Hospital Grand Island, NE

Howard County Medical Center

Howard County Medical Center in St Paul, NE publishes cash prices for 337 common procedures listed here, from its own machine-readable price file updated Feb 4, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Nebraska median for 220 of 337 procedures and below it for 109. By typical cash price it ranks #26 of 34 Nebraska hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

P O Box 406, 1113 Sherman St, St Paul, NE 68873 Collected Sep 27, 2026 Source price file (308) 754-4421

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 281338 · CMS hospital register

The price file shows no self-pay discount

For 1573 of the 1573 prices listed here, the cash price in Howard County Medical Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 All Outpatient Services	$337.00	$337.00	$168.50–$323.52	44% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3 VIEWS-LEFT	$337.00	$337.00	$168.50–$323.52	44% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3 VIEWS-RIGHT	$337.00	$337.00	$168.50–$323.52	44% above	—
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 All Inpatient Services	$337.00	$337.00	$252.75–$323.52	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE 3 VIEWS-LEFT	$337.00	$337.00	$252.75–$323.52	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE 3 VIEWS-RIGHT	$337.00	$337.00	$252.75–$323.52	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ART-UE/LE PHYS.-LIMITED	$607.00	$607.00	$303.50–$582.72	64% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 All Outpatient Services	$607.00	$607.00	$303.50–$582.72	64% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 All Inpatient Services	$607.00	$607.00	$455.25–$582.72	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ART-UE/LE PHYS.-LIMITED	$607.00	$607.00	$455.25–$582.72	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 All Outpatient Services	$1,779.00	$1,779.00	$889.50–$1,707.84	8% above	—
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE AND OR JNT WHOLE BOD	$1,779.00	$1,779.00	$889.50–$1,707.84	8% above	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 All Inpatient Services	$1,779.00	$1,779.00	$1,334.25–$1,707.84	—	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE AND OR JNT WHOLE BOD	$1,779.00	$1,779.00	$1,334.25–$1,707.84	—	—
Breast ultrasound, complete, one breast CPT 76641 All Outpatient Services	$437.00	$437.00	$218.50–$419.52	at median	—
Breast ultrasound, complete, one breast one side CPT 76641 US LEFT BREAST UNILAT COMPLETE	$437.00	$437.00	$218.50–$419.52	at median	—
Breast ultrasound, complete, one breast one side CPT 76641 US RT BREAST UNILAT COMPLETE	$437.00	$437.00	$218.50–$419.52	at median	—
Breast ultrasound, complete, one breast inpatient CPT 76641 All Inpatient Services	$437.00	$437.00	$327.75–$419.52	—	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US LEFT BREAST UNILAT COMPLETE	$437.00	$437.00	$327.75–$419.52	—	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US RT BREAST UNILAT COMPLETE	$437.00	$437.00	$327.75–$419.52	—	—
Breast ultrasound, limited (one breast or one area) CPT 76642 All Outpatient Services	$339.00	$339.00	$169.50–$325.44	2% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US LEFT BREAST UNILAT LIMITED	$339.00	$339.00	$169.50–$325.44	2% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US RIGHT BREAST UNILAT LIMITED	$339.00	$339.00	$169.50–$325.44	2% above	—
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 All Inpatient Services	$339.00	$339.00	$254.25–$325.44	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US LEFT BREAST UNILAT LIMITED	$339.00	$339.00	$254.25–$325.44	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US RIGHT BREAST UNILAT LIMITED	$339.00	$339.00	$254.25–$325.44	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 All Outpatient Services	$3,824.00	$3,824.00	$1,912.00–$3,671.04	32% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST WOW CONTRAST	$3,824.00	$3,824.00	$1,912.00–$3,671.04	32% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 All Inpatient Services	$3,824.00	$3,824.00	$2,868.00–$3,671.04	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST WOW CONTRAST	$3,824.00	$3,824.00	$2,868.00–$3,671.04	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS WO CONTRAST	$2,842.00	$2,842.00	$1,421.00–$2,728.32	1% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 All Outpatient Services	$2,842.00	$2,842.00	$1,421.00–$2,728.32	1% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 All Inpatient Services	$2,842.00	$2,842.00	$2,131.50–$2,728.32	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS WO CONTRAST	$2,842.00	$2,842.00	$2,131.50–$2,728.32	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W CONTRAST	$3,999.00	$3,999.00	$1,999.50–$3,839.04	7% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 All Outpatient Services	$3,999.00	$3,999.00	$1,999.50–$3,839.04	7% above	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W CONTRAST	$3,999.00	$3,999.00	$2,999.25–$3,839.04	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 All Inpatient Services	$3,999.00	$3,999.00	$2,999.25–$3,839.04	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS W/WO CONTRAST	$4,237.00	$4,237.00	$2,118.50–$4,067.52	1% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 All Outpatient Services	$4,237.00	$4,237.00	$2,118.50–$4,067.52	1% above	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS W/WO CONTRAST	$4,237.00	$4,237.00	$3,177.75–$4,067.52	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 All Inpatient Services	$4,237.00	$4,237.00	$3,177.75–$4,067.52	—	—
CT scan of the abdomen with contrast CPT 74160 All Outpatient Services	$3,086.00	$3,086.00	$1,543.00–$2,962.56	36% above	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST	$3,086.00	$3,086.00	$1,543.00–$2,962.56	36% above	—
CT scan of the abdomen with contrast inpatient CPT 74160 All Inpatient Services	$3,086.00	$3,086.00	$2,314.50–$2,962.56	—	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST	$3,086.00	$3,086.00	$2,314.50–$2,962.56	—	—
CT scan of the abdomen without contrast CPT 74150 All Outpatient Services	$2,670.00	$2,670.00	$1,335.00–$2,563.20	47% above	—
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST	$2,670.00	$2,670.00	$1,335.00–$2,563.20	47% above	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST	$2,670.00	$2,670.00	$2,002.50–$2,563.20	—	—
CT scan of the abdomen without contrast inpatient CPT 74150 All Inpatient Services	$2,670.00	$2,670.00	$2,002.50–$2,563.20	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 All Outpatient Services	$2,057.00	$2,057.00	$1,028.50–$1,974.72	34% above	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS	$2,057.00	$2,057.00	$1,028.50–$1,974.72	34% above	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONTRAST	$2,057.00	$2,057.00	$1,028.50–$1,974.72	34% above	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONTRAST	$2,057.00	$2,057.00	$1,542.75–$1,974.72	—	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS	$2,057.00	$2,057.00	$1,542.75–$1,974.72	—	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 All Inpatient Services	$2,057.00	$2,057.00	$1,542.75–$1,974.72	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$2,385.00	$2,385.00	$1,192.50–$2,289.60	49% above	—
CT scan of the head or brain, no contrast dye CPT 70450 All Outpatient Services	$2,385.00	$2,385.00	$1,192.50–$2,289.60	49% above	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 All Inpatient Services	$2,385.00	$2,385.00	$1,788.75–$2,289.60	—	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST	$2,385.00	$2,385.00	$1,788.75–$2,289.60	—	—
CT scan of the head with contrast CPT 70460 CT HEAD WITH CONTRAST	$2,104.00	$2,104.00	$1,052.00–$2,019.84	6% above	—
CT scan of the head with contrast CPT 70460 All Outpatient Services	$2,104.00	$2,104.00	$1,052.00–$2,019.84	6% above	—
CT scan of the head with contrast inpatient CPT 70460 All Inpatient Services	$2,104.00	$2,104.00	$1,578.00–$2,019.84	—	—
CT scan of the head with contrast inpatient CPT 70460 CT HEAD WITH CONTRAST	$2,104.00	$2,104.00	$1,578.00–$2,019.84	—	—
CT scan of the head without and with contrast CPT 70470 CT HEAD WOW CONTRAST	$2,895.00	$2,895.00	$1,447.50–$2,779.20	36% above	—
CT scan of the head without and with contrast CPT 70470 All Outpatient Services	$2,895.00	$2,895.00	$1,447.50–$2,779.20	36% above	—
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WOW CONTRAST	$2,895.00	$2,895.00	$2,171.25–$2,779.20	—	—
CT scan of the head without and with contrast inpatient CPT 70470 All Inpatient Services	$2,895.00	$2,895.00	$2,171.25–$2,779.20	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONTRAST	$2,669.00	$2,669.00	$1,334.50–$2,562.24	40% above	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 All Outpatient Services	$2,669.00	$2,669.00	$1,334.50–$2,562.24	40% above	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 All Inpatient Services	$2,669.00	$2,669.00	$2,001.75–$2,562.24	—	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONTRAST	$2,669.00	$2,669.00	$2,001.75–$2,562.24	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 All Outpatient Services	$2,495.00	$2,495.00	$1,247.50–$2,395.20	30% above	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTRAST	$2,495.00	$2,495.00	$1,247.50–$2,395.20	30% above	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 All Inpatient Services	$2,495.00	$2,495.00	$1,871.25–$2,395.20	—	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CONTRAST	$2,495.00	$2,495.00	$1,871.25–$2,395.20	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST	$2,926.00	$2,926.00	$1,463.00–$2,808.96	29% above	—
CT scan of the pelvis, with contrast dye CPT 72193 All Outpatient Services	$2,926.00	$2,926.00	$1,463.00–$2,808.96	29% above	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 All Inpatient Services	$2,926.00	$2,926.00	$2,194.50–$2,808.96	—	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH CONTRAST	$2,926.00	$2,926.00	$2,194.50–$2,808.96	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID DUPLEX BILAT	$1,669.00	$1,669.00	$834.50–$1,602.24	—	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 All Outpatient Services	$1,669.00	$1,669.00	$834.50–$1,602.24	8% above	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID DUPLEX BILAT	$1,685.00	$1,685.00	$1,263.75–$1,617.60	—	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 All Inpatient Services	$1,685.00	$1,685.00	$1,263.75–$1,617.60	—	—
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$391.00	$391.00	$132.75–$375.36	57% above	—
Chest X-ray, 2 views CPT 71046 All Outpatient Services	$391.00	$391.00	$132.75–$375.36	57% above	—
Chest X-ray, 2 views inpatient CPT 71046 All Inpatient Services	$391.00	$391.00	$293.25–$375.36	—	—
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS	$391.00	$391.00	$293.25–$375.36	—	—
Chest X-ray, single view CPT 71045 All Outpatient Services	$317.00	$317.00	$158.50–$304.32	65% above	—
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$317.00	$317.00	$158.50–$304.32	65% above	—
Chest X-ray, single view inpatient CPT 71045 All Inpatient Services	$317.00	$317.00	$237.75–$304.32	—	—
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW	$317.00	$317.00	$237.75–$304.32	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITON COMPLETE	$937.00	$937.00	$468.50–$899.52	23% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 All Outpatient Services	$937.00	$937.00	$468.50–$899.52	23% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITON COMPLETE	$937.00	$937.00	$702.75–$899.52	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 All Inpatient Services	$937.00	$937.00	$702.75–$899.52	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 All Outpatient Services	$531.00	$531.00	$265.50–$509.76	41% above	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA AXIAL HIP/SPINE	$531.00	$531.00	$265.50–$509.76	41% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA AXIAL HIP/SPINE	$531.00	$531.00	$398.25–$509.76	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 All Outpatient Services	$263.00	$263.00	$131.50–$252.48	53% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA APPENDICULAR/WRIST	$263.00	$263.00	$131.50–$252.48	53% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA APPENDICULAR/WRIST	$263.00	$263.00	$197.25–$252.48	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 All Inpatient Services	$263.00	$263.00	$197.25–$252.48	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 All Outpatient Services	$2,618.00	$2,618.00	$1,309.00–$2,513.28	38% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST	$2,618.00	$2,618.00	$1,309.00–$2,513.28	38% above	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 All Inpatient Services	$2,618.00	$2,618.00	$1,963.50–$2,513.28	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONTRAST	$2,618.00	$2,618.00	$1,963.50–$2,513.28	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 All Outpatient Services	$3,000.00	$3,000.00	$1,500.00–$2,880.00	30% above	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST WITH CONTRAST	$3,000.00	$3,000.00	$1,500.00–$2,880.00	30% above	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 All Inpatient Services	$3,000.00	$3,000.00	$2,250.00–$2,880.00	—	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST WITH CONTRAST	$3,000.00	$3,000.00	$2,250.00–$2,880.00	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAM DIGITAL DX BILATERAL	$431.00	$431.00	$215.50–$413.76	—	—
Diagnostic mammogram, both breasts CPT 77066 All Outpatient Services	$431.00	$431.00	$215.50–$413.76	3% below	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMOGRAM DIGITAL DX BILATERAL	$431.00	$431.00	$323.25–$413.76	—	—
Diagnostic mammogram, both breasts inpatient CPT 77066 All Inpatient Services	$431.00	$431.00	$323.25–$413.76	—	—
Diagnostic mammogram, one breast CPT 77065 All Outpatient Services	$400.00	$400.00	$200.00–$384.00	99% above	—
Diagnostic mammogram, one breast one side CPT 77065 DX LT DIGITAL MAMMO	$375.00	$375.00	$187.50–$360.00	87% above	—
Diagnostic mammogram, one breast one side CPT 77065 DX RT DIGITAL MAMMO	$375.00	$375.00	$187.50–$360.00	87% above	—
Diagnostic mammogram, one breast one side CPT 77065 UNILAT MAMMO POST PROC RIGHT	$400.00	$400.00	$200.00–$384.00	99% above	—
Diagnostic mammogram, one breast one side CPT 77065 UNILAT MAMMO POST PROC LEFT	$400.00	$400.00	$200.00–$384.00	99% above	—
Diagnostic mammogram, one breast inpatient CPT 77065 All Inpatient Services	$375.00	$375.00	$281.25–$360.00	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX RT DIGITAL MAMMO	$375.00	$375.00	$281.25–$360.00	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX LT DIGITAL MAMMO	$375.00	$375.00	$281.25–$360.00	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 UNILAT MAMMO POST PROC LEFT	$400.00	$400.00	$300.00–$384.00	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 UNILAT MAMMO POST PROC RIGHT	$400.00	$400.00	$300.00–$384.00	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE ARTERIAL DUPLEX BILAT	$1,306.00	$1,306.00	$653.00–$1,253.76	—	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 All Outpatient Services	$1,306.00	$1,306.00	$653.00–$1,253.76	26% above	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE ARTERIAL DUPLEX BILAT	$1,306.00	$1,306.00	$979.50–$1,253.76	—	—
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 All Inpatient Services	$1,306.00	$1,306.00	$979.50–$1,253.76	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US EXT VENOUS DUPLEX BILAT	$1,498.00	$1,498.00	$749.00–$1,438.08	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970 All Outpatient Services	$1,498.00	$1,498.00	$749.00–$1,438.08	8% above	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US EXT VENOUS DUPLEX BILAT	$1,498.00	$1,498.00	$1,123.50–$1,438.08	—	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 All Inpatient Services	$1,498.00	$1,498.00	$1,123.50–$1,438.08	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$2,339.00	$2,339.00	$1,169.50–$2,245.44	17% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 All Outpatient Services	$2,339.00	$2,339.00	$1,169.50–$2,245.44	17% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE	$2,339.00	$2,339.00	$1,754.25–$2,245.44	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 All Inpatient Services	$2,339.00	$2,339.00	$1,754.25–$2,245.44	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 All Outpatient Services	$4,841.00	$4,841.00	$2,420.50–$4,647.36	37% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 TITRATION/SPLIT NIGHT	$4,841.00	$4,841.00	$2,420.50–$4,647.36	37% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 TITRATION/SPLIT NIGHT	$4,841.00	$4,841.00	$3,630.75–$4,647.36	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 All Inpatient Services	$4,841.00	$4,841.00	$3,630.75–$4,647.36	—	—
Knee X-ray, 3 views CPT 73562 All Outpatient Services	$425.00	$425.00	$212.50–$408.00	25% above	—
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEWS-RIGHT	$425.00	$425.00	$212.50–$408.00	25% above	—
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEWS-LEFT	$425.00	$425.00	$212.50–$408.00	25% above	—
Knee X-ray, 3 views inpatient CPT 73562 All Inpatient Services	$425.00	$425.00	$318.75–$408.00	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEWS-LEFT	$425.00	$425.00	$318.75–$408.00	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEWS-RIGHT	$425.00	$425.00	$318.75–$408.00	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL LIMITED	$735.00	$735.00	$367.50–$705.60	42% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 All Outpatient Services	$735.00	$735.00	$367.50–$705.60	42% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 All Inpatient Services	$735.00	$735.00	$551.25–$705.60	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL LIMITED	$735.00	$735.00	$551.25–$705.60	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 All Outpatient Services	$1,347.00	$1,347.00	$673.50–$1,293.12	285% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT SCAN	$1,347.00	$1,347.00	$673.50–$1,293.12	285% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LOW DOSE CT SCAN	$1,347.00	$1,347.00	$1,010.25–$1,293.12	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 All Inpatient Services	$1,347.00	$1,347.00	$1,010.25–$1,293.12	—	—
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 All Outpatient Services	$2,965.00	$2,965.00	$1,482.50–$2,846.40	20% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOWER EXT(JOINT)WO-RIGHT	$2,965.00	$2,965.00	$1,482.50–$2,846.40	20% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOWER EXT(JOINT)WO-LEFT	$2,965.00	$2,965.00	$1,482.50–$2,846.40	20% above	—
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 All Inpatient Services	$2,965.00	$2,965.00	$2,223.75–$2,846.40	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOWER EXT(JOINT)WO-RIGHT	$2,965.00	$2,965.00	$2,223.75–$2,846.40	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOWER EXT(JOINT)WO-LEFT	$2,965.00	$2,965.00	$2,223.75–$2,846.40	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 All Outpatient Services	$3,714.00	$3,714.00	$1,857.00–$3,565.44	10% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWER EXT(JOINT) WOW-RIGHT	$3,714.00	$3,714.00	$1,857.00–$3,565.44	10% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWER EXT(JOINT) WOW-LEFT	$3,714.00	$3,714.00	$1,857.00–$3,565.44	10% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 All Inpatient Services	$3,714.00	$3,714.00	$2,785.50–$3,565.44	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOWER EXT(JOINT) WOW-LEFT	$3,714.00	$3,714.00	$2,785.50–$3,565.44	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOWER EXT(JOINT) WOW-RIGHT	$3,714.00	$3,714.00	$2,785.50–$3,565.44	—	—
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST	$3,741.00	$3,741.00	$1,870.50–$3,591.36	38% above	—
MRI of the abdomen without contrast CPT 74181 All Outpatient Services	$3,741.00	$3,741.00	$1,870.50–$3,591.36	38% above	—
MRI of the abdomen without contrast inpatient CPT 74181 All Inpatient Services	$3,741.00	$3,741.00	$2,805.75–$3,591.36	—	—
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST	$3,741.00	$3,741.00	$2,805.75–$3,591.36	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 All Outpatient Services	$4,407.00	$4,407.00	$2,203.50–$4,230.72	20% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WOW CONTRAST	$4,407.00	$4,407.00	$2,203.50–$4,230.72	20% above	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WOW CONTRAST	$4,407.00	$4,407.00	$3,305.25–$4,230.72	—	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 All Inpatient Services	$4,407.00	$4,407.00	$3,305.25–$4,230.72	—	—
MRI of the brain, no contrast dye CPT 70551 All Outpatient Services	$4,070.00	$4,070.00	$2,035.00–$3,907.20	70% above	—
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST	$4,070.00	$4,070.00	$2,035.00–$3,907.20	70% above	—
MRI of the brain, no contrast dye inpatient CPT 70551 All Inpatient Services	$4,070.00	$4,070.00	$3,052.50–$3,907.20	—	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST	$4,070.00	$4,070.00	$3,052.50–$3,907.20	—	—
MRI of the brain, with and without contrast dye CPT 70553 All Outpatient Services	$4,627.00	$4,627.00	$2,313.50–$4,441.92	24% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WOW CONTRAST	$4,627.00	$4,627.00	$2,313.50–$4,441.92	24% above	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST	$4,627.00	$4,627.00	$3,470.25–$4,441.92	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 All Inpatient Services	$4,627.00	$4,627.00	$3,470.25–$4,441.92	—	—
MRI of the lower back, no contrast dye CPT 72148 All Outpatient Services	$3,924.00	$3,924.00	$1,962.00–$3,767.04	33% above	—
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR WO CONTRAST	$3,924.00	$3,924.00	$1,962.00–$3,767.04	33% above	—
MRI of the lower back, no contrast dye inpatient CPT 72148 All Inpatient Services	$3,924.00	$3,924.00	$2,943.00–$3,767.04	—	—
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR WO CONTRAST	$3,924.00	$3,924.00	$2,943.00–$3,767.04	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 All Outpatient Services	$4,582.00	$4,582.00	$2,291.00–$4,398.72	23% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR WOW CONTRAST	$4,582.00	$4,582.00	$2,291.00–$4,398.72	23% above	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 All Inpatient Services	$4,582.00	$4,582.00	$3,436.50–$4,398.72	—	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR WOW CONTRAST	$4,582.00	$4,582.00	$3,436.50–$4,398.72	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC WO CONTRAST	$4,047.00	$4,047.00	$2,023.50–$3,885.12	39% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 All Outpatient Services	$4,047.00	$4,047.00	$2,023.50–$3,885.12	39% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC WO CONTRAST	$4,047.00	$4,047.00	$3,035.25–$3,885.12	—	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 All Inpatient Services	$4,047.00	$4,047.00	$3,035.25–$3,885.12	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 All Outpatient Services	$4,555.00	$4,555.00	$2,277.50–$4,372.80	22% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL WOW CONTRAST	$4,555.00	$4,555.00	$2,277.50–$4,372.80	22% above	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 All Inpatient Services	$4,555.00	$4,555.00	$3,416.25–$4,372.80	—	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL WOW CONTRAST	$4,555.00	$4,555.00	$3,416.25–$4,372.80	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL WO CONTRAST	$4,002.00	$4,002.00	$2,001.00–$3,841.92	33% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 All Outpatient Services	$4,002.00	$4,002.00	$2,001.00–$3,841.92	33% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 All Inpatient Services	$4,002.00	$4,002.00	$3,001.50–$3,841.92	—	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL WO CONTRAST	$4,002.00	$4,002.00	$3,001.50–$3,841.92	—	—
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WOW CONTRAST	$4,141.00	$4,141.00	$2,070.50–$3,975.36	33% above	—
MRI of the pelvis without and with contrast CPT 72197 All Outpatient Services	$4,141.00	$4,141.00	$2,070.50–$3,975.36	33% above	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WOW CONTRAST	$4,141.00	$4,141.00	$3,105.75–$3,975.36	—	—
MRI of the pelvis without and with contrast inpatient CPT 72197 All Inpatient Services	$4,141.00	$4,141.00	$3,105.75–$3,975.36	—	—
MRI of the pelvis, no contrast dye CPT 72195 All Outpatient Services	$3,355.00	$3,355.00	$1,677.50–$3,220.80	42% above	—
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST	$3,355.00	$3,355.00	$1,677.50–$3,220.80	42% above	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 All Inpatient Services	$3,355.00	$3,355.00	$2,516.25–$3,220.80	—	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST	$3,355.00	$3,355.00	$2,516.25–$3,220.80	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 All Outpatient Services	$2,944.00	$2,944.00	$1,472.00–$2,826.24	22% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXT(J)WO CONTRA-RIGHT	$2,944.00	$2,944.00	$1,472.00–$2,826.24	22% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXT (J) WO CONTRA-LEFT	$2,944.00	$2,944.00	$1,472.00–$2,826.24	22% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 All Inpatient Services	$2,944.00	$2,944.00	$2,208.00–$2,826.24	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EXT (J) WO CONTRA-LEFT	$2,944.00	$2,944.00	$2,208.00–$2,826.24	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EXT(J)WO CONTRA-RIGHT	$2,944.00	$2,944.00	$2,208.00–$2,826.24	—	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM HT MUSCLE IMAGE SPECT MULT	$4,809.00	$4,809.00	$2,404.50–$4,616.64	31% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 All Outpatient Services	$4,809.00	$4,809.00	$2,404.50–$4,616.64	31% above	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 All Inpatient Services	$4,809.00	$4,809.00	$3,606.75–$4,616.64	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM HT MUSCLE IMAGE SPECT MULT	$4,809.00	$4,809.00	$3,606.75–$4,616.64	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LMTD-NONOB	$319.00	$319.00	$159.50–$306.24	5% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 All Outpatient Services	$319.00	$319.00	$159.50–$306.24	5% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 All Inpatient Services	$319.00	$319.00	$239.25–$306.24	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LMTD-NONOB	$319.00	$319.00	$239.25–$306.24	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 All Outpatient Services	$909.00	$909.00	$454.50–$872.64	23% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC ULTRASOUND	$909.00	$909.00	$454.50–$872.64	23% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC ULTRASOUND	$909.00	$909.00	$681.75–$872.64	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 All Inpatient Services	$909.00	$909.00	$681.75–$872.64	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB ULTRASOUND COMPLETE	$812.00	$812.00	$406.00–$779.52	20% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 All Outpatient Services	$812.00	$812.00	$406.00–$779.52	20% above	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 All Inpatient Services	$812.00	$812.00	$609.00–$779.52	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB ULTRASOUND COMPLETE	$812.00	$812.00	$609.00–$779.52	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB<14WK SINGL OR FIRST	$618.00	$618.00	$309.00–$593.28	4% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 All Outpatient Services	$618.00	$618.00	$309.00–$593.28	4% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 All Inpatient Services	$618.00	$618.00	$463.50–$593.28	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB<14WK SINGL OR FIRST	$618.00	$618.00	$463.50–$593.28	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 All Outpatient Services	$504.00	$504.00	$252.00–$483.84	50% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB ULTRASOUND LIMITED	$504.00	$504.00	$252.00–$483.84	50% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 All Inpatient Services	$504.00	$504.00	$378.00–$483.84	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB ULTRASOUND LIMITED	$504.00	$504.00	$378.00–$483.84	—	—
Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMMO DIGITAL BILAT	$401.00	$401.00	$115.25–$384.96	—	—
Screening mammogram, both breasts both sides CPT 77067 BILAT SCREEN DIG MAM W/IMPLANT	$401.00	$401.00	$115.25–$384.96	—	—
Screening mammogram, both breasts CPT 77067 All Outpatient Services	$401.00	$401.00	$115.25–$384.96	99% above	—
Screening mammogram, both breasts CPT 77067 RT SCREENING DIGITAL MAMMO	$401.00	$401.00	$115.25–$384.96	99% above	—
Screening mammogram, both breasts CPT 77067 LT SCREENING DIGITAL MAMMO	$401.00	$401.00	$115.25–$384.96	99% above	—
Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMMO DIGITAL BILAT	$401.00	$401.00	$300.75–$384.96	—	—
Screening mammogram, both breasts inpatient both sides CPT 77067 BILAT SCREEN DIG MAM W/IMPLANT	$401.00	$401.00	$300.75–$384.96	—	—
Screening mammogram, both breasts inpatient CPT 77067 LT SCREENING DIGITAL MAMMO	$401.00	$401.00	$300.75–$384.96	—	—
Screening mammogram, both breasts inpatient CPT 77067 All Inpatient Services	$401.00	$401.00	$300.75–$384.96	—	—
Screening mammogram, both breasts inpatient CPT 77067 RT SCREENING DIGITAL MAMMO	$401.00	$401.00	$300.75–$384.96	—	—
Shoulder X-ray, complete, 2 or more views CPT 73030 All Outpatient Services	$379.00	$379.00	$189.50–$363.84	22% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 3 VIEWS-RIGHT	$379.00	$379.00	$189.50–$363.84	22% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 2 VIEWS-LEFT	$379.00	$379.00	$189.50–$363.84	22% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 2 VIEWS-RIGHT	$379.00	$379.00	$189.50–$363.84	22% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 3 VIEWS-LEFT	$379.00	$379.00	$189.50–$363.84	22% above	—
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 All Inpatient Services	$379.00	$379.00	$284.25–$363.84	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 2 VIEWS-LEFT	$379.00	$379.00	$284.25–$363.84	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 3 VIEWS-LEFT	$379.00	$379.00	$284.25–$363.84	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 3 VIEWS-RIGHT	$379.00	$379.00	$284.25–$363.84	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 2 VIEWS-RIGHT	$379.00	$379.00	$284.25–$363.84	—	—
Sleep study in a lab (polysomnography) CPT 95810 DIAGNOSTIC SLEEP STUDY	$3,873.00	$3,873.00	$1,936.50–$3,718.08	24% above	—
Sleep study in a lab (polysomnography) CPT 95810 All Outpatient Services	$3,873.00	$3,873.00	$1,936.50–$3,718.08	24% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 All Inpatient Services	$3,873.00	$3,873.00	$2,904.75–$3,718.08	—	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 DIAGNOSTIC SLEEP STUDY	$3,873.00	$3,873.00	$2,904.75–$3,718.08	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 CINE/VID X-RAY THROAT/ESOPH	$607.00	$607.00	$303.50–$582.72	22% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 All Outpatient Services	$607.00	$607.00	$303.50–$582.72	22% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 CINE/VID X-RAY THROAT/ESOPH	$607.00	$607.00	$455.25–$582.72	—	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 All Inpatient Services	$607.00	$607.00	$455.25–$582.72	—	—
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL ULTRASOUND	$650.00	$650.00	$325.00–$624.00	22% above	—
Transvaginal pelvic ultrasound CPT 76830 All Outpatient Services	$650.00	$650.00	$325.00–$624.00	22% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 All Inpatient Services	$650.00	$650.00	$487.50–$624.00	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL ULTRASOUND	$650.00	$650.00	$487.50–$624.00	—	—
Transvaginal ultrasound during pregnancy CPT 76817 All Outpatient Services	$588.00	$588.00	$294.00–$564.48	27% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$588.00	$588.00	$294.00–$564.48	27% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 All Inpatient Services	$588.00	$588.00	$441.00–$564.48	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL	$588.00	$588.00	$441.00–$564.48	—	—
Ultrasound of the abdomen, complete CPT 76700 All Outpatient Services	$977.00	$977.00	$488.50–$937.92	22% above	—
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL COMPLETE	$977.00	$977.00	$488.50–$937.92	22% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 All Inpatient Services	$977.00	$977.00	$732.75–$937.92	—	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL COMPLETE	$977.00	$977.00	$732.75–$937.92	—	—
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$650.00	$650.00	$325.00–$624.00	8% above	—
Ultrasound of the scrotum and testicles CPT 76870 All Outpatient Services	$650.00	$650.00	$325.00–$624.00	8% above	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 All Inpatient Services	$650.00	$650.00	$487.50–$624.00	—	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$650.00	$650.00	$487.50–$624.00	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 All Outpatient Services	$714.00	$714.00	$357.00–$685.44	25% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD & NECK SOFT TISSUES	$714.00	$714.00	$357.00–$685.44	25% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD & NECK SOFT TISSUES	$714.00	$714.00	$535.50–$685.44	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 All Inpatient Services	$714.00	$714.00	$535.50–$685.44	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 All Outpatient Services	$1,188.00	$1,188.00	$594.00–$1,140.48	20% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US EXT VENOUS DUPLEX UNI/LIMIT	$1,188.00	$1,188.00	$594.00–$1,140.48	20% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX SCAN EXT VEINS-UNI	$1,199.00	$1,199.00	$599.50–$1,151.04	21% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US EXT VENOUS DUPLEX UNI/LIMIT	$1,188.00	$1,188.00	$891.00–$1,140.48	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 All Inpatient Services	$1,188.00	$1,188.00	$891.00–$1,140.48	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX SCAN EXT VEINS-UNI	$1,199.00	$1,199.00	$899.25–$1,151.04	—	—
Wrist X-ray, complete, 3 or more views CPT 73110 All Outpatient Services	$331.00	$331.00	$165.50–$317.76	6% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS-RIGHT	$331.00	$331.00	$165.50–$317.76	6% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS-LEFT	$331.00	$331.00	$165.50–$317.76	6% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 5 VIEWS-LEFT	$331.00	$331.00	$165.50–$317.76	6% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 4 VIEWS-RIGHT	$331.00	$331.00	$165.50–$317.76	6% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 4 VIEWS-LEFT	$331.00	$331.00	$165.50–$317.76	6% above	—
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 All Inpatient Services	$331.00	$331.00	$248.25–$317.76	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 4 VIEWS-LEFT	$331.00	$331.00	$248.25–$317.76	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 5 VIEWS-LEFT	$331.00	$331.00	$248.25–$317.76	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 4 VIEWS-RIGHT	$331.00	$331.00	$248.25–$317.76	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 3 VIEWS-RIGHT	$331.00	$331.00	$248.25–$317.76	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 3 VIEWS-LEFT	$331.00	$331.00	$248.25–$317.76	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 All Outpatient Services	$345.00	$345.00	$172.50–$331.20	124% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP-2 VIEWS-LEFT	$345.00	$345.00	$172.50–$331.20	124% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2 VIEWS-RIGHT	$345.00	$345.00	$172.50–$331.20	124% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 All Inpatient Services	$345.00	$345.00	$258.75–$331.20	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2 VIEWS-RIGHT	$345.00	$345.00	$258.75–$331.20	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP-2 VIEWS-LEFT	$345.00	$345.00	$258.75–$331.20	—	—
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW KUB	$314.00	$314.00	$157.00–$301.44	39% above	—
X-ray of the abdomen, 1 view CPT 74018 All Outpatient Services	$314.00	$314.00	$157.00–$301.44	39% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 All Inpatient Services	$314.00	$314.00	$235.50–$301.44	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW KUB	$314.00	$314.00	$235.50–$301.44	—	—
X-ray of the ankle, 2 views CPT 73600 All Outpatient Services	$278.00	$278.00	$139.00–$266.88	50% above	—
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS -RIGHT	$278.00	$278.00	$139.00–$266.88	50% above	—
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS-LEFT	$278.00	$278.00	$139.00–$266.88	50% above	—
X-ray of the ankle, 2 views inpatient CPT 73600 All Inpatient Services	$278.00	$278.00	$208.50–$266.88	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEWS -RIGHT	$278.00	$278.00	$208.50–$266.88	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEWS-LEFT	$278.00	$278.00	$208.50–$266.88	—	—
X-ray of the finger(s), 2 or more views CPT 73140 All Outpatient Services	$252.00	$252.00	$126.00–$241.92	47% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER 3 VIEWS-RIGHT	$252.00	$252.00	$126.00–$241.92	47% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER 2 VIEWS-RIGHT	$252.00	$252.00	$126.00–$241.92	47% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER 3 VIEWS-LEFT	$252.00	$252.00	$126.00–$241.92	47% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER 2 VIEWS-LEFT	$252.00	$252.00	$126.00–$241.92	47% above	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 All Inpatient Services	$252.00	$252.00	$189.00–$241.92	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER 3 VIEWS-RIGHT	$252.00	$252.00	$189.00–$241.92	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER 2 VIEWS-RIGHT	$252.00	$252.00	$189.00–$241.92	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER 2 VIEWS-LEFT	$252.00	$252.00	$189.00–$241.92	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER 3 VIEWS-LEFT	$252.00	$252.00	$189.00–$241.92	—	—
X-ray of the foot, 2 views CPT 73620 All Outpatient Services	$282.00	$282.00	$141.00–$270.72	45% above	—
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEWS-LEFT	$282.00	$282.00	$141.00–$270.72	45% above	—
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEWS-RIGHT	$282.00	$282.00	$141.00–$270.72	45% above	—
X-ray of the foot, 2 views inpatient CPT 73620 All Inpatient Services	$282.00	$282.00	$211.50–$270.72	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEWS-LEFT	$282.00	$282.00	$211.50–$270.72	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEWS-RIGHT	$282.00	$282.00	$211.50–$270.72	—	—
X-ray of the foot, complete, 3 or more views CPT 73630 All Outpatient Services	$343.00	$343.00	$171.50–$329.28	45% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT-MINIMUM 3 VIEWS-RIGHT	$343.00	$343.00	$171.50–$329.28	45% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT-MINIMUM 3 VIEWS-LEFT	$343.00	$343.00	$171.50–$329.28	45% above	—
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 All Inpatient Services	$343.00	$343.00	$257.25–$329.28	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT-MINIMUM 3 VIEWS-LEFT	$343.00	$343.00	$257.25–$329.28	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT-MINIMUM 3 VIEWS-RIGHT	$343.00	$343.00	$257.25–$329.28	—	—
X-ray of the hand, 3 or more views CPT 73130 All Outpatient Services	$342.00	$342.00	$171.00–$328.32	2% above	—
X-ray of the hand, 3 or more views one side CPT 73130 HAND 3 VIEWS-LEFT	$342.00	$342.00	$171.00–$328.32	2% above	—
X-ray of the hand, 3 or more views one side CPT 73130 HAND 3 VIEWS-RIGHT	$342.00	$342.00	$171.00–$328.32	2% above	—
X-ray of the hand, 3 or more views inpatient CPT 73130 All Inpatient Services	$342.00	$342.00	$256.50–$328.32	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND 3 VIEWS-LEFT	$342.00	$342.00	$256.50–$328.32	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND 3 VIEWS-RIGHT	$342.00	$342.00	$256.50–$328.32	—	—
X-ray of the knee, 1 or 2 views CPT 73560 All Outpatient Services	$319.00	$319.00	$159.50–$306.24	18% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1 -2 VIEWS-LEFT	$319.00	$319.00	$159.50–$306.24	18% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1-2 VIEWS-RIGHT	$319.00	$319.00	$159.50–$306.24	18% above	—
X-ray of the knee, 1 or 2 views inpatient CPT 73560 All Inpatient Services	$319.00	$319.00	$239.25–$306.24	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1 -2 VIEWS-LEFT	$319.00	$319.00	$239.25–$306.24	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1-2 VIEWS-RIGHT	$319.00	$319.00	$239.25–$306.24	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2 VIEWS	$449.00	$449.00	$224.50–$431.04	38% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 3 VIEWS	$449.00	$449.00	$224.50–$431.04	38% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 All Outpatient Services	$449.00	$449.00	$224.50–$431.04	38% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 All Inpatient Services	$449.00	$449.00	$336.75–$431.04	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 3 VIEWS	$449.00	$449.00	$336.75–$431.04	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 2 VIEWS	$449.00	$449.00	$336.75–$431.04	—	—
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE 5 VIEWS	$607.00	$607.00	$303.50–$582.72	48% above	—
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE 4 VIEWS	$607.00	$607.00	$303.50–$582.72	48% above	—
X-ray of the lower back, 4 or more views CPT 72110 All Outpatient Services	$607.00	$607.00	$303.50–$582.72	48% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 All Inpatient Services	$607.00	$607.00	$455.25–$582.72	—	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE 4 VIEWS	$607.00	$607.00	$455.25–$582.72	—	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE 5 VIEWS	$607.00	$607.00	$455.25–$582.72	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VIEWS	$404.00	$404.00	$202.00–$387.84	49% above	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 All Outpatient Services	$404.00	$404.00	$202.00–$387.84	49% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 All Inpatient Services	$404.00	$404.00	$303.00–$387.84	—	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2 VIEWS	$404.00	$404.00	$303.00–$387.84	—	—
X-ray of the nasal bones, 3 or more views both sides CPT 70160 NASAL BONES 3 VIEWS-BILAT	$371.00	$371.00	$185.50–$356.16	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 All Outpatient Services	$371.00	$371.00	$185.50–$356.16	41% above	—
X-ray of the nasal bones, 3 or more views inpatient both sides CPT 70160 NASAL BONES 3 VIEWS-BILAT	$371.00	$371.00	$278.25–$356.16	—	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 All Inpatient Services	$371.00	$371.00	$278.25–$356.16	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 2 VIEWS	$364.00	$364.00	$182.00–$349.44	40% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 3 VIEWS	$364.00	$364.00	$182.00–$349.44	40% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 All Outpatient Services	$364.00	$364.00	$182.00–$349.44	40% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE 3 VIEWS	$364.00	$364.00	$273.00–$349.44	—	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 All Inpatient Services	$364.00	$364.00	$273.00–$349.44	—	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE 2 VIEWS	$364.00	$364.00	$273.00–$349.44	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1-2 VIEWS	$314.00	$314.00	$157.00–$301.44	38% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170 All Outpatient Services	$314.00	$314.00	$157.00–$301.44	38% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 All Inpatient Services	$314.00	$314.00	$235.50–$301.44	—	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1-2 VIEWS	$314.00	$314.00	$235.50–$301.44	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 All Outpatient Services	$340.00	$340.00	$170.00–$326.40	32% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM 2 VIEWS	$340.00	$340.00	$170.00–$326.40	32% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 COCCYX 2 VIEWS	$340.00	$340.00	$170.00–$326.40	32% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 COCCYX 2 VIEWS	$340.00	$340.00	$255.00–$326.40	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 All Inpatient Services	$340.00	$340.00	$255.00–$326.40	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM 2 VIEWS	$340.00	$340.00	$255.00–$326.40	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 All Outpatient Services	$58.00	$58.00	$5.30–$55.68	2% below	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT / SGPT	$58.00	$58.00	$5.30–$55.68	2% below	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT / SGPT	$58.00	$58.00	$43.50–$55.68	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 All Inpatient Services	$58.00	$58.00	$43.50–$55.68	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 All Outpatient Services	$80.00	$80.00	$5.18–$76.80	70% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 AST / SGOT	$80.00	$80.00	$5.18–$76.80	70% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST / SGOT	$80.00	$80.00	$60.00–$76.80	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 All Inpatient Services	$80.00	$80.00	$60.00–$76.80	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE	$360.00	$360.00	$47.63–$345.60	15% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 All Outpatient Services	$360.00	$360.00	$47.63–$345.60	15% above	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 All Inpatient Services	$360.00	$360.00	$270.00–$345.60	—	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE	$360.00	$360.00	$270.00–$345.60	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ALMOND IgE	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 All Outpatient Services	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PECAN NUT IgE	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HAZEL NUT TREE IgE	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BRAZIL NUT IgE	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG YOLK IgE	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WALNUT IgE	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN QUANTITATIVE	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COW'S MILK IgE	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SESAME SEED IgE	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHEAT IgE	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG WHITE IgE	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SOYBEAN IgE	$70.00	$70.00	$5.22–$67.20	66% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SOYBEAN IgE	$70.00	$70.00	$52.50–$67.20	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHEAT IgE	$70.00	$70.00	$52.50–$67.20	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WALNUT IgE	$70.00	$70.00	$52.50–$67.20	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG WHITE IgE	$70.00	$70.00	$52.50–$67.20	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG YOLK IgE	$70.00	$70.00	$52.50–$67.20	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COW'S MILK IgE	$70.00	$70.00	$52.50–$67.20	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PECAN NUT IgE	$70.00	$70.00	$52.50–$67.20	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HAZEL NUT TREE IgE	$70.00	$70.00	$52.50–$67.20	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ALMOND IgE	$70.00	$70.00	$52.50–$67.20	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 All Inpatient Services	$70.00	$70.00	$52.50–$67.20	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BRAZIL NUT IgE	$70.00	$70.00	$52.50–$67.20	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SESAME SEED IgE	$70.00	$70.00	$52.50–$67.20	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN QUANTITATIVE	$70.00	$70.00	$52.50–$67.20	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 All Outpatient Services	$179.00	$179.00	$12.95–$171.84	119% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$179.00	$179.00	$12.95–$171.84	119% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 All Inpatient Services	$179.00	$179.00	$134.25–$171.84	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY	$179.00	$179.00	$134.25–$171.84	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 All Outpatient Services	$131.00	$131.00	$12.09–$125.76	195% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$131.00	$131.00	$12.09–$125.76	195% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 All Inpatient Services	$131.00	$131.00	$98.25–$125.76	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$131.00	$131.00	$98.25–$125.76	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 All Outpatient Services	$317.00	$317.00	$39.26–$304.32	67% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE-BNP	$317.00	$317.00	$39.26–$304.32	67% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE-BNP	$317.00	$317.00	$237.75–$304.32	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 All Inpatient Services	$317.00	$317.00	$237.75–$304.32	—	—
Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL W/CO2	$167.00	$167.00	$8.46–$160.32	27% above	—
Basic metabolic panel (blood test) CPT 80048 All Outpatient Services	$167.00	$167.00	$8.46–$160.32	27% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 All Inpatient Services	$167.00	$167.00	$125.25–$160.32	—	—
Basic metabolic panel (blood test) inpatient CPT 80048 METABOLIC PANEL W/CO2	$167.00	$167.00	$125.25–$160.32	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH - LEVEL IV	$235.00	$235.00	$53.43–$225.60	23% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 All Outpatient Services	$235.00	$235.00	$53.43–$225.60	23% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATH - LEVEL IV	$235.00	$235.00	$176.25–$225.60	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 All Inpatient Services	$235.00	$235.00	$176.25–$225.60	—	—
Blood culture for bacteria CPT 87040 CULTURE/BLOOD AEROBIC-ANA	$236.00	$236.00	$10.32–$226.56	31% above	—
Blood culture for bacteria CPT 87040 All Outpatient Services	$236.00	$236.00	$10.32–$226.56	31% above	—
Blood culture for bacteria inpatient CPT 87040 CULTURE/BLOOD AEROBIC-ANA	$236.00	$236.00	$177.00–$226.56	—	—
Blood culture for bacteria inpatient CPT 87040 All Inpatient Services	$236.00	$236.00	$177.00–$226.56	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$19.00	$19.00	$1.80–$30.51	8% below	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$19.00	$19.00	$1.80–$30.51	—	—
Blood glucose (sugar) test CPT 82947 GLUCOSE-QUANTITATI. BLOOD	$61.00	$61.00	$3.93–$58.56	47% above	—
Blood glucose (sugar) test CPT 82947 All Outpatient Services	$61.00	$61.00	$3.93–$58.56	47% above	—
Blood glucose (sugar) test inpatient CPT 82947 All Inpatient Services	$61.00	$61.00	$45.75–$58.56	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE-QUANTITATI. BLOOD	$61.00	$61.00	$45.75–$58.56	—	—
Blood lead test CPT 83655 All Outpatient Services	$84.00	$84.00	$12.11–$80.64	40% above	—
Blood lead test CPT 83655 LEAD LEVEL - BLOOD	$84.00	$84.00	$12.11–$80.64	40% above	—
Blood lead test inpatient CPT 83655 LEAD LEVEL - BLOOD	$84.00	$84.00	$63.00–$80.64	—	—
Blood lead test inpatient CPT 83655 All Inpatient Services	$84.00	$84.00	$63.00–$80.64	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 All Outpatient Services	$153.00	$153.00	$7.52–$146.88	43% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 hCG-QUALITATIVE-SERUM	$153.00	$153.00	$7.52–$146.88	43% above	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 All Inpatient Services	$153.00	$153.00	$114.75–$146.88	—	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 hCG-QUALITATIVE-SERUM	$153.00	$153.00	$114.75–$146.88	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUPING/ABO	$73.00	$73.00	$36.50–$128.90	40% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE CONFIRM UNIT	$78.00	$78.00	$39.00–$128.90	49% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 All Outpatient Services	$78.00	$78.00	$39.00–$128.90	49% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD GROUPING/ABO	$73.00	$73.00	$54.75–$70.08	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 All Inpatient Services	$73.00	$73.00	$54.75–$70.08	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE CONFIRM UNIT	$78.00	$78.00	$58.50–$74.88	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 All Outpatient Services	$121.00	$121.00	$5.18–$116.16	30% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN - CRP	$121.00	$121.00	$5.18–$116.16	30% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN - CRP	$121.00	$121.00	$90.75–$116.16	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 All Inpatient Services	$121.00	$121.00	$90.75–$116.16	—	—
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$226.00	$226.00	$20.81–$216.96	96% above	—
CA 19-9 blood test (tumor marker) CPT 86301 All Outpatient Services	$226.00	$226.00	$20.81–$216.96	96% above	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$226.00	$226.00	$169.50–$216.96	—	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 All Inpatient Services	$226.00	$226.00	$169.50–$216.96	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 All Outpatient Services	$208.00	$208.00	$20.81–$199.68	89% above	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125(IMMUNOASSY-TUMOR)	$208.00	$208.00	$20.81–$199.68	89% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125(IMMUNOASSY-TUMOR)	$208.00	$208.00	$156.00–$199.68	—	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 All Inpatient Services	$208.00	$208.00	$156.00–$199.68	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 All Outpatient Services	$224.00	$224.00	$51.31–$215.04	92% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS COVID 19 FILM ARRAY	$224.00	$224.00	$51.31–$215.04	92% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS COVID 19 RAPID TEST	$224.00	$224.00	$51.31–$215.04	92% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS COVID 19 RAPID TEST	$224.00	$224.00	$168.00–$215.04	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 All Inpatient Services	$224.00	$224.00	$168.00–$215.04	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS COVID 19 FILM ARRAY	$224.00	$224.00	$168.00–$215.04	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 All Outpatient Services	$110.00	$110.00	$35.09–$105.60	1% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AMPLIFIED PROBE	$110.00	$110.00	$35.09–$105.60	1% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AMPLIFIED PROBE	$110.00	$110.00	$82.50–$105.60	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 All Inpatient Services	$110.00	$110.00	$82.50–$105.60	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 All Outpatient Services	$150.00	$150.00	$13.39–$144.00	52% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$150.00	$150.00	$13.39–$144.00	52% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 All Inpatient Services	$150.00	$150.00	$112.50–$144.00	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$150.00	$150.00	$112.50–$144.00	—	—
Complete blood count (CBC) with differential CPT 85025 CBC-AUTOMATED-AUTO.DIFF.	$119.00	$119.00	$7.77–$114.24	43% above	—
Complete blood count (CBC) with differential CPT 85025 All Outpatient Services	$119.00	$119.00	$7.77–$114.24	43% above	—
Complete blood count (CBC) with differential inpatient CPT 85025 All Inpatient Services	$119.00	$119.00	$89.25–$114.24	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 CBC-AUTOMATED-AUTO.DIFF.	$119.00	$119.00	$89.25–$114.24	—	—
Complete blood count (CBC), no differential CPT 85027 All Outpatient Services	$94.00	$94.00	$6.47–$90.24	35% above	—
Complete blood count (CBC), no differential CPT 85027 CBC-AUTOMATED-NO DIFF.	$94.00	$94.00	$6.47–$90.24	35% above	—
Complete blood count (CBC), no differential inpatient CPT 85027 All Inpatient Services	$94.00	$94.00	$70.50–$90.24	—	—
Complete blood count (CBC), no differential inpatient CPT 85027 CBC-AUTOMATED-NO DIFF.	$94.00	$94.00	$70.50–$90.24	—	—
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE MET. PANEL	$191.00	$191.00	$10.56–$183.36	32% above	—
Comprehensive metabolic panel (blood test) CPT 80053 All Outpatient Services	$191.00	$191.00	$10.56–$183.36	32% above	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 All Inpatient Services	$191.00	$191.00	$143.25–$183.36	—	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE MET. PANEL	$191.00	$191.00	$143.25–$183.36	—	—
D-dimer blood test (blood clot marker) CPT 85379 All Outpatient Services	$171.00	$171.00	$10.18–$164.16	28% above	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER/QUANTITATIVE	$171.00	$171.00	$10.18–$164.16	28% above	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 All Inpatient Services	$171.00	$171.00	$128.25–$164.16	—	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER/QUANTITATIVE	$171.00	$171.00	$128.25–$164.16	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$227.00	$227.00	$22.23–$217.92	60% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 All Outpatient Services	$227.00	$227.00	$22.23–$217.92	60% above	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 All Inpatient Services	$227.00	$227.00	$170.25–$217.92	—	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$227.00	$227.00	$170.25–$217.92	—	—
Estradiol blood test CPT 82670 ESTRADIOL	$197.00	$197.00	$27.94–$189.12	75% above	—
Estradiol blood test CPT 82670 All Outpatient Services	$197.00	$197.00	$27.94–$189.12	75% above	—
Estradiol blood test inpatient CPT 82670 All Inpatient Services	$197.00	$197.00	$147.75–$189.12	—	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$197.00	$197.00	$147.75–$189.12	—	—
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIM. HORMONE	$163.00	$163.00	$18.58–$156.48	45% above	—
FSH (follicle-stimulating hormone) test CPT 83001 All Outpatient Services	$163.00	$163.00	$18.58–$156.48	45% above	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIM. HORMONE	$163.00	$163.00	$122.25–$156.48	—	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 All Inpatient Services	$163.00	$163.00	$122.25–$156.48	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 All Outpatient Services	$519.00	$519.00	$19.63–$498.24	49% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL	$519.00	$519.00	$19.63–$498.24	49% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL	$519.00	$519.00	$389.25–$498.24	—	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 All Inpatient Services	$519.00	$519.00	$389.25–$498.24	—	—
Ferritin blood test (iron stores) CPT 82728 All Outpatient Services	$153.00	$153.00	$13.63–$146.88	49% above	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN (FERRITIN)	$153.00	$153.00	$13.63–$146.88	49% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 All Inpatient Services	$153.00	$153.00	$114.75–$146.88	—	—
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN (FERRITIN)	$153.00	$153.00	$114.75–$146.88	—	—
Folate (folic acid) blood test CPT 82746 All Outpatient Services	$166.00	$166.00	$14.70–$159.36	57% above	—
Folate (folic acid) blood test CPT 82746 FOLIC ACID/FOLATE LEVEL	$166.00	$166.00	$14.70–$159.36	57% above	—
Folate (folic acid) blood test inpatient CPT 82746 All Inpatient Services	$166.00	$166.00	$124.50–$159.36	—	—
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID/FOLATE LEVEL	$166.00	$166.00	$124.50–$159.36	—	—
Free T3 thyroid hormone test CPT 84481 All Outpatient Services	$235.00	$235.00	$16.94–$225.60	81% above	—
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3-FREE	$235.00	$235.00	$16.94–$225.60	81% above	—
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE T3-FREE	$235.00	$235.00	$176.25–$225.60	—	—
Free T3 thyroid hormone test inpatient CPT 84481 All Inpatient Services	$235.00	$235.00	$176.25–$225.60	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE-T4 FREE	$107.00	$107.00	$9.02–$102.72	46% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 All Outpatient Services	$107.00	$107.00	$9.02–$102.72	46% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 All Inpatient Services	$107.00	$107.00	$80.25–$102.72	—	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE-T4 FREE	$107.00	$107.00	$80.25–$102.72	—	—
Free testosterone test CPT 84402 All Outpatient Services	$216.00	$216.00	$25.47–$207.36	109% above	—
Free testosterone test CPT 84402 TESTOSTERONE - FREE	$216.00	$216.00	$25.47–$207.36	109% above	—
Free testosterone test inpatient CPT 84402 TESTOSTERONE - FREE	$216.00	$216.00	$162.00–$207.36	—	—
Free testosterone test inpatient CPT 84402 All Inpatient Services	$216.00	$216.00	$162.00–$207.36	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE-POST GLUCOSE DOSE	$76.00	$76.00	$4.75–$72.96	55% above	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 All Outpatient Services	$76.00	$76.00	$4.75–$72.96	55% above	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 All Inpatient Services	$76.00	$76.00	$57.00–$72.96	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE-POST GLUCOSE DOSE	$76.00	$76.00	$57.00–$72.96	—	—
Glucose tolerance test, 3 samples CPT 82951 GTT-3 spec-includes gluco	$181.00	$181.00	$12.87–$173.76	56% above	—
Glucose tolerance test, 3 samples CPT 82951 All Outpatient Services	$181.00	$181.00	$12.87–$173.76	56% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 All Inpatient Services	$181.00	$181.00	$135.75–$173.76	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT-3 spec-includes gluco	$181.00	$181.00	$135.75–$173.76	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 All Outpatient Services	$164.00	$164.00	$35.09–$157.44	75% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORR AMP PROB	$164.00	$164.00	$35.09–$157.44	75% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORR AMP PROB	$164.00	$164.00	$123.00–$157.44	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 All Inpatient Services	$164.00	$164.00	$123.00–$157.44	—	—
H. pylori antibody blood test CPT 86677 All Outpatient Services	$184.00	$184.00	$16.85–$176.64	149% above	—
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIB	$184.00	$184.00	$16.85–$176.64	149% above	—
H. pylori antibody blood test inpatient CPT 86677 All Inpatient Services	$184.00	$184.00	$138.00–$176.64	—	—
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI ANTIB	$184.00	$184.00	$138.00–$176.64	—	—
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN STOOL	$271.00	$271.00	$14.38–$260.16	133% above	—
H. pylori stool antigen test CPT 87338 All Outpatient Services	$271.00	$271.00	$14.38–$260.16	133% above	—
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ANTIGEN STOOL	$271.00	$271.00	$203.25–$260.16	—	—
H. pylori stool antigen test inpatient CPT 87338 All Inpatient Services	$271.00	$271.00	$203.25–$260.16	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1/2 AG/AB, 4th GEN W/ RFLX	$115.00	$115.00	$24.08–$110.40	59% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 All Outpatient Services	$115.00	$115.00	$24.08–$110.40	59% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1/2 AG/AB, 4th GEN W/ RFLX	$115.00	$115.00	$86.25–$110.40	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 All Inpatient Services	$115.00	$115.00	$86.25–$110.40	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HGB A1-C	$92.00	$92.00	$9.71–$88.32	40% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 All Outpatient Services	$92.00	$92.00	$9.71–$88.32	40% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HGB A1-C	$92.00	$92.00	$69.00–$88.32	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 All Inpatient Services	$92.00	$92.00	$69.00–$88.32	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS Bg (HBsAg)	$126.00	$126.00	$10.33–$120.96	45% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 All Outpatient Services	$126.00	$126.00	$10.33–$120.96	45% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS Bg (HBsAg)	$126.00	$126.00	$94.50–$120.96	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 All Inpatient Services	$126.00	$126.00	$94.50–$120.96	—	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$139.00	$139.00	$14.27–$133.44	61% above	—
Hepatitis C antibody blood test (screening) CPT 86803 All Outpatient Services	$139.00	$139.00	$14.27–$133.44	61% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 All Inpatient Services	$139.00	$139.00	$104.25–$133.44	—	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$139.00	$139.00	$104.25–$133.44	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C QUANTIFICATIO	$592.00	$592.00	$42.84–$568.32	79% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 All Outpatient Services	$592.00	$592.00	$42.84–$568.32	79% above	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C QUANTIFICATIO	$592.00	$592.00	$444.00–$568.32	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 All Inpatient Services	$592.00	$592.00	$444.00–$568.32	—	—
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 ANTIBODY	$131.00	$131.00	$13.19–$125.76	33% above	—
Herpes blood test, HSV-1 antibody CPT 86695 All Outpatient Services	$131.00	$131.00	$13.19–$125.76	33% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX 1 ANTIBODY	$131.00	$131.00	$98.25–$125.76	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 All Inpatient Services	$131.00	$131.00	$98.25–$125.76	—	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 ANTIBODY	$125.00	$125.00	$19.35–$120.00	18% above	—
Herpes blood test, HSV-2 antibody CPT 86696 All Outpatient Services	$125.00	$125.00	$19.35–$120.00	18% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 All Inpatient Services	$125.00	$125.00	$93.75–$120.00	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX 2 ANTIBODY	$125.00	$125.00	$93.75–$120.00	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN-H.SEN.	$127.00	$127.00	$12.95–$121.92	59% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 All Outpatient Services	$127.00	$127.00	$12.95–$121.92	59% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN-H.SEN.	$127.00	$127.00	$95.25–$121.92	—	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 All Inpatient Services	$127.00	$127.00	$95.25–$121.92	—	—
Homocysteine blood test CPT 83090 HOMOCYSTINE	$234.00	$234.00	$17.92–$224.64	67% above	—
Homocysteine blood test CPT 83090 All Outpatient Services	$234.00	$234.00	$17.92–$224.64	67% above	—
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE	$234.00	$234.00	$175.50–$224.64	—	—
Homocysteine blood test inpatient CPT 83090 All Inpatient Services	$234.00	$234.00	$175.50–$224.64	—	—
Insulin blood test CPT 83525 All Outpatient Services	$154.00	$154.00	$11.43–$147.84	47% above	—
Insulin blood test CPT 83525 INSULIN - SERUM	$154.00	$154.00	$11.43–$147.84	47% above	—
Insulin blood test inpatient CPT 83525 All Inpatient Services	$154.00	$154.00	$115.50–$147.84	—	—
Insulin blood test inpatient CPT 83525 INSULIN - SERUM	$154.00	$154.00	$115.50–$147.84	—	—
Iron blood test (serum iron) CPT 83540 IRON	$75.00	$75.00	$6.47–$72.00	19% above	—
Iron blood test (serum iron) CPT 83540 All Outpatient Services	$75.00	$75.00	$6.47–$72.00	19% above	—
Iron blood test (serum iron) inpatient CPT 83540 All Inpatient Services	$75.00	$75.00	$56.25–$72.00	—	—
Iron blood test (serum iron) inpatient CPT 83540 IRON	$75.00	$75.00	$56.25–$72.00	—	—
Iron-binding capacity (TIBC) test CPT 83550 All Outpatient Services	$100.00	$100.00	$8.74–$96.00	54% above	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING/TIBC	$100.00	$100.00	$8.74–$96.00	54% above	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING/TIBC	$100.00	$100.00	$75.00–$96.00	—	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 All Inpatient Services	$100.00	$100.00	$75.00–$96.00	—	—
Kidney function blood test panel CPT 80069 All Outpatient Services	$165.00	$165.00	$8.68–$158.40	26% above	—
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$165.00	$165.00	$8.68–$158.40	26% above	—
Kidney function blood test panel inpatient CPT 80069 All Inpatient Services	$165.00	$165.00	$123.75–$158.40	—	—
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$165.00	$165.00	$123.75–$158.40	—	—
LH (luteinizing hormone) test CPT 83002 All Outpatient Services	$145.00	$145.00	$18.52–$139.20	17% above	—
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE-LH	$145.00	$145.00	$18.52–$139.20	17% above	—
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE-LH	$145.00	$145.00	$108.75–$139.20	—	—
LH (luteinizing hormone) test inpatient CPT 83002 All Inpatient Services	$145.00	$145.00	$108.75–$139.20	—	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$132.00	$132.00	$6.89–$126.72	41% above	—
Lipase blood test (pancreas enzyme) CPT 83690 All Outpatient Services	$132.00	$132.00	$6.89–$126.72	41% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 All Inpatient Services	$132.00	$132.00	$99.00–$126.72	—	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$132.00	$132.00	$99.00–$126.72	—	—
Liver function blood test panel CPT 80076 All Outpatient Services	$152.00	$152.00	$8.17–$145.92	26% above	—
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$152.00	$152.00	$8.17–$145.92	26% above	—
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$152.00	$152.00	$114.00–$145.92	—	—
Liver function blood test panel inpatient CPT 80076 All Inpatient Services	$152.00	$152.00	$114.00–$145.92	—	—
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$181.00	$181.00	$17.03–$173.76	42% above	—
Lyme disease antibody test CPT 86618 All Outpatient Services	$181.00	$181.00	$17.03–$173.76	42% above	—
Lyme disease antibody test inpatient CPT 86618 All Inpatient Services	$181.00	$181.00	$135.75–$173.76	—	—
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY	$181.00	$181.00	$135.75–$173.76	—	—
Magnesium blood test CPT 83735 All Outpatient Services	$100.00	$100.00	$6.70–$96.00	59% above	—
Magnesium blood test CPT 83735 MAGNESIUM SERUM	$100.00	$100.00	$6.70–$96.00	59% above	—
Magnesium blood test inpatient CPT 83735 All Inpatient Services	$100.00	$100.00	$75.00–$96.00	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM SERUM	$100.00	$100.00	$75.00–$96.00	—	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA IgG	$131.00	$131.00	$12.88–$125.76	70% above	—
Measles (rubeola) antibody test CPT 86765 All Outpatient Services	$131.00	$131.00	$12.88–$125.76	70% above	—
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IgG	$131.00	$131.00	$98.25–$125.76	—	—
Measles (rubeola) antibody test inpatient CPT 86765 All Inpatient Services	$131.00	$131.00	$98.25–$125.76	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT	$90.00	$90.00	$5.18–$86.40	66% above	—
Mono test (heterophile antibody, Monospot) CPT 86308 All Outpatient Services	$90.00	$90.00	$5.18–$86.40	66% above	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 All Inpatient Services	$90.00	$90.00	$67.50–$86.40	—	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSPOT	$90.00	$90.00	$67.50–$86.40	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 All Outpatient Services	$174.00	$174.00	$18.39–$167.04	37% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA-FREE	$174.00	$174.00	$18.39–$167.04	37% above	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA-FREE	$174.00	$174.00	$130.50–$167.04	—	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 All Inpatient Services	$174.00	$174.00	$130.50–$167.04	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA-TOTAL (DIAGNOSTIC)	$159.00	$159.00	$18.39–$152.64	71% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 All Outpatient Services	$159.00	$159.00	$18.39–$152.64	71% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA-TOTAL (DIAGNOSTIC)	$159.00	$159.00	$119.25–$152.64	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 All Inpatient Services	$159.00	$159.00	$119.25–$152.64	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 All Outpatient Services	$46.00	$46.00	$20.26–$44.16	5% below	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATHOLOGY PAP	$46.00	$46.00	$20.26–$44.16	5% below	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATHOLOGY PAP	$46.00	$46.00	$34.50–$44.16	—	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 All Inpatient Services	$46.00	$46.00	$34.50–$44.16	—	—
Parathyroid hormone (PTH) blood test CPT 83970 All Outpatient Services	$293.00	$293.00	$41.28–$281.28	39% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$293.00	$293.00	$41.28–$281.28	39% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 All Inpatient Services	$293.00	$293.00	$219.75–$281.28	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$293.00	$293.00	$219.75–$281.28	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 All Outpatient Services	$107.00	$107.00	$6.01–$102.72	59% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$107.00	$107.00	$6.01–$102.72	59% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 All Inpatient Services	$107.00	$107.00	$80.25–$102.72	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$107.00	$107.00	$80.25–$102.72	—	—
Progesterone blood test CPT 84144 All Outpatient Services	$154.00	$154.00	$20.86–$147.84	44% above	—
Progesterone blood test CPT 84144 PROGESTERONE LEVEL	$154.00	$154.00	$20.86–$147.84	44% above	—
Progesterone blood test inpatient CPT 84144 All Inpatient Services	$154.00	$154.00	$115.50–$147.84	—	—
Progesterone blood test inpatient CPT 84144 PROGESTERONE LEVEL	$154.00	$154.00	$115.50–$147.84	—	—
Prolactin blood test CPT 84146 All Outpatient Services	$191.00	$191.00	$19.38–$183.36	122% above	—
Prolactin blood test CPT 84146 PROLACTIN LEVEL	$191.00	$191.00	$19.38–$183.36	122% above	—
Prolactin blood test inpatient CPT 84146 All Inpatient Services	$191.00	$191.00	$143.25–$183.36	—	—
Prolactin blood test inpatient CPT 84146 PROLACTIN LEVEL	$191.00	$191.00	$143.25–$183.36	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 All Outpatient Services	$75.00	$75.00	$4.29–$72.00	67% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$75.00	$75.00	$4.29–$72.00	67% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 All Inpatient Services	$75.00	$75.00	$56.25–$72.00	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$75.00	$75.00	$56.25–$72.00	—	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 All Outpatient Services	$101.00	$101.00	$16.53–$96.96	107% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP TEST-STREP A	$101.00	$101.00	$16.53–$96.96	107% above	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP TEST-STREP A	$101.00	$101.00	$75.75–$96.96	—	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 All Inpatient Services	$101.00	$101.00	$75.75–$96.96	—	—
Rheumatoid factor (RF) test CPT 86431 All Outpatient Services	$83.00	$83.00	$5.67–$79.68	85% above	—
Rheumatoid factor (RF) test CPT 86431 RA/RF/RHEM ARTH FACT-QUAN	$83.00	$83.00	$5.67–$79.68	85% above	—
Rheumatoid factor (RF) test inpatient CPT 86431 All Inpatient Services	$83.00	$83.00	$62.25–$79.68	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 RA/RF/RHEM ARTH FACT-QUAN	$83.00	$83.00	$62.25–$79.68	—	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA	$94.00	$94.00	$14.39–$90.24	25% above	—
Rubella antibody test (immunity check) CPT 86762 All Outpatient Services	$94.00	$94.00	$14.39–$90.24	25% above	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA	$94.00	$94.00	$70.50–$90.24	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 All Inpatient Services	$94.00	$94.00	$70.50–$90.24	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 All Outpatient Services	$64.00	$64.00	$2.70–$61.44	43% above	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDRATE/ESR	$64.00	$64.00	$2.70–$61.44	43% above	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDRATE/ESR	$64.00	$64.00	$48.00–$61.44	—	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 All Inpatient Services	$64.00	$64.00	$48.00–$61.44	—	—
Stool ova and parasites exam CPT 87177 All Outpatient Services	$118.00	$118.00	$8.90–$113.28	82% above	—
Stool ova and parasites exam CPT 87177 OVA & PARASITES	$118.00	$118.00	$8.90–$113.28	82% above	—
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES	$118.00	$118.00	$88.50–$113.28	—	—
Stool ova and parasites exam inpatient CPT 87177 All Inpatient Services	$118.00	$118.00	$88.50–$113.28	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 All Outpatient Services	$48.00	$48.00	$4.38–$46.08	145% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN, FECAL	$48.00	$48.00	$4.38–$46.08	145% above	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 All Inpatient Services	$48.00	$48.00	$36.00–$46.08	—	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREEN, FECAL	$48.00	$48.00	$36.00–$46.08	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 All Outpatient Services	$58.00	$58.00	$4.27–$55.68	52% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST QUAL.(RPR)	$58.00	$58.00	$4.27–$55.68	52% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST QUAL.(RPR)	$58.00	$58.00	$43.50–$55.68	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 All Inpatient Services	$58.00	$58.00	$43.50–$55.68	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 All Outpatient Services	$263.00	$263.00	$61.98–$252.48	30% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFER INCUBATED	$263.00	$263.00	$61.98–$252.48	30% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 All Inpatient Services	$263.00	$263.00	$197.25–$252.48	—	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFER INCUBATED	$263.00	$263.00	$197.25–$252.48	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE LEVEL-TOTAL	$175.00	$175.00	$25.81–$168.00	100% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 All Outpatient Services	$175.00	$175.00	$25.81–$168.00	100% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 All Inpatient Services	$175.00	$175.00	$131.25–$168.00	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE LEVEL-TOTAL	$175.00	$175.00	$131.25–$168.00	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES	$150.00	$150.00	$14.55–$144.00	144% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 All Outpatient Services	$150.00	$150.00	$14.55–$144.00	144% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES	$150.00	$150.00	$112.50–$144.00	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 All Inpatient Services	$150.00	$150.00	$112.50–$144.00	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM. HORMONE-TSH	$145.00	$145.00	$16.80–$139.20	48% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 All Outpatient Services	$145.00	$145.00	$16.80–$139.20	48% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM. HORMONE-TSH	$145.00	$145.00	$108.75–$139.20	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 All Inpatient Services	$145.00	$145.00	$108.75–$139.20	—	—
Uric acid blood test CPT 84550 URIC ACID	$70.00	$70.00	$4.52–$67.20	38% above	—
Uric acid blood test CPT 84550 All Outpatient Services	$70.00	$70.00	$4.52–$67.20	38% above	—
Uric acid blood test inpatient CPT 84550 URIC ACID	$70.00	$70.00	$52.50–$67.20	—	—
Uric acid blood test inpatient CPT 84550 All Inpatient Services	$70.00	$70.00	$52.50–$67.20	—	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS-COMPLETE	$72.00	$72.00	$3.17–$69.12	58% above	—
Urinalysis with microscope exam, automated CPT 81001 All Outpatient Services	$72.00	$72.00	$3.17–$69.12	58% above	—
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS-COMPLETE	$72.00	$72.00	$54.00–$69.12	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 All Inpatient Services	$72.00	$72.00	$54.00–$69.12	—	—
Urinalysis without microscope exam, automated CPT 81003 All Outpatient Services	$47.00	$47.00	$2.25–$45.12	96% above	—
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS-DIP STICK ONLY	$47.00	$47.00	$2.25–$45.12	96% above	—
Urinalysis without microscope exam, automated inpatient CPT 81003 All Inpatient Services	$47.00	$47.00	$35.25–$45.12	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS-DIP STICK ONLY	$47.00	$47.00	$35.25–$45.12	—	—
Urine culture for bacteria, with colony count CPT 87086 All Outpatient Services	$111.00	$111.00	$8.07–$106.56	64% above	—
Urine culture for bacteria, with colony count CPT 87086 CULTURE-URINE-COLONY CT	$111.00	$111.00	$8.07–$106.56	64% above	—
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE-URINE-COLONY CT	$111.00	$111.00	$83.25–$106.56	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 All Inpatient Services	$111.00	$111.00	$83.25–$106.56	—	—
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST-URINE-hCG	$106.00	$106.00	$8.61–$101.76	86% above	—
Urine pregnancy test, read by color change CPT 81025 All Outpatient Services	$106.00	$106.00	$8.61–$101.76	86% above	—
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST-URINE-hCG	$106.00	$106.00	$79.50–$101.76	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 All Inpatient Services	$106.00	$106.00	$79.50–$101.76	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 B-12	$174.00	$174.00	$15.08–$167.04	54% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 All Outpatient Services	$174.00	$174.00	$15.08–$167.04	54% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B-12	$174.00	$174.00	$130.50–$167.04	—	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 All Inpatient Services	$174.00	$174.00	$130.50–$167.04	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 All Outpatient Services	$207.00	$207.00	$29.60–$198.72	58% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-OH VITAMIN D	$207.00	$207.00	$29.60–$198.72	58% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 All Inpatient Services	$207.00	$207.00	$155.25–$198.72	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-OH VITAMIN D	$207.00	$207.00	$155.25–$198.72	—	—
Zinc blood test CPT 84630 ZINC - SERUM	$82.00	$82.00	$11.39–$78.72	131% above	—
Zinc blood test CPT 84630 All Outpatient Services	$82.00	$82.00	$11.39–$78.72	131% above	—
Zinc blood test inpatient CPT 84630 All Inpatient Services	$82.00	$82.00	$61.50–$78.72	—	—
Zinc blood test inpatient CPT 84630 ZINC - SERUM	$82.00	$82.00	$61.50–$78.72	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG-SERUM QUANTITATI	$164.00	$164.00	$15.05–$157.44	85% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 All Outpatient Services	$164.00	$164.00	$15.05–$157.44	85% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 All Inpatient Services	$164.00	$164.00	$123.00–$157.44	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG-SERUM QUANTITATI	$164.00	$164.00	$123.00–$157.44	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$297.00	$297.00	$102.52–$627.31	10% below	—
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$390.00	$390.00	$195.00–$374.40	18% above	—
Botox injections for chronic migraine CPT 64615 All Outpatient Services	$390.00	$390.00	$195.00–$374.40	18% above	—
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRAINE	$297.00	$297.00	$102.52–$627.31	—	—
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRAINE	$390.00	$390.00	$292.50–$374.40	—	—
Botox injections for chronic migraine inpatient CPT 64615 All Inpatient Services	$390.00	$390.00	$292.50–$374.40	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TRMT OF DISTAL ANKLE FRAC	$651.00	$651.00	$167.28–$1,389.02	63% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TRMT OF DISTAL ANKLE FRAC	$651.00	$651.00	$167.28–$1,389.02	—	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD TRMT OF METATARSAL FRAC	$453.00	$453.00	$133.82–$966.74	24% above	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD TRMT OF METATARSAL FRAC	$453.00	$453.00	$133.82–$966.74	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC, EXT	$314.00	$314.00	$97.41–$655.37	75% below	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 ED CARDIOVERSION ELECTRIC EXT	$405.00	$405.00	$202.50–$388.80	67% below	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CRNA CARDIOVERSION ELECTRIC	$459.00	$459.00	$97.41–$655.37	63% below	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 OP CARDIOVERSION	$1,456.00	$1,456.00	$728.00–$1,397.76	18% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 All Outpatient Services	$1,456.00	$1,456.00	$728.00–$1,397.76	18% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC, EXT	$314.00	$314.00	$97.41–$655.37	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED CARDIOVERSION ELECTRIC EXT	$405.00	$405.00	$303.75–$388.80	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CRNA CARDIOVERSION ELECTRIC	$459.00	$459.00	$97.41–$655.37	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 All Inpatient Services	$1,456.00	$1,456.00	$1,092.00–$1,397.76	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 OP CARDIOVERSION	$1,456.00	$1,456.00	$1,092.00–$1,397.76	—	—
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$903.00	$903.00	$393.85–$1,912.77	24% below	—
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$3,226.00	$3,226.00	$1,613.00–$3,096.96	171% above	—
Carpal tunnel release, open surgery CPT 64721 All Outpatient Services	$3,226.00	$3,226.00	$1,613.00–$3,096.96	171% above	—
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL SURGERY	$903.00	$903.00	$393.85–$1,912.77	—	—
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL SURGERY	$3,226.00	$3,226.00	$2,419.50–$3,096.96	—	—
Carpal tunnel release, open surgery inpatient CPT 64721 All Inpatient Services	$3,226.00	$3,226.00	$2,419.50–$3,096.96	—	—
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$316.00	$316.00	$28.60–$658.56	25% below	—
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX	$316.00	$316.00	$28.60–$658.56	—	—
Cesarean delivery, including prenatal and postpartum care CPT 59510 ROUTINE OB CARE WITH C-SECTION	$5,112.00	$5,112.00	$2,265.66–$10,945.75	8% above	—
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 ROUTINE OB CARE WITH C-SECTION	$5,112.00	$5,112.00	$2,265.66–$10,945.75	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION	$303.00	$303.00	$63.08–$639.48	30% below	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION	$303.00	$303.00	$63.08–$639.48	—	—
Circumcision, surgical, older than a newborn CPT 54160 Circu with clamp	$450.00	$450.00	$27.70–$955.59	32% below	—
Circumcision, surgical, older than a newborn inpatient CPT 54160 Circu with clamp	$450.00	$450.00	$27.70–$955.59	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 FRAC DISTL RADIUS & ULNAR CLSD	$705.00	$705.00	$185.02–$1,506.01	85% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 FRAC DISTL RADIUS & ULNAR CLSD	$705.00	$705.00	$185.02–$1,506.01	—	—
Colonoscopy with polyp removal CPT 45385 LESION REMV COLONOSCOPY	$932.00	$932.00	$223.93–$1,950.59	8% below	—
Colonoscopy with polyp removal inpatient CPT 45385 LESION REMV COLONOSCOPY	$932.00	$932.00	$223.93–$1,950.59	—	—
Colonoscopy with tissue sample CPT 45380 COLONSCOPYAND BIOPSY	$892.00	$892.00	$177.02–$1,861.76	15% below	—
Colonoscopy with tissue sample inpatient CPT 45380 COLONSCOPYAND BIOPSY	$892.00	$892.00	$177.02–$1,861.76	—	—
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$696.00	$696.00	$162.77–$1,459.34	8% below	—
Colonoscopy, diagnostic inpatient CPT 45378 DIAGNOSTIC COLONOSCOPY	$696.00	$696.00	$162.77–$1,459.34	—	—
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/ SCOPE LEEP	$646.00	$646.00	$140.55–$1,343.19	2% above	—
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 BX OF CERVIX W/ SCOPE LEEP	$646.00	$646.00	$140.55–$1,343.19	—	—
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 All Outpatient Services	$132.00	$132.00	$66.00–$126.72	52% below	—
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 SC BX/CURETT OF CERVIX W/SCOPE	$132.00	$132.00	$66.00–$126.72	52% below	—
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colpscopy	$344.00	$344.00	$117.76–$722.26	25% above	—
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 All Inpatient Services	$132.00	$132.00	$99.00–$126.72	—	—
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 SC BX/CURETT OF CERVIX W/SCOPE	$132.00	$132.00	$99.00–$126.72	—	—
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Colpscopy	$344.00	$344.00	$117.76–$722.26	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$493.00	$493.00	$71.43–$1,029.90	10% below	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$493.00	$493.00	$71.43–$1,029.90	—	—
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE	$608.00	$608.00	$206.86–$1,279.10	at median	—
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURETTAGE	$608.00	$608.00	$206.86–$1,279.10	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 SC DESTRUCT PREMALG LESION	$76.00	$76.00	$38.00–$72.96	40% below	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 All Outpatient Services	$76.00	$76.00	$38.00–$72.96	40% below	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 CRYO SINGLE LESION	$138.00	$138.00	$49.88–$293.90	8% above	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 All Inpatient Services	$76.00	$76.00	$57.00–$72.96	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 SC DESTRUCT PREMALG LESION	$76.00	$76.00	$57.00–$72.96	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 CRYO SINGLE LESION	$138.00	$138.00	$49.88–$293.90	—	—
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING	$328.00	$328.00	$143.51–$690.51	42% below	—
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 CREATE EARDRUM OPENING	$328.00	$328.00	$143.51–$690.51	—	—
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 All Outpatient Services	$238.00	$238.00	$119.00–$228.48	39% below	—
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 SC CREATE EARDRUM OPENING	$238.00	$238.00	$119.00–$228.48	39% below	—
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 SC CREATE EARDRUM OPENING	$238.00	$238.00	$178.50–$228.48	—	—
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 All Inpatient Services	$238.00	$238.00	$178.50–$228.48	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 All Outpatient Services	$31.00	$31.00	$15.50–$29.76	34% below	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$31.00	$31.00	$13.74–$67.69	34% below	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 SC REMOVE IMPACT EAR WAX UNI	$31.00	$31.00	$15.50–$29.76	34% below	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 ED REMOVE IMPACT EAR WAX UNI	$60.00	$60.00	$30.00–$57.60	29% above	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI	$31.00	$31.00	$13.74–$67.69	—	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 SC REMOVE IMPACT EAR WAX UNI	$31.00	$31.00	$23.25–$29.76	—	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 All Inpatient Services	$31.00	$31.00	$23.25–$29.76	—	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 ED REMOVE IMPACT EAR WAX UNI	$60.00	$60.00	$45.00–$57.60	—	—
Earwax removal with instruments, one ear CPT 69210 SC REMOVE IMPACTED EAR WAX UNI	$42.00	$42.00	$21.00–$40.32	43% below	—
Earwax removal with instruments, one ear CPT 69210 REMV of ear wax by suction spn	$97.00	$97.00	$24.93–$206.19	31% above	—
Earwax removal with instruments, one ear CPT 69210 ED REMOVE IMPACTED EAR WAX UNI	$119.00	$119.00	$59.50–$114.24	61% above	—
Earwax removal with instruments, one ear CPT 69210 All Outpatient Services	$119.00	$119.00	$59.50–$114.24	61% above	—
Earwax removal with instruments, one ear inpatient CPT 69210 SC REMOVE IMPACTED EAR WAX UNI	$42.00	$42.00	$31.50–$40.32	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 REMV of ear wax by suction spn	$97.00	$97.00	$24.93–$206.19	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 All Inpatient Services	$119.00	$119.00	$89.25–$114.24	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 ED REMOVE IMPACTED EAR WAX UNI	$119.00	$119.00	$89.25–$114.24	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 SC ENDOMETRIAL BIOPSY	$92.00	$92.00	$46.00–$88.32	55% below	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY	$207.00	$207.00	$49.70–$434.18	1% above	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 OP ENDOMETRIAL BIOPSY	$371.00	$371.00	$185.50–$356.16	81% above	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 All Outpatient Services	$371.00	$371.00	$185.50–$356.16	81% above	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 SC ENDOMETRIAL BIOPSY	$92.00	$92.00	$69.00–$88.32	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BIOPSY	$207.00	$207.00	$49.70–$434.18	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 OP ENDOMETRIAL BIOPSY	$371.00	$371.00	$278.25–$356.16	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 All Inpatient Services	$371.00	$371.00	$278.25–$356.16	—	—
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NASALSINUS ENDO WTOTAL ETHMOID	$654.00	$654.00	$285.71–$1,372.30	42% below	—
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 NASALSINUS ENDO WTOTAL ETHMOID	$654.00	$654.00	$285.71–$1,372.30	—	—
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NASALSINUS ENDO WFRONTAL SINUS	$764.00	$764.00	$333.87–$1,604.50	47% below	—
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 NASALSINUS ENDO WFRONTAL SINUS	$764.00	$764.00	$333.87–$1,604.50	—	—
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 EXPLORATION MAXILLARY SINUS	$365.00	$365.00	$159.90–$766.17	24% below	—
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 EXPLORATION MAXILLARY SINUS	$365.00	$365.00	$159.90–$766.17	—	—
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 NASALSINUS ENDO W REMV OF TISS	$537.00	$537.00	$234.50–$1,127.31	40% below	—
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 NASALSINUS ENDO W REMV OF TISS	$537.00	$537.00	$234.50–$1,127.31	—	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$539.00	$539.00	$96.88–$1,135.45	49% below	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 All Outpatient Services	$1,066.00	$1,066.00	$533.00–$1,023.36	1% above	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INTERLAMINAR CRV/THRC	$1,066.00	$1,066.00	$533.00–$1,023.36	1% above	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTERLAMINAR CRV/THRC	$539.00	$539.00	$96.88–$1,135.45	—	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INTERLAMINAR CRV/THRC	$1,066.00	$1,066.00	$799.50–$1,023.36	—	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 All Inpatient Services	$1,066.00	$1,066.00	$799.50–$1,023.36	—	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 MBB LUMBAR OR SACRAL 1ST LEV	$361.00	$361.00	$52.05–$767.63	72% below	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 MBB LUMBAR OR SACRAL 1ST LEV	$1,787.00	$1,787.00	$893.50–$1,715.52	39% above	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 All Outpatient Services	$1,787.00	$1,787.00	$893.50–$1,715.52	39% above	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 BILATER LUMB OR SACRAL 1ST LEV	$3,470.00	$3,470.00	$1,735.00–$3,331.20	171% above	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 MBB LUMBAR OR SACRAL 1ST LEV	$361.00	$361.00	$52.05–$767.63	—	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 All Inpatient Services	$1,787.00	$1,787.00	$1,340.25–$1,715.52	—	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 MBB LUMBAR OR SACRAL 1ST LEV	$1,787.00	$1,787.00	$1,340.25–$1,715.52	—	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 BILATER LUMB OR SACRAL 1ST LEV	$3,470.00	$3,470.00	$2,602.50–$3,331.20	—	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HRN 1ST <3 CM RDC	$665.00	$665.00	$292.67–$1,400.60	4% below	—
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 RPR AA HRN 1ST <3 CM RDC	$665.00	$665.00	$292.67–$1,400.60	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$382.00	$382.00	$37.97–$798.84	3% below	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$382.00	$382.00	$37.97–$798.84	—	—
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$1,293.00	$1,293.00	$571.17–$2,731.98	12% below	—
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$1,293.00	$1,293.00	$571.17–$2,731.98	—	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Lap Chole with Cholangio	$628.00	$628.00	$620.41–$2,968.45	60% below	—
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 Lap Chole with Cholangio	$628.00	$628.00	$620.41–$2,968.45	—	—
Hemorrhoid banding (rubber band ligation) CPT 46221 LITIGATION OF HEMORRHOID(S)	$581.00	$581.00	$77.78–$1,216.99	2% below	—
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LITIGATION OF HEMORRHOID(S)	$581.00	$581.00	$77.78–$1,216.99	—	—
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABD HYSTERECTOMY	$2,046.00	$2,046.00	$899.59–$4,324.95	at median	—
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABD HYSTERECTOMY	$2,046.00	$2,046.00	$899.59–$4,324.95	—	—
IUD insertion (the device itself billed separately) CPT 58300 SC INSERT INTRAUTERINE DEVICE	$122.00	$122.00	$61.00–$117.12	44% below	—
IUD insertion (the device itself billed separately) CPT 58300 All Outpatient Services	$122.00	$122.00	$61.00–$117.12	44% below	—
IUD insertion (the device itself billed separately) CPT 58300 IUD INSERT	$228.00	$228.00	$45.78–$469.13	4% above	—
IUD insertion (the device itself billed separately) inpatient CPT 58300 SC INSERT INTRAUTERINE DEVICE	$122.00	$122.00	$91.50–$117.12	—	—
IUD insertion (the device itself billed separately) inpatient CPT 58300 All Inpatient Services	$122.00	$122.00	$91.50–$117.12	—	—
IUD insertion (the device itself billed separately) inpatient CPT 58300 IUD INSERT	$228.00	$228.00	$45.78–$469.13	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 I & D AND STYE	$259.00	$259.00	$52.91–$551.12	at median	—
Incision and drainage of a simple or single skin abscess CPT 10060 All Outpatient Services	$403.00	$403.00	$201.50–$386.88	56% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 ED I&D ABSCESS	$403.00	$403.00	$201.50–$386.88	56% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D AND STYE	$259.00	$259.00	$52.91–$551.12	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 All Inpatient Services	$403.00	$403.00	$302.25–$386.88	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ED I&D ABSCESS	$403.00	$403.00	$302.25–$386.88	—	—
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REP INITIAL HERNIA	$1,029.00	$1,029.00	$454.72–$2,173.36	20% below	—
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REP INITIAL HERNIA	$1,029.00	$1,029.00	$454.72–$2,173.36	—	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 SC INJ TENDON SHEATH/LIGAMENT	$49.00	$49.00	$24.50–$47.04	74% below	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SNGLE TENDON SHEATH OR LIG	$118.00	$118.00	$18.32–$248.97	38% below	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$178.00	$178.00	$89.00–$170.88	7% below	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 All Outpatient Services	$178.00	$178.00	$89.00–$170.88	7% below	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 SC INJ TENDON SHEATH/LIGAMENT	$49.00	$49.00	$36.75–$47.04	—	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SNGLE TENDON SHEATH OR LIG	$118.00	$118.00	$18.32–$248.97	—	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT	$178.00	$178.00	$133.50–$170.88	—	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 All Inpatient Services	$178.00	$178.00	$133.50–$170.88	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 SC DRN/INJ MJR JT BURS W/O US	$58.00	$58.00	$29.00–$55.68	70% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 OP DRN/INJ JNT/BURSA WO US BIL	$99.00	$99.00	$49.50–$95.04	48% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPINJ LRG JOINT SHLDRHIPKNEE	$131.00	$131.00	$24.52–$278.12	31% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 OR DRN/INJ MJR JT BURS W/O US	$164.00	$164.00	$82.00–$157.44	14% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ED DRN/INJ MJR JT BURS W/O US	$164.00	$164.00	$82.00–$157.44	14% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 All Outpatient Services	$164.00	$164.00	$82.00–$157.44	14% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 SC DRN/INJ MJR JT BURS W/O US	$58.00	$58.00	$43.50–$55.68	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 All Inpatient Services	$99.00	$99.00	$74.25–$95.04	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 OP DRN/INJ JNT/BURSA WO US BIL	$99.00	$99.00	$74.25–$95.04	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPINJ LRG JOINT SHLDRHIPKNEE	$131.00	$131.00	$24.52–$278.12	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ED DRN/INJ MJR JT BURS W/O US	$164.00	$164.00	$123.00–$157.44	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 OR DRN/INJ MJR JT BURS W/O US	$164.00	$164.00	$123.00–$157.44	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT, NON-BIODGDBLE DRG IMPL	$203.00	$203.00	$54.96–$427.99	10% below	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT, NON-BIODGDBLE DRG IMPL	$203.00	$203.00	$54.96–$427.99	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 All Outpatient Services	$49.00	$49.00	$24.50–$47.04	76% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 SC DRN/INJ INTM JT BURS W/O US	$49.00	$49.00	$24.50–$47.04	76% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJECT INTER ELBOW/WRIST	$112.00	$112.00	$22.23–$237.59	45% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 OR DRN/INJ INTM JT BURS W/O US	$135.00	$135.00	$67.50–$129.60	34% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ED DRAIN/INJ JOINT/BURSA W/O U	$247.00	$247.00	$123.50–$237.12	21% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 SC DRN/INJ INTM JT BURS W/O US	$49.00	$49.00	$36.75–$47.04	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJECT INTER ELBOW/WRIST	$112.00	$112.00	$22.23–$237.59	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 All Inpatient Services	$135.00	$135.00	$101.25–$129.60	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 OR DRN/INJ INTM JT BURS W/O US	$135.00	$135.00	$101.25–$129.60	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ED DRAIN/INJ JOINT/BURSA W/O U	$247.00	$247.00	$185.25–$237.12	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION/INJECT SM JT FINGER	$108.00	$108.00	$18.47–$231.63	26% below	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 All Outpatient Services	$203.00	$203.00	$101.50–$194.88	39% above	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 MINOR JOINT/BURSA	$203.00	$203.00	$101.50–$194.88	39% above	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRATION/INJECT SM JT FINGER	$108.00	$108.00	$18.47–$231.63	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 MINOR JOINT/BURSA	$203.00	$203.00	$152.25–$194.88	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 All Inpatient Services	$203.00	$203.00	$152.25–$194.88	—	—
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 LAPS TL HYSTERECT 250GM<TBRML	$1,834.00	$1,834.00	$803.04–$3,874.19	1% below	—
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 LAPS TL HYSTERECT 250GM<TBRML	$1,834.00	$1,834.00	$803.04–$3,874.19	—	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP, SURG; REP INGUINAL HERNIA	$853.00	$853.00	$377.68–$1,804.73	14% below	—
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAP, SURG; REP INGUINAL HERNIA	$853.00	$853.00	$377.68–$1,804.73	—	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP ING HERNIA REPAIR RECUR	$1,113.00	$1,113.00	$491.83–$2,353.24	14% below	—
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAP ING HERNIA REPAIR RECUR	$1,113.00	$1,113.00	$491.83–$2,353.24	—	—
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY REMOV ADNEXA	$628.00	$628.00	$575.45–$2,773.60	63% below	—
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPAROSCOPY REMOV ADNEXA	$628.00	$628.00	$575.45–$2,773.60	—	—
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 All Outpatient Services	$501.00	$501.00	$250.50–$480.96	31% below	—
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 LASER SURGERY (YAG LASER)	$501.00	$501.00	$250.50–$480.96	31% below	—
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 LASER SURGERY (YAG LASER)	$501.00	$501.00	$375.75–$480.96	—	—
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 All Inpatient Services	$501.00	$501.00	$375.75–$480.96	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLSRE OF WND 2.5 CM OR <	$541.00	$541.00	$75.69–$1,133.20	31% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ED INTMD RPR S/A/T/EXT 2.5CM/<	$562.00	$562.00	$281.00–$539.52	36% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 All Outpatient Services	$562.00	$562.00	$281.00–$539.52	36% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLSRE OF WND 2.5 CM OR <	$541.00	$541.00	$75.69–$1,133.20	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 ED INTMD RPR S/A/T/EXT 2.5CM/<	$562.00	$562.00	$421.50–$539.52	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 All Inpatient Services	$562.00	$562.00	$421.50–$539.52	—	—
Lower-back epidural injection, with imaging guidance CPT 62323 INTERLAMINAR LUMBAR/SACRAL	$531.00	$531.00	$89.56–$1,115.88	50% below	—
Lower-back epidural injection, with imaging guidance CPT 62323 CRNA INTERLAMINAR LUMBAR/SACRA	$537.00	$537.00	$89.56–$1,115.88	49% below	—
Lower-back epidural injection, with imaging guidance CPT 62323 INTERLAMINAR LMBR/SAC	$1,066.00	$1,066.00	$533.00–$1,023.36	1% above	—
Lower-back epidural injection, with imaging guidance CPT 62323 All Outpatient Services	$1,066.00	$1,066.00	$533.00–$1,023.36	1% above	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INTERLAMINAR LUMBAR/SACRAL	$531.00	$531.00	$89.56–$1,115.88	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CRNA INTERLAMINAR LUMBAR/SACRA	$537.00	$537.00	$89.56–$1,115.88	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 All Inpatient Services	$1,066.00	$1,066.00	$799.50–$1,023.36	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INTERLAMINAR LMBR/SAC	$1,066.00	$1,066.00	$799.50–$1,023.36	—	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJECT SPINE LUMBAR/SACRAL	$284.00	$284.00	$70.40–$584.44	55% below	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJECT SPINE LUMBAR/SACRAL	$808.00	$808.00	$404.00–$775.68	28% above	—
Lower-back epidural injection, without imaging guidance CPT 62322 All Outpatient Services	$808.00	$808.00	$404.00–$775.68	28% above	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECT SPINE LUMBAR/SACRAL	$284.00	$284.00	$70.40–$584.44	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 All Inpatient Services	$808.00	$808.00	$606.00–$775.68	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECT SPINE LUMBAR/SACRAL	$808.00	$808.00	$606.00–$775.68	—	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORAMIL LUMBAR/SACRAL	$506.00	$506.00	$51.62–$1,065.70	56% below	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORAMIL LUMBAR/SACRAL	$1,609.00	$1,609.00	$804.50–$1,544.64	41% above	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 All Outpatient Services	$1,609.00	$1,609.00	$804.50–$1,544.64	41% above	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TRANSFORAMIL LUMBAR/SACRAL	$506.00	$506.00	$51.62–$1,065.70	—	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 All Inpatient Services	$1,609.00	$1,609.00	$1,206.75–$1,544.64	—	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TRANSFORAMIL LUMBAR/SACRAL	$1,609.00	$1,609.00	$1,206.75–$1,544.64	—	—
Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE	$870.00	$870.00	$331.78–$1,834.20	21% below	—
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 CARE OF MISCARRIAGE	$870.00	$870.00	$331.78–$1,834.20	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC OF SKN LESN 0.5 CM	$263.00	$263.00	$45.10–$553.66	15% below	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC OF SKN LESN 0.5 CM	$263.00	$263.00	$45.10–$553.66	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 SC EXC B9 F/E/E/N/L/MM 0.5/<	$175.00	$175.00	$87.50–$168.00	49% below	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC OF SKN LESN 0.5 CM OR <	$296.00	$296.00	$71.87–$622.33	14% below	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 ED EXC OF SKN LESN 0.5CM OR<	$406.00	$406.00	$203.00–$389.76	18% above	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 All Outpatient Services	$406.00	$406.00	$203.00–$389.76	18% above	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 SC EXC B9 F/E/E/N/L/MM 0.5/<	$175.00	$175.00	$131.25–$168.00	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC OF SKN LESN 0.5 CM OR <	$296.00	$296.00	$71.87–$622.33	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 ED EXC OF SKN LESN 0.5CM OR<	$406.00	$406.00	$304.50–$389.76	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 All Inpatient Services	$406.00	$406.00	$304.50–$389.76	—	—
Nail removal (partial or complete), one nail CPT 11730 SC REMOVAL OF NAIL PLATE	$128.00	$128.00	$64.00–$122.88	52% below	—
Nail removal (partial or complete), one nail CPT 11730 ED REMOVAL OF NAIL PLATE	$202.00	$202.00	$101.00–$193.92	24% below	—
Nail removal (partial or complete), one nail CPT 11730 All Outpatient Services	$202.00	$202.00	$101.00–$193.92	24% below	—
Nail removal (partial or complete), one nail CPT 11730 REMV OF NAIL PLATE	$237.00	$237.00	$37.17–$499.81	11% below	—
Nail removal (partial or complete), one nail inpatient CPT 11730 SC REMOVAL OF NAIL PLATE	$128.00	$128.00	$96.00–$122.88	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 ED REMOVAL OF NAIL PLATE	$202.00	$202.00	$151.50–$193.92	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 All Inpatient Services	$202.00	$202.00	$151.50–$193.92	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 REMV OF NAIL PLATE	$237.00	$237.00	$37.17–$499.81	—	—
Occipital nerve block (injection for headaches) CPT 64405 N BLOCK INJ OCCIPITAL	$148.00	$148.00	$31.07–$315.77	64% below	—
Occipital nerve block (injection for headaches) CPT 64405 All Outpatient Services	$692.00	$692.00	$346.00–$664.32	67% above	—
Occipital nerve block (injection for headaches) CPT 64405 NERVE BLOCK INJ OCCIPITAL	$692.00	$692.00	$346.00–$664.32	67% above	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 N BLOCK INJ OCCIPITAL	$148.00	$148.00	$31.07–$315.77	—	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 NERVE BLOCK INJ OCCIPITAL	$692.00	$692.00	$519.00–$664.32	—	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 All Inpatient Services	$692.00	$692.00	$519.00–$664.32	—	—
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENT.W/IMAGING	$608.00	$608.00	$94.84–$1,252.41	17% below	—
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENT.W/IMAGING	$608.00	$608.00	$94.84–$1,252.41	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMV INGROWN NAIL	$330.00	$330.00	$92.73–$700.19	1% below	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMV INGROWN NAIL	$330.00	$330.00	$92.73–$700.19	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 BILAT RFA LUMBAR OR SACRAL	$6,150.00	$6,150.00	$3,075.00–$5,904.00	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 RF OF L5 DORSAL PRIM RAMUS	$909.00	$909.00	$174.31–$1,908.74	52% below	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 RFA - LUMBAR OR SACRAL	$4,100.00	$4,100.00	$2,050.00–$3,936.00	119% above	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 All Outpatient Services	$6,150.00	$6,150.00	$3,075.00–$5,904.00	228% above	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient both sides CPT 64635 BILAT RFA LUMBAR OR SACRAL	$6,150.00	$6,150.00	$4,612.50–$5,904.00	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 RF OF L5 DORSAL PRIM RAMUS	$909.00	$909.00	$174.31–$1,908.74	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 RFA - LUMBAR OR SACRAL	$4,100.00	$4,100.00	$3,075.00–$3,936.00	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 All Inpatient Services	$4,100.00	$4,100.00	$3,075.00–$3,936.00	—	—
Removal of a foreign object under the skin, simple CPT 10120 INC & REMVL FOREIGN BDY-SUBCU	$309.00	$309.00	$55.22–$657.90	10% below	—
Removal of a foreign object under the skin, simple CPT 10120 All Outpatient Services	$436.00	$436.00	$218.00–$418.56	27% above	—
Removal of a foreign object under the skin, simple CPT 10120 ED INS & RMVL FB-SUBCU	$436.00	$436.00	$218.00–$418.56	27% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC & REMVL FOREIGN BDY-SUBCU	$309.00	$309.00	$55.22–$657.90	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 ED INS & RMVL FB-SUBCU	$436.00	$436.00	$327.00–$418.56	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 All Inpatient Services	$436.00	$436.00	$327.00–$418.56	—	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 SCREEN COLONSCOPY-NOT HIGH RSK	$696.00	$696.00	$162.87–$688.59	3% below	—
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 SCREEN COLONSCOPY-NOT HIGH RSK	$696.00	$696.00	$162.87–$688.59	—	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 SCREENING COLONSCOPY-HIGH RISK	$696.00	$696.00	$162.77–$688.37	4% below	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 SCREENING COLONSCOPY-HIGH RISK	$696.00	$696.00	$162.77–$688.37	—	—
Septoplasty to straighten the nasal septum CPT 30520 SEPTO/SUB RESECJ W/WO CARTIL	$1,393.00	$1,393.00	$598.06–$2,913.07	8% below	—
Septoplasty to straighten the nasal septum inpatient CPT 30520 SEPTO/SUB RESECJ W/WO CARTIL	$1,393.00	$1,393.00	$598.06–$2,913.07	—	—
Short arm cast (elbow to hand) CPT 29075 All Outpatient Services	$95.00	$95.00	$47.50–$91.20	51% below	—
Short arm cast (elbow to hand) CPT 29075 SC APPLICATION OF FOREARM CAST	$95.00	$95.00	$47.50–$91.20	51% below	—
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST	$178.00	$178.00	$26.67–$380.35	8% below	—
Short arm cast (elbow to hand) inpatient CPT 29075 SC APPLICATION OF FOREARM CAST	$95.00	$95.00	$71.25–$91.20	—	—
Short arm cast (elbow to hand) inpatient CPT 29075 All Inpatient Services	$95.00	$95.00	$71.25–$91.20	—	—
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF FOREARM CAST	$178.00	$178.00	$26.67–$380.35	—	—
Short arm splint (forearm and hand) CPT 29125 All Outpatient Services	$80.00	$80.00	$40.00–$76.80	47% below	—
Short arm splint (forearm and hand) CPT 29125 SC APPLY SHORT ARM SPLINT	$80.00	$80.00	$40.00–$76.80	47% below	—
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$135.00	$135.00	$20.16–$291.05	11% below	—
Short arm splint (forearm and hand) CPT 29125 ED APPLY SHORT ARM SPLINT	$148.00	$148.00	$74.00–$142.08	2% below	—
Short arm splint (forearm and hand) inpatient CPT 29125 SC APPLY SHORT ARM SPLINT	$80.00	$80.00	$60.00–$76.80	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT	$135.00	$135.00	$20.16–$291.05	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 ED APPLY SHORT ARM SPLINT	$148.00	$148.00	$111.00–$142.08	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 All Inpatient Services	$148.00	$148.00	$111.00–$142.08	—	—
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST	$163.00	$163.00	$36.90–$349.76	11% below	—
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION OF SHORT LEG CAST	$163.00	$163.00	$36.90–$349.76	—	—
Short leg splint (calf to foot) CPT 29515 APPLICAT OF SHORT LEG SPLINT	$146.00	$146.00	$26.78–$314.99	6% below	—
Short leg splint (calf to foot) CPT 29515 ED APLICAT OF SHORT LEG SPLINT	$183.00	$183.00	$91.50–$175.68	17% above	—
Short leg splint (calf to foot) CPT 29515 All Outpatient Services	$183.00	$183.00	$91.50–$175.68	17% above	—
Short leg splint (calf to foot) inpatient CPT 29515 APPLICAT OF SHORT LEG SPLINT	$146.00	$146.00	$26.78–$314.99	—	—
Short leg splint (calf to foot) inpatient CPT 29515 ED APLICAT OF SHORT LEG SPLINT	$183.00	$183.00	$137.25–$175.68	—	—
Short leg splint (calf to foot) inpatient CPT 29515 All Inpatient Services	$183.00	$183.00	$137.25–$175.68	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 All Outpatient Services	$159.00	$159.00	$79.50–$152.64	24% below	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ED RPR SPR S/N/A/EG/T/EXT2.5/<	$159.00	$159.00	$79.50–$152.64	24% below	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REP SUPRFCL WND(S) 2.5CM OR LE	$190.00	$190.00	$38.83–$401.76	9% below	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 All Inpatient Services	$159.00	$159.00	$119.25–$152.64	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ED RPR SPR S/N/A/EG/T/EXT2.5/<	$159.00	$159.00	$119.25–$152.64	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REP SUPRFCL WND(S) 2.5CM OR LE	$190.00	$190.00	$38.83–$401.76	—	—
Skin biopsy, punch, one lesion CPT 11104 All Outpatient Services	$157.00	$157.00	$78.50–$150.72	38% below	—
Skin biopsy, punch, one lesion CPT 11104 SC PUNCH BIOPSY OF SKIN	$157.00	$157.00	$78.50–$150.72	38% below	—
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN	$258.00	$258.00	$41.77–$538.95	1% above	—
Skin biopsy, punch, one lesion inpatient CPT 11104 SC PUNCH BIOPSY OF SKIN	$157.00	$157.00	$117.75–$150.72	—	—
Skin biopsy, punch, one lesion inpatient CPT 11104 All Inpatient Services	$157.00	$157.00	$117.75–$150.72	—	—
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN	$258.00	$258.00	$41.77–$538.95	—	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 SKN LESN, MAL, 0.5 CM OR <	$405.00	$405.00	$47.94–$851.01	6% below	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 SKN LESN, MAL, 0.5 CM OR <	$405.00	$405.00	$47.94–$851.01	—	—
Skin tag removal, up to 15 tags CPT 11200 SKIN TAG REMV TO 15	$187.00	$187.00	$47.18–$401.00	5% below	—
Skin tag removal, up to 15 tags CPT 11200 ED SKIN TAG REMV TO 15	$289.00	$289.00	$144.50–$277.44	47% above	—
Skin tag removal, up to 15 tags CPT 11200 All Outpatient Services	$289.00	$289.00	$144.50–$277.44	47% above	—
Skin tag removal, up to 15 tags inpatient CPT 11200 SKIN TAG REMV TO 15	$187.00	$187.00	$47.18–$401.00	—	—
Skin tag removal, up to 15 tags inpatient CPT 11200 ED SKIN TAG REMV TO 15	$289.00	$289.00	$216.75–$277.44	—	—
Skin tag removal, up to 15 tags inpatient CPT 11200 All Inpatient Services	$289.00	$289.00	$216.75–$277.44	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DIAGNOSTIC	$936.00	$936.00	$468.00–$898.56	152% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 All Outpatient Services	$936.00	$936.00	$468.00–$898.56	152% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL FLUID TAP DIAGNOSTIC	$936.00	$936.00	$702.00–$898.56	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 All Inpatient Services	$936.00	$936.00	$702.00–$898.56	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 All Outpatient Services	$207.00	$207.00	$103.50–$198.72	12% below	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ED RP SPR S/N/A/EG/T/EX2.6-7.5	$207.00	$207.00	$103.50–$198.72	12% below	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REP SUPRFCL WND 2.6 TO 7.5 CM	$230.00	$230.00	$50.90–$485.71	2% below	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 All Inpatient Services	$207.00	$207.00	$155.25–$198.72	—	—
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 RP SPR S/N/A/EG/T/EX2.6-7.5	$207.00	$207.00	$155.25–$198.72	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REP SUPRFCL WND 2.6 TO 7.5 CM	$230.00	$230.00	$50.90–$485.71	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SC RPR SPR F/E/E/N/L/MM 2.5/<	$116.00	$116.00	$58.00–$111.36	49% below	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ED RPR SPR F/E/E/N/L/MM 2.5/<	$195.00	$195.00	$97.50–$187.20	14% below	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 All Outpatient Services	$195.00	$195.00	$97.50–$187.20	14% below	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REP SUPRFCL WND 2.5 CM OR <	$228.00	$228.00	$48.24–$477.15	at median	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SC RPR SPR F/E/E/N/L/MM 2.5/<	$116.00	$116.00	$87.00–$111.36	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 All Inpatient Services	$116.00	$116.00	$87.00–$111.36	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ED RPR SPR F/E/E/N/L/MM 2.5/<	$195.00	$195.00	$146.25–$187.20	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REP SUPRFCL WND 2.5 CM OR <	$228.00	$228.00	$48.24–$477.15	—	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN	$209.00	$209.00	$33.80–$433.75	21% above	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$247.00	$247.00	$123.50–$237.12	43% above	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 All Outpatient Services	$247.00	$247.00	$123.50–$237.12	43% above	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN	$209.00	$209.00	$33.80–$433.75	—	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 All Inpatient Services	$247.00	$247.00	$185.25–$237.12	—	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES	$247.00	$247.00	$185.25–$237.12	—	—
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$653.00	$653.00	$17.37–$1,345.54	3% below	—
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$653.00	$653.00	$17.37–$1,345.54	—	—
Tonsil and adenoid removal, child under 12 CPT 42820 TONSILLECTMY&ADENOIDECTMY < 12	$597.00	$597.00	$262.93–$1,262.01	at median	—
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 TONSILLECTMY&ADENOIDECTMY < 12	$597.00	$597.00	$262.93–$1,262.01	—	—
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY ONE-HALF AGE 12>	$524.00	$524.00	$231.30–$1,109.50	16% below	—
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY ONE-HALF AGE 12>	$524.00	$524.00	$231.30–$1,109.50	—	—
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTOMY ONE-HALF <AGE 12	$551.00	$551.00	$243.43–$1,166.04	4% above	—
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 TONSILLECTOMY ONE-HALF <AGE 12	$551.00	$551.00	$243.43–$1,166.04	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT 1-2 MUSCLES	$108.00	$108.00	$26.67–$226.86	22% below	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1-2 MUSCL	$136.00	$136.00	$68.00–$130.56	2% below	—
Trigger point injections, 1 or 2 muscles CPT 20552 All Outpatient Services	$136.00	$136.00	$68.00–$130.56	2% below	—
Trigger point injections, 1 or 2 muscles CPT 20552 ED INJ TRIGGER POINT 1-2 MUSCL	$137.00	$137.00	$68.50–$131.52	1% below	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT 1-2 MUSCLES	$108.00	$108.00	$26.67–$226.86	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1-2 MUSCL	$136.00	$136.00	$102.00–$130.56	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 All Inpatient Services	$137.00	$137.00	$102.75–$131.52	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ED INJ TRIGGER POINT 1-2 MUSCL	$137.00	$137.00	$102.75–$131.52	—	—
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY SURG W/FUL OVIDUCT	$754.00	$754.00	$328.84–$1,588.86	17% below	—
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAPAROSCOPY SURG W/FUL OVIDUCT	$754.00	$754.00	$328.84–$1,588.86	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$2,513.00	$2,513.00	$1,256.50–$2,412.48	37% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 All Outpatient Services	$2,513.00	$2,513.00	$1,256.50–$2,412.48	37% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 All Inpatient Services	$2,513.00	$2,513.00	$1,884.75–$2,412.48	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST 1ST LESION US IMAG	$2,513.00	$2,513.00	$1,884.75–$2,412.48	—	—
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 UGI-W/DILATE ESOPHAGUS	$2,232.00	$2,232.00	$135.39–$4,584.22	25% above	—
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 UGI-W/DILATE ESOPHAGUS	$2,232.00	$2,232.00	$135.39–$4,584.22	—	—
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDO,BIOPSY	$775.00	$775.00	$122.28–$1,615.46	40% below	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDO,BIOPSY	$775.00	$775.00	$122.28–$1,615.46	—	—
Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDO, DIAGNOSIS	$592.00	$592.00	$108.52–$1,236.43	13% below	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER GI ENDO, DIAGNOSIS	$592.00	$592.00	$108.52–$1,236.43	—	—
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 VBAC DELIVERY	$2,921.00	$2,921.00	$2,133.74–$10,308.29	4% below	—
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 VBAC DELIVERY	$2,921.00	$2,921.00	$2,133.74–$10,308.29	—	—
Vaginal delivery, including prenatal and postpartum care CPT 59400 OBSTETRICAL CARE	$4,669.00	$4,669.00	$2,059.83–$9,943.82	at median	—
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 OBSTETRICAL CARE	$4,669.00	$4,669.00	$2,059.83–$9,943.82	—	—
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$686.00	$686.00	$182.39–$1,448.38	20% below	—
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 All Outpatient Services	$1,393.00	$1,393.00	$696.50–$1,337.28	62% above	—
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$1,393.00	$1,393.00	$696.50–$1,337.28	62% above	—
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$686.00	$686.00	$182.39–$1,448.38	—	—
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 All Inpatient Services	$1,393.00	$1,393.00	$1,044.75–$1,337.28	—	—
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$1,393.00	$1,393.00	$1,044.75–$1,337.28	—	—
Vein ablation, radiofrequency, first vein CPT 36475 IR ENDOVENOUS RF 1ST VEIN	$6,451.00	$6,451.00	$3,225.50–$6,192.96	83% above	—
Vein ablation, radiofrequency, first vein CPT 36475 All Outpatient Services	$6,451.00	$6,451.00	$3,225.50–$6,192.96	83% above	—
Vein ablation, radiofrequency, first vein inpatient CPT 36475 All Inpatient Services	$6,451.00	$6,451.00	$4,838.25–$6,192.96	—	—
Vein ablation, radiofrequency, first vein inpatient CPT 36475 IR ENDOVENOUS RF 1ST VEIN	$6,451.00	$6,451.00	$4,838.25–$6,192.96	—	—
Wart removal, up to 14 warts CPT 17110 All Outpatient Services	$147.00	$147.00	$73.50–$141.12	14% below	—
Wart removal, up to 14 warts CPT 17110 SC DESTRUCT B9 LESION 1-14	$147.00	$147.00	$73.50–$141.12	14% below	—
Wart removal, up to 14 warts CPT 17110 WARTS UP TO 14 LESIONS	$234.00	$234.00	$31.51–$492.92	38% above	—
Wart removal, up to 14 warts inpatient CPT 17110 SC DESTRUCT B9 LESION 1-14	$147.00	$147.00	$110.25–$141.12	—	—
Wart removal, up to 14 warts inpatient CPT 17110 All Inpatient Services	$147.00	$147.00	$110.25–$141.12	—	—
Wart removal, up to 14 warts inpatient CPT 17110 WARTS UP TO 14 LESIONS	$234.00	$234.00	$31.51–$492.92	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 SC DBRDMT SUBQ TIS 1ST 20SQCM<	$152.00	$152.00	$76.00–$145.92	51% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 All Outpatient Services	$158.00	$158.00	$79.00–$151.68	49% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WC DEB SQ TISSUE FRST 20SQCM/<	$158.00	$158.00	$79.00–$151.68	49% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ED DEB SQ TISSUE FRST 20SQCM/<	$224.00	$224.00	$112.00–$215.04	28% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN, TISSUE	$264.00	$264.00	$54.12–$558.39	15% below	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 SC DBRDMT SUBQ TIS 1ST 20SQCM<	$152.00	$152.00	$114.00–$145.92	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 All Inpatient Services	$152.00	$152.00	$114.00–$145.92	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WC DEB SQ TISSUE FRST 20SQCM/<	$158.00	$158.00	$118.50–$151.68	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 ED DEB SQ TISSUE FRST 20SQCM/<	$224.00	$224.00	$168.00–$215.04	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN, TISSUE	$264.00	$264.00	$54.12–$558.39	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD COMP	$81.00	$81.00	$37.53–$178.74	88% below	—
Blood transfusion (giving blood or blood components) CPT 36430 OP BLOOD ADMINISTRATION	$744.00	$744.00	$372.00–$714.24	7% above	—
Blood transfusion (giving blood or blood components) CPT 36430 ED BLOOD TRANSFUSION	$979.00	$979.00	$489.50–$939.84	41% above	—
Blood transfusion (giving blood or blood components) CPT 36430 All Outpatient Services	$979.00	$979.00	$489.50–$939.84	41% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD COMP	$81.00	$81.00	$37.53–$178.74	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 All Inpatient Services	$744.00	$744.00	$558.00–$714.24	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 OP BLOOD ADMINISTRATION	$744.00	$744.00	$558.00–$714.24	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ED BLOOD TRANSFUSION	$979.00	$979.00	$734.25–$939.84	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ED INHALATION TX - NURSING	$30.00	$30.00	$15.00–$28.80	70% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TRMT	$32.00	$32.00	$6.92–$61.48	69% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TX - NURSING OBS	$260.00	$260.00	$130.00–$249.60	156% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 All Outpatient Services	$263.00	$263.00	$131.50–$252.48	159% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT INHALATION TREATMENT	$263.00	$263.00	$131.50–$252.48	159% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ED INHALATION TX - NURSING	$30.00	$30.00	$22.50–$28.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 All Inpatient Services	$30.00	$30.00	$22.50–$28.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TRMT	$32.00	$32.00	$6.92–$61.48	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TX - NURSING OBS	$260.00	$260.00	$195.00–$249.60	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT INHALATION TREATMENT	$263.00	$263.00	$197.25–$252.48	—	—
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE, FIRST HOUR	$561.00	$561.00	$160.84–$1,182.34	10% below	—
Critical care, first 30 to 74 minutes CPT 99291 ER - CRITICAL CARE	$1,885.00	$1,885.00	$942.50–$1,809.60	203% above	—
Critical care, first 30 to 74 minutes CPT 99291 All Outpatient Services	$1,885.00	$1,885.00	$942.50–$1,809.60	203% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE, FIRST HOUR	$561.00	$561.00	$160.84–$1,182.34	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 All Inpatient Services	$1,885.00	$1,885.00	$1,413.75–$1,809.60	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER - CRITICAL CARE	$1,885.00	$1,885.00	$1,413.75–$1,809.60	—	—
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM, COMPLETE	$56.00	$56.00	$12.81–$60.63	1% below	—
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ELECTROCARDIOGRAM, COMPLETE	$56.00	$56.00	$12.81–$60.63	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG-ROUTINE-TRACING ONLY	$314.00	$314.00	$157.00–$301.44	57% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 All Outpatient Services	$314.00	$314.00	$157.00–$301.44	57% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG-ROUTINE-TRACING ONLY	$314.00	$314.00	$235.50–$301.44	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 All Inpatient Services	$314.00	$314.00	$235.50–$301.44	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT VISIT -1	$43.00	$43.00	$10.16–$81.49	63% below	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY SERVICE-LEVEL 1	$227.00	$227.00	$113.50–$217.92	97% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 All Outpatient Services	$227.00	$227.00	$113.50–$217.92	97% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPT VISIT -1	$43.00	$43.00	$10.16–$81.49	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY SERVICE-LEVEL 1	$227.00	$227.00	$170.25–$217.92	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 All Inpatient Services	$227.00	$227.00	$170.25–$217.92	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT -2	$85.00	$85.00	$37.59–$178.97	52% below	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 All Outpatient Services	$391.00	$391.00	$195.50–$375.36	121% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY SERVICE-LEVEL 2	$391.00	$391.00	$195.50–$375.36	121% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT -2	$85.00	$85.00	$37.59–$178.97	—	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 All Inpatient Services	$391.00	$391.00	$293.25–$375.36	—	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY SERVICE-LEVEL 2	$391.00	$391.00	$293.25–$375.36	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT -3	$146.00	$146.00	$63.71–$304.79	39% below	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY SERVICE-LEVEL 3	$587.00	$587.00	$293.50–$563.52	144% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 All Outpatient Services	$587.00	$587.00	$293.50–$563.52	144% above	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT -3	$146.00	$146.00	$63.71–$304.79	—	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY SERVICE-LEVEL 3	$587.00	$587.00	$440.25–$563.52	—	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 All Inpatient Services	$587.00	$587.00	$440.25–$563.52	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT -4	$248.00	$248.00	$108.39–$518.72	41% below	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY SERVICE-LEVEL 4	$906.00	$906.00	$453.00–$869.76	117% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 All Outpatient Services	$906.00	$906.00	$453.00–$869.76	117% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT -4	$248.00	$248.00	$108.39–$518.72	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY SERVICE-LEVEL 4	$906.00	$906.00	$679.50–$869.76	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 All Inpatient Services	$906.00	$906.00	$679.50–$869.76	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT -5	$359.00	$359.00	$157.05–$751.73	39% below	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY SERVICE-LEVEL 5	$1,391.00	$1,391.00	$695.50–$1,335.36	138% above	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 All Outpatient Services	$1,391.00	$1,391.00	$695.50–$1,335.36	138% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT -5	$359.00	$359.00	$157.05–$751.73	—	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY SERVICE-LEVEL 5	$1,391.00	$1,391.00	$1,043.25–$1,335.36	—	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 All Inpatient Services	$1,391.00	$1,391.00	$1,043.25–$1,335.36	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$1,159.00	$1,159.00	$579.50–$1,112.64	10% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 All Outpatient Services	$1,159.00	$1,159.00	$579.50–$1,112.64	10% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST	$1,159.00	$1,159.00	$869.25–$1,112.64	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 All Inpatient Services	$1,159.00	$1,159.00	$869.25–$1,112.64	—	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/ PATIENT	$209.00	$209.00	$97.30–$457.48	2% above	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/PT 50M (0-5YR)	$217.00	$217.00	$108.50–$208.32	5% above	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/PATIENT WXE	$289.00	$289.00	$144.50–$277.44	40% above	—
Family therapy with the patient, 50 minutes CPT 90847 All Outpatient Services	$289.00	$289.00	$144.50–$277.44	40% above	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/PATIENT	$289.00	$289.00	$144.50–$277.44	40% above	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/PT 50 MIN	$289.00	$289.00	$144.50–$277.44	40% above	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W/ PATIENT	$209.00	$209.00	$97.30–$457.48	—	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W/PT 50M (0-5YR)	$217.00	$217.00	$162.75–$208.32	—	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W/PT 50 MIN	$289.00	$289.00	$216.75–$277.44	—	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W/PATIENT WXE	$289.00	$289.00	$216.75–$277.44	—	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W/PATIENT	$289.00	$289.00	$216.75–$277.44	—	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 All Inpatient Services	$289.00	$289.00	$216.75–$277.44	—	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PATIENT	$200.00	$200.00	$93.09–$436.43	1% below	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PT 50M (0-5YR	$206.00	$206.00	$103.00–$197.76	2% above	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PATIENT	$220.00	$220.00	$110.00–$211.20	9% above	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PT 50MIN	$220.00	$220.00	$110.00–$211.20	9% above	—
Family therapy without the patient, 50 minutes CPT 90846 All Outpatient Services	$220.00	$220.00	$110.00–$211.20	9% above	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYTX W/O PATIENT	$200.00	$200.00	$93.09–$436.43	—	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYTX W/O PT 50M (0-5YR	$206.00	$206.00	$154.50–$197.76	—	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYTX W/O PT 50MIN	$214.00	$214.00	$160.50–$205.44	—	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 All Inpatient Services	$214.00	$214.00	$160.50–$205.44	—	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYTX W/O PATIENT	$220.00	$220.00	$165.00–$211.20	—	—
Group psychotherapy session CPT 90853 PSYCHOTHERAPY GROUP ADDITIONAL	$205.00	$205.00	$102.50–$196.80	at median	—
Group psychotherapy session CPT 90853 All Outpatient Services	$205.00	$205.00	$102.50–$196.80	at median	—
Group psychotherapy session CPT 90853 PSYCHOTHERAPY GROUP	$205.00	$205.00	$102.50–$196.80	at median	—
Group psychotherapy session inpatient CPT 90853 PSYCHOTHERAPY GROUP	$205.00	$205.00	$153.75–$196.80	—	—
Group psychotherapy session inpatient CPT 90853 PSYCHOTHERAPY GROUP ADDITIONAL	$205.00	$205.00	$153.75–$196.80	—	—
Group psychotherapy session inpatient CPT 90853 All Inpatient Services	$205.00	$205.00	$153.75–$196.80	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 All Outpatient Services	$422.00	$422.00	$211.00–$405.12	28% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ED IV HYDRATION 1ST HR	$422.00	$422.00	$211.00–$405.12	28% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OP IV HYDRATION 1ST HR	$422.00	$422.00	$211.00–$405.12	28% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OP IV HYDRATION 1ST HR	$422.00	$422.00	$316.50–$405.12	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 All Inpatient Services	$422.00	$422.00	$316.50–$405.12	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ED IV HYDRATION 1ST HR	$422.00	$422.00	$316.50–$405.12	—	—
IV infusion of a medicine, first hour CPT 96365 OP IV INFUSION INITIAL	$433.00	$433.00	$216.50–$415.68	38% above	—
IV infusion of a medicine, first hour CPT 96365 All Outpatient Services	$433.00	$433.00	$216.50–$415.68	38% above	—
IV infusion of a medicine, first hour CPT 96365 ED IV INFUSION INITIAL	$433.00	$433.00	$216.50–$415.68	38% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 All Inpatient Services	$433.00	$433.00	$324.75–$415.68	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 OP IV INFUSION INITIAL	$433.00	$433.00	$324.75–$415.68	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 ED IV INFUSION INITIAL	$433.00	$433.00	$324.75–$415.68	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAP OR PROPHYLACTIC INJ IM	$47.00	$47.00	$13.01–$61.55	53% below	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OP SQ/IM INJECTION	$175.00	$175.00	$87.50–$168.00	75% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ED SQ/IM INJECTION	$175.00	$175.00	$87.50–$168.00	75% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 All Outpatient Services	$175.00	$175.00	$87.50–$168.00	75% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAP OR PROPHYLACTIC INJ IM	$47.00	$47.00	$13.01–$61.55	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 All Inpatient Services	$175.00	$175.00	$131.25–$168.00	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ED SQ/IM INJECTION	$175.00	$175.00	$131.25–$168.00	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OP SQ/IM INJECTION	$175.00	$175.00	$131.25–$168.00	—	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAG EVAL(WO MEDL SERV)	$252.00	$252.00	$139.43–$469.50	21% above	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH EVAL W/O MED SERV(0-5YR)	$283.00	$283.00	$141.50–$271.68	36% above	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 All Outpatient Services	$290.00	$290.00	$145.00–$278.40	39% above	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAG EVAL W/O MED SERV	$290.00	$290.00	$145.00–$278.40	39% above	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAG EVAL(WO MEDL SERV)	$252.00	$252.00	$139.43–$469.50	—	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH EVAL W/O MED SERV(0-5YR)	$283.00	$283.00	$212.25–$271.68	—	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAG EVAL W/O MED SERV	$290.00	$290.00	$217.50–$278.40	—	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 All Inpatient Services	$290.00	$290.00	$217.50–$278.40	—	—
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC RE-ED 15M (8-22)	$103.00	$103.00	$51.50–$98.88	35% above	—
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-EDUCATION 15 MIN	$103.00	$103.00	$51.50–$98.88	35% above	—
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 15MIN	$103.00	$103.00	$51.50–$98.88	35% above	—
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC RE-ED 30M (23-37)	$206.00	$206.00	$103.00–$197.76	169% above	—
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 30M (23-37	$206.00	$206.00	$103.00–$197.76	169% above	—
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 45M (38-52	$309.00	$309.00	$154.50–$296.64	304% above	—
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC RE-ED 45M (38-52)	$309.00	$309.00	$154.50–$296.64	304% above	—
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC RE-ED 60M (53-67)	$412.00	$412.00	$206.00–$395.52	439% above	—
Neuromuscular re-education, 15 minutes CPT 97112 All Outpatient Services	$412.00	$412.00	$206.00–$395.52	439% above	—
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 60M (53-67	$412.00	$412.00	$206.00–$395.52	439% above	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-EDUCATION 15 MIN	$103.00	$103.00	$77.25–$98.88	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC RE-ED 15M (8-22)	$103.00	$103.00	$77.25–$98.88	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 15MIN	$103.00	$103.00	$77.25–$98.88	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC RE-ED 30M (23-37)	$206.00	$206.00	$154.50–$197.76	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 All Inpatient Services	$206.00	$206.00	$154.50–$197.76	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 30M (23-37	$206.00	$206.00	$154.50–$197.76	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC RE-ED 45M (38-52)	$309.00	$309.00	$231.75–$296.64	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 45M (38-52	$309.00	$309.00	$231.75–$296.64	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC RE-ED 60M (53-67)	$412.00	$412.00	$309.00–$395.52	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 60M (53-67	$412.00	$412.00	$309.00–$395.52	—	—
New patient office visit, about 30 minutes CPT 99203 NEW OFFICE VIS EX.PROB.FOC-30	$228.00	$228.00	$57.85–$482.22	11% above	—
New patient office visit, about 30 minutes inpatient CPT 99203 NEW OFFICE VIS EX.PROB.FOC-30	$228.00	$228.00	$57.85–$482.22	—	—
New patient office visit, about 45 minutes CPT 99204 NEW OFFICE VISIT DETAILED - 45	$341.00	$341.00	$94.32–$725.21	13% above	—
New patient office visit, about 45 minutes inpatient CPT 99204 NEW OFFICE VISIT DETAILED - 45	$341.00	$341.00	$94.32–$725.21	—	—
New patient office visit, about 60 minutes CPT 99205 NEW OFFICE VISIT COMP/HIGH- 60	$450.00	$450.00	$122.24–$955.98	22% above	—
New patient office visit, about 60 minutes inpatient CPT 99205 NEW OFFICE VISIT COMP/HIGH- 60	$450.00	$450.00	$122.24–$955.98	—	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW OFFICE VISIT PROBLEM - 15	$148.00	$148.00	$37.73–$313.27	9% above	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW OFFICE VISIT PROBLEM - 15	$148.00	$148.00	$37.73–$313.27	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 All Outpatient Services	$54.00	$54.00	$27.00–$51.84	19% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL INDIV 15 MIN	$54.00	$54.00	$27.00–$51.84	19% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN	$76.00	$76.00	$25.50–$158.72	68% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 All Inpatient Services	$54.00	$54.00	$40.50–$51.84	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL INDIV 15 MIN	$54.00	$54.00	$40.50–$51.84	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION INDIV IN	$76.00	$76.00	$25.50–$158.72	—	—
Occupational therapy evaluation, low complexity CPT 97165 All Outpatient Services	$207.00	$207.00	$103.50–$198.72	28% above	—
Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW COMPLEXITY	$207.00	$207.00	$103.50–$198.72	28% above	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW COMPLEXITY	$207.00	$207.00	$155.25–$198.72	—	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 All Inpatient Services	$207.00	$207.00	$155.25–$198.72	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH COMPLEXITY	$204.00	$204.00	$102.00–$195.84	21% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 All Outpatient Services	$204.00	$204.00	$102.00–$195.84	21% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 All Inpatient Services	$204.00	$204.00	$153.00–$195.84	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION HIGH COMPLEXITY	$204.00	$204.00	$153.00–$195.84	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW COMPLEXITY	$190.00	$190.00	$95.00–$182.40	35% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 All Outpatient Services	$190.00	$190.00	$95.00–$182.40	35% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW COMPLEXITY	$190.00	$190.00	$142.50–$182.40	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 All Inpatient Services	$190.00	$190.00	$142.50–$182.40	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 All Outpatient Services	$197.00	$197.00	$98.50–$189.12	17% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MODERATE COMPLEX	$197.00	$197.00	$98.50–$189.12	17% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION MODERATE COMPLEX	$197.00	$197.00	$147.75–$189.12	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 All Inpatient Services	$197.00	$197.00	$147.75–$189.12	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15M (8-22)	$123.00	$123.00	$61.50–$118.08	44% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 JOINT MOBILIZATION 15 MIN	$123.00	$123.00	$61.50–$118.08	44% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 30M (23-37)	$245.00	$245.00	$69.71–$235.20	187% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 JOINT MOBILIZATION 30M (23-37)	$245.00	$245.00	$69.71–$235.20	187% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 JOINT MOBILIZATION 45M (38-52)	$368.00	$368.00	$69.71–$353.28	330% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 45M (38-52)	$368.00	$368.00	$69.71–$353.28	330% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 All Outpatient Services	$490.00	$490.00	$69.71–$470.40	473% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 JOINT MOBILIZATION 60M (53-67)	$490.00	$490.00	$69.71–$470.40	473% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 60M (53-67)	$490.00	$490.00	$69.71–$470.40	473% above	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 JOINT MOBILIZATION 15 MIN	$123.00	$123.00	$92.25–$118.08	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15M (8-22)	$123.00	$123.00	$92.25–$118.08	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 30M (23-37)	$245.00	$245.00	$183.75–$235.20	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 JOINT MOBILIZATION 30M (23-37)	$245.00	$245.00	$183.75–$235.20	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 JOINT MOBILIZATION 45M (38-52)	$368.00	$368.00	$276.00–$353.28	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 45M (38-52)	$368.00	$368.00	$276.00–$353.28	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 JOINT MOBILIZATION 60M (53-67)	$490.00	$490.00	$367.50–$470.40	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 60M (53-67)	$490.00	$490.00	$367.50–$470.40	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 All Inpatient Services	$490.00	$490.00	$367.50–$470.40	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROC 15M (8-22)	$41.00	$41.00	$20.50–$72.87	49% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROC/EXER 15M	$107.00	$107.00	$53.50–$102.72	33% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROCED 15 MIN	$107.00	$107.00	$53.50–$102.72	33% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROCED 30M (23-37)	$214.00	$214.00	$72.87–$205.44	166% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROC 30M (23-37)	$214.00	$214.00	$72.87–$205.44	166% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROC 45M (38-52)	$321.00	$321.00	$72.87–$308.16	299% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROCED 45M (38-52)	$321.00	$321.00	$72.87–$308.16	299% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROCED 60M (53-67)	$428.00	$428.00	$72.87–$410.88	433% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 All Outpatient Services	$428.00	$428.00	$72.87–$410.88	433% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROC 60M (53-67)	$428.00	$428.00	$72.87–$410.88	433% above	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROC 15M (8-22)	$41.00	$41.00	$30.75–$39.36	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROCED 15 MIN	$107.00	$107.00	$80.25–$102.72	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROC/EXER 15M	$107.00	$107.00	$80.25–$102.72	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROC 30M (23-37)	$214.00	$214.00	$160.50–$205.44	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROCED 30M (23-37)	$214.00	$214.00	$160.50–$205.44	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROC 45M (38-52)	$321.00	$321.00	$240.75–$308.16	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 All Inpatient Services	$321.00	$321.00	$240.75–$308.16	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROCED 45M (38-52)	$321.00	$321.00	$240.75–$308.16	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROCED 60M (53-67)	$428.00	$428.00	$321.00–$410.88	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROC 60M (53-67)	$428.00	$428.00	$321.00–$410.88	—	—
Preventive checkup, new patient aged 18–39 CPT 99385 NEW WELLNESS VISIT (18-39)	$267.00	$267.00	$86.28–$554.95	12% above	—
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 NEW WELLNESS VISIT (18-39)	$267.00	$267.00	$86.28–$554.95	—	—
Preventive checkup, new patient aged 40–64 CPT 99386 NEW WELLNESS VISIT (40-64)	$308.00	$308.00	$104.71–$640.89	16% above	—
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 NEW WELLNESS VISIT (40-64)	$308.00	$308.00	$104.71–$640.89	—	—
Preventive checkup, new patient aged 65 or older CPT 99387 NEW WELLNESS VISIT (65+)	$334.00	$334.00	$80.72–$695.31	28% above	—
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 NEW WELLNESS VISIT (65+)	$334.00	$334.00	$80.72–$695.31	—	—
Preventive checkup, returning patient aged 18–39 CPT 99395 EST. WELLNESS VISIT (18-39)	$240.00	$240.00	$78.82–$500.53	16% above	—
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 EST. WELLNESS VISIT (18-39)	$240.00	$240.00	$78.82–$500.53	—	—
Preventive checkup, returning patient aged 40–64 CPT 99396 EST. WELLNESS VISIT (40-64)	$256.00	$256.00	$85.63–$532.29	16% above	—
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 EST. WELLNESS VISIT (40-64)	$256.00	$256.00	$85.63–$532.29	—	—
Preventive checkup, returning patient aged 65 or older CPT 99397 EST. WELLNESS VISIT (65 +)	$275.00	$275.00	$90.10–$572.76	22% above	—
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 EST. WELLNESS VISIT (65 +)	$275.00	$275.00	$90.10–$572.76	—	—
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL(W MED SERV)	$283.00	$283.00	$158.08–$525.02	23% above	—
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL(W MED SERV)	$283.00	$283.00	$158.08–$525.02	—	—
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$276.00	$276.00	$138.00–$264.96	28% above	—
Psychotherapy for crisis, first 60 minutes CPT 90839 All Outpatient Services	$276.00	$276.00	$138.00–$264.96	28% above	—
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$292.00	$292.00	$123.11–$649.67	36% above	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 All Inpatient Services	$276.00	$276.00	$207.00–$264.96	—	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$276.00	$276.00	$207.00–$264.96	—	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$292.00	$292.00	$123.11–$649.67	—	—
Psychotherapy session, 30 minutes CPT 90832 PSYCH TX 30 MIN IND OP	$158.00	$158.00	$65.39–$347.65	at median	—
Psychotherapy session, 30 minutes CPT 90832 PROLONGED SERVICE,OFFICE	$205.00	$205.00	$102.50–$196.80	30% above	—
Psychotherapy session, 30 minutes CPT 90832 PSYCH TX 30 MIN IND OP TELEMED	$205.00	$205.00	$102.50–$196.80	30% above	—
Psychotherapy session, 30 minutes CPT 90832 PSYCH TX 30 MIN IND OP	$205.00	$205.00	$102.50–$196.80	30% above	—
Psychotherapy session, 30 minutes CPT 90832 All Outpatient Services	$205.00	$205.00	$102.50–$196.80	30% above	—
Psychotherapy session, 30 minutes CPT 90832 PSYCH TX 30 MIN IND 16-27 WXE	$205.00	$205.00	$102.50–$196.80	30% above	—
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCH TX 30 MIN IND OP	$158.00	$158.00	$65.39–$347.65	—	—
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCH TX 30 MIN IND OP TELEMED	$205.00	$205.00	$153.75–$196.80	—	—
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCH TX 30 MIN IND 16-27 WXE	$205.00	$205.00	$153.75–$196.80	—	—
Psychotherapy session, 30 minutes inpatient CPT 90832 All Inpatient Services	$205.00	$205.00	$153.75–$196.80	—	—
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCH TX 30 MIN IND OP	$205.00	$205.00	$153.75–$196.80	—	—
Psychotherapy session, 30 minutes inpatient CPT 90832 PROLONGED SERVICE,OFFICE	$205.00	$205.00	$153.75–$196.80	—	—
Psychotherapy session, 45 minutes CPT 90834 PSYCH TX 45 MIN IND OP (0-5YR)	$185.00	$185.00	$92.50–$177.60	at median	—
Psychotherapy session, 45 minutes CPT 90834 PSYCH TX 45 MIN IND OP	$208.00	$208.00	$86.55–$459.18	12% above	—
Psychotherapy session, 45 minutes CPT 90834 PSYCH TX 45 MIN IND 28-52 WXE	$234.00	$234.00	$117.00–$224.64	26% above	—
Psychotherapy session, 45 minutes CPT 90834 PSYCH TX 45 MIN IND OP	$234.00	$234.00	$117.00–$224.64	26% above	—
Psychotherapy session, 45 minutes CPT 90834 PSYCH TX 45 MIN IND TELEMED	$234.00	$234.00	$117.00–$224.64	26% above	—
Psychotherapy session, 45 minutes CPT 90834 All Outpatient Services	$234.00	$234.00	$117.00–$224.64	26% above	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCH TX 45 MIN IND OP (0-5YR)	$185.00	$185.00	$138.75–$177.60	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCH TX 45 MIN IND OP	$208.00	$208.00	$86.55–$459.18	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCH TX 45 MIN IND OP	$234.00	$234.00	$175.50–$224.64	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCH TX 45 MIN IND 28-52 WXE	$234.00	$234.00	$175.50–$224.64	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCH TX 45 MIN IND TELEMED	$234.00	$234.00	$175.50–$224.64	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 All Inpatient Services	$234.00	$234.00	$175.50–$224.64	—	—
Psychotherapy session, 60 minutes CPT 90837 All Outpatient Services	$267.00	$267.00	$133.50–$256.32	22% above	—
Psychotherapy session, 60 minutes CPT 90837 PSYCH TX 60 MIN IND TELEMED	$267.00	$267.00	$133.50–$256.32	22% above	—
Psychotherapy session, 60 minutes CPT 90837 PSYCH TX 60 MIN IND OP	$267.00	$267.00	$133.50–$256.32	22% above	—
Psychotherapy session, 60 minutes CPT 90837 PSYCH TX 60 MIN IND 53-67 WXE	$267.00	$267.00	$133.50–$256.32	22% above	—
Psychotherapy session, 60 minutes CPT 90837 PSYCH TX 60 MIN IND OP	$306.00	$306.00	$127.73–$676.87	40% above	—
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCH TX 60 MIN IND TELEMED	$267.00	$267.00	$200.25–$256.32	—	—
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCH TX 60 MIN IND OP	$267.00	$267.00	$200.25–$256.32	—	—
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCH TX 60 MIN IND 53-67 WXE	$267.00	$267.00	$200.25–$256.32	—	—
Psychotherapy session, 60 minutes inpatient CPT 90837 All Inpatient Services	$267.00	$267.00	$200.25–$256.32	—	—
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCH TX 60 MIN IND OP	$306.00	$306.00	$127.73–$676.87	—	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKE COUNSEL-3-10MIN	$30.00	$30.00	$10.63–$63.83	8% above	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKE COUNSEL-3-10MIN	$30.00	$30.00	$10.63–$63.83	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SC VISIT LEVEL 5, 40+ MIN	$210.00	$210.00	$105.00–$201.60	at median	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 All Outpatient Services	$210.00	$210.00	$105.00–$201.60	at median	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SC TH VISIT O/P EST MOD 40 MIN	$356.00	$356.00	$178.00–$341.76	70% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST. OFFICE VISIT COMP/HIGH-40	$369.00	$369.00	$86.09–$786.61	76% above	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 All Inpatient Services	$210.00	$210.00	$157.50–$201.60	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SC VISIT LEVEL 5, 40+ MIN	$210.00	$210.00	$157.50–$201.60	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SC TH VISIT O/P EST MOD 40 MIN	$356.00	$356.00	$267.00–$341.76	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST. OFFICE VISIT COMP/HIGH-40	$369.00	$369.00	$86.09–$786.61	—	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 All Outpatient Services	$110.00	$110.00	$55.00–$107.10	12% below	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SC VISIT LEVEL 3, 20+ MIN	$110.00	$110.00	$55.00–$107.10	12% below	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SC TH VISIT O/P EST LOW 20 MIN	$179.00	$179.00	$89.50–$171.84	43% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST.OFF VISIT EX.PROB.FOC-15	$186.00	$186.00	$37.27–$395.79	49% above	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 All Inpatient Services	$110.00	$110.00	$82.50–$105.60	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SC VISIT LEVEL 3, 20+ MIN	$110.00	$110.00	$82.50–$105.60	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SC TH VISIT O/P EST LOW 20 MIN	$179.00	$179.00	$134.25–$171.84	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST.OFF VISIT EX.PROB.FOC-15	$186.00	$186.00	$37.27–$395.79	—	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 All Outpatient Services	$150.00	$150.00	$75.00–$144.00	8% below	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SC VISIT LEVEL 4, 30+ MIN	$150.00	$150.00	$75.00–$144.00	8% below	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SC TH VISIT O/P EST MOD 30 MIN	$254.00	$254.00	$127.00–$243.84	56% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST. OFFICE VISIT DETAILED- 25	$263.00	$263.00	$57.65–$559.42	62% above	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SC VISIT LEVEL 4, 30+ MIN	$150.00	$150.00	$112.50–$144.00	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SC TH VISIT O/P EST MOD 30 MIN	$254.00	$254.00	$190.50–$243.84	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 All Inpatient Services	$254.00	$254.00	$190.50–$243.84	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST. OFFICE VISIT DETAILED- 25	$263.00	$263.00	$57.65–$559.42	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 All Outpatient Services	$100.00	$100.00	$50.00–$96.00	17% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SC VISIT LEVEL 2, 10+ MIN	$100.00	$100.00	$50.00–$96.00	17% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST. OFFICE VISIT PROBLEM -10	$116.00	$116.00	$20.97–$245.29	36% above	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SC VISIT LEVEL 2, 10+ MIN	$100.00	$100.00	$75.00–$96.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 All Inpatient Services	$100.00	$100.00	$75.00–$96.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST. OFFICE VISIT PROBLEM -10	$116.00	$116.00	$20.97–$245.29	—	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULTATION- 3	$235.00	$235.00	$78.82–$484.35	8% above	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 All Outpatient Services	$242.00	$242.00	$121.00–$232.32	11% above	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 SC TH OFF/OP CNSLT LOW 30	$242.00	$242.00	$121.00–$232.32	11% above	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE CONSULTATION- 3	$235.00	$235.00	$78.82–$484.35	—	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 All Inpatient Services	$242.00	$242.00	$181.50–$232.32	—	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 SC TH OFF/OP CNSLT LOW 30	$242.00	$242.00	$181.50–$232.32	—	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULTATION -4	$349.00	$349.00	$107.74–$692.61	6% above	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 All Outpatient Services	$363.00	$363.00	$181.50–$348.48	10% above	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 SC TH OFF/OP CNSLT MOD 40	$363.00	$363.00	$181.50–$348.48	10% above	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE CONSULTATION -4	$349.00	$349.00	$107.74–$692.61	—	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 All Inpatient Services	$363.00	$363.00	$272.25–$348.48	—	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 SC TH OFF/OP CNSLT MOD 40	$363.00	$363.00	$272.25–$348.48	—	—
Speech and language evaluation CPT 92523 EVAL.-LANGUAGE COMP.& EXPRESS.	$392.00	$392.00	$196.00–$376.32	40% above	—
Speech and language evaluation CPT 92523 All Outpatient Services	$392.00	$392.00	$196.00–$376.32	40% above	—
Speech and language evaluation inpatient CPT 92523 All Inpatient Services	$392.00	$392.00	$294.00–$376.32	—	—
Speech and language evaluation inpatient CPT 92523 EVAL.-LANGUAGE COMP.& EXPRESS.	$392.00	$392.00	$294.00–$376.32	—	—
Speech therapy session, individual CPT 92507 SPEECH TREATMENT	$318.00	$318.00	$159.00–$305.28	53% above	—
Speech therapy session, individual CPT 92507 All Outpatient Services	$318.00	$318.00	$159.00–$305.28	53% above	—
Speech therapy session, individual inpatient CPT 92507 SPEECH TREATMENT	$318.00	$318.00	$238.50–$305.28	—	—
Speech therapy session, individual inpatient CPT 92507 All Inpatient Services	$318.00	$318.00	$238.50–$305.28	—	—
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$65.00	$65.00	$24.38–$125.13	71% below	—
Spirometry (breathing test) CPT 94010 RT SPIROMETRY	$305.00	$305.00	$152.50–$292.80	35% above	—
Spirometry (breathing test) CPT 94010 All Outpatient Services	$305.00	$305.00	$152.50–$292.80	35% above	—
Spirometry (breathing test) inpatient CPT 94010 BREATHING CAPACITY TEST	$65.00	$65.00	$24.38–$125.13	—	—
Spirometry (breathing test) inpatient CPT 94010 RT SPIROMETRY	$305.00	$305.00	$228.75–$292.80	—	—
Spirometry (breathing test) inpatient CPT 94010 All Inpatient Services	$305.00	$305.00	$228.75–$292.80	—	—
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$109.00	$109.00	$34.90–$209.10	75% below	—
Spirometry before and after a bronchodilator CPT 94060 RT SPIRO.PRE/POST BRONCHO	$718.00	$718.00	$359.00–$689.28	65% above	—
Spirometry before and after a bronchodilator CPT 94060 All Outpatient Services	$718.00	$718.00	$359.00–$689.28	65% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 EVALUATION OF WHEEZING	$109.00	$109.00	$34.90–$209.10	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 All Inpatient Services	$718.00	$718.00	$538.50–$689.28	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 RT SPIRO.PRE/POST BRONCHO	$718.00	$718.00	$538.50–$689.28	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIV 15M (8-22)	$106.00	$106.00	$53.00–$101.76	30% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIV 30M (23-37)	$212.00	$212.00	$106.00–$203.52	161% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 All Outpatient Services	$212.00	$212.00	$106.00–$203.52	161% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIV 45M (38-52)	$318.00	$318.00	$159.00–$305.28	291% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIV 60M (53-67)	$424.00	$424.00	$212.00–$407.04	422% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIV 60M (68-83)	$530.00	$530.00	$265.00–$508.80	552% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIV 75M (68-83)	$530.00	$530.00	$265.00–$508.80	552% above	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIV 15M (8-22)	$106.00	$106.00	$79.50–$101.76	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIV 30M (23-37)	$212.00	$212.00	$159.00–$203.52	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIV 45M (38-52)	$318.00	$318.00	$238.50–$305.28	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIV 60M (53-67)	$424.00	$424.00	$318.00–$407.04	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 All Inpatient Services	$424.00	$424.00	$318.00–$407.04	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIV 75M (68-83)	$530.00	$530.00	$397.50–$508.80	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIV 60M (68-83)	$530.00	$530.00	$397.50–$508.80	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 OP PHLEBOTOMY, THERAPEUTIC	$215.00	$215.00	$107.50–$206.40	12% above	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 All Outpatient Services	$215.00	$215.00	$107.50–$206.40	12% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 OP PHLEBOTOMY, THERAPEUTIC	$215.00	$215.00	$161.25–$206.40	—	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 All Inpatient Services	$215.00	$215.00	$161.25–$206.40	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 MODERNA VACCINE 12+	$175.00	$175.00	$78.75–$286.00	35% below	—
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 MODERNA VACCINE 12+	$175.00	$175.00	$78.75–$286.00	—	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PFIZER AGES 12+	$208.00	$208.00	$93.60–$256.96	5% below	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 All Outpatient Services	$208.60	$208.60	$104.30–$200.26	4% below	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PFIZER AGES 12+ COMIRNATY	$208.60	$208.60	$104.30–$200.26	4% below	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 PFIZER AGES 12+	$208.00	$208.00	$93.60–$256.96	—	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 All Inpatient Services	$208.60	$208.60	$156.45–$200.26	—	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 PFIZER AGES 12+ COMIRNATY	$208.60	$208.60	$156.45–$200.26	—	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA (Varivax) 0.5ML VIAL	$217.00	$217.00	$97.65–$636.18	10% above	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA (Varivax) 0.5ML VIAL	$217.00	$217.00	$97.65–$636.18	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUARIX (IIV3)	$42.00	$42.00	$18.90–$72.15	32% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUARIX (IIV3)	$42.00	$42.00	$18.90–$72.15	—	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9	$370.00	$370.00	$166.50–$1,080.88	8% above	—
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9	$370.00	$370.00	$166.50–$1,080.88	—	—
Hepatitis A vaccine, adult dose CPT 90632 HEP A VACCINE, ADULT IM	$163.00	$163.00	$70.26–$137.71	140% above	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACCINE, ADULT IM	$163.00	$163.00	$70.26–$137.71	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VACCINE ADULT IM(1 ML)	$102.00	$102.00	$45.90–$137.94	12% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VACCINE ADULT IM(1 ML)	$102.00	$102.00	$45.90–$137.94	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HD	$220.80	$220.80	$110.40–$211.97	178% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 All Outpatient Services	$220.80	$220.80	$110.40–$211.97	178% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH DOSE	$228.00	$228.00	$73.40–$171.00	187% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 All Inpatient Services	$220.80	$220.80	$165.60–$211.97	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HD	$220.80	$220.80	$165.60–$211.97	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH DOSE	$228.00	$228.00	$73.40–$171.00	—	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR 0.5ML VIAL	$132.00	$132.00	$59.40–$337.55	17% above	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR 0.5ML VIAL	$132.00	$132.00	$59.40–$337.55	—	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCCAL (Menactra)	$142.00	$142.00	$63.90–$558.15	22% below	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCCAL (Menactra)	$142.00	$142.00	$63.90–$558.15	—	—
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO	$256.00	$256.00	$115.20–$794.35	19% below	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO	$256.00	$256.00	$115.20–$794.35	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 All Outpatient Services	$335.20	$335.20	$167.60–$321.79	32% below	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCCAL PREVNAR 20	$335.20	$335.20	$167.60–$321.79	32% below	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMO 20 (PCV 20)	$345.00	$345.00	$155.25–$565.77	30% below	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 All Inpatient Services	$335.20	$335.20	$251.40–$321.79	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCCAL PREVNAR 20	$335.20	$335.20	$251.40–$321.79	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMO 20 (PCV 20)	$345.00	$345.00	$155.25–$565.77	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMONIA 23 VACCINE	$171.00	$171.00	$76.95–$261.60	11% below	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMONIA 23 VACCINE	$171.00	$171.00	$76.95–$261.60	—	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB 0.5ML	$728.00	$728.00	$327.60–$1,860.71	at median	—
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB 0.5ML	$728.00	$728.00	$327.60–$1,860.71	—	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV ABRYSVO	$378.00	$378.00	$170.10–$1,108.91	at median	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV ABRYSVO	$378.00	$378.00	$170.10–$1,108.91	—	—
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV AREXVY	$378.00	$378.00	$170.10–$1,052.52	2% below	—
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV AREXVY	$378.00	$378.00	$170.10–$1,052.52	—	—
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, IM	$526.00	$526.00	$236.70–$636.49	4% below	—
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, IM	$526.00	$526.00	$236.70–$636.49	—	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (SHINGLES) VACCINE	$212.00	$212.00	$95.40–$689.43	22% below	—
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (SHINGLES) VACCINE	$212.00	$212.00	$95.40–$689.43	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD ABSORBED 7 YRS OR > .5ML	$38.00	$38.00	$17.10–$59.47	17% below	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD ABSORBED 7 YRS OR > .5ML	$38.00	$38.00	$17.10–$59.47	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP DUE TO AN INJURY	$69.00	$69.00	$31.05–$75.09	4% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP>7 YRS (Adacel)	$69.00	$69.00	$31.05–$75.09	4% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP PREVENTATIVE	$69.00	$69.00	$31.05–$75.09	4% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 All Outpatient Services	$78.85	$78.85	$39.43–$75.70	10% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TET TOX DIPH TOX & ACELLU	$78.85	$78.85	$39.43–$75.70	10% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP DUE TO AN INJURY	$69.00	$69.00	$31.05–$75.09	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP PREVENTATIVE	$69.00	$69.00	$31.05–$75.09	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP>7 YRS (Adacel)	$69.00	$69.00	$31.05–$75.09	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TET TOX DIPH TOX & ACELLU	$78.85	$78.85	$59.14–$75.70	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 All Inpatient Services	$78.85	$78.85	$59.14–$75.70	—	—
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE VI CAP POLYSAC	$175.00	$175.00	$78.75–$307.70	9% below	—
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE VI CAP POLYSAC	$175.00	$175.00	$78.75–$307.70	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZE ADMIN (PREVENTATIVE)	$41.00	$41.00	$13.45–$38.89	20% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZE ADMINISTRATION INJ	$41.00	$41.00	$13.45–$38.89	20% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZE ADMIN (TDAP INJURY)	$41.00	$41.00	$13.45–$38.89	20% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION	$77.00	$77.00	$38.50–$73.92	125% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 All Outpatient Services	$82.00	$82.00	$41.00–$78.72	140% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$82.00	$82.00	$41.00–$78.72	140% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZE ADMIN (PREVENTATIVE)	$41.00	$41.00	$13.45–$38.89	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZE ADMINISTRATION INJ	$41.00	$41.00	$13.45–$38.89	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZE ADMIN (TDAP INJURY)	$41.00	$41.00	$13.45–$38.89	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION	$77.00	$77.00	$57.75–$73.92	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$82.00	$82.00	$61.50–$78.72	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 All Inpatient Services	$82.00	$82.00	$61.50–$78.72	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZE ADM EACH ADD INJ IM	$29.00	$29.00	$12.07–$30.14	30% below	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZE ADM EACH ADD INJ IM	$29.00	$29.00	$12.07–$30.14	—	—

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/8107/470681056_howard-county-medical-center_standardcharges.csv