDER 12	$642.73	$1,038.00	$201.06–$986.10	—	38%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 PF 44960 APPENDECTOMY RUPTURED	$1,820.45	$2,940.00	$815.94–$2,793.00	2% below	38%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY RUPTURED APPENDIX WABSCESS GENERALIZED PERITONITIS	$1,820.45	$2,940.00	$2,675.40–$2,940.00	2% below	38%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 PF 44960 APPENDECTOMY RUPTURED	$1,820.45	$2,940.00	$815.94–$2,793.00	—	38%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDECTOMY RUPTURED APPENDIX WABSCESS GENERALIZED PERITONITIS	$1,820.45	$2,940.00	$2,675.40–$2,940.00	—	38%
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$1,338.72	$2,162.00	$1,967.42–$2,162.00	at median	38%
Appendectomy, open surgery CPT 44950 PF 44950 APPENDECTOMY	$1,338.72	$2,162.00	$597.94–$2,053.90	at median	38%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$1,338.72	$2,162.00	$1,967.42–$2,162.00	—	38%
Appendectomy, open surgery inpatient CPT 44950 PF 44950 APPENDECTOMY	$1,338.72	$2,162.00	$597.94–$2,053.90	—	38%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIG RPR AUGMENTATN RECONSTRCT	$2,073.09	$3,348.00	$3,046.68–$3,348.00	3% below	38%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 PF 29888 ARTHROSCOPI AIDED ANT CRUCIATE LIG RPR	$2,240.89	$3,619.00	$911.38–$3,438.05	5% above	38%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIG RPR AUGMENTATN RECONSTRCT	$2,073.09	$3,348.00	$3,046.68–$3,348.00	—	38%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 PF 29888 ARTHROSCOPI AIDED ANT CRUCIATE LIG RPR	$2,240.89	$3,619.00	$911.38–$3,438.05	—	38%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 PF 29827 ARTHROSCOPY SHOULDER WROTATOR CUFF RPR	$2,972.16	$4,800.00	$999.75–$4,560.00	6% above	38%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOPY SHLDR SURGICAL WROTATOR CUFF RPR	$2,972.16	$4,800.00	$4,368.00–$4,800.00	6% above	38%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 PF 29827 ARTHROSCOPY SHOULDER WROTATOR CUFF RPR	$2,972.16	$4,800.00	$999.75–$4,560.00	—	38%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 ARTHROSCOPY SHLDR SURGICAL WROTATOR CUFF RPR	$2,972.16	$4,800.00	$4,368.00–$4,800.00	—	38%
Balloon dilation of the maxillary sinus opening, one side CPT 31295 NASAL SINUS WDIL MAXILLARY	$2,853.28	$4,608.00	$4,193.28–$4,608.00	—	38%
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 NASAL SINUS WDIL MAXILLARY	$2,853.28	$4,608.00	$4,193.28–$4,608.00	—	38%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$325.70	$526.00	$478.66–$526.00	at median	38%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRAINE	$325.70	$526.00	$478.66–$526.00	—	38%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 SURG 19081 BX BREAST W DVC STEREOTACTIC 1ST LSN	$1,003.11	$1,620.00	$1,474.20–$1,620.00	53% below	38%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 PF 19081 BX BREAST W DVC STEREOTACT 1 LSN	$2,397.55	$3,872.00	$148.41–$3,678.40	11% above	38%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 PFR 19081 BX BREAST W DVC STEREOTACT 1 LSN	$2,397.55	$3,872.00	$148.41–$3,678.40	11% above	38%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC	$2,397.55	$3,872.00	$3,523.52–$3,872.00	11% above	38%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 SURG 19081 BX BREAST W DVC STEREOTACTIC 1ST LSN	$1,003.11	$1,620.00	$1,474.20–$1,620.00	—	38%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 PF 19081 BX BREAST W DVC STEREOTACT 1 LSN	$2,397.55	$3,872.00	$148.41–$3,678.40	—	38%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BX BREAST 1ST LESION STRTCTC	$2,397.55	$3,872.00	$3,523.52–$3,872.00	—	38%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 PFR 19081 BX BREAST W DVC STEREOTACT 1 LSN	$2,397.55	$3,872.00	$148.41–$3,678.40	—	38%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 PF 27786 FX FIB DIST WO MAN	$569.67	$920.00	$278.03–$874.00	21% above	38%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREAT DISTAL FIBULAR FX (LAT MALLEOLUS) WO MANIP	$569.67	$920.00	$837.20–$920.00	21% above	38%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 MD 27786 CLSD TX DSTL FIB FX WO MAN	$814.87	$1,316.00	$278.03–$1,250.20	73% above	38%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TREAT DISTAL FIBULAR FX (LAT MALLEOLUS) WO MANIP	$569.67	$920.00	$837.20–$920.00	—	38%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 PF 27786 FX FIB DIST WO MAN	$569.67	$920.00	$278.03–$874.00	—	38%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 MD 27786 CLSD TX DSTL FIB FX WO MAN	$814.87	$1,316.00	$278.03–$1,250.20	—	38%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 ED 28470 CLSD TX METATARSAL FX WO MANIP	$68.12	$110.00	$100.10–$110.00	76% below	38%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 PF 28470 FX METATA WO MAN CLS	$388.24	$627.00	$197.98–$595.65	38% above	38%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TREAT METATARSAL FX WO MANIP EACH	$388.24	$627.00	$570.57–$627.00	38% above	38%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 MD 28470 CLSD TX METAT FX WO MAN EA	$536.23	$866.00	$197.98–$822.70	91% above	38%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 ED 28470 CLSD TX METATARSAL FX WO MANIP	$68.12	$110.00	$100.10–$110.00	—	38%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TREAT METATARSAL FX WO MANIP EACH	$388.24	$627.00	$570.57–$627.00	—	38%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 PF 28470 FX METATA WO MAN CLS	$388.24	$627.00	$197.98–$595.65	—	38%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 MD 28470 CLSD TX METAT FX WO MAN EA	$536.23	$866.00	$197.98–$822.70	—	38%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 PF 28296 CORRECT HALLUX VALGUS W BUNION SESAMOID DIST METATAR OSTEO	$1,287.94	$2,080.00	$483.71–$1,976.00	at median	38%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECT HALLUX VALGUS W BUNION SESAMOID DIST METATAR OSTEO	$1,287.94	$2,080.00	$1,892.80–$2,080.00	at median	38%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRECT HALLUX VALGUS W BUNION SESAMOID DIST METATAR OSTEO	$1,287.94	$2,080.00	$1,892.80–$2,080.00	—	38%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 PF 28296 CORRECT HALLUX VALGUS W BUNION SESAMOID DIST METATAR OSTEO	$1,287.94	$2,080.00	$483.71–$1,976.00	—	38%
Bunion correction with removal of part of the big toe joint CPT 28292 PF 28292 CORRECT HALLUX VALGUS W BUNION SESAMOID PROX PHAL BASE	$1,349.24	$2,179.00	$457.54–$2,070.05	at median	38%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRECT HALLUX VALGUS W BUNION SESAMOID PROX PHAL BASE	$1,349.24	$2,179.00	$1,982.89–$2,179.00	at median	38%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 PF 28292 CORRECT HALLUX VALGUS W BUNION SESAMOID PROX PHAL BASE	$1,349.24	$2,179.00	$457.54–$2,070.05	—	38%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORRECT HALLUX VALGUS W BUNION SESAMOID PROX PHAL BASE	$1,349.24	$2,179.00	$1,982.89–$2,179.00	—	38%
Cardioversion, elective (restoring heart rhythm) CPT 92960 MD 92960 CARDIOVER ELECTIVE EXTERNAL	$337.47	$545.00	$98.84–$517.75	26% below	38%
Cardioversion, elective (restoring heart rhythm) CPT 92960 PF 92960 CARDIOVERSION EXTERNL	$395.67	$639.00	$98.84–$607.05	13% below	38%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE EXTERNAL	$395.67	$639.00	$581.49–$639.00	13% below	38%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 MD 92960 CARDIOVER ELECTIVE EXTERNAL	$337.47	$545.00	$98.84–$517.75	—	38%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE EXTERNAL	$395.67	$639.00	$581.49–$639.00	—	38%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 PF 92960 CARDIOVERSION EXTERNL	$395.67	$639.00	$98.84–$607.05	—	38%
Carpal tunnel release, open surgery CPT 64721 PF 64721 CARPAL TUNNEL RELEASE	$903.42	$1,459.00	$415.36–$1,386.05	18% below	38%
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY & OR TRANSPOSITION MEDIAN NERVE AT CARPAL TUNNEL	$903.42	$1,459.00	$1,327.69–$1,459.00	18% below	38%
Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY & OR TRANSPOSITION MEDIAN NERVE AT CARPAL TUNNEL	$903.42	$1,459.00	$1,327.69–$1,459.00	—	38%
Carpal tunnel release, open surgery inpatient CPT 64721 PF 64721 CARPAL TUNNEL RELEASE	$903.42	$1,459.00	$415.36–$1,386.05	—	38%
Cataract surgery with lens implant CPT 66984 PF 66984 ECCR WIOL INS 1STAGE	$1,947.39	$3,145.00	$496.64–$2,987.75	—	38%
Cataract surgery with lens implant CPT 66984 EXTRACAPSULAR CATARACT REMVL WINSERT LENS PROSTHESIS (1 STAGE)	$1,947.39	$3,145.00	$2,861.95–$3,145.00	—	38%
Cataract surgery with lens implant inpatient CPT 66984 PF 66984 ECCR WIOL INS 1STAGE	$1,947.39	$3,145.00	$496.64–$2,987.75	—	38%
Cataract surgery with lens implant inpatient CPT 66984 EXTRACAPSULAR CATARACT REMVL WINSERT LENS PROSTHESIS (1 STAGE)	$1,947.39	$3,145.00	$2,861.95–$3,145.00	—	38%
Cervical biopsy CPT 57500 BX EXC CERVIX LESN WWO FULGURATION (SEP PROC)	$319.51	$516.00	$469.56–$516.00	21% above	38%
Cervical biopsy CPT 57500 PF 57500 BX EXC CERVIX LOCAL	$319.51	$516.00	$69.89–$490.20	21% above	38%
Cervical biopsy inpatient CPT 57500 PF 57500 BX EXC CERVIX LOCAL	$319.51	$516.00	$69.89–$490.20	—	38%
Cervical biopsy inpatient CPT 57500 BX EXC CERVIX LESN WWO FULGURATION (SEP PROC)	$319.51	$516.00	$469.56–$516.00	—	38%
Cesarean delivery, including prenatal and postpartum care CPT 59510 PF 59510 ROUTINE OB CARE WANT	$4,229.14	$6,830.00	$2,490.60–$6,488.50	9% below	38%
Cesarean delivery, including prenatal and postpartum care CPT 59510 ROUTINE OBSTETRIC CARE WANTEPARTUM CARE CESAREAN DELIVERY & POSTPARTU	$4,229.14	$6,830.00	$6,215.30–$6,830.00	9% below	38%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 ROUTINE OBSTETRIC CARE WANTEPARTUM CARE CESAREAN DELIVERY & POSTPARTU	$4,229.14	$6,830.00	$6,215.30–$6,830.00	—	38%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 PF 59510 ROUTINE OB CARE WANT	$4,229.14	$6,830.00	$2,490.60–$6,488.50	—	38%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION SURGICAL EXC OTHR THN CLAMP DEVICE DORSL SLIT EXCPT NWBRN	$519.51	$839.00	$763.49–$839.00	10% above	38%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 PF 54161CIRCUMCISION	$519.51	$839.00	$183.82–$797.05	10% above	38%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION SURGICAL EXC OTHR THN CLAMP DEVICE DORSL SLIT EXCPT NWBRN	$519.51	$839.00	$763.49–$839.00	—	38%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 PF 54161CIRCUMCISION	$519.51	$839.00	$183.82–$797.05	—	38%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION USING CLAMP OTHER DEVICE NEWBORN	$123.84	$200.00	$182.00–$200.00	35% below	38%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 PF 54150 CIRC WCLAMP OTH DVC	$123.84	$200.00	$88.37–$190.00	35% below	38%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 SURG 54150 CIRCUMCISION W REGIONL BLOCK	$928.80	$1,500.00	$1,365.00–$1,500.00	391% above	38%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W REGIONAL BLOCK	$1,268.75	$2,049.00	$1,864.59–$2,049.00	570% above	38%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION USING CLAMP OTHER DEVICE NEWBORN	$123.84	$200.00	$182.00–$200.00	—	38%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 PF 54150 CIRC WCLAMP OTH DVC	$123.84	$200.00	$88.37–$190.00	—	38%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 SURG 54150 CIRCUMCISION W REGIONL BLOCK	$928.80	$1,500.00	$1,365.00–$1,500.00	—	38%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W REGIONAL BLOCK	$1,268.75	$2,049.00	$1,864.59–$2,049.00	—	38%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION SURGICAL EXC OTHER THAN CLAMP DEVICE DORSAL SLIT NEWBORN	$549.24	$887.00	$807.17–$887.00	46% above	38%
Circumcision, surgical, older than a newborn CPT 54160 MD 54160 CIRCY SURGICAL EXC NEW	$549.24	$887.00	$134.55–$842.65	46% above	38%
Circumcision, surgical, older than a newborn CPT 54160 PF 54160 CIRCY SURGICAL EXC NEW	$549.24	$887.00	$134.55–$842.65	46% above	38%
Circumcision, surgical, older than a newborn inpatient CPT 54160 MD 54160 CIRCY SURGICAL EXC NEW	$549.24	$887.00	$134.55–$842.65	—	38%
Circumcision, surgical, older than a newborn inpatient CPT 54160 PF 54160 CIRCY SURGICAL EXC NEW	$549.24	$887.00	$134.55–$842.65	—	38%
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION SURGICAL EXC OTHER THAN CLAMP DEVICE DORSAL SLIT NEWBORN	$549.24	$887.00	$807.17–$887.00	—	38%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 ED 25600 CLSD TX DISTAL RADIAL FX	$148.61	$240.00	$218.40–$240.00	64% below	38%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 MD 25600 CLSD TX RDL FX EP SPAR WO	$546.14	$882.00	$318.06–$837.90	31% above	38%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 PF 25600 FX RAD DIST WO MAN	$546.14	$882.00	$318.06–$837.90	31% above	38%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREAT DISTAL RADIAL FX EPIPHYSEAL SEPARATION WO MANIP	$546.14	$882.00	$802.62–$882.00	31% above	38%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 ED 25600 CLSD TX DISTAL RADIAL FX	$148.61	$240.00	$218.40–$240.00	—	38%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TREAT DISTAL RADIAL FX EPIPHYSEAL SEPARATION WO MANIP	$546.14	$882.00	$802.62–$882.00	—	38%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 MD 25600 CLSD TX RDL FX EP SPAR WO	$546.14	$882.00	$318.06–$837.90	—	38%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 PF 25600 FX RAD DIST WO MAN	$546.14	$882.00	$318.06–$837.90	—	38%
Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY FLEXIBLE PROXIMAL TO SPLENIC FLEXURE WENDOSCOPIC US EXAM	$712.70	$1,151.00	$1,047.41–$1,151.00	—	38%
Colonoscopy with endoscopic ultrasound CPT 45391 PF 45391 COLONOSCOPY W ULTRASOU	$712.70	$1,151.00	$234.31–$1,093.45	—	38%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 PF 45391 COLONOSCOPY W ULTRASOU	$712.70	$1,151.00	$234.31–$1,093.45	—	38%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY FLEXIBLE PROXIMAL TO SPLENIC FLEXURE WENDOSCOPIC US EXAM	$712.70	$1,151.00	$1,047.41–$1,151.00	—	38%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FLEXIBLE WREMVL LESN SNARE	$769.05	$1,242.00	$1,130.22–$1,242.00	20% below	38%
Colonoscopy with polyp removal CPT 45385 PF 45385 COLONOSC W POLYPECT	$769.05	$1,242.00	$231.23–$1,179.90	20% below	38%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FLEXIBLE WREMVL LESN SNARE	$769.05	$1,242.00	$1,130.22–$1,242.00	—	38%
Colonoscopy with polyp removal inpatient CPT 45385 PF 45385 COLONOSC W POLYPECT	$769.05	$1,242.00	$231.23–$1,179.90	—	38%
Colonoscopy with tissue sample CPT 45380 PF 45380 COLONOSCOPY W BX	$648.93	$1,048.00	$183.51–$995.60	33% below	38%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FLEXIBLE PROXIMAL TO SPLENIC FLEXURE WBX SNGL MULTIPLE	$648.93	$1,048.00	$953.68–$1,048.00	33% below	38%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FLEXIBLE PROXIMAL TO SPLENIC FLEXURE WBX SNGL MULTIPLE	$648.93	$1,048.00	$953.68–$1,048.00	—	38%
Colonoscopy with tissue sample inpatient CPT 45380 PF 45380 COLONOSCOPY W BX	$648.93	$1,048.00	$183.51–$995.60	—	38%
Colonoscopy, diagnostic CPT 45378 PF 45378 COLONOSCOPY FLEXIBLE	$850.79	$1,374.00	$168.73–$1,305.30	2% above	38%
Colonoscopy, diagnostic CPT 45378 COLONOSCPY FLEXIBLE PROXIMAL TO SPLENIC FLEXURE DX WWO SPECIMENS COLO	$850.79	$1,374.00	$1,250.34–$1,374.00	2% above	38%
Colonoscopy, diagnostic inpatient CPT 45378 PF 45378 COLONOSCOPY FLEXIBLE	$850.79	$1,374.00	$168.73–$1,305.30	—	38%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCPY FLEXIBLE PROXIMAL TO SPLENIC FLEXURE DX WWO SPECIMENS COLO	$850.79	$1,374.00	$1,250.34–$1,374.00	—	38%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 PF 57460 COLPOSCOPY BX LOP CER	$629.73	$1,017.00	$148.10–$966.15	10% above	38%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY CERVIX WUPPER ADJ VAGINA WLOOP ELECTRODE BIOPSY CERVIX	$710.85	$1,148.00	$1,044.68–$1,148.00	25% above	38%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 PF 57460 COLPOSCOPY BX LOP CER	$629.73	$1,017.00	$148.10–$966.15	—	38%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCOPY CERVIX WUPPER ADJ VAGINA WLOOP ELECTRODE BIOPSY CERVIX	$710.85	$1,148.00	$1,044.68–$1,148.00	—	38%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 PF 57454 COLPOSC BX&CURETTAGE	$349.85	$565.00	$123.78–$536.75	22% above	38%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCPY CERVIX WUPR ADJ VAGINA WBIOPSY CERVIX & ENDOCERVIC CURETT	$349.85	$565.00	$514.15–$565.00	22% above	38%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 PF 57454 COLPOSC BX&CURETTAGE	$349.85	$565.00	$123.78–$536.75	—	38%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCPY CERVIX WUPR ADJ VAGINA WBIOPSY CERVIX & ENDOCERVIC CURETT	$349.85	$565.00	$514.15–$565.00	—	38%
Complex cataract surgery with lens implant CPT 66982 EXTRACAPSULAR CATARACT REMVL WINSERT LENS PROSTHESIS (1 STAGE) CMPLX	$2,187.02	$3,532.00	$3,214.12–$3,532.00	—	38%
Complex cataract surgery with lens implant CPT 66982 PF 66982 RMV EXTRACAP CATARACT	$2,187.02	$3,532.00	$680.15–$3,355.40	—	38%
Complex cataract surgery with lens implant inpatient CPT 66982 PF 66982 RMV EXTRACAP CATARACT	$2,187.02	$3,532.00	$680.15–$3,355.40	—	38%
Complex cataract surgery with lens implant inpatient CPT 66982 EXTRACAPSULAR CATARACT REMVL WINSERT LENS PROSTHESIS (1 STAGE) CMPLX	$2,187.02	$3,532.00	$3,214.12–$3,532.00	—	38%
Cystoscopy with ureteral stent placement CPT 52332 PF 52332 CYSTOSCOPY AND TREATME	$614.87	$993.00	$142.87–$943.35	13% below	38%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOURETHROSCOPY WINSERT INDWELLING URETERAL STENT	$614.87	$993.00	$903.63–$993.00	13% below	38%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOURETHROSCOPY WINSERT INDWELLING URETERAL STENT	$614.87	$993.00	$903.63–$993.00	—	38%
Cystoscopy with ureteral stent placement inpatient CPT 52332 PF 52332 CYSTOSCOPY AND TREATME	$614.87	$993.00	$142.87–$943.35	—	38%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY (SEP PROC)	$444.59	$718.00	$653.38–$718.00	19% below	38%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 PF 52000 CYSTOURETHROSCOPY	$444.59	$718.00	$73.59–$682.10	19% below	38%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY (SEP PROC)	$444.59	$718.00	$653.38–$718.00	—	38%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 PF 52000 CYSTOURETHROSCOPY	$444.59	$718.00	$73.59–$682.10	—	38%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE DX & OR THERAPEUTIC (NONOBSTETRICAL)	$680.51	$1,099.00	$1,000.09–$1,099.00	at median	38%
D&C (dilation and curettage), not related to pregnancy CPT 58120 PF 58120 D & C DX THERAPEUTIC	$680.51	$1,099.00	$217.07–$1,044.05	at median	38%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 PF 58120 D & C DX THERAPEUTIC	$680.51	$1,099.00	$217.07–$1,044.05	—	38%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURETTAGE DX & OR THERAPEUTIC (NONOBSTETRICAL)	$680.51	$1,099.00	$1,000.09–$1,099.00	—	38%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALIG LESNS EXCPT SKIN TAGS CUTANEOUS VASC PROLIFERAT LESN	$172.14	$278.00	$252.98–$278.00	4% above	38%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PF 17000 DEST PREMAL 1ST LSN	$172.14	$278.00	$51.11–$264.10	4% above	38%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT PREMALIG LESNS EXCPT SKIN TAGS CUTANEOUS VASC PROLIFERAT LESN	$172.14	$278.00	$252.98–$278.00	—	38%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 PF 17000 DEST PREMAL 1ST LSN	$172.14	$278.00	$51.11–$264.10	—	38%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY (REQUIRING INSERT VENTILATING TUBE) GENERAL ANES	$637.16	$1,029.00	$936.39–$1,029.00	21% above	38%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 PF 69436 TYMPANOSTOMY INSERT VE	$637.16	$1,029.00	$149.33–$977.55	21% above	38%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY (REQUIRING INSERT VENTILATING TUBE) GENERAL ANES	$637.16	$1,029.00	$936.39–$1,029.00	—	38%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 PF 69436 TYMPANOSTOMY INSERT VE	$637.16	$1,029.00	$149.33–$977.55	—	38%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 PF 69433 TYMPANOST WLOC ANES	$384.53	$621.00	$124.08–$589.95	at median	38%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY (REQUIRING INSERT VENTILATING TUBE) LOCAL TOPICAL ANES	$384.53	$621.00	$565.11–$621.00	at median	38%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSTOMY (REQUIRING INSERT VENTILATING TUBE) LOCAL TOPICAL ANES	$384.53	$621.00	$565.11–$621.00	—	38%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 PF 69433 TYMPANOST WLOC ANES	$384.53	$621.00	$124.08–$589.95	—	38%
Earwax removal by irrigation (rinsing), one ear CPT 69209 ED 69209 RMVL IMPACTED CERUMEN IRRIGATION LAVAGE UNI	$37.16	$60.00	$54.60–$60.00	45% above	38%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 MD 69209 RMVL IMPACTED CERUMEN IRR LAVAGE UNILATERAL	$52.64	$85.00	$14.47–$80.75	106% above	38%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, UNILATERAL	$59.45	$96.00	$87.36–$96.00	132% above	38%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 PF 69209 RMVL IMPACTED CERUMEN IRR LAVAGE UNILATERAL	$59.45	$96.00	$87.36–$96.00	132% above	38%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 ED 69209 RMVL IMPACTED CERUMEN IRRIGATION LAVAGE UNI	$37.16	$60.00	$54.60–$60.00	—	38%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 MD 69209 RMVL IMPACTED CERUMEN IRR LAVAGE UNILATERAL	$52.64	$85.00	$14.47–$80.75	—	38%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 PF 69209 RMVL IMPACTED CERUMEN IRR LAVAGE UNILATERAL	$59.45	$96.00	$87.36–$96.00	—	38%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, UNILATERAL	$59.45	$96.00	$87.36–$96.00	—	38%
Earwax removal with instruments, one ear CPT 69210 ED 69210 REMV IMPACTED EAR WAX INSTRUMENT UNI	$37.16	$60.00	$54.60–$60.00	47% below	38%
Earwax removal with instruments, one ear CPT 69210 MD 69210 RMVL CERUMEN-SEP PROC	$62.54	$101.00	$29.56–$95.95	11% below	38%
Earwax removal with instruments, one ear CPT 69210 PF 69210 RMVL IMPACTED CERUM W INSTRUMENT	$70.59	$114.00	$29.56–$108.30	at median	38%
Earwax removal with instruments, one ear one side CPT 69210 REMVL IMPACTED CERUMEN (SEP PROC) UNILATERAL	$70.59	$114.00	$103.74–$114.00	at median	38%
Earwax removal with instruments, one ear inpatient CPT 69210 ED 69210 REMV IMPACTED EAR WAX INSTRUMENT UNI	$37.16	$60.00	$54.60–$60.00	—	38%
Earwax removal with instruments, one ear inpatient CPT 69210 MD 69210 RMVL CERUMEN-SEP PROC	$62.54	$101.00	$29.56–$95.95	—	38%
Earwax removal with instruments, one ear inpatient CPT 69210 PF 69210 RMVL IMPACTED CERUM W INSTRUMENT	$70.59	$114.00	$29.56–$108.30	—	38%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMVL IMPACTED CERUMEN (SEP PROC) UNILATERAL	$70.59	$114.00	$103.74–$114.00	—	38%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 PF 58100 ENDOMETRIAL SAMPLING	$230.35	$372.00	$58.19–$353.40	8% above	38%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX WWO ENDOCERVICAL BX WO DILATION ANY METH (SEP PROC)	$230.35	$372.00	$338.52–$372.00	8% above	38%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BX WWO ENDOCERVICAL BX WO DILATION ANY METH (SEP PROC)	$230.35	$372.00	$338.52–$372.00	—	38%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 PF 58100 ENDOMETRIAL SAMPLING	$230.35	$372.00	$58.19–$353.40	—	38%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NASAL SINUS ENDOSCOPY SURGICAL WETHMOIDECTOMY TTL(ANTERIOR & POSTR)	$1,093.51	$1,766.00	$1,607.06–$1,766.00	—	38%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 PF 31255 NASAL ENDOSCOPY W TOT	$1,093.51	$1,766.00	$297.43–$1,677.70	—	38%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 NASAL SINUS ENDOSCOPY SURGICAL WETHMOIDECTOMY TTL(ANTERIOR & POSTR)	$1,093.51	$1,766.00	$1,607.06–$1,766.00	—	38%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 PF 31255 NASAL ENDOSCOPY W TOT	$1,093.51	$1,766.00	$297.43–$1,677.70	—	38%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NASAL SINUS ENDOSCPY SURGICAL WFRONTAL SINUS EXPLORATION INCL TISS REMOV	$1,504.04	$2,429.00	$2,210.39–$2,429.00	—	38%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 PF 31276 NASAL SINUS ENDO SURG	$1,504.04	$2,429.00	$347.93–$2,307.55	—	38%
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 PF 31276 NASAL SINUS ENDO SURG	$1,504.04	$2,429.00	$347.93–$2,307.55	—	38%
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 NASAL SINUS ENDOSCPY SURGICAL WFRONTAL SINUS EXPLORATION INCL TISS REMOV	$1,504.04	$2,429.00	$2,210.39–$2,429.00	—	38%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 NASAL SINUS ENDOSCOPY SURGICAL WMAXILLARY ANTROSTOMY	$780.82	$1,261.00	$1,147.51–$1,261.00	—	38%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 PF 31256 ENDO NASAL MAXILLARY	$780.82	$1,261.00	$167.19–$1,197.95	—	38%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 PF 31256 ENDO NASAL MAXILLARY	$780.82	$1,261.00	$167.19–$1,197.95	—	38%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 NASAL SINUS ENDOSCOPY SURGICAL WMAXILLARY ANTROSTOMY	$780.82	$1,261.00	$1,147.51–$1,261.00	—	38%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 NASAL SINUS ENDOSCPY SURGICAL WMAXILLARY ANTROSTOMY WMAXILLARY TISSU	$854.50	$1,380.00	$1,255.80–$1,380.00	—	38%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 PF 31267 MAX SINUS ENDO REMVE M	$854.50	$1,380.00	$244.16–$1,311.00	—	38%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 NASAL SINUS ENDOSCPY SURGICAL WMAXILLARY ANTROSTOMY WMAXILLARY TISSU	$854.50	$1,380.00	$1,255.80–$1,380.00	—	38%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 PF 31267 MAX SINUS ENDO REMVE M	$854.50	$1,380.00	$244.16–$1,311.00	—	38%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 SURG 62321 INJ IL NDL CATH CERV THOR W GUID	$223.54	$361.00	$328.51–$361.00	80% below	38%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 PF 62321 INJ INTERLAMINAR CRV/THRC WITH IMAGING GUIDANCE	$868.12	$1,402.00	$98.84–$1,331.90	21% below	38%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 SURG 62321 INJ IL NDL CATH CERV THOR W GUID	$223.54	$361.00	$328.51–$361.00	—	38%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 PF 62321 INJ INTERLAMINAR CRV/THRC WITH IMAGING GUIDANCE	$868.12	$1,402.00	$98.84–$1,331.90	—	38%
Eye injection into the vitreous (intravitreal injection) CPT 67028 PF 67028 INTRAVITREAL INJWMED	$351.09	$567.00	$84.36–$538.65	—	38%
Eye injection into the vitreous (intravitreal injection) CPT 67028 INTRAVITREAL INJ A PHARMACOLOGIC AGENT (SEP PROC)	$351.09	$567.00	$515.97–$567.00	—	38%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 PF 67028 INTRAVITREAL INJWMED	$351.09	$567.00	$84.36–$538.65	—	38%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INTRAVITREAL INJ A PHARMACOLOGIC AGENT (SEP PROC)	$351.09	$567.00	$515.97–$567.00	—	38%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 ANES 64493 INJ FACET JNT LUM SAC 1LV	$486.70	$786.00	$746.70	51% below	38%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ AGNT JOINT LUM SAC 1ST LVL	$486.70	$786.00	$715.26–$786.00	51% below	38%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 PFR 64493 INJ FACET JNT L S 1LV	$486.70	$786.00	$84.06–$746.70	51% below	38%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 SURG 64493 INJ DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$551.09	$890.00	$809.90–$890.00	45% below	38%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ AGNT JOINT LUM SAC 1ST LVL	$486.70	$786.00	$715.26–$786.00	—	38%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 ANES 64493 INJ FACET JNT LUM SAC 1LV	$486.70	$786.00	$746.70	—	38%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 PFR 64493 INJ FACET JNT L S 1LV	$486.70	$786.00	$84.06–$746.70	—	38%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 SURG 64493 INJ DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$551.09	$890.00	$809.90–$890.00	—	38%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 PF 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$882.36	$1,425.00	$531.13–$1,353.75	56% below	38%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$882.36	$1,425.00	$1,296.75–$1,425.00	56% below	38%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 PF 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$882.36	$1,425.00	$531.13–$1,353.75	—	38%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$882.36	$1,425.00	$1,296.75–$1,425.00	—	38%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 SURG 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$341.80	$552.00	$502.32–$552.00	53% below	38%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 PF 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$1,328.19	$2,145.00	$317.44–$2,037.75	82% above	38%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$1,328.19	$2,145.00	$1,951.95–$2,145.00	82% above	38%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 SURG 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$341.80	$552.00	$502.32–$552.00	—	38%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$1,328.19	$2,145.00	$1,951.95–$2,145.00	—	38%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 PF 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$1,328.19	$2,145.00	$317.44–$2,037.75	—	38%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 PF 45330 SIGMOIDOSCOPY FLEXIBL	$266.88	$431.00	$52.65–$409.45	25% below	38%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEXIBLE DX WWO SPECIMENS BRUSHING WASHING(SEP PROC)	$266.88	$431.00	$392.21–$431.00	25% below	38%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 PF 45330 SIGMOIDOSCOPY FLEXIBL	$266.88	$431.00	$52.65–$409.45	—	38%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEXIBLE DX WWO SPECIMENS BRUSHING WASHING(SEP PROC)	$266.88	$431.00	$392.21–$431.00	—	38%
Gallbladder removal, laparoscopic CPT 47562 PF 47562 LAP CHOLECYSTECTOMY	$1,374.01	$2,219.00	$617.65–$2,108.05	20% below	38%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY SURGICAL CHOLECYSTECTOMY	$1,374.01	$2,219.00	$2,019.29–$2,219.00	20% below	38%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPY SURGICAL CHOLECYSTECTOMY	$1,374.01	$2,219.00	$2,019.29–$2,219.00	—	38%
Gallbladder removal, laparoscopic inpatient CPT 47562 PF 47562 LAP CHOLECYSTECTOMY	$1,374.01	$2,219.00	$617.65–$2,108.05	—	38%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 PF 47563 LAP CHOLECYSTECT CHOL	$1,492.28	$2,410.00	$671.53–$2,289.50	70% below	38%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPAROSCOPY SURGICAL CHOLECYSTECTOMY WCHOLANGIOGRAPHY	$1,836.55	$2,966.00	$2,699.06–$2,966.00	63% below	38%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 PF 47563 LAP CHOLECYSTECT CHOL	$1,492.28	$2,410.00	$671.53–$2,289.50	—	38%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPAROSCOPY SURGICAL CHOLECYSTECTOMY WCHOLANGIOGRAPHY	$1,836.55	$2,966.00	$2,699.06–$2,966.00	—	38%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY	$2,309.62	$3,730.00	$3,394.30–$3,730.00	1% above	38%
Gallbladder removal, open surgery through a larger incision CPT 47600 PF 47600 COLECYSTECTOMY	$2,309.62	$3,730.00	$997.60–$3,543.50	1% above	38%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLECYSTECTOMY	$2,309.62	$3,730.00	$3,394.30–$3,730.00	—	38%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 PF 47600 COLECYSTECTOMY	$2,309.62	$3,730.00	$997.60–$3,543.50	—	38%
Hammertoe correction surgery CPT 28285 PF 28285 HAMMER TOE OPERATION O	$803.11	$1,297.00	$365.79–$1,232.15	29% below	38%
Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE	$803.11	$1,297.00	$1,180.27–$1,297.00	29% below	38%
Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMERTOE	$803.11	$1,297.00	$1,180.27–$1,297.00	—	38%
Hammertoe correction surgery inpatient CPT 28285 PF 28285 HAMMER TOE OPERATION O	$803.11	$1,297.00	$365.79–$1,232.15	—	38%
Hemorrhoid banding (rubber band ligation) CPT 46221 PF 46221 LIGATE HEMORRHOID(S)	$455.74	$736.00	$181.35–$699.20	11% below	38%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY SMPL LIGATURE	$455.74	$736.00	$669.76–$736.00	11% below	38%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 PF 46221 LIGATE HEMORRHOID(S)	$455.74	$736.00	$181.35–$699.20	—	38%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY SMPL LIGATURE	$455.74	$736.00	$669.76–$736.00	—	38%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY INT & EXT SMPL	$824.78	$1,332.00	$1,212.12–$1,332.00	14% below	38%
Hemorrhoidectomy (internal and external), one area CPT 46255 PF 46255 HEMORRHOIDECT SINGLE	$824.78	$1,332.00	$332.22–$1,265.40	14% below	38%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 PF 46255 HEMORRHOIDECT SINGLE	$824.78	$1,332.00	$332.22–$1,265.40	—	38%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY INT & EXT SMPL	$824.78	$1,332.00	$1,212.12–$1,332.00	—	38%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 CONVERSION PREVIOUS HIP SURGERY TO TOTAL HIP ARTHROPLASTY WWO AUTOGRF	$3,707.77	$5,988.00	$5,449.08–$5,988.00	16% below	38%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 PF 27132 CONV PREV SURG TO TOT	$3,707.77	$5,988.00	$1,556.43–$5,688.60	16% below	38%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 PF 27132 CONV PREV SURG TO TOT	$3,707.77	$5,988.00	$1,556.43–$5,688.60	—	38%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 CONVERSION PREVIOUS HIP SURGERY TO TOTAL HIP ARTHROPLASTY WWO AUTOGRF	$3,707.77	$5,988.00	$5,449.08–$5,988.00	—	38%
Hysterectomy through an abdominal incision (total) CPT 58150 PF 58150 TOTAL HYSTERECT ABD	$2,107.14	$3,403.00	$945.25–$3,232.85	5% below	38%
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY WWO REMVL TUBE(S) OVARY(S)	$2,107.14	$3,403.00	$3,096.73–$3,403.00	5% below	38%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY WWO REMVL TUBE(S) OVARY(S)	$2,107.14	$3,403.00	$3,096.73–$3,403.00	—	38%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 PF 58150 TOTAL HYSTERECT ABD	$2,107.14	$3,403.00	$945.25–$3,232.85	—	38%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHIZATION & INTRODUCTION SALINE INFUSION SONOHYSTEROGRAPHY HYSTEROSA	$250.16	$404.00	$367.64–$404.00	at median	38%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 PFR 58340 CATH INTR SAL HYSTERO	$250.16	$404.00	$53.88–$383.80	at median	38%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 SURG 58340 HYSTERO INJ CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI	$323.23	$522.00	$475.02–$522.00	29% above	38%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATHIZATION & INTRODUCTION SALINE INFUSION SONOHYSTEROGRAPHY HYSTEROSA	$250.16	$404.00	$367.64–$404.00	—	38%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 PFR 58340 CATH INTR SAL HYSTERO	$250.16	$404.00	$53.88–$383.80	—	38%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 SURG 58340 HYSTERO INJ CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI	$323.23	$522.00	$475.02–$522.00	—	38%
Hysteroscopy with endometrial ablation CPT 58563 PF 58563 HYSTEROSCOPY WABLAT	$2,434.70	$3,932.00	$226.61–$3,735.40	4% above	38%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY SURGICAL WENDOMETRIAL ABLATION	$2,434.70	$3,932.00	$3,578.12–$3,932.00	4% above	38%
Hysteroscopy with endometrial ablation inpatient CPT 58563 PF 58563 HYSTEROSCOPY WABLAT	$2,434.70	$3,932.00	$226.61–$3,735.40	—	38%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY SURGICAL WENDOMETRIAL ABLATION	$2,434.70	$3,932.00	$3,578.12–$3,932.00	—	38%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 PF 58558 HYSTEROSCOPY WBIOPSY	$841.50	$1,359.00	$213.68–$1,291.05	57% below	38%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY SURGICAL WENDOMETRIAL BX & OR POLYPECTOMY WWO D&C	$1,273.70	$2,057.00	$1,871.87–$2,057.00	36% below	38%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 PF 58558 HYSTEROSCOPY WBIOPSY	$841.50	$1,359.00	$213.68–$1,291.05	—	38%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY SURGICAL WENDOMETRIAL BX & OR POLYPECTOMY WWO D&C	$1,273.70	$2,057.00	$1,871.87–$2,057.00	—	38%
IUD insertion (the device itself billed separately) CPT 58300 PF 58300 INSRT INTRAUTER DEVIC	$195.67	$316.00	$300.20	11% above	38%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$195.67	$316.00	$287.56–$316.00	11% above	38%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE	$195.67	$316.00	$287.56–$316.00	—	38%
IUD insertion (the device itself billed separately) inpatient CPT 58300 PF 58300 INSRT INTRAUTER DEVIC	$195.67	$316.00	$300.20	—	38%
Incision and drainage of a simple or single skin abscess CPT 10060 ED 10060 I&D SKIN ABSCESS SMPL	$123.23	$199.00	$181.09–$199.00	43% below	38%
Incision and drainage of a simple or single skin abscess CPT 10060 MD 10060 I & D ABSCESS SMPL SNGL	$208.68	$337.00	$99.76–$320.15	4% below	38%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SMPL SNGL	$208.68	$337.00	$306.67–$337.00	4% below	38%
Incision and drainage of a simple or single skin abscess CPT 10060 PF 10060 I&D ABSCESS SIMP	$208.68	$337.00	$99.76–$320.15	4% below	38%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ED 10060 I&D SKIN ABSCESS SMPL	$123.23	$199.00	$181.09–$199.00	—	38%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 PF 10060 I&D ABSCESS SIMP	$208.68	$337.00	$99.76–$320.15	—	38%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 MD 10060 I & D ABSCESS SMPL SNGL	$208.68	$337.00	$99.76–$320.15	—	38%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SMPL SNGL	$208.68	$337.00	$306.67–$337.00	—	38%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PF 49505 RPR INGUINAL HERNIA>5	$1,076.17	$1,738.00	$490.79–$1,651.10	32% below	38%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR INITIAL INGUINAL HERNIA AGE 5+ REDUCIBLE	$1,076.17	$1,738.00	$1,581.58–$1,738.00	32% below	38%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PF 49505 RPR INGUINAL HERNIA>5	$1,076.17	$1,738.00	$490.79–$1,651.10	—	38%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 RPR INITIAL INGUINAL HERNIA AGE 5+ REDUCIBLE	$1,076.17	$1,738.00	$1,581.58–$1,738.00	—	38%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PF 20550 INJ SGL TEND SHEATH	$108.98	$176.00	$36.02–$167.20	47% below	38%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ(S) SNGL TENDON SHEATH LIG APONEUROSIS	$108.98	$176.00	$160.16–$176.00	47% below	38%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PFR 20550 INJ SGL TEND SHEATH	$108.98	$176.00	$36.02–$167.20	47% below	38%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 MD 20550 INJ(S)SNGL TEND SHTH LIGMNT	$138.71	$224.00	$36.02–$212.80	33% below	38%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PF 20550 INJ SGL TEND SHEATH	$108.98	$176.00	$36.02–$167.20	—	38%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PFR 20550 INJ SGL TEND SHEATH	$108.98	$176.00	$36.02–$167.20	—	38%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ(S) SNGL TENDON SHEATH LIG APONEUROSIS	$108.98	$176.00	$160.16–$176.00	—	38%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 MD 20550 INJ(S)SNGL TEND SHTH LIGMNT	$138.71	$224.00	$36.02–$212.80	—	38%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PF 20610 ARTHROC ASP INJ MAJOR JOINT BURSA WO US GUID	$117.65	$190.00	$41.87–$180.50	59% below	38%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MD 20610 ARTHRO ASP INJ MAJOR JOINT BURSA WO US GUID	$117.65	$190.00	$41.87–$180.50	59% below	38%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENT ASP INJ MAJOR JOINT BURSA WO US GUID	$117.65	$190.00	$172.90–$190.00	59% below	38%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PFR 20610 ARTHROC ASP INJ MAJOR JOINT BURSA WO US GUID	$117.65	$190.00	$41.87–$180.50	59% below	38%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENT ASP INJ MAJOR JOINT BURSA WO US GUID	$117.65	$190.00	$172.90–$190.00	—	38%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PFR 20610 ARTHROC ASP INJ MAJOR JOINT BURSA WO US GUID	$117.65	$190.00	$41.87–$180.50	—	38%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PF 20610 ARTHROC ASP INJ MAJOR JOINT BURSA WO US GUID	$117.65	$190.00	$41.87–$180.50	—	38%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 MD 20610 ARTHRO ASP INJ MAJOR JOINT BURSA WO US GUID	$117.65	$190.00	$41.87–$180.50	—	38%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG DELIVERY IMPLANT	$286.69	$463.00	$421.33–$463.00	4% below	38%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 PF 11981 INSERT DRUG DELIVERY IMPLANT	$286.69	$463.00	$58.19–$439.85	4% below	38%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG DELIVERY IMPLANT	$286.69	$463.00	$421.33–$463.00	—	38%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 PF 11981 INSERT DRUG DELIVERY IMPLANT	$286.69	$463.00	$58.19–$439.85	—	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PFR 20605 ARTHROC ASP INJ INTERMED JNT BURSA WO US GUID	$126.94	$205.00	$33.87–$194.75	31% below	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PF 20605 ARTHROC ASP INJ INTERMED JNT BURSA WO US GUID	$126.94	$205.00	$33.87–$194.75	31% below	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 MD 20605 ARTHROCENT ASP INJ INTERMED JOINT BURSA WO US GUID	$126.94	$205.00	$33.87–$194.75	31% below	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENT ASP INJ INTMDTE JOINT BURSA WO US GUID	$126.94	$205.00	$186.55–$205.00	31% below	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ANES 20605 ARTHROC ASP INJ JOINT BURSA INTERMED WO US GUID	$126.94	$205.00	$194.75	31% below	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 SURG 20605 ARTHROCENTESIS ASP INJ INTRM JNT BURSA WO US GUID	$147.37	$238.00	$216.58–$238.00	20% below	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENT ASP INJ INTMDTE JOINT BURSA WO US GUID	$126.94	$205.00	$186.55–$205.00	—	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PFR 20605 ARTHROC ASP INJ INTERMED JNT BURSA WO US GUID	$126.94	$205.00	$33.87–$194.75	—	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PF 20605 ARTHROC ASP INJ INTERMED JNT BURSA WO US GUID	$126.94	$205.00	$33.87–$194.75	—	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 MD 20605 ARTHROCENT ASP INJ INTERMED JOINT BURSA WO US GUID	$126.94	$205.00	$33.87–$194.75	—	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ANES 20605 ARTHROC ASP INJ JOINT BURSA INTERMED WO US GUID	$126.94	$205.00	$194.75	—	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 SURG 20605 ARTHROCENTESIS ASP INJ INTRM JNT BURSA WO US GUID	$147.37	$238.00	$216.58–$238.00	—	38%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 PF 20600 ARTHROC ASP INJ SMALL JOINT BURSA WO US GUID	$97.84	$158.00	$32.95–$150.10	14% below	38%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASP INJ SMALL JOINT BURSA WO US GUID	$97.84	$158.00	$143.78–$158.00	14% below	38%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 MD 20600 ARTHRO ASP INJ SMALL JOINT BURSA WO US GUID	$126.94	$205.00	$32.95–$194.75	11% above	38%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 PFR 20600 ARTHROC ASP INJ SMALL JOINT BURSA WO US GUID	$126.94	$205.00	$32.95–$194.75	11% above	38%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 SURG 20600 ARTHROCENTESIS ASP INJ SM JNT BURSA WO US GUID	$166.57	$269.00	$244.79–$269.00	46% above	38%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 PF 20600 ARTHROC ASP INJ SMALL JOINT BURSA WO US GUID	$97.84	$158.00	$32.95–$150.10	—	38%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASP INJ SMALL JOINT BURSA WO US GUID	$97.84	$158.00	$143.78–$158.00	—	38%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 MD 20600 ARTHRO ASP INJ SMALL JOINT BURSA WO US GUID	$126.94	$205.00	$32.95–$194.75	—	38%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 PFR 20600 ARTHROC ASP INJ SMALL JOINT BURSA WO US GUID	$126.94	$205.00	$32.95–$194.75	—	38%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 SURG 20600 ARTHROCENTESIS ASP INJ SM JNT BURSA WO US GUID	$166.57	$269.00	$244.79–$269.00	—	38%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 PF 29882 ARTHROSCOPY KNEE SURGICAL MENISCUS REPAIR MED OR LAT	$2,050.18	$3,311.00	$649.05–$3,145.45	24% above	38%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ARTHROSCOPY KNEE SURGICAL WMENISCUS RPR MEDIAL LAT	$2,050.18	$3,311.00	$3,013.01–$3,311.00	24% above	38%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 PF 29882 ARTHROSCOPY KNEE SURGICAL MENISCUS REPAIR MED OR LAT	$2,050.18	$3,311.00	$649.05–$3,145.45	—	38%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHROSCOPY KNEE SURGICAL WMENISCUS RPR MEDIAL LAT	$2,050.18	$3,311.00	$3,013.01–$3,311.00	—	38%
Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY KNEE SURGICAL WMENISCECTOMY MEDIAL LAT WSHAVING	$1,142.43	$1,845.00	$1,678.95–$1,845.00	2% below	38%
Knee arthroscopy with meniscus trim CPT 29881 PF 29881 ARTHROS KNEE MENISCEC	$1,142.43	$1,845.00	$512.35–$1,752.75	2% below	38%
Knee arthroscopy with meniscus trim inpatient CPT 29881 PF 29881 ARTHROS KNEE MENISCEC	$1,142.43	$1,845.00	$512.35–$1,752.75	—	38%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY KNEE SURGICAL WMENISCECTOMY MEDIAL LAT WSHAVING	$1,142.43	$1,845.00	$1,678.95–$1,845.00	—	38%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 PF 29880 ARTHROS KNEE MENISCEC	$1,187.63	$1,918.00	$531.44–$1,822.10	20% below	38%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHROSCOPY KNEE SURGICAL WMENISCECTOMY MEDIAL & LAT WSHAVING	$1,187.63	$1,918.00	$1,745.38–$1,918.00	20% below	38%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHROSCOPY KNEE SURGICAL WMENISCECTOMY MEDIAL & LAT WSHAVING	$1,187.63	$1,918.00	$1,745.38–$1,918.00	—	38%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 PF 29880 ARTHROS KNEE MENISCEC	$1,187.63	$1,918.00	$531.44–$1,822.10	—	38%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ARTHROSCPY KNEE SURGICAL DEBRIDEMENT SHAVING ARTICULAR CARTILAGE(CHOND	$1,310.85	$2,117.00	$1,926.47–$2,117.00	1% below	38%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 PF 29877 ARTHROS KNEE WDEBRID	$1,449.55	$2,341.00	$586.86–$2,223.95	9% above	38%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHROSCPY KNEE SURGICAL DEBRIDEMENT SHAVING ARTICULAR CARTILAGE(CHOND	$1,310.85	$2,117.00	$1,926.47–$2,117.00	—	38%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 PF 29877 ARTHROS KNEE WDEBRID	$1,449.55	$2,341.00	$586.86–$2,223.95	—	38%
Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 PF 43644 LAPAROSCOPIC GASTRIC B	$4,357.32	$7,037.00	$1,611.86–$6,685.15	—	38%
Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 LAPAROSCOPIC GASTRIC RESTRICTIVE PX WGASTRIC BYPASS ROUX-EN-Y <150CM	$4,357.32	$7,037.00	$6,403.67–$7,037.00	—	38%
Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 LAPAROSCOPIC GASTRIC RESTRICTIVE PX WGASTRIC BYPASS ROUX-EN-Y <150CM	$4,357.32	$7,037.00	$6,403.67–$7,037.00	—	38%
Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 PF 43644 LAPAROSCOPIC GASTRIC B	$4,357.32	$7,037.00	$1,611.86–$6,685.15	—	38%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY SURGICAL APPENDECTOMY	$1,256.36	$2,029.00	$1,846.39–$2,029.00	31% below	38%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 PF 44970 LAP APPENDECTOMY	$1,256.36	$2,029.00	$563.15–$1,927.55	31% below	38%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY SURGICAL APPENDECTOMY	$1,256.36	$2,029.00	$1,846.39–$2,029.00	—	38%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 PF 44970 LAP APPENDECTOMY	$1,256.36	$2,029.00	$563.15–$1,927.55	—	38%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPAROSCOPY SURGICAL ESOPHAGOGASTRIC FUNDOPLASTY	$2,452.04	$3,960.00	$3,603.60–$3,960.00	14% below	38%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 PF 43280 LAP FUNDOPLASTY ESOPH	$2,452.04	$3,960.00	$1,000.37–$3,762.00	14% below	38%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAPAROSCOPY SURGICAL ESOPHAGOGASTRIC FUNDOPLASTY	$2,452.04	$3,960.00	$3,603.60–$3,960.00	—	38%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 PF 43280 LAP FUNDOPLASTY ESOPH	$2,452.04	$3,960.00	$1,000.37–$3,762.00	—	38%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 TLH UTERUS 250 G OR LESS	$2,144.91	$3,464.00	$3,152.24–$3,464.00	72% below	38%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 PF 58570 LAPAROSCOPY TOTAL HYST	$2,213.03	$3,574.00	$750.35–$3,395.30	71% below	38%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 TLH UTERUS 250 G OR LESS	$2,144.91	$3,464.00	$3,152.24–$3,464.00	—	38%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 PF 58570 LAPAROSCOPY TOTAL HYST	$2,213.03	$3,574.00	$750.35–$3,395.30	—	38%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 TLH WT O 250 G OR LESS	$2,713.34	$4,382.00	$3,987.62–$4,382.00	2% below	38%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 PF 58571 LAPAR RMV TUB OV<250G	$2,713.34	$4,382.00	$843.03–$4,162.90	2% below	38%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 PF 58571 LAPAR RMV TUB OV<250G	$2,713.34	$4,382.00	$843.03–$4,162.90	—	38%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 TLH WT O 250 G OR LESS	$2,713.34	$4,382.00	$3,987.62–$4,382.00	—	38%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 PF 49650 LAP RPR HERNIA INIT	$898.46	$1,451.00	$407.04–$1,378.45	19% below	38%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAPAROSCOPY SURGICAL RPR INGUINAL HERNIA INITIAL	$898.46	$1,451.00	$1,320.41–$1,451.00	19% below	38%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 PF 49650 LAP RPR HERNIA INIT	$898.46	$1,451.00	$407.04–$1,378.45	—	38%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAPAROSCOPY SURGICAL RPR INGUINAL HERNIA INITIAL	$898.46	$1,451.00	$1,320.41–$1,451.00	—	38%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAPAROSCOPY SURGICAL RPR INGUINAL HERNIA RECURRENT	$1,169.05	$1,888.00	$1,718.08–$1,888.00	19% below	38%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 PF 49651 LAPSCOPY REC ING HERNI	$1,253.88	$2,025.00	$530.82–$1,923.75	13% below	38%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAPAROSCOPY SURGICAL RPR INGUINAL HERNIA RECURRENT	$1,169.05	$1,888.00	$1,718.08–$1,888.00	—	38%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 PF 49651 LAPSCOPY REC ING HERNI	$1,253.88	$2,025.00	$530.82–$1,923.75	—	38%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY SURGICAL WREMVL ADNEXAL STRUCTURES	$1,356.67	$2,191.00	$1,993.81–$2,191.00	20% below	38%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 PF 58661 LAP OOPHORECTOMY	$2,305.91	$3,724.00	$605.02–$3,537.80	36% above	38%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPAROSCOPY SURGICAL WREMVL ADNEXAL STRUCTURES	$1,356.67	$2,191.00	$1,993.81–$2,191.00	—	38%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 PF 58661 LAP OOPHORECTOMY	$2,305.91	$3,724.00	$605.02–$3,537.80	—	38%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 DISCISSION SECONDARY MEMBRANOUS CATARACT LASER (1+ STAGES)	$647.69	$1,046.00	$951.86–$1,046.00	—	38%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 PF 66821 DISCIS CATARACT LSR	$647.69	$1,046.00	$284.50–$993.70	—	38%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 PF 66821 DISCIS CATARACT LSR	$647.69	$1,046.00	$284.50–$993.70	—	38%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 DISCISSION SECONDARY MEMBRANOUS CATARACT LASER (1+ STAGES)	$647.69	$1,046.00	$951.86–$1,046.00	—	38%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ED 12031 LYR CLSR OF WND 2.5CM OR <	$247.68	$400.00	$364.00–$400.00	28% below	38%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PF 12031 RPR INT SCLP <2.5CM	$497.22	$803.00	$140.71–$762.85	45% above	38%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 MD 12031 LYR CLSR S A T EXT 2.5 CM <	$497.22	$803.00	$140.71–$762.85	45% above	38%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE WNDS SCALP AXILLAE TRUNK EXTREM 2.5 CM <	$497.22	$803.00	$730.73–$803.00	45% above	38%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 ED 12031 LYR CLSR OF WND 2.5CM OR <	$247.68	$400.00	$364.00–$400.00	—	38%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 PF 12031 RPR INT SCLP <2.5CM	$497.22	$803.00	$140.71–$762.85	—	38%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE WNDS SCALP AXILLAE TRUNK EXTREM 2.5 CM <	$497.22	$803.00	$730.73–$803.00	—	38%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 MD 12031 LYR CLSR S A T EXT 2.5 CM <	$497.22	$803.00	$140.71–$762.85	—	38%
Lower-back epidural injection, with imaging guidance CPT 62323 SURG 62323 INJ IL NDL CATH LUMB SACR W GUID	$167.19	$270.00	$245.70–$270.00	82% below	38%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ INTERLAMINAR LMBR/SAC WITH IMAGING GUIDANCE	$435.92	$704.00	$640.64–$704.00	53% below	38%
Lower-back epidural injection, with imaging guidance CPT 62323 PF 62323 INJ INTERLAMINAR LMBR/SAC WITH IMAGING GUIDANCE	$435.92	$704.00	$91.45–$668.80	53% below	38%
Lower-back epidural injection, with imaging guidance CPT 62323 PFR 62323 INJ INTERLAMINAR LMBR SAC W IMAG GUID	$435.92	$704.00	$91.45–$668.80	53% below	38%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 SURG 62323 INJ IL NDL CATH LUMB SACR W GUID	$167.19	$270.00	$245.70–$270.00	—	38%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PF 62323 INJ INTERLAMINAR LMBR/SAC WITH IMAGING GUIDANCE	$435.92	$704.00	$91.45–$668.80	—	38%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ INTERLAMINAR LMBR/SAC WITH IMAGING GUIDANCE	$435.92	$704.00	$640.64–$704.00	—	38%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PFR 62323 INJ INTERLAMINAR LMBR SAC W IMAG GUID	$435.92	$704.00	$91.45–$668.80	—	38%
Lower-back epidural injection, without imaging guidance CPT 62322 ANES 62322 INJ IL NDL CATH LUMB SACR WO GUID	$413.01	$667.00	$633.65	34% below	38%
Lower-back epidural injection, without imaging guidance CPT 62322 PFR 62322 INJ NDL CATH LUMB SACR WO GUID	$413.01	$667.00	$72.05–$633.65	34% below	38%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PFR 62322 INJ NDL CATH LUMB SACR WO GUID	$413.01	$667.00	$72.05–$633.65	—	38%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 ANES 62322 INJ IL NDL CATH LUMB SACR WO GUID	$413.01	$667.00	$633.65	—	38%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ ANESTHETC STEROID TRANSFORAMINAL EPIDURAL LUMBAR SACRAL SNGL LEVEL	$448.92	$725.00	$659.75–$725.00	53% below	38%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 ANES 64483 INJ LUMB SACRAL SNGL LVL	$448.92	$725.00	$688.75	53% below	38%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PFR 64483 TRN EPID L S SGL1LVL	$448.92	$725.00	$102.53–$688.75	53% below	38%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PFR 64483 TRN EPID L S SGL1LVL	$448.92	$725.00	$102.53–$688.75	—	38%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 ANES 64483 INJ LUMB SACRAL SNGL LVL	$448.92	$725.00	$688.75	—	38%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ ANESTHETC STEROID TRANSFORAMINAL EPIDURAL LUMBAR SACRAL SNGL LEVEL	$448.92	$725.00	$659.75–$725.00	—	38%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LAMINOTOMY WPARTIAL FACETECTOMY FORAMINOTOMY HERNIATED DISKECTOMY 1 I	$3,006.84	$4,856.00	$4,418.96–$4,856.00	77% below	38%
Lumbar discectomy or laminotomy to free a nerve root, one level one side CPT 63030 PF 63030 LUMBAR UNILAT LAMINOTO	$3,006.84	$4,856.00	$863.97–$4,613.20	77% below	38%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 LAMINOTOMY WPARTIAL FACETECTOMY FORAMINOTOMY HERNIATED DISKECTOMY 1 I	$3,006.84	$4,856.00	$4,418.96–$4,856.00	—	38%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient one side CPT 63030 PF 63030 LUMBAR UNILAT LAMINOTO	$3,006.84	$4,856.00	$863.97–$4,613.20	—	38%
Lumbar laminectomy (spinal decompression), one level CPT 63047 PF 63047 LAMI DECOMP SINGLE SEG	$3,416.75	$5,518.00	$1,042.24–$5,242.10	67% below	38%
Lumbar laminectomy (spinal decompression), one level CPT 63047 LAMINECTOMY FACETECTOMY & FORAMINOTOMY 1 SEG LUMBAR	$3,416.75	$5,518.00	$5,021.38–$5,518.00	67% below	38%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 LAMINECTOMY FACETECTOMY & FORAMINOTOMY 1 SEG LUMBAR	$3,416.75	$5,518.00	$5,021.38–$5,518.00	—	38%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 PF 63047 LAMI DECOMP SINGLE SEG	$3,416.75	$5,518.00	$1,042.24–$5,242.10	—	38%
Lumbar spinal fusion (posterior), one level CPT 22612 ARTHRODESIS POSTR POSTEROLAT TECHNIQUE SNGL INTERSPACE LUMBAR	$2,907.15	$4,695.00	$4,272.45–$4,695.00	63% below	38%
Lumbar spinal fusion (posterior), one level CPT 22612 PF 22612 ARTHRODESIS POSTR POSTEROLAT TECHN SNGL INTERSPACE LUMBAR	$2,907.15	$4,695.00	$1,478.84–$4,460.25	63% below	38%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 ARTHRODESIS POSTR POSTEROLAT TECHNIQUE SNGL INTERSPACE LUMBAR	$2,907.15	$4,695.00	$4,272.45–$4,695.00	—	38%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 PF 22612 ARTHRODESIS POSTR POSTEROLAT TECHN SNGL INTERSPACE LUMBAR	$2,907.15	$4,695.00	$1,478.84–$4,460.25	—	38%
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL LUMPECTOMY	$1,357.91	$2,193.00	$1,995.63–$2,193.00	12% below	38%
Lumpectomy (partial mastectomy) CPT 19301 PF 19301 MASTECTOMY PARTIAL	$1,357.91	$2,193.00	$616.11–$2,083.35	12% below	38%
Lumpectomy (partial mastectomy) inpatient CPT 19301 PF 19301 MASTECTOMY PARTIAL	$1,357.91	$2,193.00	$616.11–$2,083.35	—	38%
Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL LUMPECTOMY	$1,357.91	$2,193.00	$1,995.63–$2,193.00	—	38%
Mastectomy (total removal of the breast) CPT 19303 PF 19303 MASTECTOMY SMP CMPL	$2,103.43	$3,397.00	$895.07–$3,227.15	2% below	38%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SMPL COMP	$2,103.43	$3,397.00	$3,091.27–$3,397.00	2% below	38%
Mastectomy (total removal of the breast) inpatient CPT 19303 PF 19303 MASTECTOMY SMP CMPL	$2,103.43	$3,397.00	$895.07–$3,227.15	—	38%
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SMPL COMP	$2,103.43	$3,397.00	$3,091.27–$3,397.00	—	38%
Miscarriage treatment with D&C, first trimester CPT 59820 TREAT MISSED ABORTION COMPD SURGICALLY 1ST TRIMESTER	$842.74	$1,361.00	$1,238.51–$1,361.00	57% below	38%
Miscarriage treatment with D&C, first trimester CPT 59820 PF 59820 TX MISS ABORT1ST TRI	$859.45	$1,388.00	$361.17–$1,318.60	56% below	38%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TREAT MISSED ABORTION COMPD SURGICALLY 1ST TRIMESTER	$842.74	$1,361.00	$1,238.51–$1,361.00	—	38%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 PF 59820 TX MISS ABORT1ST TRI	$859.45	$1,388.00	$361.17–$1,318.60	—	38%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 PF 17311 MOHS 1STG H N HF G <	$1,087.32	$1,756.00	$326.37–$1,668.20	—	38%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 MOHS MICRO TECH STAGE 1 HEAD	$1,087.32	$1,756.00	$1,597.96–$1,756.00	—	38%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 MOHS MICRO TECH STAGE 1 HEAD	$1,087.32	$1,756.00	$1,597.96–$1,756.00	—	38%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 PF 17311 MOHS 1STG H N HF G <	$1,087.32	$1,756.00	$326.37–$1,668.20	—	38%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 ED 11400 EXC BNGN LSN .5 CM OR <TAL	$217.96	$352.00	$320.32–$352.00	4% below	38%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENGN SKN LESN INC MARGIN NO SKN TAG TRNK ARM LEG EXC DIA 0.5 CM <	$263.16	$425.00	$386.75–$425.00	16% above	38%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 MD 11400 EXC BENIGN SKIN LSN	$263.16	$425.00	$79.13–$403.75	16% above	38%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 PF 11400 EXC BGN TRNK<0.5CM	$263.16	$425.00	$79.13–$403.75	16% above	38%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 ED 11400 EXC BNGN LSN .5 CM OR <TAL	$217.96	$352.00	$320.32–$352.00	—	38%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 PF 11400 EXC BGN TRNK<0.5CM	$263.16	$425.00	$79.13–$403.75	—	38%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 MD 11400 EXC BENIGN SKIN LSN	$263.16	$425.00	$79.13–$403.75	—	38%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BENGN SKN LESN INC MARGIN NO SKN TAG TRNK ARM LEG EXC DIA 0.5 CM <	$263.16	$425.00	$386.75–$425.00	—	38%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BENIGN SKIN LESN INCL MARGINS FACE EXC DIAM 0.5 CM <	$295.36	$477.00	$434.07–$477.00	23% below	38%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 PF 11440 EXC BGN LSN FCE<0.5CM	$295.36	$477.00	$100.38–$453.15	23% below	38%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN SKIN LESN INCL MARGINS FACE EXC DIAM 0.5 CM <	$295.36	$477.00	$434.07–$477.00	—	38%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 PF 11440 EXC BGN LSN FCE<0.5CM	$295.36	$477.00	$100.38–$453.15	—	38%
Nail removal (partial or complete), one nail CPT 11730 ED 11730 REMV OF NAIL PLATE	$123.23	$199.00	$181.09–$199.00	19% below	38%
Nail removal (partial or complete), one nail CPT 11730 MD 11730 REMOVAL OF NAIL PLATE	$180.19	$291.00	$49.57–$276.45	18% above	38%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL COMP SMPL SNGL	$206.20	$333.00	$303.03–$333.00	36% above	38%
Nail removal (partial or complete), one nail CPT 11730 PF 11730 AVULSON NAIL PLT SGL	$206.82	$334.00	$49.57–$317.30	36% above	38%
Nail removal (partial or complete), one nail inpatient CPT 11730 ED 11730 REMV OF NAIL PLATE	$123.23	$199.00	$181.09–$199.00	—	38%
Nail removal (partial or complete), one nail inpatient CPT 11730 MD 11730 REMOVAL OF NAIL PLATE	$180.19	$291.00	$49.57–$276.45	—	38%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL COMP SMPL SNGL	$206.20	$333.00	$303.03–$333.00	—	38%
Nail removal (partial or complete), one nail inpatient CPT 11730 PF 11730 AVULSON NAIL PLT SGL	$206.82	$334.00	$49.57–$317.30	—	38%
Occipital nerve block (injection for headaches) CPT 64405 ED 64405 INJ NERVE BLOCK GR OCCPTAL	$58.83	$95.00	$86.45–$95.00	73% below	38%
Occipital nerve block (injection for headaches) CPT 64405 SURG 64405 GR OCCIPITAL NERVE BLOCK	$117.65	$190.00	$172.90–$190.00	46% below	38%
Occipital nerve block (injection for headaches) CPT 64405 MD 64405 INJ NERVE BLOCK OCCIPITAL	$229.11	$370.00	$48.96–$351.50	5% above	38%
Occipital nerve block (injection for headaches) CPT 64405 PFR 64405 INJ ANES BLOCK GREAT	$229.11	$370.00	$48.96–$351.50	5% above	38%
Occipital nerve block (injection for headaches) CPT 64405 PF 64405 INJ ANES BLOCK GREAT	$229.11	$370.00	$48.96–$351.50	5% above	38%
Occipital nerve block (injection for headaches) CPT 64405 ANES 64405 OCCIPITAL NERVE INJECTION	$229.11	$370.00	$351.50	5% above	38%
Occipital nerve block (injection for headaches) CPT 64405 INJ ANESTHETIC AGENT GREATER OCCIPITAL NERVE	$229.11	$370.00	$336.70–$370.00	5% above	38%
Occipital nerve block (injection for headaches) inpatient CPT 64405 ED 64405 INJ NERVE BLOCK GR OCCPTAL	$58.83	$95.00	$86.45–$95.00	—	38%
Occipital nerve block (injection for headaches) inpatient CPT 64405 SURG 64405 GR OCCIPITAL NERVE BLOCK	$117.65	$190.00	$172.90–$190.00	—	38%
Occipital nerve block (injection for headaches) inpatient CPT 64405 PF 64405 INJ ANES BLOCK GREAT	$229.11	$370.00	$48.96–$351.50	—	38%
Occipital nerve block (injection for headaches) inpatient CPT 64405 ANES 64405 OCCIPITAL NERVE INJECTION	$229.11	$370.00	$351.50	—	38%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANESTHETIC AGENT GREATER OCCIPITAL NERVE	$229.11	$370.00	$336.70–$370.00	—	38%
Occipital nerve block (injection for headaches) inpatient CPT 64405 MD 64405 INJ NERVE BLOCK OCCIPITAL	$229.11	$370.00	$48.96–$351.50	—	38%
Occipital nerve block (injection for headaches) inpatient CPT 64405 PFR 64405 INJ ANES BLOCK GREAT	$229.11	$370.00	$48.96–$351.50	—	38%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS WIMAGING	$320.13	$517.00	$470.47–$517.00	at median	38%
Paracentesis with imaging guidance CPT 49083 PF 49083 ABD PARACENTESIS WIMG	$320.13	$517.00	$96.99–$491.15	at median	38%
Paracentesis with imaging guidance CPT 49083 MD 49083 ABD PARACEN WIMAGING GUID	$320.13	$517.00	$96.99–$491.15	at median	38%
Paracentesis with imaging guidance CPT 49083 PFR 49083 ABD PARACENTESIS WIMG	$320.13	$517.00	$96.99–$491.15	at median	38%
Paracentesis with imaging guidance CPT 49083 ED 49083 ABD PARACNTSIS WIMAG GUID	$580.20	$937.00	$852.67–$937.00	81% above	38%
Paracentesis with imaging guidance CPT 49083 SURG 49083 ABD PARACENTESIS W IMAGING	$580.20	$937.00	$852.67–$937.00	81% above	38%
Paracentesis with imaging guidance inpatient CPT 49083 PF 49083 ABD PARACENTESIS WIMG	$320.13	$517.00	$96.99–$491.15	—	38%
Paracentesis with imaging guidance inpatient CPT 49083 MD 49083 ABD PARACEN WIMAGING GUID	$320.13	$517.00	$96.99–$491.15	—	38%
Paracentesis with imaging guidance inpatient CPT 49083 PFR 49083 ABD PARACENTESIS WIMG	$320.13	$517.00	$96.99–$491.15	—	38%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS WIMAGING	$320.13	$517.00	$470.47–$517.00	—	38%
Paracentesis with imaging guidance inpatient CPT 49083 SURG 49083 ABD PARACENTESIS W IMAGING	$580.20	$937.00	$852.67–$937.00	—	38%
Paracentesis with imaging guidance inpatient CPT 49083 ED 49083 ABD PARACNTSIS WIMAG GUID	$580.20	$937.00	$852.67–$937.00	—	38%
Partial knee replacement (one compartment) CPT 27446 ARTHROPLASTY KNEE CONDYLE & PLATEAU MEDIAL LAT COMPARTMENT	$2,058.23	$3,324.00	$3,024.84–$3,324.00	38% below	38%
Partial knee replacement (one compartment) inpatient CPT 27446 ARTHROPLASTY KNEE CONDYLE & PLATEAU MEDIAL LAT COMPARTMENT	$2,058.23	$3,324.00	$3,024.84–$3,324.00	—	38%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 ED 11750 REMV OF NAIL BED	$247.68	$400.00	$364.00–$400.00	31% below	38%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL NAIL MATRIX PERM REMVL	$467.50	$755.00	$687.05–$755.00	31% above	38%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PF 11750 EXC NAIL & MATRIX	$467.50	$755.00	$94.53–$717.25	31% above	38%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 MD 11750 EXC NAIL MATRIX PERM RMVL	$467.50	$755.00	$94.53–$717.25	31% above	38%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ED 11750 REMV OF NAIL BED	$247.68	$400.00	$364.00–$400.00	—	38%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 MD 11750 EXC NAIL MATRIX PERM RMVL	$467.50	$755.00	$94.53–$717.25	—	38%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 PF 11750 EXC NAIL & MATRIX	$467.50	$755.00	$94.53–$717.25	—	38%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL NAIL MATRIX PERM REMVL	$467.50	$755.00	$687.05–$755.00	—	38%
Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPAROSCOPY SURGICAL PROSTATECTOMY RETROPUBIC RADICAL WNERVE SPARING	$3,544.31	$5,724.00	$5,208.84–$5,724.00	30% below	38%
Prostate removal (prostatectomy), laparoscopic CPT 55866 PF 55866 LAPARO RADICAL PROSTAT	$3,544.31	$5,724.00	$1,101.05–$5,437.80	30% below	38%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 LAPAROSCOPY SURGICAL PROSTATECTOMY RETROPUBIC RADICAL WNERVE SPARING	$3,544.31	$5,724.00	$5,208.84–$5,724.00	—	38%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 PF 55866 LAPARO RADICAL PROSTAT	$3,544.31	$5,724.00	$1,101.05–$5,437.80	—	38%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 PF 64635 DESTRUCT NRV LUM SACRA	$767.81	$1,240.00	$177.66–$1,178.00	41% below	38%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB SAC FACET JNT	$767.81	$1,240.00	$1,128.40–$1,240.00	41% below	38%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTROY LUMB SAC FACET JNT	$767.81	$1,240.00	$1,128.40–$1,240.00	—	38%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 PF 64635 DESTRUCT NRV LUM SACRA	$767.81	$1,240.00	$177.66–$1,178.00	—	38%
Removal of a breast lump, open surgery CPT 19120 PF 19120 EXC CYST LSN BREAST	$1,019.83	$1,647.00	$392.88–$1,564.65	18% below	38%
Removal of a breast lump, open surgery CPT 19120 EXC BREAST LESN(S) OPEN MALE FEMALE 1 OR MORE	$1,019.83	$1,647.00	$1,498.77–$1,647.00	18% below	38%
Removal of a breast lump, open surgery inpatient CPT 19120 PF 19120 EXC CYST LSN BREAST	$1,019.83	$1,647.00	$392.88–$1,564.65	—	38%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC BREAST LESN(S) OPEN MALE FEMALE 1 OR MORE	$1,019.83	$1,647.00	$1,498.77–$1,647.00	—	38%
Removal of a foreign object under the skin, simple CPT 10120 ED 10120 INC&REMV FB SMPL	$247.68	$400.00	$364.00–$400.00	at median	38%
Removal of a foreign object under the skin, simple CPT 10120 MD 10120 INC&RMVL FB SQ TISSUES SMPL	$270.60	$437.00	$98.53–$415.15	9% above	38%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMVL FB SUBQ TISSUES SMPL	$317.04	$512.00	$465.92–$512.00	28% above	38%
Removal of a foreign object under the skin, simple CPT 10120 PF 10120 INC & RMVL FB SQ SMPL	$317.04	$512.00	$98.53–$486.40	28% above	38%
Removal of a foreign object under the skin, simple inpatient CPT 10120 ED 10120 INC&REMV FB SMPL	$247.68	$400.00	$364.00–$400.00	—	38%
Removal of a foreign object under the skin, simple inpatient CPT 10120 MD 10120 INC&RMVL FB SQ TISSUES SMPL	$270.60	$437.00	$98.53–$415.15	—	38%
Removal of a foreign object under the skin, simple inpatient CPT 10120 PF 10120 INC & RMVL FB SQ SMPL	$317.04	$512.00	$98.53–$486.40	—	38%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMVL FB SUBQ TISSUES SMPL	$317.04	$512.00	$465.92–$512.00	—	38%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 PF 60220 PARTIAL REMOVAL OF THYROID	$1,487.94	$2,403.00	$658.91–$2,282.85	77% below	38%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 TOTAL THYROID LOBECTOMY UNILAT WWO ISTHMUSECTOMY	$1,487.94	$2,403.00	$2,186.73–$2,403.00	77% below	38%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 PF 60220 PARTIAL REMOVAL OF THYROID	$1,487.94	$2,403.00	$658.91–$2,282.85	—	38%
Removal of one lobe of the thyroid (lobectomy) inpatient one side CPT 60220 TOTAL THYROID LOBECTOMY UNILAT WWO ISTHMUSECTOMY	$1,487.94	$2,403.00	$2,186.73–$2,403.00	—	38%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$656.98	$1,061.00	$965.51–$1,061.00	17% below	38%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 PF G0121 COLON CANC SCR NON-HR	$670.60	$1,083.00	$169.04–$1,028.85	15% below	38%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$656.98	$1,061.00	$965.51–$1,061.00	—	38%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 PF G0121 COLON CANC SCR NON-HR	$670.60	$1,083.00	$169.04–$1,028.85	—	38%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN HI RISK IND	$433.44	$700.00	$637.00–$700.00	45% below	38%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 PF G0105 COLON CANCER SCR HIGH	$669.36	$1,081.00	$168.73–$1,026.95	16% below	38%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL SCRN HI RISK IND	$433.44	$700.00	$637.00–$700.00	—	38%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 PF G0105 COLON CANCER SCR HIGH	$669.36	$1,081.00	$168.73–$1,026.95	—	38%
Septoplasty to straighten the nasal septum CPT 30520 SEPTOPLASTY SUBMUCOUS RESECTION WWO CARTILAGE SCORING CONTOURING GRFT	$1,112.09	$1,796.00	$1,634.36–$1,796.00	29% below	38%
Septoplasty to straighten the nasal septum CPT 30520 PF 30520 SEPTOPLASTY INDEPENDEN	$1,112.09	$1,796.00	$622.27–$1,706.20	29% below	38%
Septoplasty to straighten the nasal septum inpatient CPT 30520 SEPTOPLASTY SUBMUCOUS RESECTION WWO CARTILAGE SCORING CONTOURING GRFT	$1,112.09	$1,796.00	$1,634.36–$1,796.00	—	38%
Septoplasty to straighten the nasal septum inpatient CPT 30520 PF 30520 SEPTOPLASTY INDEPENDEN	$1,112.09	$1,796.00	$622.27–$1,706.20	—	38%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 PF 50590 LITHOTRIPSY EXTRACORP	$2,122.00	$3,427.00	$531.13–$3,255.65	22% above	38%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY EXTRACORPOREAL SHOCK WAVE	$2,122.00	$3,427.00	$3,118.57–$3,427.00	22% above	38%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY EXTRACORPOREAL SHOCK WAVE	$2,122.00	$3,427.00	$3,118.57–$3,427.00	—	38%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 PF 50590 LITHOTRIPSY EXTRACORP	$2,122.00	$3,427.00	$531.13–$3,255.65	—	38%
Short arm cast (elbow to hand) CPT 29075 ED 29075 APPL CAST FOREARM ARM	$164.71	$266.00	$242.06–$266.00	12% below	38%
Short arm cast (elbow to hand) CPT 29075 PF 29075 APPL CAST ARM SHORT	$180.19	$291.00	$59.42–$276.45	4% below	38%
Short arm cast (elbow to hand) CPT 29075 APPLN CAST ELBOW TO FINGER (SHORT ARM)	$180.19	$291.00	$264.81–$291.00	4% below	38%
Short arm cast (elbow to hand) CPT 29075 MD 29075 APP CAST ELBOW TO FINGER	$180.19	$291.00	$59.42–$276.45	4% below	38%
Short arm cast (elbow to hand) inpatient CPT 29075 ED 29075 APPL CAST FOREARM ARM	$164.71	$266.00	$242.06–$266.00	—	38%
Short arm cast (elbow to hand) inpatient CPT 29075 PF 29075 APPL CAST ARM SHORT	$180.19	$291.00	$59.42–$276.45	—	38%
Short arm cast (elbow to hand) inpatient CPT 29075 MD 29075 APP CAST ELBOW TO FINGER	$180.19	$291.00	$59.42–$276.45	—	38%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLN CAST ELBOW TO FINGER (SHORT ARM)	$180.19	$291.00	$264.81–$291.00	—	38%
Short arm splint (forearm and hand) CPT 29125 ED 29125 APPL SPLINT FOREARM	$79.88	$129.00	$117.39–$129.00	34% below	38%
Short arm splint (forearm and hand) CPT 29125 MD 29125 APP SHT ARM SPLINT FOR-HAN	$134.37	$217.00	$37.87–$206.15	11% above	38%
Short arm splint (forearm and hand) CPT 29125 PF 29125 APPL SPNT ARM STATIC	$134.37	$217.00	$37.87–$206.15	11% above	38%
Short arm splint (forearm and hand) CPT 29125 APPLN SHORT ARM SPLINT (FOREARM TO HAND) STATIC	$134.37	$217.00	$197.47–$217.00	11% above	38%
Short arm splint (forearm and hand) inpatient CPT 29125 ED 29125 APPL SPLINT FOREARM	$79.88	$129.00	$117.39–$129.00	—	38%
Short arm splint (forearm and hand) inpatient CPT 29125 PF 29125 APPL SPNT ARM STATIC	$134.37	$217.00	$37.87–$206.15	—	38%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLN SHORT ARM SPLINT (FOREARM TO HAND) STATIC	$134.37	$217.00	$197.47–$217.00	—	38%
Short arm splint (forearm and hand) inpatient CPT 29125 MD 29125 APP SHT ARM SPLINT FOR-HAN	$134.37	$217.00	$37.87–$206.15	—	38%
Short leg cast (below the knee) CPT 29405 ED 29405 APPL CAST SHORT LEG	$34.06	$55.00	$50.05–$55.00	81% below	38%
Short leg cast (below the knee) CPT 29405 PF 29405 APPLY SHORT LEG CAST	$174.00	$281.00	$55.11–$266.95	4% below	38%
Short leg cast (below the knee) CPT 29405 APPLN SHORT LEG CAST (BELOW KNEE TO TOES)	$174.00	$281.00	$255.71–$281.00	4% below	38%
Short leg cast (below the knee) CPT 29405 MD 29405 APPL SHRT LEG CAST BELOW KN	$252.02	$407.00	$55.11–$386.65	40% above	38%
Short leg cast (below the knee) inpatient CPT 29405 ED 29405 APPL CAST SHORT LEG	$34.06	$55.00	$50.05–$55.00	—	38%
Short leg cast (below the knee) inpatient CPT 29405 PF 29405 APPLY SHORT LEG CAST	$174.00	$281.00	$55.11–$266.95	—	38%
Short leg cast (below the knee) inpatient CPT 29405 APPLN SHORT LEG CAST (BELOW KNEE TO TOES)	$174.00	$281.00	$255.71–$281.00	—	38%
Short leg cast (below the knee) inpatient CPT 29405 MD 29405 APPL SHRT LEG CAST BELOW KN	$252.02	$407.00	$55.11–$386.65	—	38%
Short leg splint (calf to foot) CPT 29515 ED 29515 APPL SPLINT SHORT LEG	$97.84	$158.00	$143.78–$158.00	32% below	38%
Short leg splint (calf to foot) CPT 29515 APPLN SHORT LEG SPLINT (CALF TO FOOT)	$152.95	$247.00	$224.77–$247.00	6% above	38%
Short leg splint (calf to foot) CPT 29515 PF 29515 APPL SPLNT LEG SHORT	$152.95	$247.00	$46.80–$234.65	6% above	38%
Short leg splint (calf to foot) CPT 29515 MD 29515 APPL SHT LEG SPLINT-CALF FT	$196.91	$318.00	$46.80–$302.10	37% above	38%
Short leg splint (calf to foot) inpatient CPT 29515 ED 29515 APPL SPLINT SHORT LEG	$97.84	$158.00	$143.78–$158.00	—	38%
Short leg splint (calf to foot) inpatient CPT 29515 PF 29515 APPL SPLNT LEG SHORT	$152.95	$247.00	$46.80–$234.65	—	38%
Short leg splint (calf to foot) inpatient CPT 29515 APPLN SHORT LEG SPLINT (CALF TO FOOT)	$152.95	$247.00	$224.77–$247.00	—	38%
Short leg splint (calf to foot) inpatient CPT 29515 MD 29515 APPL SHT LEG SPLINT-CALF FT	$196.91	$318.00	$46.80–$302.10	—	38%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 ARTHROSCOPY SHLDR SURGICAL DISTAL CLAVICULECTOMY WARTICULAR SURFACE	$1,213.02	$1,959.00	$1,782.69–$1,959.00	8% below	38%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 PF 29824 CLVILCTOMY DSTL SCOPE	$1,844.60	$2,979.00	$639.51–$2,830.05	39% above	38%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 ARTHROSCOPY SHLDR SURGICAL DISTAL CLAVICULECTOMY WARTICULAR SURFACE	$1,213.02	$1,959.00	$1,782.69–$1,959.00	—	38%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 PF 29824 CLVILCTOMY DSTL SCOPE	$1,844.60	$2,979.00	$639.51–$2,830.05	—	38%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTHROSCPY SHLDR SURGICAL DECOMPRESSION SUBACROMIAL SPACE WPARTIAL AC	$751.71	$1,214.00	$1,104.74–$1,214.00	at median	38%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 PF 29826 DEC SUBACR SPC SCOPE	$751.71	$1,214.00	$158.57–$1,153.30	at median	38%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 ARTHROSCPY SHLDR SURGICAL DECOMPRESSION SUBACROMIAL SPACE WPARTIAL AC	$751.71	$1,214.00	$1,104.74–$1,214.00	—	38%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 PF 29826 DEC SUBACR SPC SCOPE	$751.71	$1,214.00	$158.57–$1,153.30	—	38%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ED 12001 RPR SUPERFCL WND 2.5CM OR<	$123.23	$199.00	$181.09–$199.00	47% below	38%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL RPR SUPERL WNDS SCALP NECK AXILLAE GENITALIA TRNK EXTREM 2.5 CM <	$183.29	$296.00	$269.36–$296.00	21% below	38%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PF 12001 RPR SMP SCLP<2.5CM	$183.29	$296.00	$41.26–$281.20	21% below	38%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 MD 12001 SMPL RPR S N A G T 2.5 CM <	$315.18	$509.00	$41.26–$483.55	37% above	38%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ED 12001 RPR SUPERFCL WND 2.5CM OR<	$123.23	$199.00	$181.09–$199.00	—	38%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMPL RPR SUPERL WNDS SCALP NECK AXILLAE GENITALIA TRNK EXTREM 2.5 CM <	$183.29	$296.00	$269.36–$296.00	—	38%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 PF 12001 RPR SMP SCLP<2.5CM	$183.29	$296.00	$41.26–$281.20	—	38%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 MD 12001 SMPL RPR S N A G T 2.5 CM <	$315.18	$509.00	$41.26–$483.55	—	38%
Skin biopsy, punch, one lesion CPT 11104 ED 11104 PUNCH BX SKIN SINGLE LESION	$247.68	$400.00	$364.00–$400.00	at median	38%
Skin biopsy, punch, one lesion CPT 11104 PF 11104 PUNCH BX SKIN SINGLE LESION	$330.66	$534.00	$43.11–$507.30	34% above	38%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN; SINGLE LESION	$330.66	$534.00	$485.94–$534.00	34% above	38%
Skin biopsy, punch, one lesion CPT 11104 MD 11104 PUNCH BX SKIN SINGLE LESION	$368.43	$595.00	$43.11–$565.25	49% above	38%
Skin biopsy, punch, one lesion inpatient CPT 11104 ED 11104 PUNCH BX SKIN SINGLE LESION	$247.68	$400.00	$364.00–$400.00	—	38%
Skin biopsy, punch, one lesion inpatient CPT 11104 PF 11104 PUNCH BX SKIN SINGLE LESION	$330.66	$534.00	$43.11–$507.30	—	38%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN; SINGLE LESION	$330.66	$534.00	$485.94–$534.00	—	38%
Skin biopsy, punch, one lesion inpatient CPT 11104 MD 11104 PUNCH BX SKIN SINGLE LESION	$368.43	$595.00	$43.11–$565.25	—	38%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC MALIG LESN INCL MARGINS TRUNK ARMS LEGS EXC DIAM 0.5 CM <	$227.87	$368.00	$334.88–$368.00	36% below	38%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 PF 11600 EXC LSN MAL TRK<0.5CM	$309.60	$500.00	$113.62–$475.00	14% below	38%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC MALIG LESN INCL MARGINS TRUNK ARMS LEGS EXC DIAM 0.5 CM <	$227.87	$368.00	$334.88–$368.00	—	38%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 PF 11600 EXC LSN MAL TRK<0.5CM	$309.60	$500.00	$113.62–$475.00	—	38%
Skin tag removal, up to 15 tags CPT 11200 MD 11200 RMVL SKN TAGS MULT ANY AREA	$136.23	$220.00	$71.74–$209.00	at median	38%
Skin tag removal, up to 15 tags CPT 11200 REMVL SKIN TAGS MULT FIBROCUTANEOUS TAGS ANY AREA UP TO & INCL 15 LESN	$185.15	$299.00	$272.09–$299.00	36% above	38%
Skin tag removal, up to 15 tags CPT 11200 PF 11200 REM SKIN TAGS TO 15	$187.00	$302.00	$71.74–$286.90	37% above	38%
Skin tag removal, up to 15 tags inpatient CPT 11200 MD 11200 RMVL SKN TAGS MULT ANY AREA	$136.23	$220.00	$71.74–$209.00	—	38%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMVL SKIN TAGS MULT FIBROCUTANEOUS TAGS ANY AREA UP TO & INCL 15 LESN	$185.15	$299.00	$272.09–$299.00	—	38%
Skin tag removal, up to 15 tags inpatient CPT 11200 PF 11200 REM SKIN TAGS TO 15	$187.00	$302.00	$71.74–$286.90	—	38%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PFR 62270 LUMBAR PUNCTURE	$256.97	$415.00	$59.42–$394.25	1% above	38%
Spinal tap (lumbar puncture), diagnostic CPT 62270 MD 62270 SPINAL PUNCTURE LUMBAR DX	$256.97	$415.00	$59.42–$394.25	1% above	38%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PF 62270 PUNCTURE SPINAL LUMBAR DIAG	$256.97	$415.00	$59.42–$394.25	1% above	38%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DX	$256.97	$415.00	$377.65–$415.00	1% above	38%
Spinal tap (lumbar puncture), diagnostic CPT 62270 ED 62270 SPINAL TAP LUMBAR DIAG	$427.25	$690.00	$627.90–$690.00	67% above	38%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SURG 62270 SPINAL PUNCTURE LUMBAR DIAG	$427.25	$690.00	$627.90–$690.00	67% above	38%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 MD 62270 SPINAL PUNCTURE LUMBAR DX	$256.97	$415.00	$59.42–$394.25	—	38%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PFR 62270 LUMBAR PUNCTURE	$256.97	$415.00	$59.42–$394.25	—	38%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PF 62270 PUNCTURE SPINAL LUMBAR DIAG	$256.97	$415.00	$59.42–$394.25	—	38%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DX	$256.97	$415.00	$377.65–$415.00	—	38%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ED 62270 SPINAL TAP LUMBAR DIAG	$427.25	$690.00	$627.90–$690.00	—	38%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SURG 62270 SPINAL PUNCTURE LUMBAR DIAG	$427.25	$690.00	$627.90–$690.00	—	38%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ED 12002 RPR SUPERFCL WND 2.6-7.5CM	$164.71	$266.00	$242.06–$266.00	30% below	38%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PF 12002 RPR SMP SCLP2.6-7.5CM	$231.59	$374.00	$54.19–$355.30	1% below	38%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL RPR SUPERL WNDS SCALP NECK AXILLAE GENITAL TRNK EXTREM 2.6-7.5 CM	$231.59	$374.00	$340.34–$374.00	1% below	38%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 MD 12002 SMPL RPR S N A G T2.6-7.5CM	$365.33	$590.00	$54.19–$560.50	56% above	38%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ED 12002 RPR SUPERFCL WND 2.6-7.5CM	$164.71	$266.00	$242.06–$266.00	—	38%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL RPR SUPERL WNDS SCALP NECK AXILLAE GENITAL TRNK EXTREM 2.6-7.5 CM	$231.59	$374.00	$340.34–$374.00	—	38%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 PF 12002 RPR SMP SCLP2.6-7.5CM	$231.59	$374.00	$54.19–$355.30	—	38%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 MD 12002 SMPL RPR S N A G T2.6-7.5CM	$365.33	$590.00	$54.19–$560.50	—	38%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ED 12011 RPR SUPERFCL WND 2.5CM OR<	$123.23	$199.00	$181.09–$199.00	52% below	38%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMPL RPR SUPERL WNDS FACEUS MEMBRANES 2.5 CM <	$227.87	$368.00	$334.88–$368.00	12% below	38%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PF 12011 RPR SMPL FCE <2.5CM	$232.20	$375.00	$51.42–$356.25	10% below	38%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 MD 12011 RPR SMPL FCE <2.5CM	$393.82	$636.00	$51.42–$604.20	52% above	38%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ED 12011 RPR SUPERFCL WND 2.5CM OR<	$123.23	$199.00	$181.09–$199.00	—	38%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SMPL RPR SUPERL WNDS FACEUS MEMBRANES 2.5 CM <	$227.87	$368.00	$334.88–$368.00	—	38%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 PF 12011 RPR SMPL FCE <2.5CM	$232.20	$375.00	$51.42–$356.25	—	38%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 MD 12011 RPR SMPL FCE <2.5CM	$393.82	$636.00	$51.42–$604.20	—	38%
TURP (transurethral resection of the prostate) CPT 52601 TRANSURETHRAL ELECTROSURGICAL RESECTION PROSTATE WCONTROL POSTOP BLEE	$1,879.28	$3,035.00	$2,761.85–$3,035.00	16% below	38%
TURP (transurethral resection of the prostate) CPT 52601 PF 52601 TURP	$1,879.28	$3,035.00	$673.07–$2,883.25	16% below	38%
TURP (transurethral resection of the prostate) inpatient CPT 52601 PF 52601 TURP	$1,879.28	$3,035.00	$673.07–$2,883.25	—	38%
TURP (transurethral resection of the prostate) inpatient CPT 52601 TRANSURETHRAL ELECTROSURGICAL RESECTION PROSTATE WCONTROL POSTOP BLEE	$1,879.28	$3,035.00	$2,761.85–$3,035.00	—	38%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION	$126.94	$205.00	$186.55–$205.00	27% below	38%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 PF 11102 TANGENTIAL BX SKIN SINGLE LESION	$126.94	$205.00	$34.48–$194.75	27% below	38%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 MD 11102 TANGENTIAL BX SKIN SINGLE LESION	$295.36	$477.00	$34.48–$453.15	71% above	38%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION	$126.94	$205.00	$186.55–$205.00	—	38%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 PF 11102 TANGENTIAL BX SKIN SINGLE LESION	$126.94	$205.00	$34.48–$194.75	—	38%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 MD 11102 TANGENTIAL BX SKIN SINGLE LESION	$295.36	$477.00	$34.48–$453.15	—	38%
Thoracentesis with imaging guidance CPT 32555 PFR 32555 THORCENT WIMAGING	$355.43	$574.00	$98.84–$545.30	2% below	38%
Thoracentesis with imaging guidance CPT 32555 MD 32555 THORACENTESIS W IMAGING	$355.43	$574.00	$98.84–$545.30	2% below	38%
Thoracentesis with imaging guidance CPT 32555 SURG 32555 THORACENTESIS W IMAGING	$601.87	$972.00	$884.52–$972.00	65% above	38%
Thoracentesis with imaging guidance inpatient CPT 32555 PFR 32555 THORCENT WIMAGING	$355.43	$574.00	$98.84–$545.30	—	38%
Thoracentesis with imaging guidance inpatient CPT 32555 MD 32555 THORACENTESIS W IMAGING	$355.43	$574.00	$98.84–$545.30	—	38%
Thoracentesis with imaging guidance inpatient CPT 32555 SURG 32555 THORACENTESIS W IMAGING	$601.87	$972.00	$884.52–$972.00	—	38%
Tonsil and adenoid removal, age 12 or older CPT 42821 PF 42821 TONSIL ADENOIDECTOMY	$797.53	$1,288.00	$285.42–$1,223.60	1% above	38%
Tonsil and adenoid removal, age 12 or older CPT 42821 TONSILLECTOMY & ADENOIDECTOMY AGE 12+	$797.53	$1,288.00	$1,172.08–$1,288.00	1% above	38%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 PF 42821 TONSIL ADENOIDECTOMY	$797.53	$1,288.00	$285.42–$1,223.60	—	38%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 TONSILLECTOMY & ADENOIDECTOMY AGE 12+	$797.53	$1,288.00	$1,172.08–$1,288.00	—	38%
Tonsil and adenoid removal, child under 12 CPT 42820 PF 42820 TONSILEC ADENOTDECTOMY	$755.43	$1,220.00	$273.72–$1,159.00	at median	38%
Tonsil and adenoid removal, child under 12 CPT 42820 TONSILLECTOMY & ADENOIDECTOMY < AGE 12	$755.43	$1,220.00	$1,110.20–$1,220.00	at median	38%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 TONSILLECTOMY & ADENOIDECTOMY < AGE 12	$755.43	$1,220.00	$1,110.20–$1,220.00	—	38%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 PF 42820 TONSILEC ADENOTDECTOMY	$755.43	$1,220.00	$273.72–$1,159.00	—	38%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY PRIME SECONDARY AGE 12+	$538.71	$870.00	$791.70–$870.00	15% below	38%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 PF 42826 TONSILLECTOMY PRIM 12	$538.71	$870.00	$240.78–$826.50	15% below	38%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 PF 42826 TONSILLECTOMY PRIM 12	$538.71	$870.00	$240.78–$826.50	—	38%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY PRIME SECONDARY AGE 12+	$538.71	$870.00	$791.70–$870.00	—	38%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTOMY PRIME SECONDARY < AGE 12	$645.83	$1,043.00	$949.13–$1,043.00	at median	38%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 PF 42825 TONSILLECTOMY UNDER 12	$645.83	$1,043.00	$253.40–$990.85	at median	38%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 PF 42825 TONSILLECTOMY UNDER 12	$645.83	$1,043.00	$253.40–$990.85	—	38%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 TONSILLECTOMY PRIME SECONDARY < AGE 12	$645.83	$1,043.00	$949.13–$1,043.00	—	38%
Total hip replacement CPT 27130 PF 27130 ARTHROPL HIP TTL	$3,013.03	$4,866.00	$1,198.65–$4,622.70	32% below	38%
Total hip replacement CPT 27130 ARTHROPLASTY ACETABULAR PROXIMAL FEMORAL PROSTHETIC REPLACE WWO AUTOG	$3,013.03	$4,866.00	$4,428.06–$4,866.00	32% below	38%
Total hip replacement inpatient CPT 27130 PF 27130 ARTHROPL HIP TTL	$3,013.03	$4,866.00	$1,198.65–$4,622.70	—	38%
Total hip replacement inpatient CPT 27130 ARTHROPLASTY ACETABULAR PROXIMAL FEMORAL PROSTHETIC REPLACE WWO AUTOG	$3,013.03	$4,866.00	$4,428.06–$4,866.00	—	38%
Total knee replacement CPT 27447 PF 27447 ARTHROPL KNE TIB FEM	$3,217.99	$5,197.00	$1,197.12–$4,937.15	41% below	38%
Total knee replacement CPT 27447 ARTHROPLASTY KNEE CONDYLE & PLATEAU MEDIAL & LAT COMPARTMENTS WWO PAT	$3,217.99	$5,197.00	$4,729.27–$5,197.00	41% below	38%
Total knee replacement inpatient CPT 27447 ARTHROPLASTY KNEE CONDYLE & PLATEAU MEDIAL & LAT COMPARTMENTS WWO PAT	$3,217.99	$5,197.00	$4,729.27–$5,197.00	—	38%
Total knee replacement inpatient CPT 27447 PF 27447 ARTHROPL KNE TIB FEM	$3,217.99	$5,197.00	$1,197.12–$4,937.15	—	38%
Total shoulder replacement CPT 23472 ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHLDR	$2,774.64	$4,481.00	$4,077.71–$4,481.00	30% below	38%
Total shoulder replacement CPT 23472 PF 23472 SHOULD ARTHOPLAS W GLE	$2,774.64	$4,481.00	$1,346.75–$4,256.95	30% below	38%
Total shoulder replacement inpatient CPT 23472 PF 23472 SHOULD ARTHOPLAS W GLE	$2,774.64	$4,481.00	$1,346.75–$4,256.95	—	38%
Total shoulder replacement inpatient CPT 23472 ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHLDR	$2,774.64	$4,481.00	$4,077.71–$4,481.00	—	38%
Total thyroid removal (thyroidectomy) CPT 60240 PF 60240 REMOVAL OF THYROID	$1,990.73	$3,215.00	$852.88–$3,054.25	at median	38%
Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMY TOTAL COMP	$2,260.08	$3,650.00	$3,321.50–$3,650.00	13% above	38%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 PF 60240 REMOVAL OF THYROID	$1,990.73	$3,215.00	$852.88–$3,054.25	—	38%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 THYROIDECTOMY TOTAL COMP	$2,260.08	$3,650.00	$3,321.50–$3,650.00	—	38%
Trigger finger release surgery CPT 26055 PF 26055 INCIS TEND SHETH FNGR	$1,199.40	$1,937.00	$280.19–$1,840.15	31% above	38%
Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION	$1,199.40	$1,937.00	$1,762.67–$1,937.00	31% above	38%
Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION	$1,199.40	$1,937.00	$1,762.67–$1,937.00	—	38%
Trigger finger release surgery inpatient CPT 26055 PF 26055 INCIS TEND SHETH FNGR	$1,199.40	$1,937.00	$280.19–$1,840.15	—	38%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ(S) SNGL MULTIPLE TRIGGER POINT(S) 1-2 MUSCLES	$78.64	$127.00	$115.57–$127.00	35% below	38%
Trigger point injections, 1 or 2 muscles CPT 20552 PF 20552 INJ TRIGR PT1-2MUSCLE	$78.64	$127.00	$33.56–$120.65	35% below	38%
Trigger point injections, 1 or 2 muscles CPT 20552 PFR 20552 INJ(S) SNGL MULTIPLE TRIGGER POINT(S) 1-2 MUSCLES	$78.64	$127.00	$33.56–$120.65	35% below	38%
Trigger point injections, 1 or 2 muscles CPT 20552 MD 20552 INJ TRIGGER PT(S)1-2MUSCLES	$78.64	$127.00	$33.56–$120.65	35% below	38%
Trigger point injections, 1 or 2 muscles CPT 20552 ED 20552 INJ 1-2 MUSC GRPS	$183.29	$296.00	$269.36–$296.00	51% above	38%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 MD 20552 INJ TRIGGER PT(S)1-2MUSCLES	$78.64	$127.00	$33.56–$120.65	—	38%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ(S) SNGL MULTIPLE TRIGGER POINT(S) 1-2 MUSCLES	$78.64	$127.00	$115.57–$127.00	—	38%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PFR 20552 INJ(S) SNGL MULTIPLE TRIGGER POINT(S) 1-2 MUSCLES	$78.64	$127.00	$33.56–$120.65	—	38%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PF 20552 INJ TRIGR PT1-2MUSCLE	$78.64	$127.00	$33.56–$120.65	—	38%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ED 20552 INJ 1-2 MUSC GRPS	$183.29	$296.00	$269.36–$296.00	—	38%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY SURGICAL WFULGURATION OF OVIDUCTS WWO TRANSECTION	$1,419.21	$2,292.00	$2,085.72–$2,292.00	49% above	38%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 PF 58670 LAP FULG OF OVIDUCT	$1,419.21	$2,292.00	$345.46–$2,177.40	49% above	38%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAPAROSCOPY SURGICAL WFULGURATION OF OVIDUCTS WWO TRANSECTION	$1,419.21	$2,292.00	$2,085.72–$2,292.00	—	38%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 PF 58670 LAP FULG OF OVIDUCT	$1,419.21	$2,292.00	$345.46–$2,177.40	—	38%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 PFR 19083 BX BREAST W DVC US GUIDE 1 LSN	$887.94	$1,434.00	$139.48–$1,362.30	13% below	38%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 SURG 19083 BX BREAST W DVC US GUIDE 1ST LSN	$1,003.11	$1,620.00	$1,474.20–$1,620.00	2% below	38%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 PFR 19083 BX BREAST W DVC US GUIDE 1 LSN	$887.94	$1,434.00	$139.48–$1,362.30	—	38%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 SURG 19083 BX BREAST W DVC US GUIDE 1ST LSN	$1,003.11	$1,620.00	$1,474.20–$1,620.00	—	38%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 PF 43249 EGD WESOPH BALLOON	$401.25	$648.00	$140.09–$615.60	57% below	38%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 UPPER GI ENDOSCOPY WBALLOON DILATION (< 30 MM DIAM)	$401.25	$648.00	$589.68–$648.00	57% below	38%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 UPPER GI ENDOSCOPY WBALLOON DILATION (< 30 MM DIAM)	$401.25	$648.00	$589.68–$648.00	—	38%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 PF 43249 EGD WESOPH BALLOON	$401.25	$648.00	$140.09–$615.60	—	38%
Upper endoscopy (EGD) with biopsy CPT 43239 PF 43239 EGD W BIOPSY	$707.13	$1,142.00	$126.24–$1,084.90	17% below	38%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY WBX SNGL MULTIPLE	$707.13	$1,142.00	$1,039.22–$1,142.00	17% below	38%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PF 43239 EGD W BIOPSY	$707.13	$1,142.00	$126.24–$1,084.90	—	38%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDOSCOPY WBX SNGL MULTIPLE	$707.13	$1,142.00	$1,039.22–$1,142.00	—	38%
Upper endoscopy (EGD) with injection into the lining CPT 43236 PF 43236 EGD W SUBMUCOS INJ	$681.12	$1,100.00	$126.24–$1,045.00	54% below	38%
Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPER GI ENDOSCOPY WDIRECTED SUBMUCOSAL INJ(S) ANY SUBSTANCE	$681.12	$1,100.00	$1,001.00–$1,100.00	54% below	38%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 PF 43236 EGD W SUBMUCOS INJ	$681.12	$1,100.00	$126.24–$1,045.00	—	38%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UPPER GI ENDOSCOPY WDIRECTED SUBMUCOSAL INJ(S) ANY SUBSTANCE	$681.12	$1,100.00	$1,001.00–$1,100.00	—	38%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UPPER GI ENDOSCOPY WREMVL LESN SNARE	$695.99	$1,124.00	$1,022.84–$1,124.00	18% below	38%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 PF 43251 OPERATIVE UPPER GI ENDO	$695.99	$1,124.00	$178.58–$1,067.80	18% below	38%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 UPPER GI ENDOSCOPY WREMVL LESN SNARE	$695.99	$1,124.00	$1,022.84–$1,124.00	—	38%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 PF 43251 OPERATIVE UPPER GI ENDO	$695.99	$1,124.00	$178.58–$1,067.80	—	38%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 PF 43248 EGD WDIL ESOPH GDWRE	$635.92	$1,027.00	$151.49–$975.65	at median	38%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UPPER GI ENDOSCOPY WINSERT GUIDE WIRE DILATION OVER GUIDE WIRE	$635.92	$1,027.00	$934.57–$1,027.00	at median	38%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 UPPER GI ENDOSCOPY WINSERT GUIDE WIRE DILATION OVER GUIDE WIRE	$635.92	$1,027.00	$934.57–$1,027.00	—	38%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 PF 43248 EGD WDIL ESOPH GDWRE	$635.92	$1,027.00	$151.49–$975.65	—	38%
Upper endoscopy (EGD), diagnostic CPT 43235 UPR GI ENDOSCOPY DX WWO SPECIMEN COLLECTION BRUSH WASH(SEP PROC)	$577.10	$932.00	$848.12–$932.00	26% below	38%
Upper endoscopy (EGD), diagnostic CPT 43235 PF 43235 EGD	$577.10	$932.00	$112.38–$885.40	26% below	38%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PF 43235 EGD	$577.10	$932.00	$112.38–$885.40	—	38%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPR GI ENDOSCOPY DX WWO SPECIMEN COLLECTION BRUSH WASH(SEP PROC)	$577.10	$932.00	$848.12–$932.00	—	38%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 PF 43240 UGI ENDOSCOPY DRAIN PS	$844.59	$1,364.00	$355.32–$1,295.80	—	38%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 UPPER GI ENDOSCOPY WTRANSMURAL DRAINAGE PSEUDOCYST	$844.59	$1,364.00	$1,241.24–$1,364.00	—	38%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 PF 43240 UGI ENDOSCOPY DRAIN PS	$844.59	$1,364.00	$355.32–$1,295.80	—	38%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 UPPER GI ENDOSCOPY WTRANSMURAL DRAINAGE PSEUDOCYST	$844.59	$1,364.00	$1,241.24–$1,364.00	—	38%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETHROSCOPY WURETEROSCOPY & OR PYELOSCOPY WLITHOTRIPSY	$1,178.96	$1,904.00	$1,732.64–$1,904.00	5% below	38%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 PF 52353 CYSTOURETHRO W LITHOTR	$1,178.96	$1,904.00	$357.16–$1,808.80	5% below	38%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 PF 52353 CYSTOURETHRO W LITHOTR	$1,178.96	$1,904.00	$357.16–$1,808.80	—	38%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CYSTOURETHROSCOPY WURETEROSCOPY & OR PYELOSCOPY WLITHOTRIPSY	$1,178.96	$1,904.00	$1,732.64–$1,904.00	—	38%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 ROUTINE OBSTETRIC CARE VAGINAL DELIVERY WANTEPARTUM POSTPARTUM CARE P	$3,430.37	$5,540.00	$5,041.40–$5,540.00	at median	38%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 PF 59610 ROUTINE OB CAR WANT	$3,430.37	$5,540.00	$2,348.66–$5,263.00	at median	38%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 ROUTINE OBSTETRIC CARE VAGINAL DELIVERY WANTEPARTUM POSTPARTUM CARE P	$3,430.37	$5,540.00	$5,041.40–$5,540.00	—	38%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 PF 59610 ROUTINE OB CAR WANT	$3,430.37	$5,540.00	$2,348.66–$5,263.00	—	38%
Vaginal delivery, including prenatal and postpartum care CPT 59400 PF 59400 DEL VAG ANT PP CARE	$4,266.29	$6,890.00	$2,242.13–$6,545.50	2% below	38%
Vaginal delivery, including prenatal and postpartum care CPT 59400 ROUTINE OBSTETRIC CARE ANTEPARTUM CARE VAGINAL DELIVERY & POSTPARTUM	$4,266.29	$6,890.00	$6,269.90–$6,890.00	2% below	38%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 ROUTINE OBSTETRIC CARE ANTEPARTUM CARE VAGINAL DELIVERY & POSTPARTUM	$4,266.29	$6,890.00	$6,269.90–$6,890.00	—	38%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 PF 59400 DEL VAG ANT PP CARE	$4,266.29	$6,890.00	$2,242.13–$6,545.50	—	38%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY UNILAT BILAT WPOSTOPERATIVE SEMEN EXAM (SEP PROC)	$535.61	$865.00	$787.15–$865.00	—	38%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 PF 55250 VASECT WPOSTOP SEME	$535.61	$865.00	$215.22–$821.75	23% below	38%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNILAT BILAT WPOSTOPERATIVE SEMEN EXAM (SEP PROC)	$535.61	$865.00	$787.15–$865.00	—	38%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 PF 55250 VASECT WPOSTOP SEME	$535.61	$865.00	$215.22–$821.75	—	38%
Wart removal, up to 14 warts CPT 17110 PF 17110 DEST BENIGN LSN<15	$237.78	$384.00	$64.35–$364.80	10% above	38%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS 1 TO 14	$237.78	$384.00	$349.44–$384.00	10% above	38%
Wart removal, up to 14 warts CPT 17110 MD 17110 DESTRUCT FLAT WARTS	$237.78	$384.00	$64.35–$364.80	10% above	38%
Wart removal, up to 14 warts inpatient CPT 17110 PF 17110 DEST BENIGN LSN<15	$237.78	$384.00	$64.35–$364.80	—	38%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS 1 TO 14	$237.78	$384.00	$349.44–$384.00	—	38%
Wart removal, up to 14 warts inpatient CPT 17110 MD 17110 DESTRUCT FLAT WARTS	$237.78	$384.00	$64.35–$364.80	—	38%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 MD 11042 DEBR SUBQ TISSUE 1ST 20 SQ CM	$207.44	$335.00	$56.04–$318.25	10% above	38%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 PF 11042 DEBR SKIN SUBQ TISSUE	$207.44	$335.00	$56.04–$318.25	10% above	38%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN & SUBQ TISSUE	$207.44	$335.00	$304.85–$335.00	10% above	38%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ED 11042 DEBR SKN SUBQ TISS 20 CM <	$247.68	$400.00	$364.00–$400.00	31% above	38%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 PF 11042 DEBR SKIN SUBQ TISSUE	$207.44	$335.00	$56.04–$318.25	—	38%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 MD 11042 DEBR SUBQ TISSUE 1ST 20 SQ CM	$207.44	$335.00	$56.04–$318.25	—	38%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN & SUBQ TISSUE	$207.44	$335.00	$304.85–$335.00	—	38%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 ED 11042 DEBR SKN SUBQ TISS 20 CM <	$247.68	$400.00	$364.00–$400.00	—	38%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 PF 25607 OPEN TX RADIAL FX INTE	$1,090.42	$1,761.00	$704.17–$1,672.95	36% below	38%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 FX W INTERNAL FIXN	$1,090.42	$1,761.00	$1,602.51–$1,761.00	36% below	38%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 PF 25607 OPEN TX RADIAL FX INTE	$1,090.42	$1,761.00	$704.17–$1,672.95	—	38%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 FX W INTERNAL FIXN	$1,090.42	$1,761.00	$1,602.51–$1,761.00	—	38%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Montana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD BLOOD COMPONENTS	$193.20	$312.00	$283.92–$312.00	80% below	38%
Blood transfusion (giving blood or blood components) CPT 36430 PF 36430 BLOOD OR BLD COMP TRAN	$198.77	$321.00	$292.11–$321.00	80% below	38%
Blood transfusion (giving blood or blood components) CPT 36430 ED 36430 TRANSFUSION BLOOD	$271.21	$438.00	$398.58–$438.00	72% below	38%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD	$271.21	$438.00	$398.58–$438.00	72% below	38%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD BLOOD COMPONENTS	$193.20	$312.00	$283.92–$312.00	—	38%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 PF 36430 BLOOD OR BLD COMP TRAN	$198.77	$321.00	$292.11–$321.00	—	38%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD	$271.21	$438.00	$398.58–$438.00	—	38%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ED 36430 TRANSFUSION BLOOD	$271.21	$438.00	$398.58–$438.00	—	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED NONPRESSURIZED INHALATION RX AIRWAY OBSTRUCTION DX SPUTUM	$39.63	$64.00	$58.24–$64.00	69% below	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PF 94640 NEBULIZER TREATMENT	$40.87	$66.00	$60.06–$66.00	68% below	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 DIAGNOSTIC SPUTUM	$78.64	$127.00	$115.57–$127.00	39% below	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TENT HOURLY	$126.32	$204.00	$185.64–$204.00	2% below	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI SUBSEQ TX	$126.32	$204.00	$185.64–$204.00	2% below	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI INITIAL TX	$126.32	$204.00	$185.64–$204.00	2% below	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZ PAP INITIAL	$126.32	$204.00	$185.64–$204.00	2% below	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB INITIAL TX	$126.32	$204.00	$185.64–$204.00	2% below	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI INHALER	$126.32	$204.00	$185.64–$204.00	2% below	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB SUBSEQ TX	$126.32	$204.00	$185.64–$204.00	2% below	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED NONPRESSURIZED INHALATION RX AIRWAY OBSTRUCTION DX SPUTUM	$39.63	$64.00	$58.24–$64.00	—	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PF 94640 NEBULIZER TREATMENT	$40.87	$66.00	$60.06–$66.00	—	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DIAGNOSTIC SPUTUM	$78.64	$127.00	$115.57–$127.00	—	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI INHALER	$126.32	$204.00	$185.64–$204.00	—	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZ PAP INITIAL	$126.32	$204.00	$185.64–$204.00	—	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB SUBSEQ TX	$126.32	$204.00	$185.64–$204.00	—	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB INITIAL TX	$126.32	$204.00	$185.64–$204.00	—	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI INITIAL TX	$126.32	$204.00	$185.64–$204.00	—	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI SUBSEQ TX	$126.32	$204.00	$185.64–$204.00	—	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TENT HOURLY	$126.32	$204.00	$185.64–$204.00	—	38%
Chemotherapy IV infusion, first hour CPT 96413 CHEMOTHERAPY ADMIN IV INF UP TO 1 HOUR	$469.98	$759.00	$690.69–$759.00	1% below	38%
Chemotherapy IV infusion, first hour CPT 96413 PF 96413 CHEMO IV INF UP TO 1H	$484.22	$782.00	$711.62–$782.00	2% above	38%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUSION 1ST HR	$499.08	$806.00	$733.46–$806.00	6% above	38%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTHERAPY ADMIN IV INF UP TO 1 HOUR	$469.98	$759.00	$690.69–$759.00	—	38%
Chemotherapy IV infusion, first hour inpatient CPT 96413 PF 96413 CHEMO IV INF UP TO 1H	$484.22	$782.00	$711.62–$782.00	—	38%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUSION 1ST HR	$499.08	$806.00	$733.46–$806.00	—	38%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 OPHTHALMOLOGICAL MEDICAL EXAM & EVAL COMPREHENSVE NEW PATIENT 1+ VISIT	$183.29	$296.00	$269.36–$296.00	—	38%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 PF 92004 EYE EXAM NEW COMPREHE	$183.29	$296.00	$84.98–$281.20	—	38%
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 OPHTHALMOLOGICAL MEDICAL EXAM & EVAL COMPREHENSVE NEW PATIENT 1+ VISIT	$183.29	$296.00	$269.36–$296.00	—	38%
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 PF 92004 EYE EXAM NEW COMPREHE	$183.29	$296.00	$84.98–$281.20	—	38%
Comprehensive eye exam, returning patient CPT 92014 OPHTHALMOLOGICAL MEDICAL EXM & EVAL COMPREHENSIVE ESTABLISHED PATIENT	$152.33	$246.00	$223.86–$246.00	—	38%
Comprehensive eye exam, returning patient CPT 92014 PF 92014 EYE EXAM ESTAB COMPRE	$152.33	$246.00	$68.66–$233.70	—	38%
Comprehensive eye exam, returning patient inpatient CPT 92014 PF 92014 EYE EXAM ESTAB COMPRE	$152.33	$246.00	$68.66–$233.70	—	38%
Comprehensive eye exam, returning patient inpatient CPT 92014 OPHTHALMOLOGICAL MEDICAL EXM & EVAL COMPREHENSIVE ESTABLISHED PATIENT	$152.33	$246.00	$223.86–$246.00	—	38%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE AUDIOMETRY THRESHOLD EVAL & SPEECH RECOGNITION	$76.79	$124.00	$112.84–$124.00	—	38%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 PF 92557 AUDIOMETRY EVAL CMPRH	$76.79	$124.00	$112.84–$124.00	—	38%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE AUDIOMETRY THRESHOLD EVAL & SPEECH RECOGNITION	$76.79	$124.00	$112.84–$124.00	—	38%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 PF 92557 AUDIOMETRY EVAL CMPRH	$76.79	$124.00	$112.84–$124.00	—	38%
Critical care, first 30 to 74 minutes CPT 99291 ED 99291 CRITICAL CARE E&M 30-74 MIN	$566.57	$915.00	$832.65–$915.00	4% below	38%
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE E&M 30-74 MIN	$607.44	$981.00	$892.71–$981.00	3% above	38%
Critical care, first 30 to 74 minutes CPT 99291 MD 99291 CRIT CARE E&M 30-74 MIN	$625.40	$1,010.00	$195.82–$959.50	6% above	38%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ED 99291 CRITICAL CARE E&M 30-74 MIN	$566.57	$915.00	$832.65–$915.00	—	38%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE E&M 30-74 MIN	$607.44	$981.00	$892.71–$981.00	—	38%
Critical care, first 30 to 74 minutes inpatient CPT 99291 MD 99291 CRIT CARE E&M 30-74 MIN	$625.40	$1,010.00	$195.82–$959.50	—	38%
EEG (brain wave test), awake and drowsy, routine CPT 95816 PF 95816 EEG AWAKE DROWSY	$342.42	$553.00	$503.23–$553.00	65% below	38%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 PF 95816 EEG AWAKE DROWSY	$342.42	$553.00	$503.23–$553.00	—	38%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM ROUTINE WAT LEAST 12 LEADS WINTERP & REPORT	$37.16	$60.00	$54.60–$60.00	63% below	38%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PF 93000 EKG ROUTINE W INT&RPT	$38.40	$62.00	$13.24–$58.90	62% below	38%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ELECTROCARDIOGRAM ROUTINE WAT LEAST 12 LEADS WINTERP & REPORT	$37.16	$60.00	$54.60–$60.00	—	38%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PF 93000 EKG ROUTINE W INT&RPT	$38.40	$62.00	$13.24–$58.90	—	38%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 18 LEAD	$68.12	$110.00	$100.10–$110.00	56% below	38%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM ROUTINE WAT LEAST 12 LEADS TRACING ONLY WO INTERP	$68.12	$110.00	$100.10–$110.00	56% below	38%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG TRACING WO INTERP	$70.59	$114.00	$103.74–$114.00	54% below	38%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM ROUTINE WAT LEAST 12 LEADS TRACING ONLY WO INTERP	$68.12	$110.00	$100.10–$110.00	—	38%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 18 LEAD	$68.12	$110.00	$100.10–$110.00	—	38%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG TRACING WO INTERP	$70.59	$114.00	$103.74–$114.00	—	38%
Electroconvulsive therapy (ECT), one session CPT 90870 PF 90870 ELECTROCONVULSIVE THER	$203.72	$329.00	$96.06–$312.55	—	38%
Electroconvulsive therapy (ECT), one session CPT 90870 ELECTROCONVULSIVE THERAPY	$203.72	$329.00	$299.39–$329.00	—	38%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ELECTROCONVULSIVE THERAPY	$203.72	$329.00	$299.39–$329.00	—	38%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 PF 90870 ELECTROCONVULSIVE THER	$203.72	$329.00	$96.06–$312.55	—	38%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 MD 99281 EMERGENCY DEPT VISIT LVL I	$81.74	$132.00	$10.47–$125.40	7% below	38%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED 99281 EMER CASE LEVEL I	$133.75	$216.00	$196.56–$216.00	52% above	38%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 MD 99281 EMERGENCY DEPT VISIT LVL I	$81.74	$132.00	$10.47–$125.40	—	38%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED 99281 EMER CASE LEVEL I	$133.75	$216.00	$196.56–$216.00	—	38%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 MD 99282 EMERGENCY DEPT VISIT LVL II	$140.56	$227.00	$38.49–$215.65	at median	38%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED 99282 EMER CASE LEVEL II	$171.52	$277.00	$252.07–$277.00	22% above	38%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 MD 99282 EMERGENCY DEPT VISIT LVL II	$140.56	$227.00	$38.49–$215.65	—	38%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED 99282 EMER CASE LEVEL II	$171.52	$277.00	$252.07–$277.00	—	38%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 MD 99283 EMERGENCY DEPT VISIT LVL III	$190.72	$308.00	$64.97–$292.60	18% below	38%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED 99283 EMER CASE LEVEL III	$322.61	$521.00	$474.11–$521.00	39% above	38%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 MD 99283 EMERGENCY DEPT VISIT LVL III	$190.72	$308.00	$64.97–$292.60	—	38%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED 99283 EMER CASE LEVEL III	$322.61	$521.00	$474.11–$521.00	—	38%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 MD 99284 EMERGENCY DEPT VISIT LVL IV	$284.84	$460.00	$110.84–$437.00	31% below	38%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED 99284 EMER CASE LEVEL IV	$408.68	$660.00	$600.60–$660.00	1% below	38%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 MD 99284 EMERGENCY DEPT VISIT LVL IV	$284.84	$460.00	$110.84–$437.00	—	38%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED 99284 EMER CASE LEVEL IV	$408.68	$660.00	$600.60–$660.00	—	38%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 MD 99285 EMERGENCY DEPT VISIT LVL V	$525.71	$849.00	$160.72–$806.55	5% below	38%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED 99285 EMER CASE LEVEL V	$619.20	$1,000.00	$910.00–$1,000.00	12% above	38%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 MD 99285 EMERGENCY DEPT VISIT LVL V	$525.71	$849.00	$160.72–$806.55	—	38%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED 99285 EMER CASE LEVEL V	$619.20	$1,000.00	$910.00–$1,000.00	—	38%
Exercise stress test, tracing only, the hospital charge CPT 93017 PF 93017 STRESS TEST TRACING	$169.05	$273.00	$248.43–$273.00	69% below	38%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST WECG MONITOR TRACING ONLY WO INTERP & RPT	$169.05	$273.00	$248.43–$273.00	69% below	38%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST TRACING	$193.20	$312.00	$283.92–$312.00	64% below	38%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 PF 93017 STRESS TEST TRACING	$169.05	$273.00	$248.43–$273.00	—	38%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOVASCULAR STRESS TEST WECG MONITOR TRACING ONLY WO INTERP & RPT	$169.05	$273.00	$248.43–$273.00	—	38%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TEST TRACING	$193.20	$312.00	$283.92–$312.00	—	38%
Eye exam, returning patient, intermediate CPT 92012 OPHTHALMOLOGICAL MEDICAL EXAM & EVAL INTMDTE ESTABLISHED PATIENT	$105.27	$170.00	$154.70–$170.00	—	38%
Eye exam, returning patient, intermediate CPT 92012 PF 92012 EYE EXAM ESTAB INTERM	$105.27	$170.00	$45.57–$161.50	—	38%
Eye exam, returning patient, intermediate inpatient CPT 92012 OPHTHALMOLOGICAL MEDICAL EXAM & EVAL INTMDTE ESTABLISHED PATIENT	$105.27	$170.00	$154.70–$170.00	—	38%
Eye exam, returning patient, intermediate inpatient CPT 92012 PF 92012 EYE EXAM ESTAB INTERM	$105.27	$170.00	$45.57–$161.50	—	38%
Family therapy with the patient, 50 minutes CPT 90847 PF 90847 FAMILY THERAPY	$120.13	$194.00	$97.60–$184.30	25% below	38%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY (CONJOINT PSYCHOTHERAPY) (WPATIENT PRESENT)	$120.13	$194.00	$176.54–$194.00	25% below	38%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY (CONJOINT PSYCHOTHERAPY) (WPATIENT PRESENT)	$120.13	$194.00	$176.54–$194.00	—	38%
Family therapy with the patient, 50 minutes inpatient CPT 90847 PF 90847 FAMILY THERAPY	$120.13	$194.00	$97.60–$184.30	—	38%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY (WO PATIENT PRESENT)	$120.13	$194.00	$176.54–$194.00	29% below	38%
Family therapy without the patient, 50 minutes CPT 90846 PF 90846 FAMILY THERAPY PT NOT	$120.13	$194.00	$93.60–$184.30	29% below	38%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY (WO PATIENT PRESENT)	$120.13	$194.00	$176.54–$194.00	—	38%
Family therapy without the patient, 50 minutes inpatient CPT 90846 PF 90846 FAMILY THERAPY PT NOT	$120.13	$194.00	$93.60–$184.30	—	38%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY (OTHER THAN MULTIPLE-FAMILY GROUP)	$71.83	$116.00	$105.56–$116.00	27% below	38%
Group psychotherapy session CPT 90853 PF 90853 PSYCHOTHERAPY GROUP	$71.83	$116.00	$23.09–$110.20	27% below	38%
Group psychotherapy session inpatient CPT 90853 PF 90853 PSYCHOTHERAPY GROUP	$71.83	$116.00	$23.09–$110.20	—	38%
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY (OTHER THAN MULTIPLE-FAMILY GROUP)	$71.83	$116.00	$105.56–$116.00	—	38%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 PF 93224 ECG MON REP TO 48 HRS	$191.34	$309.00	$64.97–$293.55	at median	38%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 ECG MONITR UP TO 48 HOURS CONTINUOUS RHYTHM WRECORDING ANALYSIS WRPT	$191.34	$309.00	$281.19–$309.00	at median	38%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 ECG MONITR UP TO 48 HOURS CONTINUOUS RHYTHM WRECORDING ANALYSIS WRPT	$191.34	$309.00	$281.19–$309.00	—	38%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 PF 93224 ECG MON REP TO 48 HRS	$191.34	$309.00	$64.97–$293.55	—	38%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$135.61	$219.00	$199.29–$219.00	50% below	38%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 PF 96360 IV HYDRAT INIT 31-60M	$139.94	$226.00	$205.66–$226.00	49% below	38%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INITIAL 31-60MINS	$144.28	$233.00	$212.03–$233.00	47% below	38%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INITIAL31-60MIN2VM59	$144.28	$233.00	$212.03–$233.00	47% below	38%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ED 96360 IV INFUS THERAPY HYDRATION FLUIDS INITIAL 31 MIN-1HR	$144.28	$233.00	$212.03–$233.00	47% below	38%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$135.61	$219.00	$199.29–$219.00	—	38%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 PF 96360 IV HYDRAT INIT 31-60M	$139.94	$226.00	$205.66–$226.00	—	38%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRAT INITIAL31-60MIN2VM59	$144.28	$233.00	$212.03–$233.00	—	38%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRAT INITIAL 31-60MINS	$144.28	$233.00	$212.03–$233.00	—	38%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ED 96360 IV INFUS THERAPY HYDRATION FLUIDS INITIAL 31 MIN-1HR	$144.28	$233.00	$212.03–$233.00	—	38%
IV infusion of a medicine, first hour CPT 96365 THER PROPH DIAG IV INF INTL	$227.87	$368.00	$334.88–$368.00	34% below	38%
IV infusion of a medicine, first hour CPT 96365 PF 96365 IV INF THPY PRO DX UP	$234.68	$379.00	$344.89–$379.00	32% below	38%
IV infusion of a medicine, first hour CPT 96365 ED 96365 IV INFUS THER PROPH DIAG INITIAL UP TO 1HR	$242.11	$391.00	$355.81–$391.00	30% below	38%
IV infusion of a medicine, first hour CPT 96365 INFUS TX PX DX 1 HR 2V M59	$242.11	$391.00	$355.81–$391.00	30% below	38%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION TX PROPH DX INIT TO 1HR	$242.11	$391.00	$355.81–$391.00	30% below	38%
IV infusion of a medicine, first hour inpatient CPT 96365 THER PROPH DIAG IV INF INTL	$227.87	$368.00	$334.88–$368.00	—	38%
IV infusion of a medicine, first hour inpatient CPT 96365 PF 96365 IV INF THPY PRO DX UP	$234.68	$379.00	$344.89–$379.00	—	38%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUS TX PX DX 1 HR 2V M59	$242.11	$391.00	$355.81–$391.00	—	38%
IV infusion of a medicine, first hour inpatient CPT 96365 ED 96365 IV INFUS THER PROPH DIAG INITIAL UP TO 1HR	$242.11	$391.00	$355.81–$391.00	—	38%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION TX PROPH DX INIT TO 1HR	$242.11	$391.00	$355.81–$391.00	—	38%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PF 96372 THER PRO DX INJ SQ IM	$41.49	$67.00	$60.97–$67.00	46% below	38%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 MD 96372 THER PRO DX INJ SQ IM	$41.49	$67.00	$13.24–$63.65	46% below	38%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER PROPHY DIAG INJ SC IM	$41.49	$67.00	$60.97–$67.00	46% below	38%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 TX RM 96372 THER PROPH DIAG INJ SQ IM	$44.59	$72.00	$65.52–$72.00	42% below	38%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SC IM INJECTION	$44.59	$72.00	$65.52–$72.00	42% below	38%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ED 96372 THER PROPH DIAG INJECTION SQ IM	$44.59	$72.00	$65.52–$72.00	42% below	38%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PF 96372 THER PRO DX INJ SQ IM	$41.49	$67.00	$60.97–$67.00	—	38%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER PROPHY DIAG INJ SC IM	$41.49	$67.00	$60.97–$67.00	—	38%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 MD 96372 THER PRO DX INJ SQ IM	$41.49	$67.00	$13.24–$63.65	—	38%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 SC IM INJECTION	$44.59	$72.00	$65.52–$72.00	—	38%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 TX RM 96372 THER PROPH DIAG INJ SQ IM	$44.59	$72.00	$65.52–$72.00	—	38%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ED 96372 THER PROPH DIAG INJECTION SQ IM	$44.59	$72.00	$65.52–$72.00	—	38%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$154.19	$249.00	$226.59–$249.00	35% below	38%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$154.19	$249.00	$226.59–$249.00	—	38%
Neuromuscular re-education, 15 minutes CPT 97112 THERAPEUTIC PROC 1+ AREAS EACH 15 MIN NEUROMUSCULAR REEDUCATION	$42.11	$68.00	$61.88–$68.00	49% below	38%
Neuromuscular re-education, 15 minutes CPT 97112 PF 97112 NEUROMUSCULAR RE-ED MO	$42.73	$69.00	$62.79–$69.00	48% below	38%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC RE ED EA 15MIN 97112	$66.88	$108.00	$98.28–$108.00	18% below	38%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 THERAPEUTIC PROC 1+ AREAS EACH 15 MIN NEUROMUSCULAR REEDUCATION	$42.11	$68.00	$61.88–$68.00	—	38%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PF 97112 NEUROMUSCULAR RE-ED MO	$42.73	$69.00	$62.79–$69.00	—	38%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC RE ED EA 15MIN 97112	$66.88	$108.00	$98.28–$108.00	—	38%
New patient office visit, about 30 minutes CPT 99203 PF 99203 FAC OFFICE OP VISIT NEW PT LEVEL III	$74.93	$121.00	$110.11–$121.00	54% below	38%
New patient office visit, about 30 minutes CPT 99203 PF 99203 OFFICE OP VISIT NEW PT LEVEL III	$187.00	$302.00	$75.44–$286.90	16% above	38%
New patient office visit, about 30 minutes CPT 99203 OFFICE OP VISIT NEW PT LEVEL III	$187.00	$302.00	$274.82–$302.00	16% above	38%
New patient office visit, about 30 minutes inpatient CPT 99203 PF 99203 FAC OFFICE OP VISIT NEW PT LEVEL III	$74.93	$121.00	$110.11–$121.00	—	38%
New patient office visit, about 30 minutes inpatient CPT 99203 PF 99203 OFFICE OP VISIT NEW PT LEVEL III	$187.00	$302.00	$75.44–$286.90	—	38%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE OP VISIT NEW PT LEVEL III	$187.00	$302.00	$274.82–$302.00	—	38%
New patient office visit, about 45 minutes CPT 99204 PF 99204 FAC OFFICE OP VISIT NEW PT LEVEL IV	$102.79	$166.00	$151.06–$166.00	64% below	38%
New patient office visit, about 45 minutes CPT 99204 OFFICE OP VISIT NEW PT LEVEL IV	$257.59	$416.00	$378.56–$416.00	9% below	38%
New patient office visit, about 45 minutes CPT 99204 PF 99204 OFFICE OP VISIT NEW PT LEVEL IV	$257.59	$416.00	$122.85–$395.20	9% below	38%
New patient office visit, about 45 minutes inpatient CPT 99204 PF 99204 FAC OFFICE OP VISIT NEW PT LEVEL IV	$102.79	$166.00	$151.06–$166.00	—	38%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE OP VISIT NEW PT LEVEL IV	$257.59	$416.00	$378.56–$416.00	—	38%
New patient office visit, about 45 minutes inpatient CPT 99204 PF 99204 OFFICE OP VISIT NEW PT LEVEL IV	$257.59	$416.00	$122.85–$395.20	—	38%
New patient office visit, about 60 minutes CPT 99205 PF 99205 FAC OFFICE OP VISIT NEW PT LEVEL V	$129.42	$209.00	$190.19–$209.00	62% below	38%
New patient office visit, about 60 minutes CPT 99205 PF 99205 OFFICE OP VISIT NEW PT LEVEL V	$323.23	$522.00	$167.19–$495.90	6% below	38%
New patient office visit, about 60 minutes CPT 99205 OFFICE OP VISIT NEW PT LEVEL V	$323.23	$522.00	$475.02–$522.00	6% below	38%
New patient office visit, about 60 minutes inpatient CPT 99205 PF 99205 FAC OFFICE OP VISIT NEW PT LEVEL V	$129.42	$209.00	$190.19–$209.00	—	38%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE OP VISIT NEW PT LEVEL V	$323.23	$522.00	$475.02–$522.00	—	38%
New patient office visit, about 60 minutes inpatient CPT 99205 PF 99205 OFFICE OP VISIT NEW PT LEVEL V	$323.23	$522.00	$167.19–$495.90	—	38%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PF 99202 FAC OFFICE OP VISIT NEW PT LEVEL II	$43.35	$70.00	$63.70–$70.00	69% below	38%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PF 99202 OFFICE OP VISIT NEW PT LEVEL II	$108.98	$176.00	$43.11–$167.20	22% below	38%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE OP VISIT NEW PT LEVEL II	$108.98	$176.00	$160.16–$176.00	22% below	38%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PF 99202 FAC OFFICE OP VISIT NEW PT LEVEL II	$43.35	$70.00	$63.70–$70.00	—	38%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PF 99202 OFFICE OP VISIT NEW PT LEVEL II	$108.98	$176.00	$43.11–$167.20	—	38%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE OP VISIT NEW PT LEVEL II	$108.98	$176.00	$160.16–$176.00	—	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION, INDIV, PER 15 MINUTES	$40.25	$65.00	$59.15–$65.00	17% below	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL INDIVIDUAL15 MIN	$41.49	$67.00	$60.97–$67.00	14% below	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 PF 97802 NUTRITION EVAL 15 MIN	$41.49	$67.00	$60.97–$67.00	14% below	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION, INDIV, PER 15 MINUTES	$40.25	$65.00	$59.15–$65.00	—	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 PF 97802 NUTRITION EVAL 15 MIN	$41.49	$67.00	$60.97–$67.00	—	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL INDIVIDUAL15 MIN	$41.49	$67.00	$60.97–$67.00	—	38%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEXITY 97165	$107.75	$174.00	$158.34–$174.00	41% below	38%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY 97165	$107.75	$174.00	$158.34–$174.00	—	38%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEXITY 97163	$110.84	$179.00	$162.89–$179.00	47% below	38%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY 97163	$110.84	$179.00	$162.89–$179.00	—	38%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEXITY 97161	$110.84	$179.00	$162.89–$179.00	40% below	38%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY 97161	$110.84	$179.00	$162.89–$179.00	—	38%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MODERATE COMPLEXITY 97162	$110.84	$179.00	$162.89–$179.00	42% below	38%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MODERATE COMPLEXITY 97162	$110.84	$179.00	$162.89–$179.00	—	38%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY TECHNIQUES 1+ REGIONS EACH 15 MIN	$36.54	$59.00	$53.69–$59.00	51% below	38%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PF 97140 MANUAL THERAPY 1 MORE	$37.16	$60.00	$54.60–$60.00	50% below	38%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN 97140	$63.78	$103.00	$93.73–$103.00	14% below	38%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY TECHNIQUES 1+ REGIONS EACH 15 MIN	$36.54	$59.00	$53.69–$59.00	—	38%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PF 97140 MANUAL THERAPY 1 MORE	$37.16	$60.00	$54.60–$60.00	—	38%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15 MIN 97140	$63.78	$103.00	$93.73–$103.00	—	38%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROC 1+ AREAS EACH 15 MIN THERAPEUTIC EXERCISES	$39.63	$64.00	$58.24–$64.00	47% below	38%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PF 97110 THERAPEUTIC EXERCISES	$40.25	$65.00	$59.15–$65.00	46% below	38%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXERCISE EA 15 MIN 97110	$68.12	$110.00	$100.10–$110.00	8% below	38%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROC 1+ AREAS EACH 15 MIN THERAPEUTIC EXERCISES	$39.63	$64.00	$58.24–$64.00	—	38%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PF 97110 THERAPEUTIC EXERCISES	$40.25	$65.00	$59.15–$65.00	—	38%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXERCISE EA 15 MIN 97110	$68.12	$110.00	$100.10–$110.00	—	38%
Preventive checkup, new patient aged 18–39 CPT 99385 SPORTS, CAMP, OTHER SPECIAL PX NEW PT 18-39YR	$18.58	$30.00	$27.30–$30.00	90% below	38%
Preventive checkup, new patient aged 18–39 CPT 99385 DOT PX NEW PT 18-39YR	$61.92	$100.00	$91.00–$100.00	67% below	38%
Preventive checkup, new patient aged 18–39 CPT 99385 EMPLOYMENT PX NEW PT 18-39YR	$61.92	$100.00	$91.00–$100.00	67% below	38%
Preventive checkup, new patient aged 18–39 CPT 99385 PREV MED E&M NEW 18-39 Y O	$235.92	$381.00	$346.71–$381.00	25% above	38%
Preventive checkup, new patient aged 18–39 CPT 99385 PF 99385 PREVENT MED NEW18-39Y	$235.92	$381.00	$361.95	25% above	38%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 SPORTS, CAMP, OTHER SPECIAL PX NEW PT 18-39YR	$18.58	$30.00	$27.30–$30.00	—	38%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 EMPLOYMENT PX NEW PT 18-39YR	$61.92	$100.00	$91.00–$100.00	—	38%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 DOT PX NEW PT 18-39YR	$61.92	$100.00	$91.00–$100.00	—	38%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PF 99385 PREVENT MED NEW18-39Y	$235.92	$381.00	$361.95	—	38%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREV MED E&M NEW 18-39 Y O	$235.92	$381.00	$346.71–$381.00	—	38%
Preventive checkup, new patient aged 40–64 CPT 99386 EMPLOYMENT PX NEW PT 40-64YR	$61.92	$100.00	$91.00–$100.00	73% below	38%
Preventive checkup, new patient aged 40–64 CPT 99386 DOT PX NEW PT 40-64YR	$61.92	$100.00	$91.00–$100.00	73% below	38%
Preventive checkup, new patient aged 40–64 CPT 99386 PF 99386 PREVENT MED NEW40-64Y	$253.26	$409.00	$388.55	12% above	38%
Preventive checkup, new patient aged 40–64 CPT 99386 PREV MED E&M NEW 40-64 Y O	$253.26	$409.00	$372.19–$409.00	12% above	38%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 EMPLOYMENT PX NEW PT 40-64YR	$61.92	$100.00	$91.00–$100.00	—	38%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 DOT PX NEW PT 40-64YR	$61.92	$100.00	$91.00–$100.00	—	38%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PF 99386 PREVENT MED NEW40-64Y	$253.26	$409.00	$388.55	—	38%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREV MED E&M NEW 40-64 Y O	$253.26	$409.00	$372.19–$409.00	—	38%
Preventive checkup, new patient aged 65 or older CPT 99387 DOT PX NEW PT 65+YR	$61.92	$100.00	$91.00–$100.00	82% below	38%
Preventive checkup, new patient aged 65 or older CPT 99387 PREV MED E&M NEW 65 AND OVER	$273.07	$441.00	$401.31–$441.00	19% below	38%
Preventive checkup, new patient aged 65 or older CPT 99387 PF 99387 PREVENT MED NEW>65YR	$273.07	$441.00	$418.95	19% below	38%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 DOT PX NEW PT 65+YR	$61.92	$100.00	$91.00–$100.00	—	38%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PREV MED E&M NEW 65 AND OVER	$273.07	$441.00	$401.31–$441.00	—	38%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PF 99387 PREVENT MED NEW>65YR	$273.07	$441.00	$418.95	—	38%
Preventive checkup, returning patient aged 18–39 CPT 99395 SPORTS, CAMP, OTHER SPECIAL PX EST PT 18-39YR	$18.58	$30.00	$27.30–$30.00	89% below	38%
Preventive checkup, returning patient aged 18–39 CPT 99395 EMPLOYMENT PX EST PT 18-39YR	$61.92	$100.00	$91.00–$100.00	62% below	38%
Preventive checkup, returning patient aged 18–39 CPT 99395 DOT PX EST PT 18-39YR	$61.92	$100.00	$91.00–$100.00	62% below	38%
Preventive checkup, returning patient aged 18–39 CPT 99395 PF 99395 FAC PREVENT MED EST18-39Y	$90.41	$146.00	$132.86–$146.00	45% below	38%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV MED E&M EST 18-39 Y O	$226.01	$365.00	$332.15–$365.00	38% above	38%
Preventive checkup, returning patient aged 18–39 CPT 99395 PF 99395 PREVENT MED EST18-39Y	$226.01	$365.00	$346.75	38% above	38%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 SPORTS, CAMP, OTHER SPECIAL PX EST PT 18-39YR	$18.58	$30.00	$27.30–$30.00	—	38%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 EMPLOYMENT PX EST PT 18-39YR	$61.92	$100.00	$91.00–$100.00	—	38%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 DOT PX EST PT 18-39YR	$61.92	$100.00	$91.00–$100.00	—	38%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PF 99395 FAC PREVENT MED EST18-39Y	$90.41	$146.00	$132.86–$146.00	—	38%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PF 99395 PREVENT MED EST18-39Y	$226.01	$365.00	$346.75	—	38%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREV MED E&M EST 18-39 Y O	$226.01	$365.00	$332.15–$365.00	—	38%
Preventive checkup, returning patient aged 40–64 CPT 99396 SPORTS, CAMP, OTHER SPECIAL PX EST PT 40-64YR	$18.58	$30.00	$27.30–$30.00	88% below	38%
Preventive checkup, returning patient aged 40–64 CPT 99396 DOT PX EST PT 40-64YR	$61.92	$100.00	$91.00–$100.00	61% below	38%
Preventive checkup, returning patient aged 40–64 CPT 99396 EMPLOYMENT PX EST PT 40-64YR	$61.92	$100.00	$91.00–$100.00	61% below	38%
Preventive checkup, returning patient aged 40–64 CPT 99396 PF 99396 PREVENT MED EST40-64Y	$245.83	$397.00	$377.15	54% above	38%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV MED E&M EST 40-64 Y O	$245.83	$397.00	$361.27–$397.00	54% above	38%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 SPORTS, CAMP, OTHER SPECIAL PX EST PT 40-64YR	$18.58	$30.00	$27.30–$30.00	—	38%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 DOT PX EST PT 40-64YR	$61.92	$100.00	$91.00–$100.00	—	38%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 EMPLOYMENT PX EST PT 40-64YR	$61.92	$100.00	$91.00–$100.00	—	38%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PF 99396 PREVENT MED EST40-64Y	$245.83	$397.00	$377.15	—	38%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PREV MED E&M EST 40-64 Y O	$245.83	$397.00	$361.27–$397.00	—	38%
Preventive checkup, returning patient aged 65 or older CPT 99397 DOT PX EST PT 65+YR	$61.92	$100.00	$91.00–$100.00	64% below	38%
Preventive checkup, returning patient aged 65 or older CPT 99397 EMPLOYMENT PX EST PT 65+ YR	$61.92	$100.00	$91.00–$100.00	64% below	38%
Preventive checkup, returning patient aged 65 or older CPT 99397 PF 99397 FAC PREVENT MED EST >65YR	$107.13	$173.00	$157.43–$173.00	39% below	38%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREV MED E&M EST 65 AND OVER	$268.12	$433.00	$394.03–$433.00	54% above	38%
Preventive checkup, returning patient aged 65 or older CPT 99397 PF 99397 PREVENT MED EST >65YR	$268.12	$433.00	$411.35	54% above	38%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 DOT PX EST PT 65+YR	$61.92	$100.00	$91.00–$100.00	—	38%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 EMPLOYMENT PX EST PT 65+ YR	$61.92	$100.00	$91.00–$100.00	—	38%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PF 99397 FAC PREVENT MED EST >65YR	$107.13	$173.00	$157.43–$173.00	—	38%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PREV MED E&M EST 65 AND OVER	$268.12	$433.00	$394.03–$433.00	—	38%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PF 99397 PREVENT MED EST >65YR	$268.12	$433.00	$411.35	—	38%
Psychiatric evaluation with medical services CPT 90792 MD 90792 PSYCH DX EVAL W MED SVC	$196.91	$318.00	$155.80–$302.10	35% below	38%
Psychiatric evaluation with medical services CPT 90792 PF 90792 PSYCH DX EVAL WMED SERV	$218.58	$353.00	$155.80–$335.35	28% below	38%
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL WMED SRVCS	$218.58	$353.00	$321.23–$353.00	28% below	38%
Psychiatric evaluation with medical services inpatient CPT 90792 MD 90792 PSYCH DX EVAL W MED SVC	$196.91	$318.00	$155.80–$302.10	—	38%
Psychiatric evaluation with medical services inpatient CPT 90792 PF 90792 PSYCH DX EVAL WMED SERV	$218.58	$353.00	$155.80–$335.35	—	38%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL WMED SRVCS	$218.58	$353.00	$321.23–$353.00	—	38%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$161.00	$260.00	$236.60–$260.00	20% below	38%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$161.00	$260.00	$236.60–$260.00	—	38%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PATIENT 16-37 MINUTES	$72.45	$117.00	$106.47–$117.00	40% below	38%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY W/PATIENT 16-37 MINUTES	$72.45	$117.00	$106.47–$117.00	—	38%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/PATIENT 38-52 MINUTES	$97.22	$157.00	$142.87–$157.00	34% below	38%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY W/PATIENT 38-52 MINUTES	$97.22	$157.00	$142.87–$157.00	—	38%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/PATIENT 53+ MINUTES	$102.17	$165.00	$150.15–$165.00	46% below	38%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY W/PATIENT 53+ MINUTES	$102.17	$165.00	$150.15–$165.00	—	38%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$24.15	$39.00	$35.49–$39.00	7% below	38%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 PF 99406 SMOK CESS CONS INTMD	$24.77	$40.00	$10.78–$38.00	4% below	38%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CONSULT 3-10 MIN	$34.06	$55.00	$50.05–$55.00	32% above	38%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$24.15	$39.00	$35.49–$39.00	—	38%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 PF 99406 SMOK CESS CONS INTMD	$24.77	$40.00	$10.78–$38.00	—	38%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CONSULT 3-10 MIN	$34.06	$55.00	$50.05–$55.00	—	38%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF 99215 FAC OFFICE OP VISIT EST PT LEVEL V W PROC M25	$91.65	$148.00	$134.68–$148.00	64% below	38%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF 99215 FAC OFFICE OP VISIT EST PT LEVEL V	$91.65	$148.00	$134.68–$148.00	64% below	38%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE OP VISIT EST PT LEVEL V	$228.49	$369.00	$335.79–$369.00	11% below	38%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF 99215 OFFICE OP VISIT EST PT LEVEL V	$228.49	$369.00	$132.09–$350.55	11% below	38%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF 99215 FAC OFFICE OP VISIT EST PT LEVEL V W PROC M25	$91.65	$148.00	$134.68–$148.00	—	38%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF 99215 FAC OFFICE OP VISIT EST PT LEVEL V	$91.65	$148.00	$134.68–$148.00	—	38%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE OP VISIT EST PT LEVEL V	$228.49	$369.00	$335.79–$369.00	—	38%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF 99215 OFFICE OP VISIT EST PT LEVEL V	$228.49	$369.00	$132.09–$350.55	—	38%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF 99213 FAC OFFICE OP VISIT EST PT LEVEL III W PROC M25	$46.44	$75.00	$68.25–$75.00	61% below	38%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF 99213 FAC OFFICE OP VISIT EST PT LEVEL III	$46.44	$75.00	$68.25–$75.00	61% below	38%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF 99213 OFFICE OP VISIT EST PT LEVEL III	$115.80	$187.00	$60.66–$177.65	2% below	38%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE OP VISIT EST PT LEVEL III	$115.80	$187.00	$170.17–$187.00	2% below	38%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PF 99213 FAC OFFICE OP VISIT EST PT LEVEL III W PROC M25	$46.44	$75.00	$68.25–$75.00	—	38%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PF 99213 FAC OFFICE OP VISIT EST PT LEVEL III	$46.44	$75.00	$68.25–$75.00	—	38%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE OP VISIT EST PT LEVEL III	$115.80	$187.00	$170.17–$187.00	—	38%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PF 99213 OFFICE OP VISIT EST PT LEVEL III	$115.80	$187.00	$60.66–$177.65	—	38%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF 99214 FAC OFFICE OP VISIT EST PT LEVEL IV	$67.50	$109.00	$99.19–$109.00	67% below	38%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF 99214 FAC OFFICE OP VISIT EST PT LEVEL IV W PROC M25	$67.50	$109.00	$99.19–$109.00	67% below	38%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE OP VISIT EST PT LEVEL IV	$169.05	$273.00	$248.43–$273.00	16% below	38%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF 99214 OFFICE OP VISIT EST PT LEVEL IV	$169.05	$273.00	$89.29–$259.35	16% below	38%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PF 99214 FAC OFFICE OP VISIT EST PT LEVEL IV W PROC M25	$67.50	$109.00	$99.19–$109.00	—	38%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PF 99214 FAC OFFICE OP VISIT EST PT LEVEL IV	$67.50	$109.00	$99.19–$109.00	—	38%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE OP VISIT EST PT LEVEL IV	$169.05	$273.00	$248.43–$273.00	—	38%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PF 99214 OFFICE OP VISIT EST PT LEVEL IV	$169.05	$273.00	$89.29–$259.35	—	38%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PF 99212 FAC OFFICE OP VISIT EST PT LEVEL II	$27.87	$45.00	$40.95–$45.00	68% below	38%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PF 99212 FAC OFFICE OP VISIT EST PT LEVEL II W PROC M25	$27.87	$45.00	$40.95–$45.00	68% below	38%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PF 99212 OFFICE OP VISIT EST PT LEVEL II	$69.97	$113.00	$32.33–$107.35	19% below	38%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OP VISIT EST PT LEVEL II	$69.97	$113.00	$102.83–$113.00	19% below	38%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PF 99212 FAC OFFICE OP VISIT EST PT LEVEL II	$27.87	$45.00	$40.95–$45.00	—	38%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PF 99212 FAC OFFICE OP VISIT EST PT LEVEL II W PROC M25	$27.87	$45.00	$40.95–$45.00	—	38%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE OP VISIT EST PT LEVEL II	$69.97	$113.00	$102.83–$113.00	—	38%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PF 99212 OFFICE OP VISIT EST PT LEVEL II	$69.97	$113.00	$32.33–$107.35	—	38%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PF 99243 OFFICE OP CONSULT NEW/EST LOW MDM 30 MIN	$260.07	$420.00	$399.00	6% above	38%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE OP CONSULT NEW/EST LOW MDM 30 MIN	$260.07	$420.00	$382.20–$420.00	6% above	38%
Specialist consultation, low complexity or 30+ minutes CPT 99243 MD 99243 OFFICE OP CONSULT NEW/EST LOW MDM 30 MIN MOD 25	$262.55	$424.00	$402.80	7% above	38%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PF 99243 OFFICE OP CONSULT NEW/EST LOW MDM 30 MIN	$260.07	$420.00	$399.00	—	38%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE OP CONSULT NEW/EST LOW MDM 30 MIN	$260.07	$420.00	$382.20–$420.00	—	38%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 MD 99243 OFFICE OP CONSULT NEW/EST LOW MDM 30 MIN MOD 25	$262.55	$424.00	$402.80	—	38%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE OP CONSULT NEW/EST MOD MDM 40 MIN	$358.52	$579.00	$526.89–$579.00	1% above	38%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PF 99244 OFFICE OP CONSULT NEW/EST MOD MDM 40 MIN	$366.57	$592.00	$562.40	4% above	38%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 MD 99244 OFFICE OP CONSULT NEW/EST MOD MDM 40 MIN	$405.58	$655.00	$622.25	15% above	38%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE OP CONSULT NEW/EST MOD MDM 40 MIN	$358.52	$579.00	$526.89–$579.00	—	38%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PF 99244 OFFICE OP CONSULT NEW/EST MOD MDM 40 MIN	$366.57	$592.00	$562.40	—	38%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 MD 99244 OFFICE OP CONSULT NEW/EST MOD MDM 40 MIN	$405.58	$655.00	$622.25	—	38%
Speech and language evaluation CPT 92523 SPEECH EVAL LANG COMP EXPRESSION 92523	$232.82	$376.00	$342.16–$376.00	36% below	38%
Speech and language evaluation inpatient CPT 92523 SPEECH EVAL LANG COMP EXPRESSION 92523	$232.82	$376.00	$342.16–$376.00	—	38%
Speech therapy session, individual CPT 92507 SPEECH THERAPY TX 92507	$92.88	$150.00	$136.50–$150.00	45% below	38%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY TX 92507	$92.88	$150.00	$136.50–$150.00	—	38%
Spirometry (breathing test) CPT 94010 PFT SCREEN SPIROMETRY (NO BD)	$96.60	$156.00	$141.96–$156.00	37% below	38%
Spirometry (breathing test) inpatient CPT 94010 PFT SCREEN SPIROMETRY (NO BD)	$96.60	$156.00	$141.96–$156.00	—	38%
Spirometry before and after a bronchodilator CPT 94060 PFT SCREEN SPIROMETRY (WITH BD)	$209.91	$339.00	$308.49–$339.00	19% below	38%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT SCREEN SPIROMETRY (WITH BD)	$209.91	$339.00	$308.49–$339.00	—	38%
Therapeutic activities (functional training), 15 minutes CPT 97530 PF 97530 THERAPY ACTIVITY DIREC	$50.78	$82.00	$74.62–$82.00	44% below	38%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTVITIES DIRECT PATIENT CONTACT EACH 15 MIN	$50.78	$82.00	$74.62–$82.00	44% below	38%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTIVITIES EA15 MIN 97530	$63.78	$103.00	$93.73–$103.00	29% below	38%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTVITIES DIRECT PATIENT CONTACT EACH 15 MIN	$50.78	$82.00	$74.62–$82.00	—	38%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PF 97530 THERAPY ACTIVITY DIREC	$50.78	$82.00	$74.62–$82.00	—	38%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTIVITIES EA15 MIN 97530	$63.78	$103.00	$93.73–$103.00	—	38%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC (SEP PROC)	$184.53	$298.00	$271.18–$298.00	3% above	38%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$190.10	$307.00	$279.37–$307.00	6% above	38%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC (SEP PROC)	$184.53	$298.00	$271.18–$298.00	—	38%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$190.10	$307.00	$279.37–$307.00	—	38%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CARDIOVASCULAR STRESS TEST WECG MONITR WPHYS SUPERVSN INTERP & RPT	$130.04	$210.00	$191.10–$210.00	—	38%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 PF 93015 STRESS TEST CMPL WPF	$130.04	$210.00	$191.10–$210.00	—	38%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 PF 93015 STRESS TEST CMPL WPF	$130.04	$210.00	$191.10–$210.00	—	38%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CARDIOVASCULAR STRESS TEST WECG MONITR WPHYS SUPERVSN INTERP & RPT	$130.04	$210.00	$191.10–$210.00	—	38%
Visual field test, extended both sides CPT 92083 VISUAL FIELD EXAM UNILAT BILAT WINTERPRETATION & REPORT EXTENDED	$65.02	$105.00	$95.55–$105.00	—	38%
Visual field test, extended CPT 92083 PF 92083 EXAM VISUAL FLD EXTEN	$66.88	$108.00	$98.28–$108.00	—	38%
Visual field test, extended inpatient both sides CPT 92083 VISUAL FIELD EXAM UNILAT BILAT WINTERPRETATION & REPORT EXTENDED	$65.02	$105.00	$95.55–$105.00	—	38%
Visual field test, extended inpatient CPT 92083 PF 92083 EXAM VISUAL FLD EXTEN	$66.88	$108.00	$98.28–$108.00	—	38%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Montana	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 CDMR FLU VACCINE ADJUVANT IM	$24.15	$39.00	$35.49–$39.00	53% below	38%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 CDMR PF 90653 FLU VACCINE ADJUVANT IM	$24.77	$40.00	$36.40–$40.00	52% below	38%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Influenza Vac Type A&B Surface Ant Adj Susp Pref Syr 0.5 ML	$46.42	$74.96	$68.21–$74.96	9% below	38%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 CDMR FLU VACCINE ADJUVANT IM	$24.15	$39.00	$35.49–$39.00	—	38%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 CDMR PF 90653 FLU VACCINE ADJUVANT IM	$24.77	$40.00	$36.40–$40.00	—	38%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Influenza Vac Type A&B Surface Ant Adj Susp Pref Syr 0.5 ML	$46.42	$74.96	$68.21–$74.96	—	38%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 CDMR SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$107.13	$173.00	$157.43–$173.00	28% below	38%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 CDMR PF 91322 SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$110.22	$178.00	$161.98–$178.00	26% below	38%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 (SARS-CoV-2)mRNA Vacc-Moderna IM Susp 50 MCG/0.5ML	$282.57	$456.34	$415.27–$456.34	90% above	38%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 mRNA Vaccine-Moderna IM Susp Pref Syr 50 MCG/0.5ML	$296.50	$478.84	$435.74–$478.84	99% above	38%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 CDMR SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$107.13	$173.00	$157.43–$173.00	—	38%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 CDMR PF 91322 SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$110.22	$178.00	$161.98–$178.00	—	38%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 (SARS-CoV-2)mRNA Vacc-Moderna IM Susp 50 MCG/0.5ML	$282.57	$456.34	$415.27–$456.34	—	38%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 mRNA Vaccine-Moderna IM Susp Pref Syr 50 MCG/0.5ML	$296.50	$478.84	$435.74–$478.84	—	38%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 CDMR SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$113.32	$183.00	$166.53–$183.00	28% below	38%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 mRNA Vac Tris-Sucrose-Pfizer IM Susp 30 MCG/0.3ML	$283.04	$457.09	$415.95–$457.09	81% above	38%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 mRNA Vac TriS-Pfizer IM Susp Pref Syr 30 MCG/0.3ML	$287.68	$464.59	$422.78–$464.59	84% above	38%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 CDMR SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$113.32	$183.00	$166.53–$183.00	—	38%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 mRNA Vac Tris-Sucrose-Pfizer IM Susp 30 MCG/0.3ML	$283.04	$457.09	$415.95–$457.09	—	38%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 mRNA Vac TriS-Pfizer IM Susp Pref Syr 30 MCG/0.3ML	$287.68	$464.59	$422.78–$464.59	—	38%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE SUBQ USE	$138.09	$223.00	$202.93–$223.00	54% below	38%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 PF 90716 VARICELLA VACC SQ	$144.90	$234.00	$212.94–$234.00	52% below	38%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE SUBQ USE	$138.09	$223.00	$202.93–$223.00	—	38%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 PF 90716 VARICELLA VACC SQ	$144.90	$234.00	$212.94–$234.00	—	38%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CDMR INFLUENZA VACCINE TRIVALENT PRESER FREE 0.5 ML DOSAGE IM	$17.96	$29.00	$26.39–$29.00	19% below	38%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CDMR PF 90656 FLU VACC TRIVALENT SPLT PF 0.5 ML DOSAGE IM	$18.58	$30.00	$27.30–$30.00	17% below	38%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 CDMR INFLUENZA VACCINE TRIVALENT PRESER FREE 0.5 ML DOSAGE IM	$17.96	$29.00	$26.39–$29.00	—	38%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 CDMR PF 90656 FLU VACC TRIVALENT SPLT PF 0.5 ML DOSAGE IM	$18.58	$30.00	$27.30–$30.00	—	38%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS 6 11 16 18 31 33 45 52 58 NONAVALENT 3 DOSE IM	$255.12	$412.00	$374.92–$412.00	10% below	38%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PF 90651 HPV VIRUS VACCINE 9 VAL IM	$268.12	$433.00	$394.03–$433.00	6% below	38%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Human Papillomavirus (HPV) 9-Valent Recomb Vac Susp Pref Syr	$391.83	$632.79	$575.84–$632.79	38% above	38%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS 6 11 16 18 31 33 45 52 58 NONAVALENT 3 DOSE IM	$255.12	$412.00	$374.92–$412.00	—	38%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PF 90651 HPV VIRUS VACCINE 9 VAL IM	$268.12	$433.00	$394.03–$433.00	—	38%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Human Papillomavirus (HPV) 9-Valent Recomb Vac Susp Pref Syr	$391.83	$632.79	$575.84–$632.79	—	38%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE ADULT DOSAGE IM USE	$87.31	$141.00	$128.31–$141.00	36% below	38%
Hepatitis A vaccine, adult dose CPT 90632 PF 90632 HEPAT A VACC ADULT	$89.79	$145.00	$131.95–$145.00	34% below	38%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE ADULT DOSAGE IM USE	$87.31	$141.00	$128.31–$141.00	—	38%
Hepatitis A vaccine, adult dose inpatient CPT 90632 PF 90632 HEPAT A VACC ADULT	$89.79	$145.00	$131.95–$145.00	—	38%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE ADULT DOSAGE IM USE	$94.12	$152.00	$138.32–$152.00	16% below	38%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PF 90746 HEPAT B VACC ADULT IM	$97.22	$157.00	$142.87–$157.00	14% below	38%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE ADULT DOSAGE IM USE	$94.12	$152.00	$138.32–$152.00	—	38%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 PF 90746 HEPAT B VACC ADULT IM	$97.22	$157.00	$142.87–$157.00	—	38%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CDMR FLU VACC PRSV FREE INC ANTIG	$27.87	$45.00	$40.95–$45.00	60% below	38%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CDMR PF 90662 INFLU VACC PF ANTIGEN	$28.49	$46.00	$41.86–$46.00	60% below	38%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 CDMR FLU VACC PRSV FREE INC ANTIG	$27.87	$45.00	$40.95–$45.00	—	38%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 CDMR PF 90662 INFLU VACC PF ANTIGEN	$28.49	$46.00	$41.86–$46.00	—	38%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES MUMPS AND RUBELLA VIRUS VACCINE (MMR) LIVE SUB-Q USE	$77.40	$125.00	$113.75–$125.00	58% below	38%
MMR vaccine (measles, mumps and rubella), live CPT 90707 PF 90707 MMR VIRUS VAC LIVE SQ	$81.74	$132.00	$120.12–$132.00	56% below	38%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles-Mumps-Rubella Virus Vaccines For Inj Soln	$141.14	$227.93	$207.42–$227.93	23% below	38%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES MUMPS AND RUBELLA VIRUS VACCINE (MMR) LIVE SUB-Q USE	$77.40	$125.00	$113.75–$125.00	—	38%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 PF 90707 MMR VIRUS VAC LIVE SQ	$81.74	$132.00	$120.12–$132.00	—	38%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Measles-Mumps-Rubella Virus Vaccines For Inj Soln	$141.14	$227.93	$207.42–$227.93	—	38%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJUGATE VACCINE SEROGROUPS A C Y & W-135(4-VALENT) IM	$158.52	$256.00	$232.96–$256.00	37% below	38%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 PF 90734 MENING CONJ VACC-QUADRIVALENT IM	$166.57	$269.00	$244.79–$269.00	34% below	38%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal (A, C, Y, and W-135) Oligo Conj Vac For Inj	$199.28	$321.82	$292.86–$321.82	21% below	38%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL CONJUGATE VACCINE SEROGROUPS A C Y & W-135(4-VALENT) IM	$158.52	$256.00	$232.96–$256.00	—	38%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 PF 90734 MENING CONJ VACC-QUADRIVALENT IM	$166.57	$269.00	$244.79–$269.00	—	38%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal (A, C, Y, and W-135) Oligo Conj Vac For Inj	$199.28	$321.82	$292.86–$321.82	—	38%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL RECOMB PROTEIN&OUTER MEMBRN VESICAL SEROGRP B 2 DOSE IM	$354.81	$573.00	$521.43–$573.00	7% below	38%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL RECOMB PROTEIN&OUTER MEMBRN VESICAL SEROGRP B 2 DOSE IM	$354.81	$573.00	$521.43–$573.00	—	38%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE FOR INTRAMUSCULAR USE	$416.73	$673.00	$612.43–$673.00	at median	38%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PF 90677 PNEUMO VACC 20 VAL IM	$437.78	$707.00	$643.37–$707.00	5% above	38%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PCV20 VACCINE FOR INTRAMUSCULAR USE	$416.73	$673.00	$612.43–$673.00	—	38%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PF 90677 PNEUMO VACC 20 VAL IM	$437.78	$707.00	$643.37–$707.00	—	38%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL POLYSACCHARIDE VACCINE 23-VALENT ADULT IMMUNOSUPPRESSED P	$111.46	$180.00	$163.80–$180.00	19% below	38%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PF 90732 IMM PNEUMOCOCCAL VACC	$114.56	$185.00	$168.35–$185.00	16% below	38%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Vaccine Polyvalent Inj Soln 25 MCG/0.5ML	$190.81	$308.15	$280.42–$308.15	39% above	38%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Vaccine Polyvalent Soln Pref Syr 25 MCG/0.5ML	$191.84	$309.81	$281.93–$309.81	40% above	38%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL POLYSACCHARIDE VACCINE 23-VALENT ADULT IMMUNOSUPPRESSED P	$111.46	$180.00	$163.80–$180.00	—	38%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PF 90732 IMM PNEUMOCOCCAL VACC	$114.56	$185.00	$168.35–$185.00	—	38%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Vaccine Polyvalent Inj Soln 25 MCG/0.5ML	$190.81	$308.15	$280.42–$308.15	—	38%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Vaccine Polyvalent Soln Pref Syr 25 MCG/0.5ML	$191.84	$309.81	$281.93–$309.81	—	38%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOC ANTB SEASN .5ML IM	$426.63	$689.00	$626.99–$689.00	52% below	38%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 PF 90380 RSV MONOC ANTB SEASN .5ML IM	$439.64	$710.00	$646.10–$710.00	51% below	38%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Nirsevimab-alip IM Soln Prefilled Syringe 50 MG/0.5ML	$879.73	$1,420.74	$1,292.87–$1,420.74	2% below	38%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 RSV MONOC ANTB SEASN .5ML IM	$426.63	$689.00	$626.99–$689.00	—	38%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 PF 90380 RSV MONOC ANTB SEASN .5ML IM	$439.64	$710.00	$646.10–$710.00	—	38%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Nirsevimab-alip IM Soln Prefilled Syringe 50 MG/0.5ML	$879.73	$1,420.74	$1,292.87–$1,420.74	—	38%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$256.97	$415.00	$377.65–$415.00	29% below	38%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 PF 90678 RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$264.40	$427.00	$388.57–$427.00	27% below	38%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$256.97	$415.00	$377.65–$415.00	—	38%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 PF 90678 RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$264.40	$427.00	$388.57–$427.00	—	38%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV VACC PREF RECOMB ADJT INTRAMUSCULAR	$226.63	$366.00	$333.06–$366.00	36% below	38%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 PF 90679 RSV VACC PREF RECOMB ADJT INTRAMUSCULAR	$233.44	$377.00	$343.07–$377.00	34% below	38%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV VACC PREF RECOMB ADJT INTRAMUSCULAR	$226.63	$366.00	$333.06–$366.00	—	38%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 PF 90679 RSV VACC PREF RECOMB ADJT INTRAMUSCULAR	$233.44	$377.00	$343.07–$377.00	—	38%
Rabies vaccine, one dose CPT 90675 Rabies Virus Vaccine, HDC For Inj Susp	$689.42	$1,113.39	$1,013.18–$1,113.39	6% below	38%
Rabies vaccine, one dose CPT 90675 Rabies Vaccine, PCEC For Inj	$727.16	$1,174.35	$1,068.66–$1,174.35	at median	38%
Rabies vaccine, one dose inpatient CPT 90675 Rabies Virus Vaccine, HDC For Inj Susp	$689.42	$1,113.39	$1,013.18–$1,113.39	—	38%
Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine, PCEC For Inj	$727.16	$1,174.35	$1,068.66–$1,174.35	—	38%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VACCINE HZV, RECOMBINANT, SUBUNIT, ADJUVANTED, INTRAMUSCULAR	$173.38	$280.00	$254.80–$280.00	10% below	38%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 PF 90750 ZOSTER VAC HZV RECOMBINANT SUBUNIT ADJUVANTED IM	$173.38	$280.00	$254.80–$280.00	10% below	38%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 PF 90750 ZOSTER VAC HZV RECOMBINANT SUBUNIT ADJUVANTED IM	$173.38	$280.00	$254.80–$280.00	—	38%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VACCINE HZV, RECOMBINANT, SUBUNIT, ADJUVANTED, INTRAMUSCULAR	$173.38	$280.00	$254.80–$280.00	—	38%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD TOXOIDS ABSORBED PRESERVATIVE FREE	$37.16	$60.00	$54.60–$60.00	62% below	38%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus-Diphtheria Toxoids (Td) Inj 2-2 LF/0.5ML	$55.03	$88.87	$80.87–$88.87	44% below	38%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD TOXOIDS ABSORBED PRESERVATIVE FREE	$37.16	$60.00	$54.60–$60.00	—	38%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus-Diphtheria Toxoids (Td) Inj 2-2 LF/0.5ML	$55.03	$88.87	$80.87–$88.87	—	38%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP 7 YRS OR OLDER IM	$62.54	$101.00	$91.91–$101.00	56% below	38%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PF 90715 TDAP VACC >7 YR IM	$65.64	$106.00	$96.46–$106.00	53% below	38%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tet-Diph-Acell Pertuss Ad Pref Syr 5-2.5-18.5 LF-MCG/0.5ML	$82.21	$132.76	$120.81–$132.76	42% below	38%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP 7 YRS OR OLDER IM	$62.54	$101.00	$91.91–$101.00	—	38%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PF 90715 TDAP VACC >7 YR IM	$65.64	$106.00	$96.46–$106.00	—	38%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tet-Diph-Acell Pertuss Ad Pref Syr 5-2.5-18.5 LF-MCG/0.5ML	$82.21	$132.76	$120.81–$132.76	—	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ED G0008 ADMIN INFLUENZA VIRUS VACCINE	$33.44	$54.00	$49.14–$54.00	32% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN PNEUMOCOCCAL VAC	$33.44	$54.00	$49.14–$54.00	32% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN HEPATITIS B VACCINE	$35.30	$57.00	$51.87–$57.00	28% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION 1 SNGL COMBINATION VACCINE TOXOID	$35.30	$57.00	$51.87–$57.00	28% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PF 90471 IMMUN ADM 1 VACC IM	$35.92	$58.00	$52.78–$58.00	27% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUN ADMIN 1 VACCINE	$44.59	$72.00	$65.52–$72.00	9% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ED 90471 IMMUNE ADMIN 1 VACCINE	$44.59	$72.00	$65.52–$72.00	9% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN INFLUENZA VIR VAC	$44.59	$72.00	$65.52–$72.00	9% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ED G0008 ADMIN INFLUENZA VIRUS VACCINE	$33.44	$54.00	$49.14–$54.00	—	38%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN PNEUMOCOCCAL VAC	$33.44	$54.00	$49.14–$54.00	—	38%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION 1 SNGL COMBINATION VACCINE TOXOID	$35.30	$57.00	$51.87–$57.00	—	38%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN HEPATITIS B VACCINE	$35.30	$57.00	$51.87–$57.00	—	38%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PF 90471 IMMUN ADM 1 VACC IM	$35.92	$58.00	$52.78–$58.00	—	38%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN INFLUENZA VIR VAC	$44.59	$72.00	$65.52–$72.00	—	38%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUN ADMIN 1 VACCINE	$44.59	$72.00	$65.52–$72.00	—	38%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ED 90471 IMMUNE ADMIN 1 VACCINE	$44.59	$72.00	$65.52–$72.00	—	38%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDL SNGL COMBINATION VACCINE TOXOID	$24.15	$39.00	$35.49–$39.00	23% below	38%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ED 90472 IMMUN ADMIN EA ADDL VACCINE	$24.77	$40.00	$36.40–$40.00	21% below	38%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PF 90472 IMMUN ADM ADD VAC IM	$24.77	$40.00	$36.40–$40.00	21% below	38%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN EA ADDL VACCINE	$24.77	$40.00	$36.40–$40.00	21% below	38%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDL SNGL COMBINATION VACCINE TOXOID	$24.15	$39.00	$35.49–$39.00	—	38%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADMIN EA ADDL VACCINE	$24.77	$40.00	$36.40–$40.00	—	38%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ED 90472 IMMUN ADMIN EA ADDL VACCINE	$24.77	$40.00	$36.40–$40.00	—	38%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PF 90472 IMMUN ADM ADD VAC IM	$24.77	$40.00	$36.40–$40.00	—	38%

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/8028/810233499_sidney-health-center_standardcharges.csv