Holy Redeemer Hospital and Medical Center
Holy Redeemer Hospital and Medical Center in Meadowbrook, PA publishes cash prices for 385 common procedures listed here, from its own machine-readable price file updated Sep 21, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Pennsylvania median for 285 of 380 procedures and above it for 93. By typical cash price it ranks #18 of 102 Pennsylvania hospitals and #3 of 27 hospitals in the Philadelphia, PA area, cheapest first. Select a procedure to compare it with other hospitals nearby.
1648 Huntingdon Pike, Meadowbrook, PA 19046 Collected Sep 27, 2026 Source price file Check a bill from this hospital (215) 947-3000
Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 390097 · CMS hospital register NPI 1750371522
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Holy Redeemer Hospital and Medical Center is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 Abdomen Combined - CT | $958.59 | $1,597.65 | $142.72–$1,389.96 | 49% below | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 Abdomen Combined - CT | $958.59 | $1,597.65 | — | — | 40% |
| Abdominal X-ray, 2 views both sides CPT 74019 Chest Decub Bilat | $194.44 | $324.06 | $85.47–$249.53 | — | 40% |
| Abdominal X-ray, 2 views both sides CPT 74019 Chest Bilat Decub Portable | $194.44 | $324.06 | $85.47–$249.53 | — | 40% |
| Abdominal X-ray, 2 views CPT 74019 Abdomen w/ Decub, Portable - 821 | $194.44 | $324.06 | $85.47–$249.53 | 41% below | 40% |
| Abdominal X-ray, 2 views CPT 74019 Abdomen Supine & Erect - 821 | $194.44 | $324.06 | $85.47–$249.53 | 41% below | 40% |
| Abdominal X-ray, 2 views inpatient both sides CPT 74019 Chest Bilat Decub Portable | $194.44 | $324.06 | — | — | 40% |
| Abdominal X-ray, 2 views inpatient both sides CPT 74019 Chest Decub Bilat | $194.44 | $324.06 | — | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 Abdomen Supine & Erect - 821 | $194.44 | $324.06 | — | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 Abdomen w/ Decub, Portable - 821 | $194.44 | $324.06 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 Ankle 3+ Views Bilat | $158.49 | $264.15 | $26.88–$203.40 | — | 40% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 Ankle 3+ Views Bilat - 821 | $158.49 | $264.15 | $26.88–$203.40 | — | 40% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 Ankle 3+ Views Bilat - FEAST | $158.49 | $264.15 | $26.88–$203.40 | — | 40% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 Ankle 3+ Views Bilat - BEN | $158.49 | $264.15 | $26.88–$203.40 | — | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle 3+ Views Lt - 821 | $158.49 | $264.15 | $26.88–$203.40 | 58% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle 3+ Views Rt - 821 | $158.49 | $264.15 | $26.88–$203.40 | 58% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle 3+ Views Rt | $158.49 | $264.15 | $26.88–$203.40 | 58% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle 3+ Views Rt - BEN | $158.49 | $264.15 | $26.88–$203.40 | 58% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle 3+ Views Lt | $158.49 | $264.15 | $26.88–$203.40 | 58% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle 3+ Views Lt - BEN | $158.49 | $264.15 | $26.88–$203.40 | 58% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle 3+ Views Rt - FEAST | $158.49 | $264.15 | $26.88–$203.40 | 58% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle 3+ Views Lt - FEAST | $158.49 | $264.15 | $26.88–$203.40 | 58% below | 40% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 Ankle 3+ Views Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 Ankle 3+ Views Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 Ankle 3+ Views Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 Ankle 3+ Views Bilat | $158.49 | $264.15 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle 3+ Views Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle 3+ Views Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle 3+ Views Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle 3+ Views Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle 3+ Views Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle 3+ Views Rt | $158.49 | $264.15 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle 3+ Views Lt | $158.49 | $264.15 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle 3+ Views Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Non-Inv Phys Arterial, Low Ext | $1,076.40 | $1,794.00 | $134.74–$1,381.38 | 134% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Popliteal Artery - HRHMC | $1,159.17 | $1,931.94 | $134.74–$1,487.59 | 152% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Non-Inv Phys Arterial, Upp Ext | $1,159.17 | $1,931.94 | $134.74–$1,487.59 | 152% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Non-Inv Phys Arterial, Low Ext | $1,076.40 | $1,794.00 | — | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Non-Inv Phys Arterial, Upp Ext | $1,159.17 | $1,931.94 | — | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Popliteal Artery - HRHMC | $1,159.17 | $1,931.94 | — | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 Upper Extremity Plain - CT | $594.13 | $990.21 | $101.12–$861.48 | 52% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 Upper Extremity Plain - CT | $594.13 | $990.21 | — | — | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Esophogram | $328.08 | $546.79 | $28.80–$421.03 | 29% below | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Esophogram | $328.08 | $546.79 | — | — | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 Bone/Joint Imaging, WB - NM | $926.10 | $1,543.50 | $78.72–$1,342.85 | 30% below | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone/Joint Imaging, WB - NM | $926.10 | $1,543.50 | — | — | 40% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Bilat - BEN | $221.60 | $369.32 | $68.84–$321.31 | — | 40% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Bilat ABUS - SWC | $254.83 | $424.71 | $68.84–$369.50 | — | 40% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Bilat - SWC | $424.71 | $707.85 | $68.84–$615.83 | — | 40% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Bilat ABUS - 821 | $424.71 | $707.85 | $68.84–$615.83 | — | 40% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Bilateral | $566.28 | $943.79 | $68.84–$821.10 | — | 40% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Bilat - 821 | $566.28 | $943.79 | $68.84–$821.10 | — | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Rt ABUS - SWC | $194.44 | $324.06 | $68.84–$281.93 | 64% below | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Lt ABUS - SWC | $194.44 | $324.06 | $68.84–$281.93 | 64% below | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Rt - BEN | $194.44 | $324.06 | $68.84–$281.93 | 64% below | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Lt - 821 | $283.03 | $471.71 | $68.84–$410.39 | 48% below | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Rt - 821 | $283.03 | $471.71 | $68.84–$410.39 | 48% below | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Rt ABUS - 821 | $424.71 | $707.85 | $68.84–$615.83 | 21% below | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Lt - SWC | $424.71 | $707.85 | $68.84–$615.83 | 21% below | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Rt - SWC | $424.71 | $707.85 | $68.84–$615.83 | 21% below | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Lt | $424.71 | $707.85 | $68.84–$615.83 | 21% below | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Rt | $424.71 | $707.85 | $68.84–$615.83 | 21% below | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Lt ABUS - 821 | $424.71 | $707.85 | $68.84–$615.83 | 21% below | 40% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Bilat - BEN | $221.60 | $369.32 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Bilat ABUS - SWC | $254.83 | $424.71 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Bilat - SWC | $424.71 | $707.85 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Bilat ABUS - 821 | $424.71 | $707.85 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Bilateral | $566.28 | $943.79 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Bilat - 821 | $566.28 | $943.79 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Rt - BEN | $194.44 | $324.06 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Rt ABUS - SWC | $194.44 | $324.06 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Lt ABUS - SWC | $194.44 | $324.06 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Lt - 821 | $283.03 | $471.71 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Rt - 821 | $283.03 | $471.71 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Rt - SWC | $424.71 | $707.85 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Lt | $424.71 | $707.85 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Rt ABUS - 821 | $424.71 | $707.85 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Lt - SWC | $424.71 | $707.85 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Lt ABUS - 821 | $424.71 | $707.85 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Rt | $424.71 | $707.85 | — | — | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US Chest Limited - IR | $169.76 | $282.92 | $68.84–$217.85 | 63% below | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US Chest Limited - IR | $169.76 | $282.92 | — | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Abdomen and Pelvis w/wo Contrast - CT | $1,074.00 | $1,789.99 | $232.00–$1,557.29 | 59% below | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Abdomen and Pelvis w/wo Contrast - CT | $1,074.00 | $1,789.99 | — | — | 40% |
| CT angiography (CTA) of the head CPT 70496 Brain - CT | $886.20 | $1,477.00 | $177.63–$1,284.99 | 45% below | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 Brain - CT | $886.20 | $1,477.00 | — | — | 40% |
| CT angiography (CTA) of the neck CPT 70498 Neck, Carotids - CT | $886.20 | $1,477.00 | $177.63–$1,284.99 | 46% below | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 Neck, Carotids - CT | $886.20 | $1,477.00 | — | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Chest - CT | $985.67 | $1,642.77 | $177.63–$1,429.21 | 48% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Chest - CT | $985.67 | $1,642.77 | — | — | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA w/wo, Strxr Quan Calc - CT | $998.54 | $1,664.22 | $206.71–$1,447.87 | 49% below | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA w/wo, Strxr - CT | $998.54 | $1,664.22 | $206.71–$1,447.87 | 49% below | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA w/wo, Strxr - CT | $998.54 | $1,664.22 | — | — | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA w/wo, Strxr Quan Calc - CT | $998.54 | $1,664.22 | — | — | 40% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 Calcium Scoring Diagnostic - CT | $674.01 | $1,123.35 | $34.65–$977.31 | 362% above | 40% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 Calcium Scoring Diagnostic - CT | $674.01 | $1,123.35 | — | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 Abdomen and Pelvis, Plain - CT | $758.16 | $1,263.60 | $148.88–$1,099.33 | 64% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Abdomen and Pelvis, Plain - CT | $758.16 | $1,263.60 | — | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Abdomen and Pelvis Enhanced - CT | $842.40 | $1,404.00 | $230.26–$1,221.48 | 72% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Abdomen and Pelvis Enhanced - CT | $842.40 | $1,404.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Abdomen & Pelvis Combined - CT | $972.00 | $1,620.00 | $232.00–$1,409.40 | 67% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Urogram - CT | $972.00 | $1,620.00 | $232.00–$1,409.40 | 67% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Abdomen & Pelvis Combined - CT | $972.00 | $1,620.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Urogram - CT | $972.00 | $1,620.00 | — | — | 40% |
| CT scan of the abdomen with contrast CPT 74160 Abdomen Enhanced - CT | $791.34 | $1,318.89 | $115.20–$1,147.43 | 52% below | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 Abdomen Enhanced - CT | $791.34 | $1,318.89 | — | — | 40% |
| CT scan of the abdomen without contrast CPT 74150 Abdomen Plain - CT | $671.52 | $1,119.19 | $99.20–$973.70 | 43% below | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 Abdomen Plain - CT | $671.52 | $1,119.19 | — | — | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 Sinuses Plain - CT | $581.65 | $969.41 | $99.20–$843.39 | 49% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Facial Bone/Mandible Plain - CT | $581.65 | $969.41 | $99.20–$843.39 | 49% below | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Sinuses Plain - CT | $581.65 | $969.41 | — | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Facial Bone/Mandible Plain - CT | $581.65 | $969.41 | — | — | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 Head/Brain Plain - CT | $550.08 | $916.80 | $99.20–$797.62 | 49% below | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 Head/Brain Plain - CT | $550.08 | $916.80 | — | — | 40% |
| CT scan of the head with contrast CPT 70460 Head/Brain Enhanced - CT | $664.03 | $1,106.71 | $102.40–$962.84 | 50% below | 40% |
| CT scan of the head with contrast inpatient CPT 70460 Head/Brain Enhanced - CT | $664.03 | $1,106.71 | — | — | 40% |
| CT scan of the head without and with contrast CPT 70470 Head/Brain Combined - CT | $813.81 | $1,356.34 | $128.00–$1,180.02 | 51% below | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 Head/Brain Combined - CT | $813.81 | $1,356.34 | — | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 Lumbar Spine Plain - CT | $691.49 | $1,152.47 | $105.87–$1,002.65 | 45% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Lumbar Spine Plain - CT | $691.49 | $1,152.47 | — | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 Cervical Spine Plain - CT | $689.47 | $1,149.11 | $102.40–$999.73 | 45% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Cervical Spine Plain - CT | $689.47 | $1,149.11 | — | — | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 Pelvis Enhanced - CT | $776.36 | $1,293.93 | $110.72–$1,125.72 | 54% below | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 Pelvis Enhanced - CT | $776.36 | $1,293.93 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex Extracranial Arteries, Bilat Complete - BEN | $1,178.21 | $1,963.67 | $218.98–$1,512.03 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex Extracranial Arteries, Bilat Complete | $1,178.21 | $1,963.67 | $218.98–$1,512.03 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex Extracranial Arteries, Bilat Complete - 821 | $1,178.21 | $1,963.67 | $218.98–$1,512.03 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex Extracranial Arteries, Bilat Complete - FEAST | $1,178.21 | $1,963.67 | $218.98–$1,512.03 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Duplex Extracranial Arteries, Bilat Complete | $1,178.21 | $1,963.67 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Duplex Extracranial Arteries, Bilat Complete - 821 | $1,178.21 | $1,963.67 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Duplex Extracranial Arteries, Bilat Complete - BEN | $1,178.21 | $1,963.67 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Duplex Extracranial Arteries, Bilat Complete - FEAST | $1,178.21 | $1,963.67 | — | — | 40% |
| Chest CT scan without and with contrast CPT 71270 Chest/Thorax Combined - CT | $988.55 | $1,647.58 | $132.48–$1,433.39 | 41% below | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 Chest/Thorax Combined - CT | $988.55 | $1,647.58 | — | — | 40% |
| Chest X-ray, 2 views both sides CPT 71046 Bilat Decub Chest - FEAST | $158.49 | $264.15 | $46.37–$203.40 | — | 40% |
| Chest X-ray, 2 views both sides CPT 71046 Chest Decub Portable Bilat - 821 | $158.49 | $264.15 | $46.37–$203.40 | — | 40% |
| Chest X-ray, 2 views both sides CPT 71046 Bilat Decub Chest - 821 | $158.49 | $264.15 | $46.37–$203.40 | — | 40% |
| Chest X-ray, 2 views both sides CPT 71046 Bilat Decub Chest - BEN | $158.49 | $264.15 | $46.37–$203.40 | — | 40% |
| Chest X-ray, 2 views CPT 71046 Chest, PA & Lateral | $158.06 | $263.42 | $46.37–$202.83 | 51% below | 40% |
| Chest X-ray, 2 views CPT 71046 Chest PA & Lat OccHlth - 821 | $158.49 | $264.15 | $46.37–$203.40 | 51% below | 40% |
| Chest X-ray, 2 views CPT 71046 Chest PA & Lat - 821 | $158.49 | $264.15 | $46.37–$203.40 | 51% below | 40% |
| Chest X-ray, 2 views CPT 71046 Chest PA & Lat Portable - 821 | $158.49 | $264.15 | $46.37–$203.40 | 51% below | 40% |
| Chest X-ray, 2 views CPT 71046 Chest, PA, Lat & Fluoro | $158.49 | $264.15 | $46.37–$203.40 | 51% below | 40% |
| Chest X-ray, 2 views CPT 71046 Chest PA & Lat OccHlth - BEN | $158.49 | $264.15 | $46.37–$203.40 | 51% below | 40% |
| Chest X-ray, 2 views CPT 71046 Chest PA & Lat - FEAST | $158.49 | $264.15 | $46.37–$203.40 | 51% below | 40% |
| Chest X-ray, 2 views CPT 71046 Chest PA & Lat OccHlth - FEAST | $158.49 | $264.15 | $46.37–$203.40 | 51% below | 40% |
| Chest X-ray, 2 views CPT 71046 Chest, PA & Lat, Portable | $158.49 | $264.15 | $46.37–$203.40 | 51% below | 40% |
| Chest X-ray, 2 views CPT 71046 Chest, PA & Lat, OccHlth | $158.49 | $264.15 | $46.37–$203.40 | 51% below | 40% |
| Chest X-ray, 2 views CPT 71046 Chest PA & Lat - BEN | $158.49 | $264.15 | $46.37–$203.40 | 51% below | 40% |
| Chest X-ray, 2 views inpatient both sides CPT 71046 Bilat Decub Chest - BEN | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient both sides CPT 71046 Chest Decub Portable Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient both sides CPT 71046 Bilat Decub Chest - 821 | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient both sides CPT 71046 Bilat Decub Chest - FEAST | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest, PA & Lateral | $158.06 | $263.42 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest PA & Lat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest PA & Lat - 821 | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest PA & Lat OccHlth - 821 | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest PA & Lat Portable - 821 | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest, PA & Lat, OccHlth | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest, PA & Lat, Portable | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest, PA, Lat & Fluoro | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest PA & Lat - BEN | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest PA & Lat OccHlth - BEN | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest PA & Lat OccHlth - FEAST | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, single view CPT 71045 Chest, Single View, Portable | $158.06 | $263.42 | $46.37–$202.83 | 16% below | 40% |
| Chest X-ray, single view CPT 71045 Chest PA OccHealth - 821 | $158.49 | $264.15 | $46.37–$203.40 | 16% below | 40% |
| Chest X-ray, single view CPT 71045 Chest Single View - 821 | $158.49 | $264.15 | $46.37–$203.40 | 16% below | 40% |
| Chest X-ray, single view CPT 71045 Chest Single View Portable - 821 | $158.49 | $264.15 | $46.37–$203.40 | 16% below | 40% |
| Chest X-ray, single view CPT 71045 Chest One View Occupatl Health | $158.49 | $264.15 | $46.37–$203.40 | 16% below | 40% |
| Chest X-ray, single view CPT 71045 Chest Single View - BEN | $158.49 | $264.15 | $46.37–$203.40 | 16% below | 40% |
| Chest X-ray, single view CPT 71045 Chest PA OccHlth - BEN | $158.49 | $264.15 | $46.37–$203.40 | 16% below | 40% |
| Chest X-ray, single view CPT 71045 Chest Single View - FEAST | $158.49 | $264.15 | $46.37–$203.40 | 16% below | 40% |
| Chest X-ray, single view CPT 71045 Chest PA OccHlth - FEAST | $158.49 | $264.15 | $46.37–$203.40 | 16% below | 40% |
| Chest X-ray, single view CPT 71045 Chest, PA, OccHealth | $158.49 | $264.15 | $46.37–$203.40 | 16% below | 40% |
| Chest X-ray, single view CPT 71045 Chest, Single View | $158.49 | $264.15 | $46.37–$203.40 | 16% below | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest, Single View, Portable | $158.06 | $263.42 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest PA OccHealth - 821 | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest Single View Portable - 821 | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest, Single View | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest, PA, OccHealth | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest One View Occupatl Health | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest Single View - BEN | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest Single View - 821 | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest PA OccHlth - BEN | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest PA OccHlth - FEAST | $158.49 | $264.15 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest Single View - FEAST | $158.49 | $264.15 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete both sides CPT 73000 Clavicle Bilat - 821 | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Collarbone (clavicle) X-ray, complete both sides CPT 73000 Clavicle Bilat - FEAST | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Collarbone (clavicle) X-ray, complete both sides CPT 73000 Clavicle Bilat - BEN | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Collarbone (clavicle) X-ray, complete both sides CPT 73000 Clavicle Bilat | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Rt | $158.49 | $264.15 | $14.72–$203.40 | 46% below | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 46% below | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 46% below | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Rt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 46% below | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Lt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 46% below | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Lt | $158.49 | $264.15 | $14.72–$203.40 | 46% below | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Rt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 46% below | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Lt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 46% below | 40% |
| Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 Clavicle Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 Clavicle Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 Clavicle Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 Clavicle Bilat | $158.49 | $264.15 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Lt | $158.49 | $264.15 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Rt | $158.49 | $264.15 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal, Complete - 821 | $800.36 | $1,333.93 | $62.72–$1,160.52 | 9% above | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal and Bladder | $800.36 | $1,333.93 | $62.72–$1,160.52 | 9% above | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal, Complete - BEN | $800.36 | $1,333.93 | $62.72–$1,160.52 | 9% above | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal, Complete - FEAST | $800.36 | $1,333.93 | $62.72–$1,160.52 | 9% above | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal, Complete - BEN | $800.36 | $1,333.93 | — | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal, Complete - FEAST | $800.36 | $1,333.93 | — | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal and Bladder | $800.36 | $1,333.93 | — | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal, Complete - 821 | $800.36 | $1,333.93 | — | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dexa Bone Density Axial - BEN | $194.44 | $324.06 | $58.82–$249.53 | 30% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dexa Bone Density Axial - SWC | $194.44 | $324.06 | $58.82–$249.53 | 30% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dexa Bone Density Axial - 821 | $194.44 | $324.06 | $58.82–$249.53 | 30% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dexa Bone Density Axial - FEAST | $194.44 | $324.06 | $58.82–$249.53 | 30% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Dexa Bone Density Axial - FEAST | $194.44 | $324.06 | — | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Dexa Bone Density Axial - 821 | $194.44 | $324.06 | — | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Dexa Bone Density Axial - SWC | $194.44 | $324.06 | — | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Dexa Bone Density Axial - BEN | $194.44 | $324.06 | — | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg w/ Detailed Anatomic - FEAST | $679.54 | $1,132.56 | $122.66–$872.07 | 42% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg w/ Detailed Anatomic - SWC | $679.54 | $1,132.56 | $122.66–$872.07 | 42% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg w/ Detailed Anatomic | $679.54 | $1,132.56 | $122.66–$872.07 | 42% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg w/ Detailed Anatomic - 821 | $679.54 | $1,132.56 | $122.66–$872.07 | 42% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg w/ Detailed Anatomic - MFM | $679.54 | $1,132.56 | $122.66–$872.07 | 42% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg w/ Detailed Anatomic - BEN | $679.54 | $1,132.56 | $122.66–$872.07 | 42% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Preg w/ Detailed Anatomic - BEN | $679.54 | $1,132.56 | — | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Preg w/ Detailed Anatomic - MFM | $679.54 | $1,132.56 | — | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Preg w/ Detailed Anatomic - 821 | $679.54 | $1,132.56 | — | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Preg w/ Detailed Anatomic | $679.54 | $1,132.56 | — | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Preg w/ Detailed Anatomic - SWC | $679.54 | $1,132.56 | — | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Preg w/ Detailed Anatomic - FEAST | $679.54 | $1,132.56 | — | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 Chest Veran - CT | $691.49 | $1,152.47 | $102.40–$1,002.65 | 38% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 Chest/Thorax Plain - CT | $691.49 | $1,152.47 | $102.40–$1,002.65 | 38% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Chest/Thorax Plain - CT | $691.49 | $1,152.47 | — | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Chest Veran - CT | $691.49 | $1,152.47 | — | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 Chest/Thorax Enhanced - CT | $808.82 | $1,348.02 | $112.00–$1,172.78 | 45% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Chest/Thorax Enhanced - CT | $808.82 | $1,348.02 | — | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 REM Diag Mammo Bilat Incl CAD - 821 BC | $240.60 | $401.00 | $71.00–$308.77 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 CB Diag Mammo Bilat Incl CAD - SWC | $248.30 | $413.83 | $71.00–$318.65 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 SD Diag Mammo Bilat Incl CAD - SWC | $248.30 | $413.83 | $71.00–$318.65 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Diag Mammo Bilat Incl CAD - SWC | $248.30 | $413.83 | $71.00–$318.65 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Diag Mammo Bilateral Incl CAD - HRHMC | $248.30 | $413.83 | $71.00–$318.65 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 CB Mam Digital Bilateral - SWC | $373.92 | $623.20 | $71.00–$479.86 | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 REM Diag Mammo Bilat Incl CAD - 821 BC | $240.60 | $401.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 CB Diag Mammo Bilat Incl CAD - SWC | $248.30 | $413.83 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Diag Mammo Bilat Incl CAD - SWC | $248.30 | $413.83 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 SD Diag Mammo Bilat Incl CAD - SWC | $248.30 | $413.83 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Diag Mammo Bilateral Incl CAD - HRHMC | $248.30 | $413.83 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 CB Mam Digital Bilateral - SWC | $373.92 | $623.20 | — | — | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 CB Diagnostic Mammo Uni - Lt Inc CAD - SWC | $134.72 | $224.52 | $71.00–$196.00 | 57% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 CB Diagnostic Mammo Uni - Rt Inc CAD - SWC | $134.72 | $224.52 | $71.00–$196.00 | 57% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 Diag Mammo Uni Rt Incl CAD - BEN | $189.33 | $315.55 | $71.00–$242.97 | 39% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 Diag Mammo Uni Lt Incl CAD - BEN | $189.33 | $315.55 | $71.00–$242.97 | 39% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 CB Diag Mammo Uni Rt Incl CAD - SWC | $229.49 | $382.48 | $71.00–$294.51 | 26% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 Diag Mammo Uni Rt Incl CAD - SWC | $229.49 | $382.48 | $71.00–$294.51 | 26% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 Diag Mammo Uni Lt Incl CAD - SWC | $229.49 | $382.48 | $71.00–$294.51 | 26% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 CB Diag Mammo Uni Lt Incl CAD - SWC | $229.49 | $382.48 | $71.00–$294.51 | 26% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 REM Diag Mammo Uni LT Incl CAD - 821 BC | $258.00 | $430.00 | $71.00–$331.10 | 17% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 REM Diag Mammo Uni RT Incl CAD - 821 BC | $258.00 | $430.00 | $71.00–$331.10 | 17% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 Diag Mammo Uni Lt Incl CAD - HRHMC | $258.18 | $430.29 | $71.00–$331.32 | 17% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 SD Diag Mammo Uni Rt Incl CAD - SWC | $258.18 | $430.29 | $71.00–$331.32 | 17% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 SD Diag Mammo Uni Lt Incl CAD - SWC | $258.18 | $430.29 | $71.00–$331.32 | 17% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 Diag Mammo Uni Rt Incl CAD - HRHMC | $258.18 | $430.29 | $71.00–$331.32 | 17% below | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 CB Diagnostic Mammo Uni - Lt Inc CAD - SWC | $134.72 | $224.52 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 CB Diagnostic Mammo Uni - Rt Inc CAD - SWC | $134.72 | $224.52 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Diag Mammo Uni Lt Incl CAD - BEN | $189.33 | $315.55 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Diag Mammo Uni Rt Incl CAD - BEN | $189.33 | $315.55 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 CB Diag Mammo Uni Rt Incl CAD - SWC | $229.49 | $382.48 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Diag Mammo Uni Rt Incl CAD - SWC | $229.49 | $382.48 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 CB Diag Mammo Uni Lt Incl CAD - SWC | $229.49 | $382.48 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Diag Mammo Uni Lt Incl CAD - SWC | $229.49 | $382.48 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 REM Diag Mammo Uni LT Incl CAD - 821 BC | $258.00 | $430.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 REM Diag Mammo Uni RT Incl CAD - 821 BC | $258.00 | $430.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Diag Mammo Uni Rt Incl CAD - HRHMC | $258.18 | $430.29 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Diag Mammo Uni Lt Incl CAD - HRHMC | $258.18 | $430.29 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 SD Diag Mammo Uni Lt Incl CAD - SWC | $258.18 | $430.29 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 SD Diag Mammo Uni Rt Incl CAD - SWC | $258.18 | $430.29 | — | — | 40% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Duplx Low Extremity AR/Gra BI | $1,159.17 | $1,931.94 | $218.98–$1,487.59 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Duplx Low Extremity AR/Gra BI - FEAST | $1,159.17 | $1,931.94 | $218.98–$1,487.59 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Duplx Low Extremity AR/Gra BI - BEN | $1,159.17 | $1,931.94 | $218.98–$1,487.59 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Duplx Low Extremity AR/Gra BI | $1,159.17 | $1,931.94 | — | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Duplx Low Extremity AR/Gra BI - BEN | $1,159.17 | $1,931.94 | — | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Duplx Low Extremity AR/Gra BI - FEAST | $1,159.17 | $1,931.94 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplx Reflx Extr Veins Low BI | $1,159.17 | $1,931.94 | $163.55–$1,487.59 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplx Reflx Extr Veins Low BI - BEN | $1,159.17 | $1,931.94 | $163.55–$1,487.59 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplx Reflx Extr Veins Low BI - FEAST | $1,159.17 | $1,931.94 | $163.55–$1,487.59 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex Extremity Veins, Bilat | $1,174.81 | $1,958.01 | $163.55–$1,507.67 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex Extremity Veins, Bilat Upper - IR | $1,178.21 | $1,963.67 | $163.55–$1,512.03 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex Extremity Veins, Bilat Upper - FEAST | $1,178.21 | $1,963.67 | $163.55–$1,512.03 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex Extremity Veins, Bilat Lower - FEAST | $1,178.21 | $1,963.67 | $163.55–$1,512.03 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex Extremity Veins, Bilat Upper - BEN | $1,178.21 | $1,963.67 | $163.55–$1,512.03 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex Extremity Veins, Bilat Lower - BEN | $1,178.21 | $1,963.67 | $163.55–$1,512.03 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex Extremity Veins, Bilat Lower - IR | $1,178.21 | $1,963.67 | $163.55–$1,512.03 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex Extremity Veins, Bilat Upper - HRHMC | $1,178.21 | $1,963.67 | $163.55–$1,512.03 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Subclavian Vein Bilateral | $1,178.21 | $1,963.67 | $163.55–$1,512.03 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex Extremity Veins, Bilat Upper - 821 | $1,178.21 | $1,963.67 | $163.55–$1,512.03 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex Extremity Veins, Bilat Lower - 821 | $1,178.21 | $1,963.67 | $163.55–$1,512.03 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplx Reflx Extr Veins Low BI - FEAST | $1,159.17 | $1,931.94 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplx Reflx Extr Veins Low BI | $1,159.17 | $1,931.94 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplx Reflx Extr Veins Low BI - BEN | $1,159.17 | $1,931.94 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplex Extremity Veins, Bilat | $1,174.81 | $1,958.01 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplex Extremity Veins, Bilat Upper - HRHMC | $1,178.21 | $1,963.67 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplex Extremity Veins, Bilat Lower - FEAST | $1,178.21 | $1,963.67 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplex Extremity Veins, Bilat Lower - IR | $1,178.21 | $1,963.67 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplex Extremity Veins, Bilat Upper - IR | $1,178.21 | $1,963.67 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplex Extremity Veins, Bilat Lower - BEN | $1,178.21 | $1,963.67 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplex Extremity Veins, Bilat Upper - BEN | $1,178.21 | $1,963.67 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplex Extremity Veins, Bilat Upper - FEAST | $1,178.21 | $1,963.67 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplex Extremity Veins, Bilat Lower - 821 | $1,178.21 | $1,963.67 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Subclavian Vein Bilateral | $1,178.21 | $1,963.67 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplex Extremity Veins, Bilat Upper - 821 | $1,178.21 | $1,963.67 | — | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Cardiogram w/ Doppler | $1,682.84 | $2,804.72 | $208.00–$2,159.63 | 12% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Infant Echo Cardiogram w/ Dop | $1,687.70 | $2,812.83 | $208.00–$2,165.88 | 12% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Cardiogram w/ Doppler - FEAST | $1,687.70 | $2,812.83 | $208.00–$2,165.88 | 12% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Transthoracic Echo Neoplastic w/ Contrast | $1,687.80 | $2,813.00 | $208.00–$2,166.01 | 12% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo Cardiogram w/ Doppler | $1,682.84 | $2,804.72 | — | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo Cardiogram w/ Doppler - FEAST | $1,687.70 | $2,812.83 | — | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Infant Echo Cardiogram w/ Dop | $1,687.70 | $2,812.83 | — | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Transthoracic Echo Neoplastic w/ Contrast | $1,687.80 | $2,813.00 | — | — | 40% |
| Elbow X-ray, 2 views both sides CPT 73070 Elbow AP & Lat Bilat - 821 | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Elbow X-ray, 2 views both sides CPT 73070 Elbow AP & Lat Bilat - BEN | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Elbow X-ray, 2 views both sides CPT 73070 Elbow AP & Lat Bilat - FEAST | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Elbow X-ray, 2 views both sides CPT 73070 Elbow AP & Lat Bilat | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow AP & Lat Rt | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow AP & Lat Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow 2 Views Portable Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow AP & Lat Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow 2 Views Portable Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow AP & Lat Lt | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow 2 Views Portable Lt | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow 2 Views Portable Rt | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow AP & Lat Lt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow AP & Lat Rt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow AP & Lat Lt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow AP & Lat Rt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, 2 views inpatient both sides CPT 73070 Elbow AP & Lat Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient both sides CPT 73070 Elbow AP & Lat Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient both sides CPT 73070 Elbow AP & Lat Bilat | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient both sides CPT 73070 Elbow AP & Lat Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow AP & Lat Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow AP & Lat Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow AP & Lat Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow 2 Views Portable Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow AP & Lat Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow 2 Views Portable Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow AP & Lat Lt | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow 2 Views Portable Lt | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow AP & Lat Rt | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow 2 Views Portable Rt | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow AP & Lat Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow AP & Lat Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 Elbow Complete Bilat - BEN | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 Elbow Complete Bilat - 821 | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 Elbow Complete Bilat - FEAST | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 Elbow Complete Bilat | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Complete Rt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Complete Rt | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Complete Lt | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Complete Lt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Complete Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Complete Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Complete Rt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Complete Lt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 51% below | 40% |
| Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 Elbow Complete Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 Elbow Complete Bilat | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 Elbow Complete Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 Elbow Complete Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Complete Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Complete Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Complete Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Complete Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Complete Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Complete Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Complete Lt | $158.49 | $264.15 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Complete Rt | $158.49 | $264.15 | — | — | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT IACS/Mastoids Plain - CT | $601.62 | $1,002.69 | $105.87–$872.34 | 45% below | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 Orbits/Sella/IAC Plain - CT | $601.62 | $1,002.69 | $105.87–$872.34 | 45% below | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Orbits/Sella/IAC Plain - CT | $601.62 | $1,002.69 | — | — | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IACS/Mastoids Plain - CT | $601.62 | $1,002.69 | — | — | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 Facial Bone Complete - 821 | $194.44 | $324.06 | $28.80–$249.53 | 53% below | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 Facial Bone Complete - FEAST | $194.44 | $324.06 | $28.80–$249.53 | 53% below | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 Facial Bone Complete - BEN | $194.44 | $324.06 | $28.80–$249.53 | 53% below | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 Facial Bone Complete | $194.44 | $324.06 | $28.80–$249.53 | 53% below | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Facial Bone Complete - FEAST | $194.44 | $324.06 | — | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Facial Bone Complete | $194.44 | $324.06 | — | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Facial Bone Complete - 821 | $194.44 | $324.06 | — | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Facial Bone Complete - BEN | $194.44 | $324.06 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 Forearm Bilat | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 Forearm Bilat - 821 | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 Forearm Bilat - FEAST | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 Forearm Bilat - BEN | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Portable Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 44% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Rt | $158.49 | $264.15 | $14.72–$203.40 | 44% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Portable Lt | $158.49 | $264.15 | $14.72–$203.40 | 44% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Lt | $158.49 | $264.15 | $14.72–$203.40 | 44% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 44% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Portable Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 44% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 44% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Rt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 44% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Lt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 44% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Rt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 44% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Lt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 44% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Portable Rt | $158.49 | $264.15 | $14.72–$203.40 | 44% below | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 Forearm Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 Forearm Bilat | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 Forearm Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 Forearm Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Portable Lt | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Portable Rt | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Rt | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Portable Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Lt | $158.49 | $264.15 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Portable Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Gallbladder w/o Pharmacol - NM | $926.10 | $1,543.50 | $225.31–$1,342.85 | 28% below | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Gallbladder w/o Pharmacol - NM | $926.10 | $1,543.50 | — | — | 40% |
| Hand X-ray, 2 views both sides CPT 73120 Hand PA & Lat Bilat - 821 | $194.44 | $324.06 | $12.80–$249.53 | — | 40% |
| Hand X-ray, 2 views both sides CPT 73120 Hand PA & Lat Bilat - FEAST | $194.44 | $324.06 | $12.80–$249.53 | — | 40% |
| Hand X-ray, 2 views both sides CPT 73120 Hand PA & Lat Bilat - BEN | $194.44 | $324.06 | $12.80–$249.53 | — | 40% |
| Hand X-ray, 2 views both sides CPT 73120 Hand PA & Lat Bilat | $194.44 | $324.06 | $12.80–$249.53 | — | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand PA & Lat Lt | $194.44 | $324.06 | $12.80–$249.53 | 31% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand 2 Views Lt Portable | $194.44 | $324.06 | $12.80–$249.53 | 31% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand PA & Lat Rt | $194.44 | $324.06 | $12.80–$249.53 | 31% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand 2 Views Rt Portable | $194.44 | $324.06 | $12.80–$249.53 | 31% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand PA & Lat Lt - BEN | $194.44 | $324.06 | $12.80–$249.53 | 31% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand PA & Lat Rt - BEN | $194.44 | $324.06 | $12.80–$249.53 | 31% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand PA & Lat Lt - FEAST | $194.44 | $324.06 | $12.80–$249.53 | 31% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand PA & Lat Rt - FEAST | $194.44 | $324.06 | $12.80–$249.53 | 31% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand PA & Lat Lt - 821 | $194.44 | $324.06 | $12.80–$249.53 | 31% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand 2 Views Lt Portable - 821 | $194.44 | $324.06 | $12.80–$249.53 | 31% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand PA & Lat Rt - 821 | $194.44 | $324.06 | $12.80–$249.53 | 31% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand 2 Views Rt Portable - 821 | $194.44 | $324.06 | $12.80–$249.53 | 31% below | 40% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 Hand PA & Lat Bilat - 821 | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 Hand PA & Lat Bilat | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 Hand PA & Lat Bilat - BEN | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 Hand PA & Lat Bilat - FEAST | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand PA & Lat Lt - 821 | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand 2 Views Lt Portable | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand 2 Views Rt Portable - 821 | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand PA & Lat Rt - 821 | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand 2 Views Lt Portable - 821 | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand PA & Lat Lt - BEN | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand 2 Views Rt Portable | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand PA & Lat Rt | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand PA & Lat Lt | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand PA & Lat Lt - FEAST | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand PA & Lat Rt - FEAST | $194.44 | $324.06 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand PA & Lat Rt - BEN | $194.44 | $324.06 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 Calcaneous, Bilat - 821 | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 Calcaneous, Bilat - FEAST | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 Calcaneous, Bilat - BEN | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 Calcaneous, Bilat | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Calcaneous, Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 39% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Calcaneous, Rt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 39% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Calcaneous, Lt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 39% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Calcaneous, Rt | $158.49 | $264.15 | $14.72–$203.40 | 39% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Calcaneous, Lt | $158.49 | $264.15 | $14.72–$203.40 | 39% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Calcaneous, Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 39% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Calcaneous, Rt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 39% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Calcaneous, Lt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 39% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 Calcaneous, Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 Calcaneous, Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 Calcaneous, Bilat | $158.49 | $264.15 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 Calcaneous, Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Calcaneous, Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Calcaneous, Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Calcaneous, Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Calcaneous, Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Calcaneous, Lt | $158.49 | $264.15 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Calcaneous, Rt | $158.49 | $264.15 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Calcaneous, Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Calcaneous, Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Portable Sleep Study - SL | $849.11 | $1,415.17 | $213.12–$1,331.00 | 56% above | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Portable Sleep Study-Inneoplastic - SL | $1,152.22 | $1,920.36 | $213.12–$1,478.68 | 111% above | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study - Home Incomplete Study - SL | $1,152.22 | $1,920.36 | $213.12–$1,478.68 | 111% above | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Portable Sleep Study - SL | $849.11 | $1,415.17 | — | — | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Portable Sleep Study-Inneoplastic - SL | $1,152.22 | $1,920.36 | — | — | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Sleep Study - Home Incomplete Study - SL | $1,152.22 | $1,920.36 | — | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnogram with CPAP - SL | $3,007.37 | $5,012.28 | $515.98–$3,859.46 | 4% below | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysomnogram with CPAP - SL | $3,007.37 | $5,012.28 | — | — | 40% |
| Knee X-ray, 3 views both sides CPT 73562 Knee 3+ Views Bilat - BEN | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| Knee X-ray, 3 views both sides CPT 73562 Knee 3+ Views Bilat | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| Knee X-ray, 3 views both sides CPT 73562 Knee 3+ Views Bilat - 821 | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| Knee X-ray, 3 views both sides CPT 73562 Knee 3+ Views Bilat - FEAST | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| Knee X-ray, 3 views one side CPT 73562 Knee 3+ Views Rt - FEAST | $158.49 | $264.15 | $21.12–$203.40 | 60% below | 40% |
| Knee X-ray, 3 views one side CPT 73562 Knee 3+ Views Rt - BEN | $158.49 | $264.15 | $21.12–$203.40 | 60% below | 40% |
| Knee X-ray, 3 views one side CPT 73562 Knee 3+ Views Lt - BEN | $158.49 | $264.15 | $21.12–$203.40 | 60% below | 40% |
| Knee X-ray, 3 views one side CPT 73562 Knee 3+ Views Lt | $158.49 | $264.15 | $21.12–$203.40 | 60% below | 40% |
| Knee X-ray, 3 views one side CPT 73562 Knee 3+ Views Rt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 60% below | 40% |
| Knee X-ray, 3 views one side CPT 73562 Knee 3+ Views Lt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 60% below | 40% |
| Knee X-ray, 3 views one side CPT 73562 Knee 3+ Views Lt - FEAST | $158.49 | $264.15 | $21.12–$203.40 | 60% below | 40% |
| Knee X-ray, 3 views one side CPT 73562 Knee 3+ Views Rt | $158.49 | $264.15 | $21.12–$203.40 | 60% below | 40% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 Knee 3+ Views Bilat | $158.49 | $264.15 | — | — | 40% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 Knee 3+ Views Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 Knee 3+ Views Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 Knee 3+ Views Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 Knee 3+ Views Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 Knee 3+ Views Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 Knee 3+ Views Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 Knee 3+ Views Lt | $158.49 | $264.15 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 Knee 3+ Views Rt | $158.49 | $264.15 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 Knee 3+ Views Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 Knee 3+ Views Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 Knee 3+ Views Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 Knee 4+ Views Bilat - FEAST | $194.44 | $324.06 | $33.92–$249.53 | — | 40% |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 Knee 4+ Views Bilat - 821 | $194.44 | $324.06 | $33.92–$249.53 | — | 40% |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 Knee 4+ Views Bilat | $194.44 | $324.06 | $33.92–$249.53 | — | 40% |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 Knee 4+ Views Bilat - BEN | $194.44 | $324.06 | $33.92–$249.53 | — | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee 4+ Views Lt - BEN | $194.44 | $324.06 | $33.92–$249.53 | 56% below | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee 4+ Views Lt - FEAST | $194.44 | $324.06 | $33.92–$249.53 | 56% below | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee 4+ Views Lt - 821 | $194.44 | $324.06 | $33.92–$249.53 | 56% below | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee 4+ Views Rt - 821 | $194.44 | $324.06 | $33.92–$249.53 | 56% below | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee 4+ Views Rt - BEN | $194.44 | $324.06 | $33.92–$249.53 | 56% below | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee 4+ Views Lt | $194.44 | $324.06 | $33.92–$249.53 | 56% below | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee 4+ Views Rt | $194.44 | $324.06 | $33.92–$249.53 | 56% below | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee 4+ Views Rt - FEAST | $194.44 | $324.06 | $33.92–$249.53 | 56% below | 40% |
| Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 Knee 4+ Views Bilat | $194.44 | $324.06 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 Knee 4+ Views Bilat - FEAST | $194.44 | $324.06 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 Knee 4+ Views Bilat - 821 | $194.44 | $324.06 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 Knee 4+ Views Bilat - BEN | $194.44 | $324.06 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee 4+ Views Rt - 821 | $194.44 | $324.06 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee 4+ Views Lt - 821 | $194.44 | $324.06 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee 4+ Views Lt | $194.44 | $324.06 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee 4+ Views Rt | $194.44 | $324.06 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee 4+ Views Lt - BEN | $194.44 | $324.06 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee 4+ Views Rt - BEN | $194.44 | $324.06 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee 4+ Views Lt - FEAST | $194.44 | $324.06 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee 4+ Views Rt - FEAST | $194.44 | $324.06 | — | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 Lower Extremity Plain - CT | $594.13 | $990.21 | $101.12–$861.48 | 43% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 Lower Extremity Plain - CT | $594.13 | $990.21 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas - FEAST | $207.20 | $345.33 | $48.00–$300.44 | 70% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen - FEAST | $207.20 | $345.33 | $48.00–$300.44 | 70% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas - BEN | $207.20 | $345.33 | $48.00–$300.44 | 70% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver - BEN | $207.20 | $345.33 | $48.00–$300.44 | 70% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder - BEN | $207.20 | $345.33 | $48.00–$300.44 | 70% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Diaphram | $207.20 | $345.33 | $48.00–$300.44 | 70% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Diaphram - 821 | $207.20 | $345.33 | $48.00–$300.44 | 70% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen - BEN | $207.20 | $345.33 | $48.00–$300.44 | 70% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Diaphram - BEN | $207.20 | $345.33 | $48.00–$300.44 | 70% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder - FEAST | $207.20 | $345.33 | $48.00–$300.44 | 70% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen - 821 | $283.03 | $471.71 | $48.00–$410.39 | 59% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas - 821 | $283.03 | $471.71 | $48.00–$410.39 | 59% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas | $283.03 | $471.71 | $48.00–$410.39 | 59% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver - 821 | $370.22 | $617.02 | $48.00–$536.81 | 46% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder - 821 | $370.44 | $617.40 | $48.00–$537.14 | 46% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ultrasound Abd Limited - IR | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver - FEAST | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen, Limited - FEAST | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen, Limited - BEN | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen, Limited - 821 | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Diaphram - FEAST | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen, Limited | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Rt Upper Quadrant Abd | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Upper Quadrant Abd Rt - FEAST | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Rt Upper Quadrant Abd - BEN | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Rt Upper Quadrant Abd - 821 | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Upper Quadrant Abd Lt - FEAST | $502.58 | $837.63 | $48.00–$728.74 | 27% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder - BEN | $207.20 | $345.33 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Diaphram - 821 | $207.20 | $345.33 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas - BEN | $207.20 | $345.33 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver - BEN | $207.20 | $345.33 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen - BEN | $207.20 | $345.33 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Diaphram | $207.20 | $345.33 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen - FEAST | $207.20 | $345.33 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Diaphram - BEN | $207.20 | $345.33 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas - FEAST | $207.20 | $345.33 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder - FEAST | $207.20 | $345.33 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas - 821 | $283.03 | $471.71 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen - 821 | $283.03 | $471.71 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas | $283.03 | $471.71 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver - 821 | $370.22 | $617.02 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder - 821 | $370.44 | $617.40 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver - FEAST | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen, Limited - FEAST | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen, Limited - BEN | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Ultrasound Abd Limited - IR | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen, Limited | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen, Limited - 821 | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Diaphram - FEAST | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Rt Upper Quadrant Abd - 821 | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Upper Quadrant Abd Lt - FEAST | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Rt Upper Quadrant Abd - BEN | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Rt Upper Quadrant Abd | $502.58 | $837.63 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Upper Quadrant Abd Rt - FEAST | $502.58 | $837.63 | — | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 US Infraclavicular/Axilla Bilat - SWC | $361.80 | $603.00 | $47.81–$524.61 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Superficial Mass - BEN | $199.80 | $333.00 | $47.81–$289.71 | 49% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Superficial Mass - SWC | $207.20 | $345.33 | $47.81–$300.44 | 47% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Superficial Mass | $207.20 | $345.33 | $47.81–$300.44 | 47% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Ultrasound, Limited Joint | $207.20 | $345.33 | $47.81–$300.44 | 47% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Superficial Mass - 821 | $207.20 | $345.33 | $47.81–$300.44 | 47% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Infraclavicular/Axilla Lt - SWC | $361.80 | $603.00 | $47.81–$524.61 | 8% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Infraclavicular/Axilla Rt - SWC | $361.80 | $603.00 | $47.81–$524.61 | 8% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient both sides CPT 76882 US Infraclavicular/Axilla Bilat - SWC | $361.80 | $603.00 | — | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Superficial Mass - BEN | $199.80 | $333.00 | — | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Superficial Mass | $207.20 | $345.33 | — | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Superficial Mass - SWC | $207.20 | $345.33 | — | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Ultrasound, Limited Joint | $207.20 | $345.33 | — | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Superficial Mass - 821 | $207.20 | $345.33 | — | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Infraclavicular/Axilla Lt - SWC | $361.80 | $603.00 | — | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Infraclavicular/Axilla Rt - SWC | $361.80 | $603.00 | — | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Lung Screening Low Dose - CT | $645.43 | $1,075.71 | $105.87–$935.87 | 29% above | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Lung Screening Low Dose - CT | $645.43 | $1,075.71 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 Lower Leg Bilat - FEAST | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 Lower Leg Bilat | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 Lower Leg Bilat - BEN | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 Lower Leg Bilat - 821 | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Lower Leg Lt - BEN | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Lower Leg Rt - BEN | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Lower Leg Lt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Lower Leg Rt - FEAST | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Lower Leg Lt - FEAST | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Lower Leg Lt Portable - 821 | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Lower Leg Lt Portable | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Lower Leg Lt | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Lower Leg Rt Portable - 821 | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Lower Leg Rt Portable | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Lower Leg Rt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Lower Leg Rt | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 Lower Leg Bilat | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 Lower Leg Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 Lower Leg Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 Lower Leg Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Lower Leg Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Lower Leg Lt | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Lower Leg Lt Portable | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Lower Leg Rt | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Lower Leg Rt Portable | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Lower Leg Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Lower Leg Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Lower Leg Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Lower Leg Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Lower Leg Rt Portable - 821 | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Lower Leg Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Lower Leg Lt Portable - 821 | $158.49 | $264.15 | — | — | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Brain - HRHMC MRI | $1,228.98 | $2,048.29 | $241.63–$1,577.18 | 31% below | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Brain (XU Mod) - HRHMC MRI | $1,290.66 | $2,151.10 | $241.63–$1,656.35 | 28% below | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Brain - HRHMC MRI | $1,228.98 | $2,048.29 | — | — | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Brain (XU Mod) - HRHMC MRI | $1,290.66 | $2,151.10 | — | — | 40% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 Bilat Breast w/ & w/o Contrast - HRHMC MRI | $2,532.11 | $4,220.18 | $356.23–$3,249.54 | — | 40% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 Breast w/ Contrast Bilat - HRHMC MRI | $2,848.62 | $4,747.70 | $356.23–$3,655.73 | — | 40% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 CAD Breast w/ & w/o Contrast Bilat - HRHMC MRI | $2,848.62 | $4,747.70 | $356.23–$3,655.73 | — | 40% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 CAD Breast w/ Contrast Bilat - HRHMC MRI | $2,848.62 | $4,747.70 | $356.23–$3,655.73 | — | 40% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 Bilat Breast w/ & w/o Contrast - HRHMC MRI | $2,532.11 | $4,220.18 | — | — | 40% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 Breast w/ Contrast Bilat - HRHMC MRI | $2,848.62 | $4,747.70 | — | — | 40% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 CAD Breast w/ Contrast Bilat - HRHMC MRI | $2,848.62 | $4,747.70 | — | — | 40% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 CAD Breast w/ & w/o Contrast Bilat - HRHMC MRI | $2,848.62 | $4,747.70 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Low Extrem Joint w/o Contrast - HRHMC MRI | $1,278.58 | $2,130.96 | $241.63–$1,640.84 | 33% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Low Extrem Joint Lt w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | $241.63–$1,577.18 | 35% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Low Extrem Joint Rt w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | $241.63–$1,577.18 | 35% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Low Extrem Joint Smith Nephew Lt - HRHMC MRI | $1,278.58 | $2,130.96 | $241.63–$1,640.84 | 33% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Low Extrem JT Zimmer Rt - HRHMC MRI | $1,278.58 | $2,130.96 | $241.63–$1,640.84 | 33% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Low Extrem Joint Zimmer Lt - HRHMC MRI | $1,278.58 | $2,130.96 | $241.63–$1,640.84 | 33% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Low Extrem Joint Rt Pre-Op - HRHMC MRI | $1,278.58 | $2,130.96 | $241.63–$1,640.84 | 33% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Low Extrem Joint Lt Pre-Op - HRHMC MRI | $1,278.58 | $2,130.96 | $241.63–$1,640.84 | 33% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Low Extrem JT Smith Nephew Rt - HRHMC MRI | $1,278.58 | $2,130.96 | $241.63–$1,640.84 | 33% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Low Extrem Joint w/o Contrast - HRHMC MRI | $1,278.58 | $2,130.96 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Low Extrem Joint Rt w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Low Extrem Joint Lt w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Low Extrem Joint Lt Pre-Op - HRHMC MRI | $1,278.58 | $2,130.96 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Low Extrem Joint Rt Pre-Op - HRHMC MRI | $1,278.58 | $2,130.96 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Low Extrem Joint Zimmer Lt - HRHMC MRI | $1,278.58 | $2,130.96 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Low Extrem Joint Smith Nephew Lt - HRHMC MRI | $1,278.58 | $2,130.96 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Low Extrem JT Zimmer Rt - HRHMC MRI | $1,278.58 | $2,130.96 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Low Extrem JT Smith Nephew Rt - HRHMC MRI | $1,278.58 | $2,130.96 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Low Extrem Joint w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | $353.30–$2,466.79 | 49% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Low Extrem Joint Lt w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | $353.30–$2,466.79 | 49% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Low Extrem Joint Rt w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | $353.30–$2,466.79 | 49% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Low Extrem Joint w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Low Extrem Joint Lt w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Low Extrem Joint Rt w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | — | — | 40% |
| MRI of the abdomen without contrast CPT 74181 Abdomen w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | $241.63–$1,577.18 | 38% below | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 Abdomen w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | — | — | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 Abdomen w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | $353.30–$2,466.79 | 47% below | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Abdomen w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | — | — | 40% |
| MRI of the brain, no contrast dye CPT 70551 Brain w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | $241.63–$1,577.18 | 31% below | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 Brain w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | — | — | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 Brain w/ & w/o Contrast - HRHMC MRI | $1,916.57 | $3,194.27 | $344.32–$2,459.59 | 34% below | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Brain w/ & w/o Contrast - HRHMC MRI | $1,916.57 | $3,194.27 | — | — | 40% |
| MRI of the lower back, no contrast dye CPT 72148 L Spine w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | $239.62–$1,577.18 | 31% below | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 L Spine w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | — | — | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 L Spine w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | $344.32–$2,466.79 | 42% below | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 L Spine w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | — | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 T Spine w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | $239.62–$1,577.18 | 41% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 T Spine w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | — | — | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 C Spine w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | $344.32–$2,466.79 | 34% below | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 C Spine w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | — | — | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 C Spine without Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | $241.63–$1,577.18 | 30% below | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 C Spine without Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | — | — | 40% |
| MRI of the pelvis without and with contrast CPT 72197 Pelvis w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | $353.30–$2,466.79 | 46% below | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 Pelvis w/ & w/o Contrast - HRHMC MRI | $1,922.18 | $3,203.62 | — | — | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 Pelvis w/o Contrast - HRHMC MRI | $1,278.58 | $2,130.96 | $241.63–$1,640.84 | 33% below | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 Pelvis w/o Contrast - HRHMC MRI | $1,278.58 | $2,130.96 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Upp Extrem Joint w/o Contrast - HRHMC MRI | $1,278.58 | $2,130.96 | $241.63–$1,640.84 | 40% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Upp Extrem Joint Rt w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | $241.63–$1,577.18 | 42% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Upp Extrem Joint Lt w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | $241.63–$1,577.18 | 42% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 Upp Extrem Joint w/o Contrast - HRHMC MRI | $1,278.58 | $2,130.96 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Upp Extrem Joint Lt w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Upp Extrem Joint Rt w/o Contrast - HRHMC MRI | $1,228.98 | $2,048.29 | — | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-Spine 4+ Views - BEN | $194.44 | $324.06 | $33.92–$249.53 | 58% below | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-Spine 4+ Views - 821 | $194.44 | $324.06 | $33.92–$249.53 | 58% below | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C Spine, (4+Views) | $194.44 | $324.06 | $33.92–$249.53 | 58% below | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-Spine 4+ Views - FEAST | $194.44 | $324.06 | $33.92–$249.53 | 58% below | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 C-Spine 4+ Views - FEAST | $194.44 | $324.06 | — | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 C-Spine 4+ Views - BEN | $194.44 | $324.06 | — | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 C Spine, (4+Views) | $194.44 | $324.06 | — | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 C-Spine 4+ Views - 821 | $194.44 | $324.06 | — | — | 40% |
| Neck soft tissue CT scan with contrast CPT 70491 Soft Tissue Neck Enhanced - CT | $698.97 | $1,164.95 | $105.60–$1,013.51 | 48% below | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 Soft Tissue Neck Enhanced - CT | $698.97 | $1,164.95 | — | — | 40% |
| Neck soft tissue CT scan without contrast CPT 70490 Soft Tissue Neck Plain - CT | $601.62 | $1,002.69 | $101.12–$872.34 | 44% below | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 Soft Tissue Neck Plain - CT | $601.62 | $1,002.69 | — | — | 40% |
| Neck soft tissue X-ray CPT 70360 Neck, Soft Tissue | $158.49 | $264.15 | $12.80–$203.40 | 43% below | 40% |
| Neck soft tissue X-ray CPT 70360 Neck Soft Tissue - 821 | $158.49 | $264.15 | $12.80–$203.40 | 43% below | 40% |
| Neck soft tissue X-ray CPT 70360 Neck Soft Tissue - FEAST | $158.49 | $264.15 | $12.80–$203.40 | 43% below | 40% |
| Neck soft tissue X-ray CPT 70360 Neck Soft Tissue - BEN | $158.49 | $264.15 | $12.80–$203.40 | 43% below | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 Neck, Soft Tissue | $158.49 | $264.15 | — | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 Neck Soft Tissue - BEN | $158.49 | $264.15 | — | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 Neck Soft Tissue - FEAST | $158.49 | $264.15 | — | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 Neck Soft Tissue - 821 | $158.49 | $264.15 | — | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Gated Myoview Stress Test - NM | $2,414.63 | $4,024.38 | $595.26–$3,098.77 | 43% below | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Thallium Stress Test - NM | $2,414.63 | $4,024.38 | $595.26–$3,098.77 | 43% below | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Gated Thallium Stress Test - NM | $2,414.63 | $4,024.38 | $595.26–$3,098.77 | 43% below | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Dual Isotope Stress Test - NM | $2,414.63 | $4,024.38 | $595.26–$3,098.77 | 43% below | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Dual Isotope Stress Test - NM | $2,414.63 | $4,024.38 | — | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Gated Thallium Stress Test - NM | $2,414.63 | $4,024.38 | — | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Gated Myoview Stress Test - NM | $2,414.63 | $4,024.38 | — | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Thallium Stress Test - NM | $2,414.63 | $4,024.38 | — | — | 40% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 Tumor Imag CT SKL-Thigh PS - PET | $4,415.56 | $7,359.26 | $1,019.21–$5,666.63 | 36% below | 40% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 Tumor Imag CT Skull-Thigh - PET | $4,428.50 | $7,380.82 | $1,019.21–$5,683.23 | 36% below | 40% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 Tumor Imag CT SKL-Thigh PI - PET | $4,428.50 | $7,380.82 | $1,019.21–$5,683.23 | 36% below | 40% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 Prostate-PSMA - PET | $4,428.60 | $7,381.00 | $1,019.21–$5,683.37 | 36% below | 40% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Tumor Imag CT SKL-Thigh PS - PET | $4,415.56 | $7,359.26 | — | — | 40% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Tumor Imag CT Skull-Thigh - PET | $4,428.50 | $7,380.82 | — | — | 40% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Tumor Imag CT SKL-Thigh PI - PET | $4,428.50 | $7,380.82 | — | — | 40% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Prostate-PSMA - PET | $4,428.60 | $7,381.00 | — | — | 40% |
| Pelvic CT scan without contrast CPT 72192 Pelvis Plain - CT | $679.01 | $1,131.67 | $86.40–$984.55 | 38% below | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 Pelvis Plain - CT | $679.01 | $1,131.67 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic, Follow-up - FEAST | $194.44 | $324.06 | $24.32–$281.93 | 56% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic, Follow-up - SWC | $194.44 | $324.06 | $24.32–$281.93 | 56% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic, Follow-up - 821 | $229.16 | $381.92 | $24.32–$332.27 | 49% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Hips | $229.16 | $381.92 | $24.32–$332.27 | 49% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Transabdominal Prostate Volume Study | $381.92 | $636.53 | $24.32–$553.78 | 15% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Bladder - FEAST | $381.92 | $636.53 | $24.32–$553.78 | 15% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic, Follow-up - BEN | $381.92 | $636.53 | $24.32–$553.78 | 15% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Bladder - BEN | $381.92 | $636.53 | $24.32–$553.78 | 15% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic, Follow-up | $381.92 | $636.53 | $24.32–$553.78 | 15% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Bladder | $381.92 | $636.53 | $24.32–$553.78 | 15% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Bladder - 821 | $381.92 | $636.53 | $24.32–$553.78 | 15% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic, Follow-up - FEAST | $194.44 | $324.06 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic, Follow-up - SWC | $194.44 | $324.06 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Hips | $229.16 | $381.92 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic, Follow-up - 821 | $229.16 | $381.92 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Bladder - FEAST | $381.92 | $636.53 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic, Follow-up - BEN | $381.92 | $636.53 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Bladder - BEN | $381.92 | $636.53 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Transabdominal Prostate Volume Study | $381.92 | $636.53 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic, Follow-up | $381.92 | $636.53 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Bladder | $381.92 | $636.53 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Bladder - 821 | $381.92 | $636.53 | — | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic, Non-Obstetric, Neoplastic | $511.21 | $852.01 | $59.52–$741.25 | 11% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic, Non-Obstetric, Neoplastic - SWC | $511.21 | $852.01 | $59.52–$741.25 | 11% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic, Non-Obstetric, Compl - BEN | $511.21 | $852.01 | $59.52–$741.25 | 11% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic, Non-Obstetric, Compl - FEAST | $511.21 | $852.01 | $59.52–$741.25 | 11% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic, Non-Obstetric, Neoplastic - 821 | $511.21 | $852.01 | $59.52–$741.25 | 11% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic, Non-Obstetric, Neoplastic - SWC | $511.21 | $852.01 | — | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic, Non-Obstetric, Compl - FEAST | $511.21 | $852.01 | — | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic, Non-Obstetric, Neoplastic - 821 | $511.21 | $852.01 | — | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic, Non-Obstetric, Neoplastic | $511.21 | $852.01 | — | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic, Non-Obstetric, Compl - BEN | $511.21 | $852.01 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Complete - 821 | $486.77 | $811.28 | $59.52–$624.69 | 25% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Complete - BEN | $486.77 | $811.28 | $59.52–$624.69 | 25% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Complete | $486.77 | $811.28 | $59.52–$624.69 | 25% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Fetal Scan Complete - MFM | $506.38 | $843.96 | $59.52–$649.85 | 22% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Complete - FEAST | $506.38 | $843.96 | $59.52–$649.85 | 22% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Complete - SWC | $506.38 | $843.96 | $59.52–$649.85 | 22% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Complete - BEN | $486.77 | $811.28 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Complete - 821 | $486.77 | $811.28 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Complete | $486.77 | $811.28 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Complete - FEAST | $506.38 | $843.96 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Fetal Scan Complete - MFM | $506.38 | $843.96 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Complete - SWC | $506.38 | $843.96 | — | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg First Trim <14 Weeks - FEAST | $508.94 | $848.23 | $75.62–$653.14 | 9% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg First Trim <14 Weeks - BEN | $508.94 | $848.23 | $75.62–$653.14 | 9% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg First Trim 14 Weeks | $508.94 | $848.23 | $75.62–$653.14 | 9% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg First Trim 14 Weeks - 821 | $508.94 | $848.23 | $75.62–$653.14 | 9% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg 1st Trim <14 Weeks - MFM | $529.78 | $882.96 | $75.62–$679.88 | 6% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg First Trim <14 Weeks - SWC | $529.78 | $882.96 | $75.62–$679.88 | 6% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg First Trim <14 Weeks - FEAST | $508.94 | $848.23 | — | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg First Trim 14 Weeks | $508.94 | $848.23 | — | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg First Trim 14 Weeks - 821 | $508.94 | $848.23 | — | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg First Trim <14 Weeks - BEN | $508.94 | $848.23 | — | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg First Trim <14 Weeks - SWC | $529.78 | $882.96 | — | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg 1st Trim <14 Weeks - MFM | $529.78 | $882.96 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Limited/Followup, No Biometry | $487.74 | $812.89 | $49.92–$625.93 | 4% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Limited/Followup, No Biometry - L & D | $487.74 | $812.89 | $49.92–$625.93 | 4% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Limited/Followup, No Biometry - MFM | $487.74 | $812.89 | $49.92–$625.93 | 4% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Limited/Followup, No Biometry - 821 | $507.32 | $845.52 | $49.92–$651.05 | 1% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Limited/Followup, No Biometry - SWC | $507.32 | $845.52 | $49.92–$651.05 | 1% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Limited/Followup, No Biometry - FEAST | $507.32 | $845.52 | $49.92–$651.05 | 1% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Limited/Followup, No Biometry - BEN | $507.32 | $845.52 | $49.92–$651.05 | 1% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Limited/Followup, No Biometry - L & D | $487.74 | $812.89 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Limited/Followup, No Biometry - MFM | $487.74 | $812.89 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Limited/Followup, No Biometry | $487.74 | $812.89 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Limited/Followup, No Biometry - FEAST | $507.32 | $845.52 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Limited/Followup, No Biometry - 821 | $507.32 | $845.52 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Limited/Followup, No Biometry - SWC | $507.32 | $845.52 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Limited/Followup, No Biometry - BEN | $507.32 | $845.52 | — | — | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs w/o Chest Rt - BEN | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs w/o Chest Lt - BEN | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs <3 Views Lt | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs <3 Views Rt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs <3 Views Lt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs w/o Chest Lt - FEAST | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs w/o Chest Rt - FEAST | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs <3 Views Rt | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs <3 Views Rt | $158.49 | $264.15 | — | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs <3 Views Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs <3 Views Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs <3 Views Lt | $158.49 | $264.15 | — | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs w/o Chest Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs w/o Chest Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs w/o Chest Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs w/o Chest Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs w/ PA Chest Rt | $194.44 | $324.06 | $21.12–$249.53 | 53% below | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs w/ PA Chest Lt | $194.44 | $324.06 | $21.12–$249.53 | 53% below | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs w/ PA Chest Rt - 821 | $194.44 | $324.06 | $21.12–$249.53 | 53% below | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs w/ PA Chest Lt - 821 | $194.44 | $324.06 | $21.12–$249.53 | 53% below | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs w/ Chest Lt - BEN | $194.44 | $324.06 | $21.12–$249.53 | 53% below | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs w/ Chest Rt - BEN | $194.44 | $324.06 | $21.12–$249.53 | 53% below | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs w/ Chest Lt - FEAST | $194.44 | $324.06 | $21.12–$249.53 | 53% below | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs w/ Chest Rt - FEAST | $194.44 | $324.06 | $21.12–$249.53 | 53% below | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs w/ PA Chest Lt - 821 | $194.44 | $324.06 | — | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs w/ PA Chest Rt - 821 | $194.44 | $324.06 | — | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs w/ PA Chest Lt | $194.44 | $324.06 | — | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs w/ PA Chest Rt | $194.44 | $324.06 | — | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs w/ Chest Lt - BEN | $194.44 | $324.06 | — | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs w/ Chest Rt - BEN | $194.44 | $324.06 | — | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs w/ Chest Lt - FEAST | $194.44 | $324.06 | — | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs w/ Chest Rt - FEAST | $194.44 | $324.06 | — | — | 40% |
| Screening mammogram, both breasts CPT 77067 Screening Mammo Uni - BEN | $198.15 | $330.24 | $71.00–$254.28 | 19% below | 40% |
| Screening mammogram, both breasts CPT 77067 Screening Mammo Uni - 821 | $198.15 | $330.24 | $71.00–$254.28 | 19% below | 40% |
| Screening mammogram, both breasts CPT 77067 Screening Mammo Uni - FEAST | $198.15 | $330.24 | $71.00–$254.28 | 19% below | 40% |
| Screening mammogram, both breasts CPT 77067 Screening Mammo Uni - SWC | $198.15 | $330.24 | $71.00–$254.28 | 19% below | 40% |
| Screening mammogram, both breasts CPT 77067 Screening Mammo Incl CAD - BEN | $248.30 | $413.83 | $71.00–$318.65 | 2% above | 40% |
| Screening mammogram, both breasts CPT 77067 Screening Mammo Incl CAD - FEAST | $248.30 | $413.83 | $71.00–$318.65 | 2% above | 40% |
| Screening mammogram, both breasts CPT 77067 Realtime Scrn Mammo Incl CAD - SWC | $248.30 | $413.83 | $71.00–$318.65 | 2% above | 40% |
| Screening mammogram, both breasts CPT 77067 Screening Mammo Incl CAD - 821 | $248.30 | $413.83 | $71.00–$318.65 | 2% above | 40% |
| Screening mammogram, both breasts CPT 77067 Screening Mammo Incl CAD - SWC | $248.30 | $413.83 | $71.00–$318.65 | 2% above | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 Screening Mammo Uni - FEAST | $198.15 | $330.24 | — | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 Screening Mammo Uni - SWC | $198.15 | $330.24 | — | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 Screening Mammo Uni - BEN | $198.15 | $330.24 | — | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 Screening Mammo Uni - 821 | $198.15 | $330.24 | — | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 Screening Mammo Incl CAD - FEAST | $248.30 | $413.83 | — | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 Screening Mammo Incl CAD - BEN | $248.30 | $413.83 | — | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 Realtime Scrn Mammo Incl CAD - SWC | $248.30 | $413.83 | — | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 Screening Mammo Incl CAD - 821 | $248.30 | $413.83 | — | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 Screening Mammo Incl CAD - SWC | $248.30 | $413.83 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Shoulder 2+ Views Bilat | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Shoulder 2+ Views Bilat - FEAST | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Shoulder 2+ Views Bilat - BEN | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Shoulder 2+ Views Bilat - 821 | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder 2+ Views Rt | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder 2+ Views Rt - FEAST | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder 2+ Views Lt - FEAST | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder 2+ Views Lt - BEN | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder 2+ Views Rt - BEN | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder 2 Views Portable Rt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder 2+ Views Rt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder 2 Views Portable Lt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder 2+ Views Lt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder 2 Views Portable Rt | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder 2+ Views Lt | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder 2 Views Portable Lt | $158.49 | $264.15 | $21.12–$203.40 | 53% below | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 Shoulder 2+ Views Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 Shoulder 2+ Views Bilat | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 Shoulder 2+ Views Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 Shoulder 2+ Views Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder 2+ Views Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder 2 Views Portable Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder 2+ Views Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder 2 Views Portable Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder 2 Views Portable Lt | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder 2+ Views Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder 2+ Views Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder 2+ Views Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder 2+ Views Rt | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder 2 Views Portable Rt | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder 2+ Views Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder 2+ Views Lt | $158.49 | $264.15 | — | — | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 Sinuses 3+ Views - 821 | $158.49 | $264.15 | $28.80–$203.40 | 63% below | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 Sinuses (3+ Views) | $158.49 | $264.15 | $28.80–$203.40 | 63% below | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 Sinuses Complete - BEN | $158.49 | $264.15 | $28.80–$203.40 | 63% below | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 Sinuses Complete - FEAST | $158.49 | $264.15 | $28.80–$203.40 | 63% below | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Sinuses Complete - BEN | $158.49 | $264.15 | — | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Sinuses 3+ Views - 821 | $158.49 | $264.15 | — | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Sinuses (3+ Views) | $158.49 | $264.15 | — | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Sinuses Complete - FEAST | $158.49 | $264.15 | — | — | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 Skull Limited 4+ Views - 821 | $194.44 | $324.06 | $26.88–$249.53 | 45% below | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 Skull, Limited (<4 Views) | $194.44 | $324.06 | $26.88–$249.53 | 45% below | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 Skull, Portable | $194.44 | $324.06 | $26.88–$249.53 | 45% below | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 Skull Limited - BEN | $194.44 | $324.06 | $26.88–$249.53 | 45% below | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 Skull Limited - FEAST | $194.44 | $324.06 | $26.88–$249.53 | 45% below | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 Skull Portable - 821 | $194.44 | $324.06 | $26.88–$249.53 | 45% below | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 Skull Limited 4+ Views - 821 | $194.44 | $324.06 | — | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 Skull Limited - BEN | $194.44 | $324.06 | — | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 Skull Limited - FEAST | $194.44 | $324.06 | — | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 Skull, Portable | $194.44 | $324.06 | — | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 Skull, Limited (<4 Views) | $194.44 | $324.06 | — | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 Skull Portable - 821 | $194.44 | $324.06 | — | — | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 Nocturnal Polysomnogram - SL | $3,007.37 | $5,012.28 | $443.60–$3,859.46 | 14% below | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysomnogram, Incomplete - SL | $3,126.24 | $5,210.40 | $443.60–$4,012.01 | 10% below | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Nocturnal Polysomnogram - SL | $3,007.37 | $5,012.28 | — | — | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnogram, Incomplete - SL | $3,126.24 | $5,210.40 | — | — | 40% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Cardiac Stress Echo - FEAST | $1,247.37 | $2,078.94 | $208.00–$1,600.78 | 34% below | 40% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Car Dobutamine Stress Echocardiogram | $1,247.37 | $2,078.94 | $208.00–$1,600.78 | 34% below | 40% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Car Dobutamine Stress Echocardiogram | $1,247.37 | $2,078.94 | — | — | 40% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Cardiac Stress Echo - FEAST | $1,247.37 | $2,078.94 | — | — | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Swallowing Function (Video) | $328.08 | $546.79 | $35.84–$421.03 | 44% below | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Swallowing Function (Video) | $328.08 | $546.79 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 Femur 2+ Views Bilat | $158.49 | $264.15 | $45.31–$203.40 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 Femur 2+ Views Bilat - BEN | $158.49 | $264.15 | $45.31–$203.40 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 Femur 2+ Views Bilat - 821 | $158.49 | $264.15 | $45.31–$203.40 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 Femur Bilat - FEAST | $158.49 | $264.15 | $45.31–$203.40 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Portable 2+ Views Lt - 821 | $158.49 | $264.15 | $45.31–$203.40 | 61% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur 2+ Views Rt | $158.49 | $264.15 | $45.31–$203.40 | 61% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur 2+ Views Lt | $158.49 | $264.15 | $45.31–$203.40 | 61% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Portable 2+ Views Rt - 821 | $158.49 | $264.15 | $45.31–$203.40 | 61% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur 2+ Views Rt - 821 | $158.49 | $264.15 | $45.31–$203.40 | 61% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Hip Femur 2+ Views Complete Lt - 821 | $158.49 | $264.15 | $45.31–$203.40 | 61% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur 2+ Views Lt - 821 | $158.49 | $264.15 | $45.31–$203.40 | 61% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur 2+ Views Rt - BEN | $158.49 | $264.15 | $45.31–$203.40 | 61% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur 2+ Views Lt - BEN | $158.49 | $264.15 | $45.31–$203.40 | 61% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Portable 2+ Views Rt | $158.49 | $264.15 | $45.31–$203.40 | 61% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Portable 2+ Views Lt | $158.49 | $264.15 | $45.31–$203.40 | 61% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 Femur Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 Femur 2+ Views Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 Femur 2+ Views Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 Femur 2+ Views Bilat | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur 2+ Views Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Hip Femur 2+ Views Complete Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur 2+ Views Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Portable 2+ Views Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur 2+ Views Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Portable 2+ Views Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur 2+ Views Lt | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Portable 2+ Views Lt | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur 2+ Views Rt | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Portable 2+ Views Rt | $158.49 | $264.15 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur 2+ Views Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 Thoracic Spine Plain - CT | $691.49 | $1,152.47 | $105.87–$1,002.65 | 43% below | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 Thoracic Spine Plain - CT | $691.49 | $1,152.47 | — | — | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 4th, Rt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 5th, Lt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 5th, Rt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 4th, Lt | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 3rd, Rt | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 3rd, Lt | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 2nd, Rt | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 2nd, Lt | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, Great, Rt | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, Great, Lt | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 5th, Rt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 5th, Lt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 4th, Rt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 4th, Lt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 3rd, Rt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 3rd Lt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 2nd Rt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 2nd Lt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, Great, Rt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, Great, Lt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 4th, Rt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 4th, Lt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 3rd, Rt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 3rd, Lt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 2nd, Rt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 2nd, Lt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, Great, Rt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, Great, Lt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, Great, Lt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 5th, Rt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 5th, Rt | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 5th, Lt | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 4th, Rt | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, Great, Rt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 5th, Lt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 2nd, Lt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 2nd, Rt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 3rd, Lt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 3rd, Rt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toe, 4th, Lt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 44% below | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, Great, Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 5th, Rt | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 5th, Lt | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 4th, Rt | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 4th, Lt | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 3rd, Rt | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 3rd, Lt | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 2nd, Rt | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 2nd, Lt | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, Great, Rt | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, Great, Lt | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 5th, Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 5th, Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 4th, Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 4th, Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 3rd, Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 3rd Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 2nd, Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, Great, Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 2nd Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 2nd Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, Great, Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, Great, Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 3rd, Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 3rd, Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 4th, Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 2nd, Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 4th, Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 5th, Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 5th, Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, Great, Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, Great, Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 2nd, Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 2nd, Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 3rd, Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 3rd, Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 4th, Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 4th, Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 5th, Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toe, 5th, Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal - SWC | $419.55 | $699.25 | $59.52–$608.35 | 25% below | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal - BEN | $419.55 | $699.25 | $59.52–$608.35 | 25% below | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal - FEAST | $419.55 | $699.25 | $59.52–$608.35 | 25% below | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal - 821 | $419.55 | $699.25 | $59.52–$608.35 | 25% below | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal | $419.55 | $699.25 | $59.52–$608.35 | 25% below | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal | $419.55 | $699.25 | — | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal - SWC | $419.55 | $699.25 | — | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal - BEN | $419.55 | $699.25 | — | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal - 821 | $419.55 | $699.25 | — | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal - FEAST | $419.55 | $699.25 | — | — | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Preg Transvaginal - MFM | $487.74 | $812.89 | $75.62–$625.93 | 11% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Preg Transvaginal | $487.74 | $812.89 | $75.62–$625.93 | 11% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Preg Transvaginal - 821 | $487.74 | $812.89 | $75.62–$625.93 | 11% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Preg Transvaginal - BEN | $487.74 | $812.89 | $75.62–$625.93 | 11% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Preg Transvaginal - FEAST | $507.32 | $845.52 | $75.62–$651.05 | 7% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Preg Transvaginal - SWC | $507.32 | $845.52 | $75.62–$651.05 | 7% below | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Transvaginal - BEN | $487.74 | $812.89 | — | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Transvaginal | $487.74 | $812.89 | — | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Transvaginal - 821 | $487.74 | $812.89 | — | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Transvaginal - MFM | $487.74 | $812.89 | — | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Transvaginal - FEAST | $507.32 | $845.52 | — | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Transvaginal - SWC | $507.32 | $845.52 | — | — | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen, Complete - FEAST | $918.24 | $1,530.40 | $73.60–$1,331.45 | 12% above | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen, Complete - 821 | $918.24 | $1,530.40 | $73.60–$1,331.45 | 12% above | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen, Complete | $918.24 | $1,530.40 | $73.60–$1,331.45 | 12% above | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen, Complete - BEN | $918.24 | $1,530.40 | $73.60–$1,331.45 | 12% above | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen, Complete - BEN | $918.24 | $1,530.40 | — | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen, Complete | $918.24 | $1,530.40 | — | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen, Complete - FEAST | $918.24 | $1,530.40 | — | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen, Complete - 821 | $918.24 | $1,530.40 | — | — | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum & Contents | $277.67 | $462.77 | $56.32–$402.61 | 55% below | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum & Contents - FEAST | $277.67 | $462.77 | $56.32–$402.61 | 55% below | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum & Contents - 821 | $277.67 | $462.77 | $56.32–$1,226.00 | 55% below | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum & Contents - BEN | $277.67 | $462.77 | $56.32–$402.61 | 55% below | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum & Contents | $277.67 | $462.77 | — | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum & Contents - BEN | $277.67 | $462.77 | — | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum & Contents - FEAST | $277.67 | $462.77 | — | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum & Contents - 821 | $277.67 | $462.77 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Supraclavicular - SWC | $361.80 | $603.00 | $73.60–$524.61 | 37% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head/Neck - 821 | $471.72 | $786.19 | $73.60–$683.99 | 18% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head/Neck - IR | $471.72 | $786.19 | $73.60–$683.99 | 18% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head/Neck | $471.72 | $786.19 | $73.60–$683.99 | 18% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head/Neck - BEN | $471.72 | $786.19 | $73.60–$683.99 | 18% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head/Neck - FEAST | $471.72 | $786.19 | $73.60–$683.99 | 18% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Supraclavicular - SWC | $361.80 | $603.00 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Head/Neck - BEN | $471.72 | $786.19 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Head/Neck - FEAST | $471.72 | $786.19 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Head/Neck - IR | $471.72 | $786.19 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Head/Neck - 821 | $471.72 | $786.19 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Head/Neck | $471.72 | $786.19 | — | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Upper GI w/o Kub | $328.08 | $546.79 | $49.92–$421.03 | 45% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Upper GI w/o Kub | $328.08 | $546.79 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views both sides CPT 73060 Humerus Bilat | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Upper arm X-ray (humerus), 2 views both sides CPT 73060 Humerus Bilat - FEAST | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Upper arm X-ray (humerus), 2 views both sides CPT 73060 Humerus Bilat - 821 | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Upper arm X-ray (humerus), 2 views both sides CPT 73060 Humerus Bilat - BEN | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Lt Portable | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Lt Portable - 821 | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Rt Portable - 821 | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Lt | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Rt | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Rt Portable | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Lt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Rt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Lt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Rt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 Humerus Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 Humerus Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 Humerus Bilat | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 Humerus Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Rt Portable - 821 | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Lt Portable - 821 | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Rt Portable | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Lt | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Lt Portable | $158.49 | $264.15 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Rt | $158.49 | $264.15 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Rt Lower | $1,076.40 | $1,794.00 | $105.87–$1,381.38 | 55% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Rt Lower - FEAST | $1,076.40 | $1,794.00 | $105.87–$1,381.38 | 55% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Lt Lower - FEAST | $1,076.40 | $1,794.00 | $105.87–$1,381.38 | 55% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Lt Lower | $1,076.40 | $1,794.00 | $105.87–$1,381.38 | 55% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Rt Upper | $1,076.40 | $1,794.00 | $105.87–$1,381.38 | 55% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Lt Upper | $1,076.40 | $1,794.00 | $105.87–$1,381.38 | 55% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Subclavian Vein Unilat | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Rt Lower - 821 | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Lt Lower - BEN | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Rt Upper - BEN | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplx Reflx Extr Veins Low LT - BEN | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplx Reflx Extr Veins Low RT - BEN | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Rt Upper - 821 | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Rt Upper - FEAST | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Lt Upper - FEAST | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplx Reflx Extr Veins Low LT - FEAST | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplx Reflx Extr Veins Low RT - FEAST | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Lt Upper - IR | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Rt Upper - IR | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Lt Lower - IR | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Lt Upper - BEN | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplx Reflx Extr Veins Low LT | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Rt Lower - BEN | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Lt Upper - 821 | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Lt Lower - 821 | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex Extremity Veins, Rt Lower - IR | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplx Reflx Extr Veins Low RT | $1,159.17 | $1,931.94 | $105.87–$1,487.59 | 67% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Lt Lower - FEAST | $1,076.40 | $1,794.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Rt Lower - FEAST | $1,076.40 | $1,794.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Lt Upper | $1,076.40 | $1,794.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Rt Lower | $1,076.40 | $1,794.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Rt Upper | $1,076.40 | $1,794.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Lt Lower | $1,076.40 | $1,794.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Lt Upper - 821 | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Subclavian Vein Unilat | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplx Reflx Extr Veins Low LT | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplx Reflx Extr Veins Low RT | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Rt Lower - IR | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Lt Lower - IR | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Rt Upper - IR | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Lt Upper - IR | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Rt Lower - BEN | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Lt Lower - BEN | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Rt Upper - 821 | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Lt Lower - 821 | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Rt Lower - 821 | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Rt Upper - BEN | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Lt Upper - BEN | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplx Reflx Extr Veins Low LT - BEN | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplx Reflx Extr Veins Low RT - BEN | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Rt Upper - FEAST | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex Extremity Veins, Lt Upper - FEAST | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplx Reflx Extr Veins Low LT - FEAST | $1,159.17 | $1,931.94 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplx Reflx Extr Veins Low RT - FEAST | $1,159.17 | $1,931.94 | — | — | 40% |
| Wrist X-ray, 2 views both sides CPT 73100 Wrist AP & Lat Bilat | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Wrist X-ray, 2 views both sides CPT 73100 Wrist AP & Lat Bilat - 821 | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Wrist X-ray, 2 views both sides CPT 73100 Wrist AP & Lat Bilat - FEAST | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Wrist X-ray, 2 views both sides CPT 73100 Wrist AP & Lat Bilat - BEN | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist AP & Lat Lt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 38% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist AP & Lat Rt | $158.49 | $264.15 | $14.72–$203.40 | 38% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist 2 View Portable Rt | $158.49 | $264.15 | $14.72–$203.40 | 38% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist AP & Lat Lt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 38% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist AP & Lat Rt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 38% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist AP & Lat Rt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 38% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist 2 Views Portable Lt | $158.49 | $264.15 | $14.72–$203.40 | 38% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist AP & Lat Lt | $158.49 | $264.15 | $14.72–$203.40 | 38% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist 2 Views Portable Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 38% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist AP & Lat Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 38% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist 2 View Portable Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 38% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist AP & Lat Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 38% below | 40% |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 Wrist AP & Lat Bilat | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 Wrist AP & Lat Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 Wrist AP & Lat Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 Wrist AP & Lat Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist AP & Lat Lt | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist AP & Lat Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist AP & Lat Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist AP & Lat Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist AP & Lat Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist AP & Lat Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist 2 View Portable Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist AP & Lat Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist 2 Views Portable Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist 2 View Portable Rt | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist AP & Lat Rt | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist 2 Views Portable Lt | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 Wrist Complete Bilat - FEAST | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 Wrist Complete Bilat - 821 | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 Wrist Complete Bilat | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 Wrist Complete Bilat - BEN | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Complete Rt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 54% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Complete Lt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 54% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Complete Rt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 54% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Complete Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 54% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Complete Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 54% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Complete Lt | $158.49 | $264.15 | $14.72–$203.40 | 54% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Complete Rt | $158.49 | $264.15 | $14.72–$203.40 | 54% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Complete Lt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 54% below | 40% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 Wrist Complete Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 Wrist Complete Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 Wrist Complete Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 Wrist Complete Bilat | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Complete Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Complete Rt | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Complete Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Complete Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Complete Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Complete Lt | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Complete Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Complete Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Uni 2-3 Views Rt - BEN | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Uni 2-3 Views Lt - FEAST | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Uni 2-3 Views Rt - FEAST | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Uni 2-3 Views Lt Portable - 821 | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Uni 2-3 Views Rt - 821 | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Uni 2-3 Views Rt Portable - 821 | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip 2-3 Views Operative Lt - 821 | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Uni 2-3 Views Lt - 821 | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip 2-3 Views Operative Rt - 821 | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip 2-3 Views Operative Lt | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip 2-3 Views Operative Rt | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Uni 2-3 Views Lt | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Uni 2-3 Views Lt Portable | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Uni 2-3 Views Rt | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Uni 2-3 Views Rt Portable | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Uni 2-3 Views Lt - BEN | $158.49 | $264.15 | $45.31–$203.40 | 56% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Uni 2-3 Views Rt Portable - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Uni 2-3 Views Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip 2-3 Views Operative Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip 2-3 Views Operative Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip 2-3 Views Operative Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Uni 2-3 Views Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Uni 2-3 Views Lt Portable | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Uni 2-3 Views Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Uni 2-3 Views Rt Portable | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Uni 2-3 Views Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Uni 2-3 Views Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Uni 2-3 Views Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Uni 2-3 Views Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Uni 2-3 Views Lt Portable - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Uni 2-3 Views Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip 2-3 Views Operative Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the abdomen, 1 view CPT 74018 Abdomen/Kub AP - 821 | $158.49 | $264.15 | $46.37–$203.40 | 45% below | 40% |
| X-ray of the abdomen, 1 view CPT 74018 Abdomen, AP, Portable | $158.49 | $264.15 | $46.37–$203.40 | 45% below | 40% |
| X-ray of the abdomen, 1 view CPT 74018 Abdomen AP Portable - 821 | $158.49 | $264.15 | $46.37–$203.40 | 45% below | 40% |
| X-ray of the abdomen, 1 view CPT 74018 Abdomen/Kub AP - BEN | $158.49 | $264.15 | $46.37–$203.40 | 45% below | 40% |
| X-ray of the abdomen, 1 view CPT 74018 Abdomen/Kub AP - FEAST | $158.49 | $264.15 | $46.37–$203.40 | 45% below | 40% |
| X-ray of the abdomen, 1 view CPT 74018 Abdomen/Kub, AP | $158.49 | $264.15 | $46.37–$203.40 | 45% below | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen/Kub, AP | $158.49 | $264.15 | — | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen/Kub AP - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen/Kub AP - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen, AP, Portable | $158.49 | $264.15 | — | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen/Kub AP - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen AP Portable - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views both sides CPT 73600 Ankle AP & Lat Bilat - FEAST | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| X-ray of the ankle, 2 views both sides CPT 73600 Ankle AP & Lat Bilat - BEN | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| X-ray of the ankle, 2 views both sides CPT 73600 Ankle AP & Lat Bilat | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| X-ray of the ankle, 2 views both sides CPT 73600 Ankle AP & Lat Bilat - 821 | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle AP & Lat Rt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 53% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle AP & Lat Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 53% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle 2 Views Portable Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 53% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle AP & Lat Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 53% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle 2 Views Portable Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 53% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle AP & Lat Lt | $158.49 | $264.15 | $14.72–$203.40 | 53% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle 2 Views Portable Lt | $158.49 | $264.15 | $14.72–$203.40 | 53% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle AP & Lat Rt | $158.49 | $264.15 | $14.72–$203.40 | 53% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle 2 Views Portable Rt | $158.49 | $264.15 | $14.72–$203.40 | 53% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle AP & Lat Lt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 53% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle AP & Lat Lt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 53% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle AP & Lat Rt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 53% below | 40% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 Ankle AP & Lat Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 Ankle AP & Lat Bilat | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 Ankle AP & Lat Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 Ankle AP & Lat Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle AP & Lat Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle AP & Lat Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle 2 Views Portable Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle AP & Lat Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle 2 Views Portable Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle AP & Lat Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle 2 Views Portable Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle AP & Lat Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle AP & Lat Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle 2 Views Portable Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle AP & Lat Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle AP & Lat Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 2nd, Lt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 5th, Rt | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Thumb, Lt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Thumb, Rt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 2nd, Rt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 3rd, Lt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 3rd, Rt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 4th, Lt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 4th, Rt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 5th, Lt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 5th, Rt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Thumb, Lt | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 3rd, Lt | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 4th, Rt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 5th, Rt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 5th, Lt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 3rd, Lt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 3rd, Rt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 2nd, Rt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 2nd, Lt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Thumb, Rt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Thumb, Lt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 5th, Rt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 4th, Rt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 5th, Lt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 4th, Lt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 2nd, Rt | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 4th, Lt - FEAST | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 2nd, Lt | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Thumb, Rt | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 3rd, Rt | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Thumb, Lt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Thumb, Rt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 2nd, Lt - 821 | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 4th, Lt | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 4th, Rt | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 5th, Lt | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 3rd, Rt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 3rd, Lt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Finger, 2nd, Rt - BEN | $158.49 | $264.15 | $11.52–$203.40 | 31% below | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Thumb, Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Thumb, Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Thumb, Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 2nd, Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 2nd, Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 3rd, Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 3rd, Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 4th, Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 4th, Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 5th, Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 5th, Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Thumb, Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Thumb, Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 2nd, Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 2nd, Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 3rd, Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 3rd, Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 4th, Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 4th, Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 5th, Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 5th, Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Thumb, Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Thumb, Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 2nd, Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 2nd, Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 3rd, Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 3rd, Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 4th, Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 4th, Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 5th, Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 5th, Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Thumb, Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 2nd, Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 2nd, Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 3rd, Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 3rd, Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 4th, Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 4th, Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 5th, Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Finger, 5th, Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views both sides CPT 73620 Foot AP & Lat Bilat | $158.49 | $264.15 | $12.80–$203.40 | — | 40% |
| X-ray of the foot, 2 views both sides CPT 73620 Foot AP & Lat Bilat - FEAST | $158.49 | $264.15 | $12.80–$203.40 | — | 40% |
| X-ray of the foot, 2 views both sides CPT 73620 Foot AP & Lat Bilat - 821 | $158.49 | $264.15 | $12.80–$203.40 | — | 40% |
| X-ray of the foot, 2 views both sides CPT 73620 Foot AP & Lat Bilat - BEN | $158.49 | $264.15 | $12.80–$203.40 | — | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot AP & Lat Rt - 821 | $158.49 | $264.15 | $12.80–$203.40 | 53% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot 2 Views Portable Rt - 821 | $158.49 | $264.15 | $12.80–$203.40 | 53% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot AP & Lat Lt | $158.49 | $264.15 | $12.80–$203.40 | 53% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot 2 Views Portable Lt | $158.49 | $264.15 | $12.80–$203.40 | 53% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot AP & Lat Rt | $158.49 | $264.15 | $12.80–$203.40 | 53% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot 2 Views Portable Rt | $158.49 | $264.15 | $12.80–$203.40 | 53% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot AP & Lat Lt - BEN | $158.49 | $264.15 | $12.80–$203.40 | 53% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot AP & Lat Rt - BEN | $158.49 | $264.15 | $12.80–$203.40 | 53% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot AP & Lat Lt - FEAST | $158.49 | $264.15 | $12.80–$203.40 | 53% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot AP & Lat Rt - FEAST | $158.49 | $264.15 | $12.80–$203.40 | 53% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot 2 Views Portable Lt - 821 | $158.49 | $264.15 | $12.80–$203.40 | 53% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot AP & Lat Lt - 821 | $158.49 | $264.15 | $12.80–$203.40 | 53% below | 40% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 Foot AP & Lat Bilat | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 Foot AP & Lat Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 Foot AP & Lat Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 Foot AP & Lat Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot AP & Lat Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot AP & Lat Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot AP & Lat Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot 2 Views Portable Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot AP & Lat Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot 2 Views Portable Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot AP & Lat Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot AP & Lat Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot 2 Views Portable Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot 2 Views Portable Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot AP & Lat Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot AP & Lat Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 Foot 3+ Views Bilat | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 Foot 3+ Views Bilat - BEN | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 Foot 3+ Views Bilat - FEAST | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 Foot 3+ Views Bilat - 821 | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot 3+ Views Rt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 57% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot 3+ Views Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 57% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot 3+ Views Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 57% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot 3+ Views Lt | $158.49 | $264.15 | $14.72–$203.40 | 57% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot 3+ Views Rt | $158.49 | $264.15 | $14.72–$203.40 | 57% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot 3+ Views Lt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 57% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot 3+ Views Rt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 57% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot 3+ Views Lt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 57% below | 40% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 Foot 3+ Views Bilat | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 Foot 3+ Views Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 Foot 3+ Views Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 Foot 3+ Views Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot 3+ Views Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot 3+ Views Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot 3+ Views Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot 3+ Views Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot 3+ Views Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot 3+ Views Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot 3+ Views Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot 3+ Views Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the hand, 3 or more views both sides CPT 73130 Hand Complete Bilat - FEAST | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| X-ray of the hand, 3 or more views both sides CPT 73130 Hand Complete Bilat | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| X-ray of the hand, 3 or more views both sides CPT 73130 Hand Complete Bilat - 821 | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| X-ray of the hand, 3 or more views both sides CPT 73130 Hand Complete Bilat - BEN | $158.49 | $264.15 | $14.72–$203.40 | — | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 Hand Complete Lt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 47% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 Hand Complete Lt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 47% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 Hand, Lt, Complete | $158.49 | $264.15 | $14.72–$203.40 | 47% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 Hand Complete Rt | $158.49 | $264.15 | $14.72–$203.40 | 47% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 Hand Complete Rt - BEN | $158.49 | $264.15 | $14.72–$203.40 | 47% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 Hand Complete Lt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 47% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 Hand Complete Rt - 821 | $158.49 | $264.15 | $14.72–$203.40 | 47% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 Hand Complete Rt - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 47% below | 40% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 Hand Complete Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 Hand Complete Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 Hand Complete Bilat | $158.49 | $264.15 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 Hand Complete Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Complete Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Complete Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Complete Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Complete Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Complete Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Complete Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand, Lt, Complete | $158.49 | $264.15 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Complete Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 Knee <3 Views Bilat | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 Knee <3 Views Bilat - 821 | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 Knee <3 Views Bilat - FEAST | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 Knee <3 Views Bilat - BEN | $158.49 | $264.15 | $21.12–$203.40 | — | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee <3 Views Lt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Portable Lt | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Portable Lt (73560) | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Portable Lt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee <3 Views Rt - FEAST | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Portable Rt | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee <3 Views Rt - BEN | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee <3 Views Lt - BEN | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee <3 Views Rt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Portable Rt - 821 | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee <3 Views Lt | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 3+ Views Rt (73560) | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee <3 Views Lt - FEAST | $158.49 | $264.15 | $21.12–$203.40 | 44% below | 40% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 Knee <3 Views Bilat - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 Knee <3 Views Bilat - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 Knee <3 Views Bilat - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 Knee <3 Views Bilat | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Portable Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Portable Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee <3 Views Lt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee <3 Views Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Portable Rt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Portable Lt (73560) | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee 3+ Views Rt (73560) | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Portable Lt | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee <3 Views Lt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee <3 Views Rt - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee <3 Views Lt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee <3 Views Rt - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee <3 Views Rt - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Lumbar Spine, Portable - 821 | $194.44 | $324.06 | $28.80–$249.53 | 52% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Lumbar Spine, AP & Lat - 821 | $194.44 | $324.06 | $28.80–$249.53 | 52% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Lumbar Spine, AP & Lat | $194.44 | $324.06 | $28.80–$249.53 | 52% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Lumbar Spine, Portable | $194.44 | $324.06 | $28.80–$249.53 | 52% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Lumbar Spine, AP & Lat - BEN | $194.44 | $324.06 | $28.80–$249.53 | 52% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Lumbar Spine, AP & Lat - FEAST | $194.44 | $324.06 | $28.80–$249.53 | 52% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Lumbar Spine, Portable | $194.44 | $324.06 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Lumbar Spine, AP & Lat - BEN | $194.44 | $324.06 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Lumbar Spine, AP & Lat - FEAST | $194.44 | $324.06 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Lumbar Spine, AP & Lat - 821 | $194.44 | $324.06 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Lumbar Spine, Portable - 821 | $194.44 | $324.06 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Lumbar Spine, AP & Lat | $194.44 | $324.06 | — | — | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 Lumbar Sp, AP, Lat & Obl - FEAST | $194.44 | $324.06 | $28.80–$249.53 | 59% below | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 Lumbar Spine, AP, Lat & Obl | $194.44 | $324.06 | $28.80–$249.53 | 59% below | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 Lumbar Spine, AP, Lat & Obl - 821 | $194.44 | $324.06 | $28.80–$249.53 | 59% below | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 Lumbar Sp, AP, Lat & Obl - BEN | $194.44 | $324.06 | $28.80–$249.53 | 59% below | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Lumbar Sp, AP, Lat & Obl - BEN | $194.44 | $324.06 | — | — | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Lumbar Spine, AP, Lat & Obl - 821 | $194.44 | $324.06 | — | — | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Lumbar Spine, AP, Lat & Obl | $194.44 | $324.06 | — | — | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Lumbar Sp, AP, Lat & Obl - FEAST | $194.44 | $324.06 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Thoracic Spine Portable - FEAST | $194.44 | $324.06 | $26.88–$249.53 | 46% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Thoracic Spine AP & Lat - FEAST | $194.44 | $324.06 | $26.88–$249.53 | 46% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Thoracolumbar Erect - FEAST | $194.44 | $324.06 | $26.88–$249.53 | 46% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Thoracic Spine, AP & Lat | $194.44 | $324.06 | $26.88–$249.53 | 46% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Thoracic Spine Portable - 821 | $194.44 | $324.06 | $26.88–$249.53 | 46% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Thoracic Spine, Portable | $194.44 | $324.06 | $26.88–$249.53 | 46% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Thoracic Spine Portable - BEN | $194.44 | $324.06 | $26.88–$249.53 | 46% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Thoracic Spine AP & Lat - 821 | $194.44 | $324.06 | $26.88–$249.53 | 46% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Thoracic Spine AP & Lat - BEN | $194.44 | $324.06 | $26.88–$249.53 | 46% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Thoracic Spine Portable - 821 | $194.44 | $324.06 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Thoracic Spine Portable - FEAST | $194.44 | $324.06 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Thoracic Spine AP & Lat - 821 | $194.44 | $324.06 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Thoracic Spine, AP & Lat | $194.44 | $324.06 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Thoracic Spine, Portable | $194.44 | $324.06 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Thoracic Spine AP & Lat - BEN | $194.44 | $324.06 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Thoracic Spine Portable - BEN | $194.44 | $324.06 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Thoracolumbar Erect - FEAST | $194.44 | $324.06 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Thoracic Spine AP & Lat - FEAST | $194.44 | $324.06 | — | — | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Nasal Bone - BEN | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Nasal Bone (3 Views) | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Nasal Bone 3 Views - 821 | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Nasal Bone - FEAST | $158.49 | $264.15 | $14.72–$203.40 | 42% below | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Nasal Bone (3 Views) | $158.49 | $264.15 | — | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Nasal Bone 3 Views - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Nasal Bone - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Nasal Bone - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Cervical Spine, 2 Views Only | $158.49 | $264.15 | $21.12–$203.40 | 52% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-Spine AP & Lat - BEN | $158.49 | $264.15 | $21.12–$203.40 | 52% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C Spine, Portable | $158.49 | $264.15 | $21.12–$203.40 | 52% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C Spine, AP & Lat | $158.49 | $264.15 | $21.12–$203.40 | 52% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-Spine AP & Lat - FEAST | $158.49 | $264.15 | $21.12–$203.40 | 52% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-Spine Portable - 821 | $158.49 | $264.15 | $21.12–$203.40 | 52% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-Spine AP & Lat - 821 | $158.49 | $264.15 | $21.12–$203.40 | 52% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C-Spine AP & Lat - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C-Spine AP & Lat - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C-Spine AP & Lat - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C-Spine Portable - 821 | $158.49 | $264.15 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Cervical Spine, 2 Views Only | $158.49 | $264.15 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C Spine, AP & Lat | $158.49 | $264.15 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C Spine, Portable | $158.49 | $264.15 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvic, AP Portable - 821 | $194.44 | $324.06 | $12.80–$249.53 | 34% below | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis, AP (Non-Injury) - 821 | $194.44 | $324.06 | $12.80–$249.53 | 34% below | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis, AP (Non-Injury) - FEAST | $194.44 | $324.06 | $12.80–$249.53 | 34% below | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis, AP (Non-Injury) - BEN | $194.44 | $324.06 | $12.80–$249.53 | 34% below | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvic, AP Portable | $194.44 | $324.06 | $12.80–$249.53 | 34% below | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis, AP (Non-Injury) | $194.44 | $324.06 | $12.80–$249.53 | 34% below | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis, AP (Non-Injury) - FEAST | $194.44 | $324.06 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis, AP (Non-Injury) | $194.44 | $324.06 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvic, AP Portable - 821 | $194.44 | $324.06 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis, AP (Non-Injury) - 821 | $194.44 | $324.06 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis, AP (Non-Injury) - BEN | $194.44 | $324.06 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvic, AP Portable | $194.44 | $324.06 | — | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum & Coccyx | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum & Coccyx - 821 | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum & Coccyx - FEAST | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum & Coccyx - BEN | $158.49 | $264.15 | $21.12–$203.40 | 51% below | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Sacrum & Coccyx - FEAST | $158.49 | $264.15 | — | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Sacrum & Coccyx | $158.49 | $264.15 | — | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Sacrum & Coccyx - BEN | $158.49 | $264.15 | — | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Sacrum & Coccyx - 821 | $158.49 | $264.15 | — | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH | $139.53 | $232.55 | $38.62–$172.82 | 31% below | 40% |
| ACTH blood test CPT 82024 Adrenocorticotropic Hormone (ARUP) | $190.28 | $317.12 | $38.62–$172.82 | 6% below | 40% |
| ACTH blood test inpatient CPT 82024 ACTH | $139.53 | $232.55 | — | — | 40% |
| ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone (ARUP) | $190.28 | $317.12 | — | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 FSURE Alt (LCORP) | $18.63 | $31.05 | $4.46–$7.95 | 50% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT/ALT | $27.61 | $46.01 | $4.46–$7.95 | 26% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 FSURE Alt (LCORP) | $18.63 | $31.05 | — | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT/ALT | $27.61 | $46.01 | — | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 FSURE AST (LCORP) | $18.63 | $31.05 | $4.46–$7.77 | 49% below | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT/AST | $27.61 | $46.01 | $4.46–$7.77 | 25% below | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 FSURE AST (LCORP) | $18.63 | $31.05 | — | — | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT/AST | $27.61 | $46.01 | — | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel | $164.03 | $273.38 | $47.63–$189.19 | 47% below | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel | $164.03 | $273.38 | — | — | 40% |
| Albumin blood test CPT 82040 Albumin A/G Ratio | $21.15 | $35.24 | $4.46–$7.43 | 34% below | 40% |
| Albumin blood test CPT 82040 Albumin Serum (ARUP) | $21.15 | $35.24 | $4.46–$7.43 | 34% below | 40% |
| Albumin blood test inpatient CPT 82040 Albumin A/G Ratio | $21.15 | $35.24 | — | — | 40% |
| Albumin blood test inpatient CPT 82040 Albumin Serum (ARUP) | $21.15 | $35.24 | — | — | 40% |
| Aldosterone blood test CPT 82088 Aldosterone-Fasting | $180.90 | $301.49 | $40.75–$185.45 | 12% below | 40% |
| Aldosterone blood test CPT 82088 Aldosterone | $180.90 | $301.49 | $40.75–$185.45 | 12% below | 40% |
| Aldosterone blood test CPT 82088 Aldosterone 24 Hr Urine | $180.90 | $301.49 | $40.75–$185.45 | 12% below | 40% |
| Aldosterone blood test CPT 82088 Aldosterone (ARUP) | $180.90 | $301.49 | $40.75–$185.45 | 12% below | 40% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone 24 Hr Urine | $180.90 | $301.49 | — | — | 40% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone-Fasting | $180.90 | $301.49 | — | — | 40% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone (ARUP) | $180.90 | $301.49 | — | — | 40% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone | $180.90 | $301.49 | — | — | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alk Phosphatase, Total (ARUP) | $22.31 | $37.18 | $4.46–$7.77 | 41% below | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $22.31 | $37.18 | $4.46–$7.77 | 41% below | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alk Phosphatase, Total (ARUP) | $22.31 | $37.18 | — | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase | $22.31 | $37.18 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 A. Niger IgE Ab (Referenced) | $6.35 | $10.57 | $5.22–$21.24 | 81% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rast | $20.73 | $34.54 | $5.22–$21.24 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Reference Allergen 6 (Vira) | $20.73 | $34.54 | $5.22–$21.24 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Reference Allergen 4 (Vira) | $20.73 | $34.54 | $5.22–$21.24 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Reference Allergen 2 (Vira) | $20.73 | $34.54 | $5.22–$21.24 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus Niger IgE (SL) | $20.73 | $34.54 | $5.22–$21.24 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus Flavus, IgE (SL) | $20.73 | $34.54 | $5.22–$21.24 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Testing, Each (86003) | $20.73 | $34.54 | $5.22–$21.24 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rast Red Snapper | $20.73 | $34.54 | $5.22–$21.24 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rast Catfish | $20.73 | $34.54 | $5.22–$21.24 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rast WhiteFish | $20.73 | $34.54 | $5.22–$21.24 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Reference Allergen 1 (Vira) | $20.73 | $34.54 | $5.22–$21.24 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific IgE (ARUP) | $20.73 | $34.54 | $5.22–$21.24 | 37% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rast Trout IgE | $214.82 | $358.03 | $5.22–$21.24 | 556% above | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 A. Niger IgE Ab (Referenced) | $6.35 | $10.57 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Reference Allergen 2 (Vira) | $20.73 | $34.54 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus Flavus, IgE (SL) | $20.73 | $34.54 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus Niger IgE (SL) | $20.73 | $34.54 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rast Red Snapper | $20.73 | $34.54 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rast Catfish | $20.73 | $34.54 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rast WhiteFish | $20.73 | $34.54 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rast | $20.73 | $34.54 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Reference Allergen 1 (Vira) | $20.73 | $34.54 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Specific IgE (ARUP) | $20.73 | $34.54 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Reference Allergen 6 (Vira) | $20.73 | $34.54 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Reference Allergen 4 (Vira) | $20.73 | $34.54 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Testing, Each (86003) | $20.73 | $34.54 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rast Trout IgE | $214.82 | $358.03 | — | — | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Maternal Alpha Feto Protein (ARUP) | $71.13 | $118.54 | $16.77–$72.92 | 35% below | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein | $71.13 | $118.54 | $16.77–$72.92 | 35% below | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP-Male & Non-Pregnant Female | $71.13 | $118.54 | $16.77–$72.92 | 35% below | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP-Male & Non-Pregnant Female | $71.13 | $118.54 | — | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein | $71.13 | $118.54 | — | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Maternal Alpha Feto Protein (ARUP) | $71.13 | $118.54 | — | — | 40% |
| Ammonia blood test CPT 82140 Ammonia | $63.57 | $105.94 | $14.57–$65.17 | 27% below | 40% |
| Ammonia blood test inpatient CPT 82140 Ammonia | $63.57 | $105.94 | — | — | 40% |
| Amylase blood test CPT 82150 Fluid Amylase | $23.74 | $39.56 | $6.48–$29.00 | 48% below | 40% |
| Amylase blood test CPT 82150 Urine Amylase Quant | $23.74 | $39.56 | $6.48–$29.00 | 48% below | 40% |
| Amylase blood test CPT 82150 Random Urine Amylase | $23.74 | $39.56 | $6.48–$29.00 | 48% below | 40% |
| Amylase blood test CPT 82150 Amylase | $32.37 | $53.94 | $6.48–$29.00 | 29% below | 40% |
| Amylase blood test CPT 82150 Fluid Amylase (HNL) | $32.37 | $53.94 | $6.48–$29.00 | 29% below | 40% |
| Amylase blood test inpatient CPT 82150 Fluid Amylase | $23.74 | $39.56 | — | — | 40% |
| Amylase blood test inpatient CPT 82150 Random Urine Amylase | $23.74 | $39.56 | — | — | 40% |
| Amylase blood test inpatient CPT 82150 Urine Amylase Quant | $23.74 | $39.56 | — | — | 40% |
| Amylase blood test inpatient CPT 82150 Amylase | $32.37 | $53.94 | — | — | 40% |
| Amylase blood test inpatient CPT 82150 Fluid Amylase (HNL) | $32.37 | $53.94 | — | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullin Peptide | $53.77 | $89.61 | $12.95–$55.12 | 41% below | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullin Peptide | $53.77 | $89.61 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA | $52.65 | $87.74 | $12.09–$53.97 | 29% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Acute Nuclear Antibodies (ANA) | $52.65 | $87.74 | $12.09–$53.97 | 29% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Fluid ANA Evaluation | $52.65 | $87.74 | $12.09–$53.97 | 29% below | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Acute Nuclear Antibodies (ANA) | $52.65 | $87.74 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA | $52.65 | $87.74 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Fluid ANA Evaluation | $52.65 | $87.74 | — | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP B-Type Nat Peptide | $118.06 | $196.76 | $39.26–$136.16 | 41% below | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Probrain Natriuretic Peptide, NT (Referenced) | $132.60 | $221.00 | $39.26–$136.16 | 33% below | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP B-Type Nat Peptide | $118.06 | $196.76 | — | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Probrain Natriuretic Peptide, NT (Referenced) | $132.60 | $221.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture | $33.36 | $55.59 | $8.62–$38.47 | 46% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Fluid Culture | $37.53 | $62.54 | $8.62–$38.47 | 39% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nose Culture | $37.53 | $62.54 | $8.62–$38.47 | 39% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasopharyngeal Culture | $37.53 | $62.54 | $8.62–$38.47 | 39% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Vaginal/Cervical Culture | $37.53 | $62.54 | $8.62–$38.47 | 39% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Urethral Culture | $37.53 | $62.54 | $8.62–$38.47 | 39% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture | $37.53 | $62.54 | $8.62–$38.47 | 39% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue Culture | $37.53 | $62.54 | $8.62–$38.47 | 39% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Ear Culture | $37.53 | $62.54 | $8.62–$38.47 | 39% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture, Beta Strep, Groups A,C,G | $37.53 | $62.54 | $8.62–$38.47 | 39% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nocardia Culture | $37.53 | $62.54 | $8.62–$38.47 | 39% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture | $33.36 | $55.59 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nocardia Culture | $37.53 | $62.54 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Fluid Culture | $37.53 | $62.54 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Eye Culture | $37.53 | $62.54 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Tissue Culture | $37.53 | $62.54 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Ear Culture | $37.53 | $62.54 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture, Beta Strep, Groups A,C,G | $37.53 | $62.54 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nose Culture | $37.53 | $62.54 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasopharyngeal Culture | $37.53 | $62.54 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Vaginal/Cervical Culture | $37.53 | $62.54 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Urethral Culture | $37.53 | $62.54 | — | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $42.26 | $70.42 | $8.46–$33.59 | 57% below | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $42.26 | $70.42 | — | — | 40% |
| Bilirubin blood test, total CPT 82247 Bilirubin Neonatal | $19.32 | $32.20 | $5.02–$19.81 | 40% below | 40% |
| Bilirubin blood test, total CPT 82247 Bilirubin, Total - Fluid | $19.32 | $32.20 | $5.02–$19.81 | 40% below | 40% |
| Bilirubin blood test, total CPT 82247 FSURE Bilirubin Total (LCORP) | $19.32 | $32.20 | $5.02–$19.81 | 40% below | 40% |
| Bilirubin blood test, total CPT 82247 Bilirubin Fluid | $19.32 | $32.20 | $5.02–$19.81 | 40% below | 40% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $25.14 | $41.90 | $5.02–$19.81 | 21% below | 40% |
| Bilirubin blood test, total inpatient CPT 82247 FSURE Bilirubin Total (LCORP) | $19.32 | $32.20 | — | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin, Total - Fluid | $19.32 | $32.20 | — | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Fluid | $19.32 | $32.20 | — | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Neonatal | $19.32 | $32.20 | — | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total | $25.14 | $41.90 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV Surg Path | $187.91 | $313.17 | $50.98–$241.14 | 2% below | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Pathology Lev IV | $197.34 | $328.89 | $50.98–$253.25 | 2% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level IV Surg Path | $187.91 | $313.17 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surgical Pathology Lev IV | $197.34 | $328.89 | — | — | 40% |
| Blood culture for bacteria CPT 87040 Culture Blood | $65.84 | $109.73 | $10.32–$46.22 | 29% below | 40% |
| Blood culture for bacteria CPT 87040 Blood Culture (Non-Patient, Charge) 40100430 | $74.07 | $123.45 | $10.32–$46.22 | 20% below | 40% |
| Blood culture for bacteria inpatient CPT 87040 Culture Blood | $65.84 | $109.73 | — | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture (Non-Patient, Charge) 40100430 | $74.07 | $123.45 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PKU Venipuncture - FEAST | $14.26 | $23.76 | $2.63–$14.01 | 5% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine Venipuncture - HATH | $14.26 | $23.76 | $2.63–$14.01 | 5% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine Venipuncture - 2 North | $14.26 | $23.76 | $2.63–$14.01 | 5% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine Venipuncture - SBH | $14.26 | $23.76 | $2.63–$14.01 | 5% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine Venipuncture - 4 Central | $14.26 | $23.76 | $2.63–$14.01 | 5% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine Venipuncture - 3 South | $14.26 | $23.76 | $2.63–$14.01 | 5% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine Venipuncture - ICCU/CCU | $14.26 | $23.76 | $2.63–$14.01 | 5% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PKU Venipuncture | $14.26 | $23.76 | $2.63–$14.01 | 5% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Directed Donor Venipuncture | $14.26 | $23.76 | $2.63–$14.01 | 5% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture - MAT | $15.43 | $25.71 | $2.63–$14.01 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture - MFM | $15.43 | $25.71 | $2.63–$14.01 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture - Lab | $15.43 | $25.71 | $2.63–$14.01 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture - FEAST | $15.43 | $25.71 | $2.63–$14.01 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PKU Venipuncture - BEN | $15.43 | $25.71 | $2.63–$1,319.00 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine Venipuncture - 2 South | $15.43 | $25.71 | $2.63–$14.01 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine Venipuncture - 3 North | $15.43 | $25.71 | $2.63–$14.01 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture - BEN | $15.43 | $25.71 | $2.63–$14.01 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture - MOU | $15.43 | $25.71 | $2.63–$14.01 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture - Cancer Center - CCC | $15.43 | $25.71 | $2.63–$14.01 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture - L & D | $15.43 | $25.71 | $2.63–$14.01 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine Venipuncture - ER | $15.43 | $25.71 | $2.63–$14.01 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Directed Donor Venipuncture | $14.26 | $23.76 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PKU Venipuncture - FEAST | $14.26 | $23.76 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Routine Venipuncture - HATH | $14.26 | $23.76 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Routine Venipuncture - 2 North | $14.26 | $23.76 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Routine Venipuncture - SBH | $14.26 | $23.76 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Routine Venipuncture - 4 Central | $14.26 | $23.76 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Routine Venipuncture - 3 South | $14.26 | $23.76 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Routine Venipuncture - ICCU/CCU | $14.26 | $23.76 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PKU Venipuncture | $14.26 | $23.76 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture - Cancer Center - CCC | $15.43 | $25.71 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture - L & D | $15.43 | $25.71 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PKU Venipuncture - BEN | $15.43 | $25.71 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture - FEAST | $15.43 | $25.71 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture - BEN | $15.43 | $25.71 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture - Lab | $15.43 | $25.71 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture - MFM | $15.43 | $25.71 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Routine Venipuncture - 3 North | $15.43 | $25.71 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Routine Venipuncture - 2 South | $15.43 | $25.71 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Routine Venipuncture - ER | $15.43 | $25.71 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture - MOU | $15.43 | $25.71 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture - MAT | $15.43 | $25.71 | — | — | 40% |
| Blood glucose (sugar) test CPT 82947 FSURE Glucose (LCORP) | $11.82 | $19.69 | $3.93–$5.90 | 58% below | 40% |
| Blood glucose (sugar) test CPT 82947 Glucose | $17.50 | $29.16 | $3.93–$5.90 | 38% below | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 FSURE Glucose (LCORP) | $11.82 | $19.69 | — | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose | $17.50 | $29.16 | — | — | 40% |
| Blood lead test CPT 83655 Lead Quan Absorption | $52.92 | $88.20 | $12.11–$54.26 | 32% below | 40% |
| Blood lead test CPT 83655 Lead (ARUP) | $52.92 | $88.20 | $12.11–$54.26 | 32% below | 40% |
| Blood lead test CPT 83655 Lead Evaluation, Blood (ARUP) | $52.92 | $88.20 | $12.11–$54.26 | 32% below | 40% |
| Blood lead test CPT 83655 Lead Evaluation, Urine (ARUP) | $52.92 | $88.20 | $12.11–$54.26 | 32% below | 40% |
| Blood lead test CPT 83655 Lead Trace Metal Tube | $52.92 | $88.20 | $12.11–$54.26 | 32% below | 40% |
| Blood lead test inpatient CPT 83655 Lead Evaluation, Urine (ARUP) | $52.92 | $88.20 | — | — | 40% |
| Blood lead test inpatient CPT 83655 Lead Quan Absorption | $52.92 | $88.20 | — | — | 40% |
| Blood lead test inpatient CPT 83655 Lead Evaluation, Blood (ARUP) | $52.92 | $88.20 | — | — | 40% |
| Blood lead test inpatient CPT 83655 Lead (ARUP) | $52.92 | $88.20 | — | — | 40% |
| Blood lead test inpatient CPT 83655 Lead Trace Metal Tube | $52.92 | $88.20 | — | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HRUPR (Pass Thru) | $20.76 | $34.59 | $7.52–$33.30 | 63% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG Qual Serum | $28.96 | $48.26 | $7.52–$33.30 | 48% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG Qual Urine | $28.96 | $48.26 | $7.52–$33.30 | 48% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HRUPR (Pass Thru) | $20.76 | $34.59 | — | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG Qual Serum | $28.96 | $48.26 | — | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG Qual Urine | $28.96 | $48.26 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Type | $211.24 | $352.06 | $3.32–$271.09 | 62% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord Blood Type | $232.02 | $386.70 | $3.32–$297.76 | 78% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Type | $211.24 | $352.06 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord Blood Type | $232.02 | $386.70 | — | — | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN | $13.26 | $22.09 | $3.95–$5.93 | 56% below | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen (BUN) | $18.08 | $30.13 | $3.95–$5.93 | 40% below | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN | $13.26 | $22.09 | — | — | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen (BUN) | $18.08 | $30.13 | — | — | 40% |
| C-peptide blood test CPT 84681 C-Peptide | $90.73 | $151.21 | $20.81–$93.01 | 14% below | 40% |
| C-peptide blood test inpatient CPT 84681 C-Peptide | $90.73 | $151.21 | — | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein /CRP (Inflammation) | $20.16 | $33.60 | $5.18–$23.25 | 48% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein /CRP (Inflammation) | $20.16 | $33.60 | — | — | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C. diff by PCR | $91.61 | $152.68 | $37.27–$85.49 | 56% below | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C Difficile Stool by PCR | $103.07 | $171.77 | $37.27–$85.49 | 50% below | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. diff by PCR | $91.61 | $152.68 | — | — | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C Difficile Stool by PCR | $103.07 | $171.77 | — | — | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $91.29 | $152.15 | $20.81–$93.59 | 35% below | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $91.29 | $152.15 | — | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $91.29 | $152.15 | $20.81–$93.59 | 31% below | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 | $91.29 | $152.15 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 by PCR | $103.91 | $173.17 | $51.31–$76.97 | 13% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 by PCR | $103.91 | $173.17 | — | — | 40% |
| Calcium blood test, total CPT 82310 Fluid Calcium | $17.11 | $28.51 | $4.46–$7.74 | 50% below | 40% |
| Calcium blood test, total CPT 82310 Calcium Urine Random | $23.33 | $38.88 | $4.46–$7.74 | 31% below | 40% |
| Calcium blood test, total CPT 82310 Calcium Blood | $23.33 | $38.88 | $4.46–$7.74 | 31% below | 40% |
| Calcium blood test, total inpatient CPT 82310 Fluid Calcium | $17.11 | $28.51 | — | — | 40% |
| Calcium blood test, total inpatient CPT 82310 Calcium Urine Random | $23.33 | $38.88 | — | — | 40% |
| Calcium blood test, total inpatient CPT 82310 Calcium Blood | $23.33 | $38.88 | — | — | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA - Carcinoembryonic Ag | $73.18 | $121.96 | $18.96–$84.40 | 29% below | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen (CEA), Pancreatic Cyst Fluid (Mayo) | $82.32 | $137.20 | $18.96–$84.40 | 21% below | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA | $82.32 | $137.20 | $18.96–$84.40 | 21% below | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA - Carcinoembryonic Ag | $73.18 | $121.96 | — | — | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA | $82.32 | $137.20 | — | — | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen (CEA), Pancreatic Cyst Fluid (Mayo) | $82.32 | $137.20 | — | — | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Herpes Zoster Ab | $51.25 | $85.41 | $12.88–$52.54 | 44% below | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster IgG | $51.25 | $85.41 | $12.88–$52.54 | 44% below | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Antibody: Varicella-Zoster, IgM (ARUP) | $51.25 | $85.41 | $12.88–$52.54 | 44% below | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Immunity | $51.25 | $85.41 | $12.88–$52.54 | 44% below | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Ab IgM | $81.19 | $135.31 | $12.88–$52.54 | 11% below | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Herpes Zoster Ab | $51.25 | $85.41 | — | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster IgG | $51.25 | $85.41 | — | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Antibody: Varicella-Zoster, IgM (ARUP) | $51.25 | $85.41 | — | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Immunity | $51.25 | $85.41 | — | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Ab IgM | $81.19 | $135.31 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachom Ampl Probe Tech | $120.72 | $201.20 | $35.09–$139.23 | 39% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis, Amplified Probe | $135.81 | $226.35 | $35.09–$139.23 | 31% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachom Ampl Probe Tech | $120.72 | $201.20 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis, Amplified Probe | $135.81 | $226.35 | — | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile | $47.30 | $78.82 | $13.39–$54.55 | 50% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel (ARUP) | $53.21 | $88.67 | $13.39–$54.55 | 44% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Profile | $47.30 | $78.82 | — | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel (ARUP) | $53.21 | $88.67 | — | — | 40% |
| Complete blood count (CBC) with differential CPT 85025 Hem CBC AutoDiff Bill Only | $30.20 | $50.33 | $7.77–$31.58 | 39% below | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Hem CBC AutoDiff Bill Only | $30.20 | $50.33 | — | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC (no diff) | $24.89 | $41.48 | $6.47–$28.71 | 45% below | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC (no diff) | $24.89 | $41.48 | — | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 Complete Metabolic Panel | $69.47 | $115.78 | $10.56–$41.91 | 44% below | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Complete Metabolic Panel | $69.47 | $115.78 | — | — | 40% |
| Cortisol blood test, total CPT 82533 Cortisol | $62.48 | $104.12 | $16.30–$72.06 | 40% below | 40% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol | $62.48 | $104.12 | — | — | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 CK Total and MB Isoenzyme | $41.34 | $68.90 | $4.46–$9.77 | 13% below | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 CK, Total (ARUP) | $46.51 | $77.51 | $4.46–$9.77 | 2% below | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CK Total and MB Isoenzyme | $41.34 | $68.90 | — | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CK, Total (ARUP) | $46.51 | $77.51 | — | — | 40% |
| Creatinine blood test CPT 82565 Creatinine Serum | $20.85 | $34.75 | $4.46–$7.68 | 40% below | 40% |
| Creatinine blood test inpatient CPT 82565 Creatinine Serum | $20.85 | $34.75 | — | — | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV IgG | $61.05 | $101.75 | $14.39–$62.58 | 27% below | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IgG | $61.05 | $101.75 | — | — | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer, Quant | $26.39 | $43.97 | $10.18–$30.43 | 65% below | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer, Quant | $26.39 | $43.97 | — | — | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate /S04/ | $111.25 | $185.41 | $22.23–$90.72 | 14% below | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA Sulfate /S04/ | $111.25 | $185.41 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Urine | $152.75 | $254.57 | $62.14–$97.18 | 16% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse Scrn Qual UA #8 | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Buprenorphine, Urine | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse with Buprenorphine and Methadone | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Meconium Toxicology Screen - NRSY | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Scrn, UR, No Conf | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Ext Drug Scrn w/ Conf | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Expanded Tox Screen | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse, Blood | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen, Meconium (ARUP) | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug screen, LCMS, Multiple Drugs One Procedure | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Salicylate Level | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Acetaminophen | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Alcohol | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Overdose Screen | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse Scrn Qual UA #2 | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse Scrn Qual UA #3 | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse Scrn Qual UA #4 | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse Scrn Qual UA #5 | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse Scrn Qual UA #6 | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse Scrn Qual UA #7 | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DAB w/ Methadone Qual UR | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Colostrum Drug Screen | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Confirmation, Ea Procedure | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Comprehensive Drug Screen | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Sngl Drug Class (Tech) | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs Of Abuse Screen-Qual Ur | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Meconium Drug Screen | $171.84 | $286.39 | $62.14–$97.18 | 5% below | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Urine | $152.75 | $254.57 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse, Blood | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Expanded Tox Screen | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen, Meconium (ARUP) | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Confirmation, Ea Procedure | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse Scrn Qual UA #3 | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse Scrn Qual UA #2 | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Acetaminophen | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Overdose Screen | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Alcohol | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Salicylate Level | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug screen, LCMS, Multiple Drugs One Procedure | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Colostrum Drug Screen | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ext Drug Scrn w/ Conf | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Meconium Toxicology Screen - NRSY | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse Scrn Qual UA #4 | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse Scrn Qual UA #5 | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse Scrn Qual UA #6 | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse Scrn Qual UA #7 | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse Scrn Qual UA #8 | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DAB w/ Methadone Qual UR | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse with Buprenorphine and Methadone | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Meconium Drug Screen | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Scrn, UR, No Conf | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs Of Abuse Screen-Qual Ur | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Sngl Drug Class (Tech) | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Buprenorphine, Urine | $171.84 | $286.39 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Comprehensive Drug Screen | $171.84 | $286.39 | — | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolytes - Serum | $45.20 | $75.33 | $7.01–$27.85 | 32% below | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolytes - Serum | $45.20 | $75.33 | — | — | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBC Viral Capsid G | $72.25 | $120.41 | $18.14–$74.07 | 29% below | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Viral Capsid M | $72.25 | $120.41 | $18.14–$74.07 | 29% below | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Viral Capsid | $72.25 | $120.41 | $18.14–$74.07 | 29% below | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Viral Capsid M | $72.25 | $120.41 | — | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBC Viral Capsid G | $72.25 | $120.41 | — | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Viral Capsid | $72.25 | $120.41 | — | — | 40% |
| Estradiol blood test CPT 82670 Estradio | $120.97 | $201.61 | $27.94–$124.02 | 21% below | 40% |
| Estradiol blood test inpatient CPT 82670 Estradio | $120.97 | $201.61 | — | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $81.21 | $135.34 | $18.58–$83.25 | 29% below | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH | $81.21 | $135.34 | — | — | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal (ARUP) | $54.30 | $90.50 | $19.63–$29.45 | 61% below | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal (ARUP) | $54.30 | $90.50 | — | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $53.02 | $88.36 | $13.63–$61.15 | 39% below | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $53.02 | $88.36 | — | — | 40% |
| Fibrinogen blood test CPT 85384 Fibrinogen /Quan/ | $43.59 | $72.65 | $9.72–$39.33 | 37% below | 40% |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen /Quan/ | $43.59 | $72.65 | — | — | 40% |
| Folate (folic acid) blood test CPT 82746 Folate Level | $56.25 | $93.75 | $14.70–$64.88 | 35% below | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level | $56.25 | $93.75 | — | — | 40% |
| Free T3 thyroid hormone test CPT 84481 Free TriIodothyronin (ARUP) | $84.51 | $140.84 | $16.94–$75.79 | 21% below | 40% |
| Free T3 thyroid hormone test CPT 84481 Free T3 by Dialysis | $125.20 | $208.66 | $16.94–$75.79 | 17% above | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 Free TriIodothyronin (ARUP) | $84.51 | $140.84 | — | — | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 Free T3 by Dialysis | $125.20 | $208.66 | — | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 by Equilib. Dialysis (ARUP) | $38.36 | $63.93 | $9.02–$39.33 | 40% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free Thyroxine T4 | $71.80 | $119.66 | $9.02–$39.33 | 13% above | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 by Equilib. Dialysis (ARUP) | $38.36 | $63.93 | — | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free Thyroxine T4 | $71.80 | $119.66 | — | — | 40% |
| Free testosterone test CPT 84402 Free Testosterone | $101.09 | $168.48 | $25.47–$103.64 | 24% below | 40% |
| Free testosterone test CPT 84402 Testosterone Free | $101.09 | $168.48 | $25.47–$103.64 | 24% below | 40% |
| Free testosterone test CPT 84402 Testosterone, Free (QUEST) | $101.09 | $168.48 | $25.47–$103.64 | 24% below | 40% |
| Free testosterone test inpatient CPT 84402 Testosterone Free | $101.09 | $168.48 | — | — | 40% |
| Free testosterone test inpatient CPT 84402 Testosterone, Free (QUEST) | $101.09 | $168.48 | — | — | 40% |
| Free testosterone test inpatient CPT 84402 Free Testosterone | $101.09 | $168.48 | — | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 FSURE GGT (LCORP) | $19.92 | $33.19 | $4.46–$10.80 | 58% below | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGTP/GGT | $28.77 | $47.95 | $4.46–$10.80 | 40% below | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 FSURE GGT (LCORP) | $19.92 | $33.19 | — | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGTP/GGT | $28.77 | $47.95 | — | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hr PP | $17.75 | $29.58 | $4.75–$20.10 | 53% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose (Post 50gm) PN Screen | $24.21 | $40.34 | $4.75–$20.10 | 36% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hr PP | $17.75 | $29.58 | — | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose (Post 50gm) PN Screen | $24.21 | $40.34 | — | — | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 3 Hr | $56.01 | $93.34 | $12.87–$57.42 | 31% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 3 Hr Gestational | $56.01 | $93.34 | $12.87–$57.42 | 31% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 2 Hr - Fisher | $56.01 | $93.34 | $12.87–$57.42 | 31% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 5 Hr | $56.01 | $93.34 | $12.87–$57.42 | 31% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 6 Hr | $56.01 | $93.34 | $12.87–$57.42 | 31% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 4 Hr | $56.01 | $93.34 | $12.87–$57.42 | 31% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 2 Hr | $56.01 | $93.34 | $12.87–$57.42 | 31% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose, 3 Specimens, Tolerance | $56.01 | $93.34 | $12.87–$57.42 | 31% below | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 3 Hr Gestational | $56.01 | $93.34 | — | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 2 Hr - Fisher | $56.01 | $93.34 | — | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 5 Hr | $56.01 | $93.34 | — | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 6 Hr | $56.01 | $93.34 | — | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 4 Hr | $56.01 | $93.34 | — | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 3 Hr | $56.01 | $93.34 | — | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose, 3 Specimens, Tolerance | $56.01 | $93.34 | — | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 2 Hr | $56.01 | $93.34 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae Amplified Prob Tech | $120.72 | $201.20 | $35.09–$139.23 | 35% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae, Amplified Probe (Mayo) | $135.81 | $226.35 | $35.09–$139.23 | 27% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae Amplified Prob Tech | $120.72 | $201.20 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae, Amplified Probe (Mayo) | $135.81 | $226.35 | — | — | 40% |
| H. pylori antibody blood test CPT 86677 Helicobacter Pylori Ab - IgG | $46.59 | $77.65 | $16.85–$25.28 | 63% below | 40% |
| H. pylori antibody blood test inpatient CPT 86677 Helicobacter Pylori Ab - IgG | $46.59 | $77.65 | — | — | 40% |
| H. pylori stool antigen test CPT 87338 Helicobacter Pylori Antigen Stool | $44.81 | $74.67 | $14.38–$45.93 | 56% below | 40% |
| H. pylori stool antigen test inpatient CPT 87338 Helicobacter Pylori Antigen Stool | $44.81 | $74.67 | — | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV1 Viral Load, PCR | $329.30 | $548.83 | $85.10–$337.61 | 34% below | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV1 Viral Load, PCR | $329.30 | $548.83 | — | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 AG/Ab | $68.33 | $113.87 | $24.08–$70.05 | 51% below | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 AG/Ab | $68.33 | $113.87 | — | — | 40% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV Screen High-Risk | $97.05 | $161.74 | $35.09–$74.58 | 54% below | 40% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV Screen High-Risk | $97.05 | $161.74 | — | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C | $36.84 | $61.40 | $9.71–$42.49 | 35% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C Referenced Testing (ARUP) | $41.45 | $69.07 | $9.71–$42.49 | 26% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C | $36.84 | $61.40 | — | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C Referenced Testing (ARUP) | $41.45 | $69.07 | — | — | 40% |
| Hemoglobin blood test CPT 85018 HGB | $8.46 | $14.10 | $2.37–$8.61 | 55% below | 40% |
| Hemoglobin blood test inpatient CPT 85018 HGB | $8.46 | $14.10 | — | — | 40% |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Ab | $46.77 | $77.94 | $12.05–$47.94 | 51% below | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Ab | $46.77 | $77.94 | — | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody - Microbiology | $41.45 | $69.07 | $10.74–$42.49 | 48% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab | $41.45 | $69.07 | $10.74–$42.49 | 48% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody - Chemistry | $41.45 | $69.07 | $10.74–$42.49 | 48% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab | $41.45 | $69.07 | — | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody - Chemistry | $41.45 | $69.07 | — | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody - Microbiology | $41.45 | $69.07 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen - Chemistry | $40.05 | $66.74 | $10.33–$41.05 | 42% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen - Microbiology | $40.05 | $66.74 | $10.33–$41.05 | 42% below | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen - Chemistry | $40.05 | $66.74 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen - Microbiology | $40.05 | $66.74 | — | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody | $55.17 | $91.94 | $14.27–$56.55 | 49% below | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody | $55.17 | $91.94 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Quantitative (PCR) | $165.78 | $276.29 | $42.84–$169.95 | 40% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA by PCR Quant | $165.78 | $276.29 | $42.84–$169.95 | 40% below | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA by PCR Quant | $165.78 | $276.29 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Quantitative (PCR) | $165.78 | $276.29 | — | — | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type 1 IgG Antibody | $63.84 | $106.40 | $13.19–$65.45 | 20% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex I IgG | $63.84 | $106.40 | $13.19–$65.45 | 20% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Virus 1 IgM Antibody | $63.84 | $106.40 | $13.19–$65.45 | 20% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type 1 IgM | $63.84 | $106.40 | $13.19–$65.45 | 20% below | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Type 1 IgG Antibody | $63.84 | $106.40 | — | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Virus 1 IgM Antibody | $63.84 | $106.40 | — | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex I IgG | $63.84 | $106.40 | — | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Type 1 IgM | $63.84 | $106.40 | — | — | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2 IgG Antibody | $81.49 | $135.81 | $19.35–$83.54 | 20% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Virus 2 IgM Antibody | $81.49 | $135.81 | $19.35–$83.54 | 20% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2 IgM | $81.49 | $135.81 | $19.35–$83.54 | 20% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex 2 IgG | $81.49 | $135.81 | $19.35–$83.54 | 20% below | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Type 2 IgG Antibody | $81.49 | $135.81 | — | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Type 2 IgM | $81.49 | $135.81 | — | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex 2 IgG | $81.49 | $135.81 | — | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Virus 2 IgM Antibody | $81.49 | $135.81 | — | — | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein-HSCRP | $50.10 | $83.49 | $12.95–$51.36 | 33% below | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein-HSCRP | $50.10 | $83.49 | — | — | 40% |
| Homocysteine blood test CPT 83090 Homocysteine | $119.85 | $199.74 | $17.92–$86.12 | at median | 40% |
| Homocysteine blood test inpatient CPT 83090 Homocysteine | $119.85 | $199.74 | — | — | 40% |
| Insulin blood test CPT 83525 Insulin | $57.15 | $95.25 | $11.43–$49.95 | 18% below | 40% |
| Insulin blood test inpatient CPT 83525 Insulin | $57.15 | $95.25 | — | — | 40% |
| Iron blood test (serum iron) CPT 83540 Iron Serum | $38.63 | $64.37 | $6.47–$29.00 | 18% below | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Serum | $38.63 | $64.37 | — | — | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 TIBC - Iron Bind | $38.09 | $63.47 | $8.74–$39.04 | 40% below | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC - Iron Bind | $38.09 | $63.47 | — | — | 40% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $33.60 | $56.00 | $8.68–$34.45 | 58% below | 40% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $33.60 | $56.00 | — | — | 40% |
| LH (luteinizing hormone) test CPT 83002 LH | $82.61 | $137.68 | $18.52–$84.69 | 29% below | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH | $82.61 | $137.68 | — | — | 40% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid | $41.07 | $68.45 | $11.57–$47.37 | 47% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid, CSF | $46.21 | $77.01 | $11.57–$47.37 | 40% below | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid | $41.07 | $68.45 | — | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid, CSF | $46.21 | $77.01 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH | $27.61 | $46.01 | $4.46–$9.06 | 23% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Fluid LDH | $31.06 | $51.76 | $4.46–$9.06 | 14% below | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH | $27.61 | $46.01 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Fluid LDH | $31.06 | $51.76 | — | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase | $28.77 | $47.95 | $6.89–$31.00 | 42% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 Fluid Lipase | $32.37 | $53.94 | $6.89–$31.00 | 35% below | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase | $28.77 | $47.95 | — | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Fluid Lipase | $32.37 | $53.94 | — | — | 40% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $34.74 | $57.89 | $8.17–$32.44 | 62% below | 40% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $34.74 | $57.89 | — | — | 40% |
| Lyme disease antibody test CPT 86618 Lyme Disease Ab Fluid | $67.77 | $112.94 | $17.03–$69.47 | 29% below | 40% |
| Lyme disease antibody test CPT 86618 Lyme Disease Ab Total | $67.77 | $112.94 | $17.03–$69.47 | 29% below | 40% |
| Lyme disease antibody test CPT 86618 Borrelia burgdorferi (ARUP) | $67.77 | $112.94 | $17.03–$69.47 | 29% below | 40% |
| Lyme disease antibody test CPT 86618 Lyme Disease Antibody | $67.77 | $112.94 | $17.03–$69.47 | 29% below | 40% |
| Lyme disease antibody test CPT 86618 Lyme Disease Ab IgM | $67.77 | $112.94 | $17.03–$69.47 | 29% below | 40% |
| Lyme disease antibody test CPT 86618 Lyme Antibody CSF | $73.33 | $122.21 | $17.03–$69.47 | 23% below | 40% |
| Lyme disease antibody test CPT 86618 Lyme Index Test (Referenced) | $137.25 | $228.74 | $17.03–$69.47 | 45% above | 40% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Ab Fluid | $67.77 | $112.94 | — | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Ab IgM | $67.77 | $112.94 | — | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 Borrelia burgdorferi (ARUP) | $67.77 | $112.94 | — | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Ab Total | $67.77 | $112.94 | — | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Antibody | $67.77 | $112.94 | — | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Antibody CSF | $73.33 | $122.21 | — | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Index Test (Referenced) | $137.25 | $228.74 | — | — | 40% |
| Magnesium blood test CPT 83735 Magnesium Level | $26.14 | $43.56 | $6.70–$30.14 | 37% below | 40% |
| Magnesium blood test CPT 83735 Magnesium Urine 24 Hr | $29.41 | $49.01 | $6.70–$30.14 | 29% below | 40% |
| Magnesium blood test CPT 83735 Fluid Magnesium | $29.41 | $49.01 | $6.70–$30.14 | 29% below | 40% |
| Magnesium blood test CPT 83735 Magnesium, RBC (ARUP) | $29.41 | $49.01 | $6.70–$30.14 | 29% below | 40% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level | $26.14 | $43.56 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 Fluid Magnesium | $29.41 | $49.01 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 Magnesium, RBC (ARUP) | $29.41 | $49.01 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 Magnesium Urine 24 Hr | $29.41 | $49.01 | — | — | 40% |
| Measles (rubeola) antibody test CPT 86765 Measles Mumps Rubella Immunity | $36.12 | $60.20 | $12.88–$37.03 | 56% below | 40% |
| Measles (rubeola) antibody test CPT 86765 Antibody: Rubeola, IgM (ARUP) | $36.12 | $60.20 | $12.88–$37.03 | 56% below | 40% |
| Measles (rubeola) antibody test CPT 86765 Rubeola/Measles | $36.12 | $60.20 | $12.88–$37.03 | 56% below | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola/Measles | $36.12 | $60.20 | — | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Antibody: Rubeola, IgM (ARUP) | $36.12 | $60.20 | — | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles Mumps Rubella Immunity | $36.12 | $60.20 | — | — | 40% |
| Mumps immunity blood test CPT 86735 Mumps Virus Ab IgG | $56.75 | $94.58 | $13.05–$65.45 | 30% below | 40% |
| Mumps immunity blood test CPT 86735 Mumps IgG Immunity | $63.84 | $106.40 | $13.05–$65.45 | 21% below | 40% |
| Mumps immunity blood test CPT 86735 Antibody: Mumps, IgM (ARUP) | $63.84 | $106.40 | $13.05–$65.45 | 21% below | 40% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Virus Ab IgG | $56.75 | $94.58 | — | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 Mumps IgG Immunity | $63.84 | $106.40 | — | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 Antibody: Mumps, IgM (ARUP) | $63.84 | $106.40 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free | $81.65 | $136.08 | $18.39–$72.92 | 13% below | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free | $81.65 | $136.08 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen | $64.97 | $108.27 | $18.39–$74.93 | 41% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, Ultra Sensitive (Post Radical Prostatectomy)(ARUP) | $73.08 | $121.80 | $18.39–$74.93 | 33% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Spec Antigen-Total | $73.08 | $121.80 | $18.39–$74.93 | 33% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total | $73.08 | $121.80 | $18.39–$74.93 | 33% below | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen | $64.97 | $108.27 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total | $73.08 | $121.80 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Spec Antigen-Total | $73.08 | $121.80 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, Ultra Sensitive (Post Radical Prostatectomy)(ARUP) | $73.08 | $121.80 | — | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 Intraop PTH 10 min | $147.42 | $245.69 | $41.28–$184.59 | 31% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 Intact PTH (HNL) | $160.05 | $266.74 | $41.28–$184.59 | 25% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH Preoperative | $180.05 | $300.08 | $41.28–$184.59 | 15% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 Intraop PTH 10min | $180.05 | $300.08 | $41.28–$184.59 | 15% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 Intact PTH | $180.05 | $300.08 | $41.28–$184.59 | 15% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH Post OP 15min | $180.05 | $300.08 | $41.28–$184.59 | 15% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH Post OP 5min | $180.05 | $300.08 | $41.28–$184.59 | 15% below | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Intraop PTH 10 min | $147.42 | $245.69 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Intact PTH (HNL) | $160.05 | $266.74 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Intact PTH | $180.05 | $300.08 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Post OP 15min | $180.05 | $300.08 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Intraop PTH 10min | $180.05 | $300.08 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Preoperative | $180.05 | $300.08 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Post OP 5min | $180.05 | $300.08 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $23.85 | $39.74 | $6.01–$26.99 | 48% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT (Lupus Sensitive) | $26.83 | $44.71 | $6.01–$26.99 | 41% below | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $23.85 | $39.74 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT (Lupus Sensitive) | $26.83 | $44.71 | — | — | 40% |
| Phosphorus (phosphate) blood test CPT 84100 Fluid Phosphorus | $20.21 | $33.68 | $4.46–$7.11 | 44% below | 40% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus | $24.50 | $40.82 | $4.46–$7.11 | 32% below | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Fluid Phosphorus | $20.21 | $33.68 | — | — | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus | $24.50 | $40.82 | — | — | 40% |
| Potassium blood test CPT 84132 Potassium Plasma | $13.18 | $21.96 | $4.46–$7.14 | 60% below | 40% |
| Potassium blood test CPT 84132 Potassium Level | $18.54 | $30.89 | $4.46–$7.14 | 44% below | 40% |
| Potassium blood test inpatient CPT 84132 Potassium Plasma | $13.18 | $21.96 | — | — | 40% |
| Potassium blood test inpatient CPT 84132 Potassium Level | $18.54 | $30.89 | — | — | 40% |
| Progesterone blood test CPT 84144 Progesterone | $91.01 | $151.67 | $20.86–$93.30 | 36% below | 40% |
| Progesterone blood test inpatient CPT 84144 Progesterone | $91.01 | $151.67 | — | — | 40% |
| Prolactin blood test CPT 84146 Prolactin | $89.38 | $148.96 | $19.38–$86.70 | 30% below | 40% |
| Prolactin blood test inpatient CPT 84146 Prolactin | $89.38 | $148.96 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $16.07 | $26.78 | $4.29–$16.08 | 45% below | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $16.07 | $26.78 | — | — | 40% |
| Rapid flu test (influenza antigen) CPT 87804 IA Antigen DTCT, FLU, Immunoassay w/ DRCT OP OBS POC | $59.54 | $99.22 | $16.55–$43.69 | 9% above | 40% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza A&B Antigen-Rapid | $81.18 | $135.30 | $16.55–$43.69 | 48% above | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 IA Antigen DTCT, FLU, Immunoassay w/ DRCT OP OBS POC | $59.54 | $99.22 | — | — | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A&B Antigen-Rapid | $81.18 | $135.30 | — | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep A Antigen | $40.63 | $67.71 | $16.53–$43.64 | 36% below | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep A Antigen | $40.63 | $67.71 | — | — | 40% |
| Renin blood test CPT 84244 Renin (ARUP) | $95.78 | $159.62 | $21.99–$98.18 | 38% below | 40% |
| Renin blood test CPT 84244 Renin | $95.78 | $159.62 | $21.99–$98.18 | 38% below | 40% |
| Renin blood test CPT 84244 Renin Activity (Referenced) | $95.78 | $159.62 | $21.99–$98.18 | 38% below | 40% |
| Renin blood test inpatient CPT 84244 Renin | $95.78 | $159.62 | — | — | 40% |
| Renin blood test inpatient CPT 84244 Renin (ARUP) | $95.78 | $159.62 | — | — | 40% |
| Renin blood test inpatient CPT 84244 Renin Activity (Referenced) | $95.78 | $159.62 | — | — | 40% |
| Rh blood typing CPT 86901 Blood RH | $61.79 | $102.97 | $3.32–$79.29 | 15% above | 40% |
| Rh blood typing CPT 86901 Cord Blood RH | $70.65 | $117.75 | $14.18–$864.00 | 32% above | 40% |
| Rh blood typing CPT 86901 Rh (D) Type Non-Patient, LVH | $70.65 | $117.75 | $3.32–$90.67 | 32% above | 40% |
| Rh blood typing inpatient CPT 86901 Blood RH | $61.79 | $102.97 | — | — | 40% |
| Rh blood typing inpatient CPT 86901 Cord Blood RH | $70.65 | $117.75 | — | — | 40% |
| Rh blood typing inpatient CPT 86901 Rh (D) Type Non-Patient, LVH | $70.65 | $117.75 | — | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Fluid Source (ARUP) | $26.09 | $43.48 | $5.67–$24.98 | 33% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 Fluid Rheumatoid Factor | $26.09 | $43.48 | $5.67–$24.98 | 33% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor, Quant. | $35.58 | $59.29 | $5.67–$24.98 | 9% below | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Fluid Source (ARUP) | $26.09 | $43.48 | — | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Fluid Rheumatoid Factor | $26.09 | $43.48 | — | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor, Quant. | $35.58 | $59.29 | — | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella IgG Antibody | $54.27 | $90.44 | $14.39–$62.58 | 36% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella | $61.05 | $101.75 | $14.39–$62.58 | 28% below | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG Antibody | $54.27 | $90.44 | — | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella | $61.05 | $101.75 | — | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR - Sedimentation Rate | $18.08 | $30.13 | $2.70–$10.62 | 19% below | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR - Sedimentation Rate | $18.08 | $30.13 | — | — | 40% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 Sperm Count | $51.53 | $85.87 | $12.31–$52.82 | 46% below | 40% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Sperm Count | $51.53 | $85.87 | — | — | 40% |
| Sodium blood test CPT 84295 Fluid Sodium | $13.31 | $22.17 | $4.46–$7.22 | 62% below | 40% |
| Sodium blood test CPT 84295 Sodium | $13.31 | $22.17 | $4.46–$7.22 | 62% below | 40% |
| Sodium blood test inpatient CPT 84295 Sodium | $13.31 | $22.17 | — | — | 40% |
| Sodium blood test inpatient CPT 84295 Fluid Sodium | $13.31 | $22.17 | — | — | 40% |
| Stool ova and parasites exam CPT 87177 Ova & Parasite - Chemistry | $66.63 | $111.05 | $8.90–$39.04 | 6% above | 40% |
| Stool ova and parasites exam inpatient CPT 87177 Ova & Parasite - Chemistry | $66.63 | $111.05 | — | — | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood - Stool | $12.11 | $20.17 | $4.38–$7.18 | 41% below | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood - Stool | $12.11 | $20.17 | — | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood, Stool, Immunoassay | $63.84 | $106.40 | $15.92–$65.45 | 77% above | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood, Stool, Immunoassay | $63.84 | $106.40 | — | — | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum | $32.54 | $54.22 | $13.24–$33.10 | 56% below | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Treponem Particle Aggl | $36.60 | $61.00 | $13.24–$33.10 | 51% below | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Antibody | $36.60 | $61.00 | $13.24–$33.10 | 51% below | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum Ab CSF | $36.60 | $61.00 | $13.24–$33.10 | 51% below | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 T Pallidum by TP-PA | $36.60 | $61.00 | $13.24–$33.10 | 51% below | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 T Pallidum Antibody IgG (ARUP) | $36.60 | $61.00 | $13.24–$33.10 | 51% below | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema Pallidum | $32.54 | $54.22 | — | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T Pallidum by TP-PA | $36.60 | $61.00 | — | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponem Particle Aggl | $36.60 | $61.00 | — | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis Antibody | $36.60 | $61.00 | — | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T Pallidum Antibody IgG (ARUP) | $36.60 | $61.00 | — | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema Pallidum Ab CSF | $36.60 | $61.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 CSF VDRL | $18.76 | $31.26 | $4.27–$19.23 | 35% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR /Qual/ | $18.76 | $31.26 | $4.27–$19.23 | 35% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR /Qual/ | $18.76 | $31.26 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 CSF VDRL | $18.76 | $31.26 | — | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon TB Gold | $236.46 | $394.10 | $61.98–$272.73 | 19% below | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon TB Gold | $236.46 | $394.10 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total (QUEST) | $112.58 | $187.62 | $25.81–$115.41 | 31% below | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone | $112.58 | $187.62 | $25.81–$115.41 | 31% below | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total | $112.58 | $187.62 | $25.81–$115.41 | 31% below | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total (QUEST) | $112.58 | $187.62 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone | $112.58 | $187.62 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total | $112.58 | $187.62 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibody (Vira) | $63.84 | $106.40 | $14.55–$65.45 | 19% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibodies (ARUP) | $63.84 | $106.40 | $14.55–$65.45 | 19% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Ab | $63.84 | $106.40 | $14.55–$65.45 | 19% below | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Antibodies (ARUP) | $63.84 | $106.40 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Antibody (Vira) | $63.84 | $106.40 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Ab | $63.84 | $106.40 | — | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $65.22 | $108.69 | $16.80–$75.21 | 35% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (Referenced) | $73.37 | $122.28 | $16.80–$75.21 | 26% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $65.22 | $108.69 | — | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (Referenced) | $73.37 | $122.28 | — | — | 40% |
| Total IgE blood test CPT 82785 Immunoglobulin E | $71.13 | $118.54 | $16.46–$72.92 | 32% below | 40% |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E | $71.13 | $118.54 | — | — | 40% |
| Total cholesterol blood test CPT 82465 FSURE Cholesterol (LCORP) | $12.04 | $20.06 | $4.35–$6.53 | 62% below | 40% |
| Total cholesterol blood test CPT 82465 Fluid Cholesterol | $12.04 | $20.06 | $4.35–$6.53 | 62% below | 40% |
| Total cholesterol blood test CPT 82465 Cholesterol Serum | $14.65 | $24.41 | $4.35–$6.53 | 54% below | 40% |
| Total cholesterol blood test inpatient CPT 82465 Fluid Cholesterol | $12.04 | $20.06 | — | — | 40% |
| Total cholesterol blood test inpatient CPT 82465 FSURE Cholesterol (LCORP) | $12.04 | $20.06 | — | — | 40% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol Serum | $14.65 | $24.41 | — | — | 40% |
| Total thyroxine (T4) blood test CPT 84436 Thyroxine (T4) | $45.20 | $75.33 | $6.87–$31.00 | at median | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine (T4) | $45.20 | $75.33 | — | — | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3) | $62.08 | $103.46 | $14.18–$61.72 | 38% below | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3) | $62.08 | $103.46 | — | — | 40% |
| Transferrin blood test CPT 84466 Transferrin (HNL) | $54.76 | $91.26 | $12.76–$63.16 | 40% below | 40% |
| Transferrin blood test CPT 84466 Transferrin | $61.61 | $102.67 | $12.76–$63.16 | 32% below | 40% |
| Transferrin blood test inpatient CPT 84466 Transferrin (HNL) | $54.76 | $91.26 | — | — | 40% |
| Transferrin blood test inpatient CPT 84466 Transferrin | $61.61 | $102.67 | — | — | 40% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas Vaganalis | $97.05 | $161.74 | $35.09–$74.76 | 47% below | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaganalis | $97.05 | $161.74 | — | — | 40% |
| Triglycerides blood test CPT 84478 Triglycerides | $18.15 | $30.25 | $4.46–$8.61 | 57% below | 40% |
| Triglycerides blood test CPT 84478 FSURE Triglycerides (LCORP) | $18.15 | $30.25 | $4.46–$8.61 | 57% below | 40% |
| Triglycerides blood test CPT 84478 Fluid Triglycerides | $18.74 | $31.23 | $4.46–$8.61 | 56% below | 40% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides | $18.15 | $30.25 | — | — | 40% |
| Triglycerides blood test inpatient CPT 84478 FSURE Triglycerides (LCORP) | $18.15 | $30.25 | — | — | 40% |
| Triglycerides blood test inpatient CPT 84478 Fluid Triglycerides | $18.74 | $31.23 | — | — | 40% |
| Troponin test, quantitative CPT 84484 Troponin Quantitative | $47.18 | $78.62 | $12.47–$34.45 | 43% below | 40% |
| Troponin test, quantitative inpatient CPT 84484 Troponin Quantitative | $47.18 | $78.62 | — | — | 40% |
| Uric acid blood test CPT 84550 Uric Acid-Rasburicase | $16.25 | $27.08 | $4.46–$6.78 | 52% below | 40% |
| Uric acid blood test CPT 84550 Uric Acid | $19.70 | $32.83 | $4.46–$6.78 | 41% below | 40% |
| Uric acid blood test inpatient CPT 84550 Uric Acid-Rasburicase | $16.25 | $27.08 | — | — | 40% |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $19.70 | $32.83 | — | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis, Auto w/ Microscopy | $17.11 | $28.51 | $3.17–$12.63 | 52% below | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis, Auto w/ Microscopy | $17.11 | $28.51 | — | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 HRURN (Pass Thru) | $6.98 | $11.63 | $2.25–$9.76 | 64% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Dipstick Only | $8.46 | $14.10 | $2.25–$9.76 | 56% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Specific Gravity | $9.52 | $15.86 | $2.25–$9.76 | 51% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis - L & D | $9.52 | $15.86 | $2.25–$9.76 | 51% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis - NRSY | $9.52 | $15.86 | $2.25–$9.76 | 51% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis - MAT | $9.52 | $15.86 | $2.25–$9.76 | 51% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urine PH | $9.52 | $15.86 | $2.25–$9.76 | 51% below | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HRURN (Pass Thru) | $6.98 | $11.63 | — | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Dipstick Only | $8.46 | $14.10 | — | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine PH | $9.52 | $15.86 | — | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Specific Gravity | $9.52 | $15.86 | — | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis - NRSY | $9.52 | $15.86 | — | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis - L & D | $9.52 | $15.86 | — | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis - MAT | $9.52 | $15.86 | — | — | 40% |
| Urinalysis without microscope exam, manual CPT 81002 pH | $9.16 | $15.26 | $3.48–$14.35 | 57% below | 40% |
| Urinalysis without microscope exam, manual CPT 81002 Bilirubin, Urine | $9.16 | $15.26 | $3.48–$14.35 | 57% below | 40% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Specific Gravity (HNL) | $12.48 | $20.80 | $3.48–$14.35 | 42% below | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Bilirubin, Urine | $9.16 | $15.26 | — | — | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 pH | $9.16 | $15.26 | — | — | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Specific Gravity (HNL) | $12.48 | $20.80 | — | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Reflex Culture | $29.73 | $49.54 | $8.07–$37.32 | 50% below | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Cath Culture | $29.73 | $49.54 | $8.07–$37.32 | 50% below | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Midstream Culture | $36.03 | $60.05 | $8.07–$37.32 | 40% below | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Reflex Culture | $29.73 | $49.54 | — | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Cath Culture | $29.73 | $49.54 | — | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Midstream Culture | $36.03 | $60.05 | — | — | 40% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin 24 Hr Urine | $25.67 | $42.77 | $5.78–$25.84 | 38% below | 40% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine Random | $25.67 | $42.77 | $5.78–$25.84 | 38% below | 40% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin (HNL) | $25.67 | $42.77 | $5.78–$25.84 | 38% below | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine Random | $25.67 | $42.77 | — | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin 24 Hr Urine | $25.67 | $42.77 | — | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin (HNL) | $25.67 | $42.77 | — | — | 40% |
| Urine pregnancy test, read by color change CPT 81025 HCG-UA Pregnancy Test - ER | $26.32 | $43.86 | $8.61–$26.99 | 30% below | 40% |
| Urine pregnancy test, read by color change CPT 81025 Pregnancy, Urine | $26.32 | $43.86 | $8.61–$26.99 | 30% below | 40% |
| Urine pregnancy test, read by color change CPT 81025 Urine, Pregnancy - SSU | $26.32 | $43.86 | $8.61–$26.99 | 30% below | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Urine, Pregnancy - SSU | $26.32 | $43.86 | — | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG-UA Pregnancy Test - ER | $26.32 | $43.86 | — | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy, Urine | $26.32 | $43.86 | — | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 B-12 Level | $58.50 | $97.49 | $15.08–$67.46 | 35% below | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B-12 Level | $58.50 | $97.49 | — | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D25 | $111.76 | $186.26 | $29.60–$128.90 | 25% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, (25-Hydroxy) (ARUP) | $125.73 | $209.54 | $29.60–$128.90 | 16% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D25 | $111.76 | $186.26 | — | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, (25-Hydroxy) (ARUP) | $125.73 | $209.54 | — | — | 40% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D 1,25 Dihydroxy | $166.05 | $276.75 | $38.50–$170.24 | 21% below | 40% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D 1,25 Dihydroxy | $166.05 | $276.75 | — | — | 40% |
| Zinc blood test CPT 84630 Zinc (ARUP) | $50.13 | $83.54 | $11.39–$51.39 | 29% below | 40% |
| Zinc blood test CPT 84630 Zinc | $50.13 | $83.54 | $11.39–$51.39 | 29% below | 40% |
| Zinc blood test inpatient CPT 84630 Zinc (ARUP) | $50.13 | $83.54 | — | — | 40% |
| Zinc blood test inpatient CPT 84630 Zinc | $50.13 | $83.54 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Quant Serum | $47.30 | $78.82 | $15.05–$54.55 | 44% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Tumor Marker | $53.21 | $88.67 | $15.05–$54.55 | 37% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG | $53.21 | $88.67 | $15.05–$54.55 | 37% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG Quant Serum | $47.30 | $78.82 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG | $53.21 | $88.67 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG Tumor Marker | $53.21 | $88.67 | — | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 Breast Bx Stereo 1st Lesion Lt - SWC | $3,004.56 | $5,007.59 | $90.00–$3,855.84 | 23% below | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 Breast Bx Stereo 1st Lesion Rt - SWC | $3,327.30 | $5,545.50 | $90.00–$4,270.04 | 15% below | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 SD Breast Bx Stereo 1st Lesion Lt - SWC | $4,460.40 | $7,434.00 | $90.00–$5,724.18 | 14% above | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 SD Breast Bx Stereo 1st Lesion Rt - SWC | $4,460.40 | $7,434.00 | $90.00–$5,724.18 | 14% above | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 Breast Bx Stereo 1st Lesion Lt - SWC | $3,004.56 | $5,007.59 | — | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 Breast Bx Stereo 1st Lesion Rt - SWC | $3,327.30 | $5,545.50 | — | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 SD Breast Bx Stereo 1st Lesion Rt - SWC | $4,460.40 | $7,434.00 | — | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 SD Breast Bx Stereo 1st Lesion Lt - SWC | $4,460.40 | $7,434.00 | — | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed Tx Metatarsal - ER | $1,399.99 | $2,333.31 | $236.00–$1,796.65 | 169% above | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed Tx Metatarsal - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Cardiac catheterization with coronary angiogram CPT 93458 LHC + Coronaries +/-LVG - CCL | $7,570.47 | $12,617.45 | $2,499.00–$9,715.44 | 6% below | 40% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 LHC + Coronaries +/-LVG - CCL | $7,570.47 | $12,617.45 | — | — | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion - CCL | $1,730.24 | $2,883.73 | $121.38–$2,508.85 | 18% above | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion - PACU | $1,770.48 | $2,950.79 | $121.38–$2,567.19 | 21% above | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion - ER | $1,916.10 | $3,193.50 | $121.38–$2,778.35 | 31% above | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion - ICCU/CCU | $2,812.20 | $4,687.00 | $121.38–$4,077.69 | 92% above | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion - CCL | $1,730.24 | $2,883.73 | — | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion - PACU | $1,770.48 | $2,950.79 | — | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion - ER | $1,916.10 | $3,193.50 | — | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion - ICCU/CCU | $2,812.20 | $4,687.00 | — | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision w/ Regional Block - NRSY | $3,840.00 | $6,400.00 | $623.79–$4,928.00 | 215% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision w/o Regional Block - NICU | $3,840.00 | $6,400.00 | $623.79–$4,928.00 | 215% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision w/Regional Block - NICU | $3,840.00 | $6,400.00 | $623.79–$4,928.00 | 215% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision w/o Regional Block - NRSY | $3,840.00 | $6,400.00 | $623.79–$4,928.00 | 215% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision w/Regional Block - NICU | $3,840.00 | $6,400.00 | — | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision w/o Regional Block - NICU | $3,840.00 | $6,400.00 | — | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision w/o Regional Block - NRSY | $3,840.00 | $6,400.00 | — | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision w/ Regional Block - NRSY | $3,840.00 | $6,400.00 | — | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed Tx Distal Radial, Colles, - ER | $1,399.99 | $2,333.31 | $236.00–$1,796.65 | 111% above | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Closed Tx Distal Radial, Colles, - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Colonoscopy with polyp removal CPT 45385 Colonscopy w/ Polyp Tumor Removal - ACU | $2,815.71 | $4,692.85 | $1,211.82–$3,613.49 | 1% above | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 Colonscopy w/ Polyp Tumor Removal - ACU | $2,815.71 | $4,692.85 | — | — | 40% |
| Colonoscopy with tissue sample CPT 45380 Colonscopy w/ Biopsy - ACU | $2,815.71 | $4,692.85 | $1,211.82–$3,613.49 | 27% above | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 Colonscopy w/ Biopsy - ACU | $2,815.71 | $4,692.85 | — | — | 40% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy - ACU | $2,815.71 | $4,692.85 | $941.75–$3,613.49 | 88% above | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy - ACU | $2,815.71 | $4,692.85 | — | — | 40% |
| Coronary stent placement, one artery CPT 92928 PTCA Single Vsl &/or Brnch w/wo Stent 1 Lsn 1+ Segmnt - CCL | $19,107.56 | $31,845.93 | $2,499.00–$27,705.96 | at median | 40% |
| Coronary stent placement, one artery inpatient CPT 92928 PTCA Single Vsl &/or Brnch w/wo Stent 1 Lsn 1+ Segmnt - CCL | $19,107.56 | $31,845.93 | — | — | 40% |
| Cystoscopy with ureteral stent placement CPT 52332 Double J Stent Placement - IR | $6,208.15 | $10,346.91 | $2,499.00–$7,967.12 | 30% above | 40% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 Double J Stent Placement - IR | $6,208.15 | $10,346.91 | — | — | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove Impacted Ear Wax Uni - ER | $1,399.99 | $2,333.31 | $59.74–$1,796.65 | 868% above | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove Impacted Ear Wax Uni - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Earwax removal with instruments, one ear CPT 69210 Remove Impacted Cerumen - ER | $1,399.99 | $2,333.31 | $59.74–$1,796.65 | 926% above | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 Remove Impacted Cerumen - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Thoracic Epidural w/Img (62321) | $1,513.19 | $2,521.97 | $714.83–$2,906.00 | 38% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Thoracic Epidural w/Img (62321) | $1,513.19 | $2,521.97 | — | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy Flexible - ACU | $4,814.10 | $8,023.50 | $941.75–$6,178.10 | 407% above | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Sigmoidoscopy Flexible - ACU | $4,814.10 | $8,023.50 | — | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Hysterosal Contr Inj Proc | $1,500.08 | $2,500.12 | $249.04–$2,906.00 | 264% above | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Hysterosal Contr Inj. Proc - 821 | $1,687.58 | $2,812.63 | $249.04–$2,906.00 | 310% above | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Hysterosalp Inject - IR | $1,687.58 | $2,812.63 | $56.32–$2,165.73 | 310% above | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Saline Introduction - 821 | $1,687.58 | $2,812.63 | $249.04–$2,906.00 | 310% above | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Saline Introduction | $1,687.58 | $2,812.63 | $249.04–$2,906.00 | 310% above | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Hysterosal Contr Inj Proc | $1,500.08 | $2,500.12 | — | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Hysterosalp Inject - IR | $1,687.58 | $2,812.63 | — | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Saline Introduction - 821 | $1,687.58 | $2,812.63 | — | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Hysterosal Contr Inj. Proc - 821 | $1,687.58 | $2,812.63 | — | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Saline Introduction | $1,687.58 | $2,812.63 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Incision & Drainage Abscess, Simple - ER | $1,333.40 | $2,222.33 | $203.18–$1,711.19 | 161% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Incision & Drainage - ER | $1,399.99 | $2,333.31 | $203.18–$1,796.65 | 174% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Incision & Drainage Abscess, Simple - WCC | $1,399.99 | $2,333.31 | $203.18–$2,906.00 | 174% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Incision & Drainage Abscess, Simple (10060) - IR | $1,399.99 | $2,333.31 | $203.18–$2,906.00 | 174% above | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & Drainage Abscess, Simple - ER | $1,333.40 | $2,222.33 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & Drainage Abscess, Simple (10060) - IR | $1,399.99 | $2,333.31 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & Drainage - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & Drainage Abscess, Simple - WCC | $1,399.99 | $2,333.31 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration, Major Joint - IR | $1,333.40 | $2,222.33 | $310.84–$2,906.00 | 176% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Inject/Aspirate Major Joint - ACU | $1,333.40 | $2,222.33 | $310.84–$2,906.00 | 176% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Inject/Aspirate Major Joint - ER | $1,399.99 | $2,333.31 | $236.00–$1,796.65 | 189% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Insertion Needle Jnt or Bursa | $1,399.99 | $2,333.31 | $310.84–$2,906.00 | 189% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Aspiration, Major Joint - IR | $1,333.40 | $2,222.33 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Inject/Aspirate Major Joint - ACU | $1,333.40 | $2,222.33 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Insertion Needle Jnt or Bursa | $1,399.99 | $2,333.31 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Inject/Aspirate Major Joint - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Aspiration, Intermed, Joint - IR | $1,399.99 | $2,333.31 | $310.84–$2,906.00 | 298% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Inject/Aspirate Intermed Joint - ER | $1,399.99 | $2,333.31 | $236.00–$1,796.65 | 298% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Inject/Aspirate Intermed Joint - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Aspiration, Intermed, Joint - IR | $1,399.99 | $2,333.31 | — | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Inject/Aspirate Small Joint - ER | $1,399.99 | $2,333.31 | $236.00–$1,796.65 | 241% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Aspiration, Small Joint - IR | $1,399.99 | $2,333.31 | $310.84–$2,906.00 | 241% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Inject/Aspirate Small Joint - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Aspiration, Small Joint - IR | $1,399.99 | $2,333.31 | — | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Layered closure < 2.5cm - WCC | $1,399.99 | $2,333.31 | $411.67–$2,906.00 | 121% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intmd Rpr S/A/T/Ext 2.5cm< - WCC | $1,399.99 | $2,333.31 | $411.67–$2,906.00 | 121% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intermed Lac Rep 2.5cm or Less (12031) - ER | $1,399.99 | $2,333.31 | $236.00–$1,796.65 | 121% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intermed Lac Rep 2.5cm or Less (12031) - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Layered closure < 2.5cm - WCC | $1,399.99 | $2,333.31 | — | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intmd Rpr S/A/T/Ext 2.5cm< - WCC | $1,399.99 | $2,333.31 | — | — | 40% |
| Left heart catheterization, diagnostic CPT 93452 LHC +/- LVG - No Coronaries - CCL | $7,719.20 | $12,865.32 | $2,499.00–$9,906.30 | 18% above | 40% |
| Left heart catheterization, diagnostic inpatient CPT 93452 LHC +/- LVG - No Coronaries - CCL | $7,719.20 | $12,865.32 | — | — | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Lumbar Epidural w/Img (62323) | $1,513.19 | $2,521.97 | $714.83–$2,906.00 | 28% below | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Inj Spine w/ Image Guidance - IR | $2,063.43 | $3,439.05 | $714.83–$2,906.00 | 2% below | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Lumbar Epidural w/Img (62323) | $1,513.19 | $2,521.97 | — | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Inj Spine w/ Image Guidance - IR | $2,063.43 | $3,439.05 | — | — | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Lumbar Epidural (62322) | $1,513.19 | $2,521.97 | $895.69–$2,906.00 | 22% below | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Inj Spine L/S (CD) - IR | $2,063.43 | $3,439.05 | $895.69–$2,906.00 | 7% above | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Lumbar Epidural (62322) | $1,513.19 | $2,521.97 | — | — | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Inj Spine L/S (CD) - IR | $2,063.43 | $3,439.05 | — | — | 40% |
| Miscarriage treatment with D&C, first trimester CPT 59820 Treatment of Missed Ab, Surgical, First Trimester - L & D | $5,551.80 | $9,253.00 | $2,499.00–$7,124.81 | 3% above | 40% |
| Miscarriage treatment with D&C, first trimester CPT 59820 Care of Miscarriage - SSU | $5,723.16 | $9,538.59 | $2,499.00–$7,344.71 | 6% above | 40% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Treatment of Missed Ab, Surgical, First Trimester - L & D | $5,551.80 | $9,253.00 | — | — | 40% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Care of Miscarriage - SSU | $5,723.16 | $9,538.59 | — | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Trnk-Extr B9+Marg 0.5cm< - WCC | $2,655.72 | $4,426.19 | $623.79–$3,408.17 | 98% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Trnk-Extr B9+Margin<0.5C - ER | $2,655.72 | $4,426.19 | $236.00–$3,408.17 | 98% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc Trnk-Extr B9+Margin<0.5C - ER | $2,655.72 | $4,426.19 | — | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc Trnk-Extr B9+Marg 0.5cm< - WCC | $2,655.72 | $4,426.19 | — | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc Face-MM B9+Marg 0.5cm< - WCC | $2,242.22 | $3,737.02 | $623.79–$2,906.00 | 33% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Exc Face-MM B9+Marg 0.5cm< - WCC | $2,242.22 | $3,737.02 | — | — | 40% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate - WCC | $1,399.99 | $2,333.31 | $203.18–$2,906.00 | 169% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Prt or Neoplastic - ER | $1,399.99 | $2,333.31 | $203.18–$1,796.65 | 169% above | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate - WCC | $1,399.99 | $2,333.31 | — | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Prt or Neoplastic - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Pacemaker implant (dual chamber) CPT 33208 Insert/Replace Pacer w/ Transven Electrode (S); AV - CCL | $18,837.60 | $31,395.99 | $2,499.00–$24,174.91 | 54% above | 40% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 Insert/Replace Pacer w/ Transven Electrode (S); AV - CCL | $18,837.60 | $31,395.99 | — | — | 40% |
| Paracentesis with imaging guidance CPT 49083 Peritoneal/Abd Paracent, 1st - IR | $2,815.71 | $4,692.85 | $918.49–$3,613.49 | 67% above | 40% |
| Paracentesis with imaging guidance CPT 49083 Peritoneal/Abd Paracent, Sub - IR | $2,815.71 | $4,692.85 | $918.49–$3,613.49 | 67% above | 40% |
| Paracentesis with imaging guidance CPT 49083 Abdominal Paracentesis - ER | $2,815.71 | $4,692.85 | $236.00–$3,613.49 | 67% above | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 Peritoneal/Abd Paracent, Sub - IR | $2,815.71 | $4,692.85 | — | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 Peritoneal/Abd Paracent, 1st - IR | $2,815.71 | $4,692.85 | — | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 Abdominal Paracentesis - ER | $2,815.71 | $4,692.85 | — | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal Nail Bed - ER | $1,399.99 | $2,333.31 | $236.00–$1,796.65 | 47% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal Nail Bed - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 I & D Remove Foreign Body, Simple - ER | $1,535.85 | $2,559.74 | $236.00–$1,971.00 | 164% above | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 I & D Remove Foreign Body, Simple - ER | $1,535.85 | $2,559.74 | — | — | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colonoscopy Screening Medicare - ACU | $2,815.71 | $4,692.85 | $941.75–$3,000.69 | 83% above | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 Colonoscopy Screening Medicare - ACU | $2,815.71 | $4,692.85 | — | — | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colonoscopy High Risk Medicare - ACU | $2,815.71 | $4,692.85 | $941.75–$3,000.69 | 60% above | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 Colonoscopy High Risk Medicare - ACU | $2,815.71 | $4,692.85 | — | — | 40% |
| Short arm cast (elbow to hand) CPT 29075 Applic Cast Elbow to Hand - ER | $4,448.23 | $7,413.71 | $236.00–$5,708.56 | 953% above | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 Applic Cast Elbow to Hand - ER | $4,448.23 | $7,413.71 | — | — | 40% |
| Short arm splint (forearm and hand) CPT 29125 Applic Short Arm Splint Static - ER | $1,692.90 | $2,821.50 | $134.74–$2,172.56 | 396% above | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Applic Short Arm Splint Static - ER | $1,692.90 | $2,821.50 | — | — | 40% |
| Short leg cast (below the knee) CPT 29405 Applic Short Leg Cast Bkn-Toes - ER | $4,448.23 | $7,413.71 | $236.00–$5,708.56 | 699% above | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 Applic Short Leg Cast Bkn-Toes - ER | $4,448.23 | $7,413.71 | — | — | 40% |
| Short leg splint (calf to foot) CPT 29515 Applic Short Leg Splint - ER | $1,692.90 | $2,821.50 | $164.56–$2,172.56 | 259% above | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 Applic Short Leg Splint - ER | $1,692.90 | $2,821.50 | — | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Lac Rep 2.5cm or Less (12001) - ER | $1,333.40 | $2,222.33 | $203.18–$1,711.19 | 159% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Suture of Skin - IR | $1,399.99 | $2,333.31 | $203.18–$2,906.00 | 172% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple Lac Rep 2.5cm or Less (12001) - ER | $1,333.40 | $2,222.33 | — | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple Suture of Skin - IR | $1,399.99 | $2,333.31 | — | — | 40% |
| Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy of Skin-Single - WCC | $1,399.99 | $2,333.31 | $411.67–$2,906.00 | 107% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy of Skin-Single - SWC | $1,399.99 | $2,333.31 | $411.67–$2,906.00 | 107% above | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy of Skin-Single - WCC | $1,399.99 | $2,333.31 | — | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy of Skin-Single - SWC | $1,399.99 | $2,333.31 | — | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Exc Trnk-Extr Mal+Marg 0.5cm/< - WCC | $2,063.43 | $3,439.05 | $623.79–$2,906.00 | 100% above | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Exc Trnk-Extr Mal+Marg 0.5cm/< - WCC | $2,063.43 | $3,439.05 | — | — | 40% |
| Skin tag removal, up to 15 tags CPT 11200 Removal of Skin Tag - ER | $1,399.99 | $2,333.31 | $203.18–$1,796.65 | 123% above | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of Skin Tag - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture | $2,063.43 | $3,439.05 | $623.79–$2,906.00 | 69% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Puncture, Lumbar-Diagnostic - ER | $2,063.43 | $3,439.05 | $236.00–$2,648.07 | 69% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Puncture, Lumbar-Diagnostic - NICU | $2,063.43 | $3,439.05 | $623.79–$2,906.00 | 69% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Puncture, Lumbar - SSU | $2,063.43 | $3,439.05 | $623.79–$2,906.00 | 69% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Diag - IR | $2,063.43 | $3,439.05 | $623.79–$2,906.00 | 69% above | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Puncture, Lumbar - SSU | $2,063.43 | $3,439.05 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Puncture, Lumbar-Diagnostic - NICU | $2,063.43 | $3,439.05 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Puncture, Lumbar-Diagnostic - ER | $2,063.43 | $3,439.05 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture | $2,063.43 | $3,439.05 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture Diag - IR | $2,063.43 | $3,439.05 | — | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple Lac Rep 2.8cm-7.5cm - ER | $1,692.90 | $2,821.50 | $203.18–$2,172.56 | 187% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Simple Lac Rep 2.8cm-7.5cm - ER | $1,692.90 | $2,821.50 | — | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple Lac Rep 2.5cm or Less (12011) - ER | $1,128.60 | $1,881.00 | $203.18–$1,448.37 | 117% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple Lac Rep 2.5cm or Less (12011) - ER | $1,128.60 | $1,881.00 | — | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential BX - WCC | $1,399.99 | $2,333.31 | $411.67–$2,906.00 | 147% above | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangential BX - WCC | $1,399.99 | $2,333.31 | — | — | 40% |
| Thoracentesis with imaging guidance CPT 32555 Thoracentesis Puncture | $2,815.71 | $4,692.85 | $635.26–$3,613.49 | 88% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 Thoracentesis, Puncture - IR | $2,815.71 | $4,692.85 | $139.00–$3,613.49 | 88% above | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis, Puncture - IR | $2,815.71 | $4,692.85 | — | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis Puncture | $2,815.71 | $4,692.85 | — | — | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Injections, Single or Multiple Trigger Points | $1,399.99 | $2,333.31 | $310.84–$2,906.00 | 155% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Point 1/2 Muscle - ER | $1,399.99 | $2,333.31 | $236.00–$1,796.65 | 155% above | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Injections, Single or Multiple Trigger Points | $1,399.99 | $2,333.31 | — | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Trigger Point 1/2 Muscle - ER | $1,399.99 | $2,333.31 | — | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Ultrasound Guided Needle Core Biopsy - 3 North | $1,785.38 | $2,975.62 | $139.00–$3,546.27 | 52% below | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx Breast US Guidance 1st Lesion - IR | $3,327.66 | $5,546.09 | $139.00–$4,270.49 | 11% below | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 Breast Bx US Guidance 1st Lesion Lt - SWC | $3,327.66 | $5,546.09 | $139.00–$4,270.49 | 11% below | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 Breast Bx US Guidance 1st Lesion Rt - SWC | $3,327.66 | $5,546.09 | $139.00–$4,270.49 | 11% below | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Ultrasound Guided Needle Core Biopsy - 3 North | $1,785.38 | $2,975.62 | — | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Bx Breast US Guidance 1st Lesion - IR | $3,327.66 | $5,546.09 | — | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 Breast Bx US Guidance 1st Lesion Rt - SWC | $3,327.66 | $5,546.09 | — | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 Breast Bx US Guidance 1st Lesion Lt - SWC | $3,327.66 | $5,546.09 | — | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD w/ Balloon Dilation Esophagus < 30 mm - ACU | $3,414.59 | $5,690.97 | $1,943.25–$4,382.05 | at median | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD w/ Balloon Dilation Esophagus < 30 mm - ACU | $3,414.59 | $5,690.97 | — | — | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD w/ Biopsy - ACU | $2,815.71 | $4,692.85 | $918.49–$3,613.49 | 27% above | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD w/ Biopsy - ACU | $2,815.71 | $4,692.85 | — | — | 40% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD w/ Submucosal Inj - ACU | $2,611.80 | $4,353.00 | $918.49–$3,351.81 | 12% below | 40% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD w/ Submucosal Inj - ACU | $2,611.80 | $4,353.00 | — | — | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD w/ Guidewire and Dilation - ACU | $2,815.71 | $4,692.85 | $918.49–$3,613.49 | 14% above | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD w/ Guidewire and Dilation - ACU | $2,815.71 | $4,692.85 | — | — | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD Diagnostic w/ or w/o Spec - ACU | $2,429.10 | $4,048.50 | $918.49–$3,117.35 | 28% above | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD Diagnostic w/ or w/o Spec - ACU | $2,429.10 | $4,048.50 | — | — | 40% |
| Vein ablation, radiofrequency, first vein CPT 36475 Endovenous RF 1st Vein - IR | $5,665.50 | $9,442.50 | $2,499.00–$7,270.73 | 38% below | 40% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 Endovenous RF 1st Vein - IR | $5,665.50 | $9,442.50 | — | — | 40% |
| Wart removal, up to 14 warts CPT 17110 Destruction of Benign Lesion - ER | $1,535.85 | $2,559.74 | $203.18–$1,971.00 | 164% above | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 Destruction of Benign Lesion - ER | $1,535.85 | $2,559.74 | — | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Sub-Q Tissue First 20 SQ CM - WCC | $2,264.57 | $3,774.28 | $411.67–$3,000.69 | 110% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Skin and Subq Tissue - ER | $2,815.71 | $4,692.85 | $236.00–$3,613.49 | 161% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Sub-Q Tissue First 20 SQ CM - WCC | $2,264.57 | $3,774.28 | — | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Skin and Subq Tissue - ER | $2,815.71 | $4,692.85 | — | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood/Components - ER | $1,333.40 | $2,222.33 | $56.32–$1,711.19 | 21% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood/Components - MOU | $1,333.40 | $2,222.33 | $56.32–$1,711.19 | 21% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion - L & D | $1,399.99 | $2,333.31 | $56.32–$1,796.65 | 27% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion Administration - CCL | $1,399.99 | $2,333.31 | $56.32–$1,796.65 | 27% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion - Antenatal - MFM | $1,399.99 | $2,333.31 | $56.32–$1,796.65 | 27% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood/Components - ACU | $1,399.99 | $2,333.31 | $56.32–$1,796.65 | 27% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion - 2 North | $1,399.99 | $2,333.31 | $56.32–$1,796.65 | 27% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood/Components - SSU | $1,399.99 | $2,333.31 | $56.32–$1,796.65 | 27% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion - ICCU/CCU | $1,399.99 | $2,333.31 | $56.32–$1,796.65 | 27% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion - 3 South | $1,399.99 | $2,333.31 | $56.32–$1,796.65 | 27% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion - 3 North | $1,399.99 | $2,333.31 | $56.32–$1,796.65 | 27% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion - 2 South | $1,399.99 | $2,333.31 | $56.32–$1,796.65 | 27% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion - 4 Central | $1,399.99 | $2,333.31 | $56.32–$1,796.65 | 27% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion - SBH | $1,399.99 | $2,333.31 | $56.32–$1,796.65 | 27% above | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood/Components - MOU | $1,333.40 | $2,222.33 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood/Components - ER | $1,333.40 | $2,222.33 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood/Components - SSU | $1,399.99 | $2,333.31 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood/Components - ACU | $1,399.99 | $2,333.31 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion - 2 North | $1,399.99 | $2,333.31 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion - SBH | $1,399.99 | $2,333.31 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion Administration - CCL | $1,399.99 | $2,333.31 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion - Antenatal - MFM | $1,399.99 | $2,333.31 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion - 4 Central | $1,399.99 | $2,333.31 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion - 3 North | $1,399.99 | $2,333.31 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion - 3 South | $1,399.99 | $2,333.31 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion - ICCU/CCU | $1,399.99 | $2,333.31 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion - 2 South | $1,399.99 | $2,333.31 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion - L & D | $1,399.99 | $2,333.31 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment - RESP | $348.38 | $580.63 | $18.96–$505.15 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Treatment - RESP | $348.38 | $580.63 | $18.96–$505.15 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment - CCC | $348.38 | $580.63 | $18.96–$505.15 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment - ER | $348.38 | $580.63 | $18.96–$505.15 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment - MOU | $877.92 | $1,463.19 | $18.96–$1,272.98 | 299% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment - RESP | $348.38 | $580.63 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment - ER | $348.38 | $580.63 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Treatment - RESP | $348.38 | $580.63 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment - CCC | $348.38 | $580.63 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment - MOU | $877.92 | $1,463.19 | — | — | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 INF IV Chemo 1st Hour - ACU | $376.20 | $627.00 | $112.53–$496.77 | 52% below | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 INF IV Chemo 1st Hour - MOU | $605.12 | $1,008.52 | $112.53–$776.56 | 22% below | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 INF IV Chemo 1st Hour - ACU | $376.20 | $627.00 | — | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 INF IV Chemo 1st Hour - MOU | $605.12 | $1,008.52 | — | — | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical Care E & M 30-74min - ER | $1,396.68 | $2,327.79 | $236.00–$1,792.40 | 31% below | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care E & M 30-74min - ER | $1,396.68 | $2,327.79 | — | — | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Portable/Bedside-Awake & Drowsy | $599.40 | $999.00 | $31.40–$869.13 | 22% below | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Routine-Awake & Drowsy | $599.40 | $999.00 | $31.40–$869.13 | 22% below | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Neonatal-Awake & Drowsy | $599.40 | $999.00 | $31.40–$869.13 | 22% below | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Neonatal-Awake & Drowsy | $599.40 | $999.00 | — | — | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Routine-Awake & Drowsy | $599.40 | $999.00 | — | — | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Portable/Bedside-Awake & Drowsy | $599.40 | $999.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram | $190.52 | $317.52 | $16.05–$244.49 | 4% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - CCC | $190.80 | $318.00 | $16.05–$244.86 | 4% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - MOU | $190.80 | $318.00 | $16.05–$244.86 | 4% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram - 821 | $191.06 | $318.43 | $16.05–$245.19 | 5% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ER 2nd in 24 Hours | $191.06 | $318.43 | $16.05–$245.19 | 5% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - 3 North | $191.06 | $318.43 | $16.05–$245.19 | 5% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - 2 South | $191.06 | $318.43 | $16.05–$245.19 | 5% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - 4 Central | $191.06 | $318.43 | $16.05–$245.19 | 5% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG (Pediatric Pt Only) | $191.06 | $318.43 | $16.05–$245.19 | 5% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - 2 North | $191.06 | $318.43 | $16.05–$245.19 | 5% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram - BEN | $191.06 | $318.43 | $16.05–$245.19 | 5% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram - FEAST | $191.06 | $318.43 | $16.05–$245.19 | 5% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - SBH | $191.06 | $318.43 | $16.05–$245.19 | 5% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - 3 South | $191.06 | $318.43 | $16.05–$245.19 | 5% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - ICCU/CCU | $191.06 | $318.43 | $16.05–$245.19 | 5% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram | $190.52 | $317.52 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - CCC | $190.80 | $318.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - MOU | $190.80 | $318.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - 3 South | $191.06 | $318.43 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - ICCU/CCU | $191.06 | $318.43 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG (Pediatric Pt Only) | $191.06 | $318.43 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram - BEN | $191.06 | $318.43 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram - FEAST | $191.06 | $318.43 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG ER 2nd in 24 Hours | $191.06 | $318.43 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - 3 North | $191.06 | $318.43 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - SBH | $191.06 | $318.43 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - 2 South | $191.06 | $318.43 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram - 821 | $191.06 | $318.43 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - 2 North | $191.06 | $318.43 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - 4 Central | $191.06 | $318.43 | — | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER Level 1 Care - ER | $1,021.50 | $1,702.50 | $85.39–$1,310.93 | 217% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LWBS After Triage - ER | $1,062.60 | $1,771.00 | $85.39–$1,363.67 | 230% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER Level 1 Care - ER | $1,021.50 | $1,702.50 | — | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 LWBS After Triage - ER | $1,062.60 | $1,771.00 | — | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER Level 2 Care - ER | $1,021.50 | $1,702.50 | $146.00–$1,310.93 | 113% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER Level 2 Care - ER | $1,021.50 | $1,702.50 | — | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER Level 3 Care w/o Modifier - ER | $1,021.50 | $1,702.50 | $236.00–$1,310.93 | 36% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER Level 3 Care - ER | $1,021.50 | $1,702.50 | $236.00–$1,310.93 | 36% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER Level 3 Care - ER | $1,021.50 | $1,702.50 | — | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER Level 3 Care w/o Modifier - ER | $1,021.50 | $1,702.50 | — | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER Level 4 Care - ER | $1,021.50 | $1,702.50 | $236.00–$1,310.93 | 18% below | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER Level 4 Care - ER | $1,021.50 | $1,702.50 | — | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER Level 5 Care - ER | $1,021.50 | $1,702.50 | $236.00–$1,310.93 | 38% below | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER Level 5 Care - ER | $1,021.50 | $1,702.50 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Car ST Persantine/Myoview | $1,821.78 | $3,036.29 | $59.52–$2,337.94 | 91% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Car ST Myoview Only | $1,821.78 | $3,036.29 | $59.52–$2,337.94 | 91% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Car Stress TM | $1,821.78 | $3,036.29 | $59.52–$2,337.94 | 91% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Car ST Persantine/Thallium | $1,894.47 | $3,157.44 | $59.52–$2,431.23 | 99% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Car ST-Dobutamine/Thallium | $1,894.47 | $3,157.44 | $59.52–$2,431.23 | 99% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Car ST-Dobutamine Myoview | $1,894.47 | $3,157.44 | $59.52–$2,431.23 | 99% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Car ST Persant/Thal Gated | $1,894.47 | $3,157.44 | $59.52–$2,431.23 | 99% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Car ST Thallium Gated | $1,894.47 | $3,157.44 | $59.52–$2,431.23 | 99% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Car ST Thallium | $1,894.47 | $3,157.44 | $59.52–$2,431.23 | 99% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Unfinished Treadmill | $1,894.47 | $3,157.44 | $59.52–$2,431.23 | 99% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Car ST-Dobutamine/Thallium Gated | $1,894.47 | $3,157.44 | $59.52–$2,431.23 | 99% above | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Car ST Myoview Only | $1,821.78 | $3,036.29 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Car ST Persantine/Myoview | $1,821.78 | $3,036.29 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Car Stress TM | $1,821.78 | $3,036.29 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Car ST Persantine/Thallium | $1,894.47 | $3,157.44 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Car ST-Dobutamine/Thallium Gated | $1,894.47 | $3,157.44 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Car ST-Dobutamine Myoview | $1,894.47 | $3,157.44 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Car ST-Dobutamine/Thallium | $1,894.47 | $3,157.44 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Car ST Persant/Thal Gated | $1,894.47 | $3,157.44 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Car ST Thallium Gated | $1,894.47 | $3,157.44 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Unfinished Treadmill | $1,894.47 | $3,157.44 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Car ST Thallium | $1,894.47 | $3,157.44 | — | — | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 Couples Counseling | $244.92 | $408.20 | $106.13–$355.13 | 19% below | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 Family Counseling | $244.92 | $408.20 | $106.13–$355.13 | 19% below | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 Family Counseling - TeleHealth | $244.92 | $408.20 | $106.13–$355.13 | 19% below | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 Family Counseling - RICH | $244.92 | $408.20 | $106.13–$355.13 | 19% below | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 Couples Counseling - RICH | $244.92 | $408.20 | $106.13–$355.13 | 19% below | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Couples Counseling | $244.92 | $408.20 | — | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Counseling - TeleHealth | $244.92 | $408.20 | — | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Couples Counseling - RICH | $244.92 | $408.20 | — | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Counseling - RICH | $244.92 | $408.20 | — | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Counseling | $244.92 | $408.20 | — | — | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 Family Psychotherapy w/o Pt Present - TeleHealth | $244.92 | $408.20 | $106.13–$355.13 | 36% above | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 Family Psychotherapy w/o Pt Present - RICH | $244.92 | $408.20 | $106.13–$355.13 | 36% above | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 Family Psychotherapy w/o Pt Present | $244.92 | $408.20 | $106.13–$355.13 | 36% above | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psychotherapy w/o Pt Present - TeleHealth | $244.92 | $408.20 | — | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psychotherapy w/o Pt Present - RICH | $244.92 | $408.20 | — | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psychotherapy w/o Pt Present | $244.92 | $408.20 | — | — | 40% |
| Group psychotherapy session CPT 90853 Group Counseling - RICH | $127.51 | $212.51 | $55.25–$184.88 | 10% below | 40% |
| Group psychotherapy session CPT 90853 Group Counseling | $127.51 | $212.51 | $55.25–$184.88 | 10% below | 40% |
| Group psychotherapy session inpatient CPT 90853 Group Counseling | $127.51 | $212.51 | — | — | 40% |
| Group psychotherapy session inpatient CPT 90853 Group Counseling - RICH | $127.51 | $212.51 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial up to 1 Hour - HATH | $347.24 | $578.73 | $56.58–$503.50 | 21% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial up to 1 Hour - 2 North | $347.24 | $578.73 | $56.58–$503.50 | 21% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial up to 1 Hour - SBH | $347.24 | $578.73 | $56.58–$503.50 | 21% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial up to 1 Hour - ICCU/CCU | $347.24 | $578.73 | $56.58–$503.50 | 21% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial up to 1 Hour - 4 Central | $347.24 | $578.73 | $56.58–$503.50 | 21% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial up to 1 Hour - IR | $347.24 | $578.73 | $56.58–$503.50 | 21% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial up to 1 Hour - 3 South | $375.80 | $626.33 | $56.58–$544.91 | 14% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF IV Hydration 31min to Hour - MOU | $375.80 | $626.33 | $56.58–$544.91 | 14% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial up to 1 Hour - ER | $375.80 | $626.33 | $215.40–$1,227.00 | 14% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial up to 1 Hour - L & D | $375.80 | $626.33 | $56.58–$544.91 | 14% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV hydration Initial up to 1 Hour - NICU | $375.80 | $626.33 | $56.58–$544.91 | 14% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial up to 1 Hour - 2 South | $375.80 | $626.33 | $56.58–$544.91 | 14% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial up to 1 Hour - 3 North | $375.80 | $626.33 | $56.58–$544.91 | 14% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial up to 1 Hour - IR | $347.24 | $578.73 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial up to 1 Hour - SBH | $347.24 | $578.73 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial up to 1 Hour - 2 North | $347.24 | $578.73 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial up to 1 Hour - HATH | $347.24 | $578.73 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial up to 1 Hour - ICCU/CCU | $347.24 | $578.73 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial up to 1 Hour - 4 Central | $347.24 | $578.73 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF IV Hydration 31min to Hour - MOU | $375.80 | $626.33 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial up to 1 Hour - ER | $375.80 | $626.33 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV hydration Initial up to 1 Hour - NICU | $375.80 | $626.33 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial up to 1 Hour - L & D | $375.80 | $626.33 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial up to 1 Hour - 2 South | $375.80 | $626.33 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial up to 1 Hour - 3 North | $375.80 | $626.33 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial up to 1 Hour - 3 South | $375.80 | $626.33 | — | — | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - SBH | $347.24 | $578.73 | $150.47–$503.50 | 27% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - HATH | $347.24 | $578.73 | $150.47–$503.50 | 27% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Therapy 1st Hour - IR | $347.24 | $578.73 | $150.47–$503.50 | 27% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - ICCU/CCU | $347.24 | $578.73 | $150.47–$503.50 | 27% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - 4 Central | $347.24 | $578.73 | $150.47–$503.50 | 27% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - NICU | $375.80 | $626.33 | $162.85–$544.91 | 21% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - L & D | $375.80 | $626.33 | $162.85–$544.91 | 21% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 INF IV Tx/DX 1st Hour - MOU | $375.80 | $626.33 | $162.85–$544.91 | 21% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 INF IV Tx/DX/Prof 16-90min - ACU | $375.80 | $626.33 | $162.85–$544.91 | 21% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - ER | $375.80 | $626.33 | $215.40–$1,227.00 | 21% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - 2 North | $375.80 | $626.33 | $162.85–$544.91 | 21% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - 2 South | $375.80 | $626.33 | $162.85–$544.91 | 21% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - 3 North | $375.80 | $626.33 | $162.85–$544.91 | 21% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - 3 South | $375.80 | $626.33 | $162.85–$544.91 | 21% below | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - SBH | $347.24 | $578.73 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - ICCU/CCU | $347.24 | $578.73 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - HATH | $347.24 | $578.73 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - 4 Central | $347.24 | $578.73 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Therapy 1st Hour - IR | $347.24 | $578.73 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - 3 North | $375.80 | $626.33 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - 2 South | $375.80 | $626.33 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - 2 North | $375.80 | $626.33 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INF IV Tx/DX 1st Hour - MOU | $375.80 | $626.33 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INF IV Tx/DX/Prof 16-90min - ACU | $375.80 | $626.33 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - ER | $375.80 | $626.33 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - L & D | $375.80 | $626.33 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - NICU | $375.80 | $626.33 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion for Therapy/Diagnosis up to 1 Hour - 3 South | $375.80 | $626.33 | — | — | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or Initial Substance/Drug - HATH | $347.24 | $578.73 | $48.61–$503.50 | 6% above | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or Initial Substance/Drug - ACU | $347.24 | $578.73 | $48.61–$503.50 | 6% above | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or Initial Substance/Drug - ICCU/CCU | $347.24 | $578.73 | $48.61–$503.50 | 6% above | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or Initial Substance/Drug - 3 South | $347.24 | $578.73 | $48.61–$503.50 | 6% above | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or Initial Substance/Drug - 4 Central | $347.24 | $578.73 | $48.61–$503.50 | 6% above | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or Initial Substance/Drug - SBH | $347.24 | $578.73 | $48.61–$503.50 | 6% above | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or Initial Substance/Drug - 2 North | $347.24 | $578.73 | $48.61–$503.50 | 6% above | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or initital Substance Drug - ER | $375.80 | $626.33 | $215.40–$1,227.00 | 14% above | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or initital Substance Drug - L & D | $375.80 | $626.33 | $48.61–$544.91 | 14% above | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or initital Substance Drug - MOU | $375.80 | $626.33 | $48.61–$544.91 | 14% above | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or initital Substance Drug - NICU | $375.80 | $626.33 | $48.61–$544.91 | 14% above | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or Initial Substance/Drug - 3 North | $375.80 | $626.33 | $48.61–$544.91 | 14% above | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push Single or Initial Substance/Drug - 2 South | $375.80 | $626.33 | $48.61–$544.91 | 14% above | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or Initial Substance/Drug - SBH | $347.24 | $578.73 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or Initial Substance/Drug - ACU | $347.24 | $578.73 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or Initial Substance/Drug - ICCU/CCU | $347.24 | $578.73 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or Initial Substance/Drug - 3 South | $347.24 | $578.73 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or Initial Substance/Drug - HATH | $347.24 | $578.73 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or Initial Substance/Drug - 2 North | $347.24 | $578.73 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or Initial Substance/Drug - 4 Central | $347.24 | $578.73 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or initital Substance Drug - MOU | $375.80 | $626.33 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or Initial Substance/Drug - 2 South | $375.80 | $626.33 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or Initial Substance/Drug - 3 North | $375.80 | $626.33 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or initital Substance Drug - NICU | $375.80 | $626.33 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or initital Substance Drug - L & D | $375.80 | $626.33 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push Single or initital Substance Drug - ER | $375.80 | $626.33 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - 2 South | $161.90 | $269.83 | $33.50–$253.00 | 29% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - NICU | $161.90 | $269.83 | $33.50–$234.75 | 29% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - MAT | $161.90 | $269.83 | $33.50–$234.75 | 29% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - NRSY | $161.90 | $269.83 | $33.50–$234.75 | 29% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - L & D | $161.90 | $269.83 | $33.50–$253.00 | 29% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - ER | $161.90 | $269.83 | $72.91–$1,227.00 | 29% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - MOU | $161.90 | $269.83 | $33.50–$253.00 | 29% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - HATH | $165.66 | $276.10 | $33.50–$253.00 | 32% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - 2 North | $165.66 | $276.10 | $33.50–$253.00 | 32% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Diagnostic Injection - NM | $165.66 | $276.10 | $33.50–$253.00 | 32% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - ICCU/CCU | $165.66 | $276.10 | $33.50–$253.00 | 32% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - 3 South | $165.66 | $276.10 | $33.50–$253.00 | 32% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - 3 North | $165.66 | $276.10 | $33.50–$253.00 | 32% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - 4 Central | $165.66 | $276.10 | $33.50–$253.00 | 32% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection - SBH | $165.66 | $276.10 | $33.50–$253.00 | 32% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - ER | $161.90 | $269.83 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - 2 South | $161.90 | $269.83 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - MOU | $161.90 | $269.83 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - MAT | $161.90 | $269.83 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - L & D | $161.90 | $269.83 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - NICU | $161.90 | $269.83 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - NRSY | $161.90 | $269.83 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - SBH | $165.66 | $276.10 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Diagnostic Injection - NM | $165.66 | $276.10 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - ICCU/CCU | $165.66 | $276.10 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - 3 South | $165.66 | $276.10 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - 3 North | $165.66 | $276.10 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - 4 Central | $165.66 | $276.10 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - 2 North | $165.66 | $276.10 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection - HATH | $165.66 | $276.10 | — | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Diag Eval (No Med Serv) No Modifier | $244.92 | $408.20 | $80.52–$355.13 | 8% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Diag Eval (No Med Serv) w/ Modifier - RICH | $244.92 | $408.20 | $80.52–$355.13 | 8% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Diag Eval (No Med Serv) w/ Modifier | $244.92 | $408.20 | $80.52–$355.13 | 8% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Diag Eval (No Med Serv) No Modifier - RICH | $244.92 | $408.20 | $80.52–$355.13 | 8% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychiatric Diag Eval (No Med Serv) No Modifier - RICH | $244.92 | $408.20 | — | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychiatric Diag Eval (No Med Serv) w/ Modifier - RICH | $244.92 | $408.20 | — | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychiatric Diag Eval (No Med Serv) No Modifier | $244.92 | $408.20 | — | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychiatric Diag Eval (No Med Serv) w/ Modifier | $244.92 | $408.20 | — | — | 40% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve Conduction 7-8 Studies - EMG | $1,485.98 | $2,476.62 | $31.51–$2,154.66 | 2% above | 40% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Nerve Conduction 7-8 Studies - EMG | $1,485.98 | $2,476.62 | — | — | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Re-Educ 15min - PedR | $126.90 | $211.50 | $21.82–$144.00 | at median | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Re-Educ 15min - RDC | $126.90 | $211.50 | $21.82–$144.00 | at median | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Re-Educ 15min - RDC | $126.90 | $211.50 | $21.82–$144.00 | at median | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Re-Educ 15min - Lymph | $126.90 | $211.50 | $21.82–$144.00 | at median | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Re-Educ 15min - OT | $126.90 | $211.50 | $21.82–$144.00 | at median | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Re-Educ 15min - PT | $126.90 | $211.50 | $21.82–$144.00 | at median | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Re-Educ 15min - Lymph | $126.90 | $211.50 | $21.82–$144.00 | at median | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Re-Educ 15min - FEAST | $126.90 | $211.50 | $21.82–$144.00 | at median | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Re-Educ 15min - SMD | $126.90 | $211.50 | $21.82–$144.00 | at median | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Re-Educ 15min - SMD | $126.90 | $211.50 | $21.82–$144.00 | at median | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Re-Educ 15min - OT | $126.90 | $211.50 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Re-Educ 15min - Lymph | $126.90 | $211.50 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Re-Educ 15min - Lymph | $126.90 | $211.50 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Re-Educ 15min - FEAST | $126.90 | $211.50 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Re-Educ 15min - PedR | $126.90 | $211.50 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Re-Educ 15min - RDC | $126.90 | $211.50 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Re-Educ 15min - RDC | $126.90 | $211.50 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Re-Educ 15min - SMD | $126.90 | $211.50 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Re-Educ 15min - SMD | $126.90 | $211.50 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Re-Educ 15min - PT | $126.90 | $211.50 | — | — | 40% |
| New patient office visit, about 30 minutes CPT 99203 E/M level 3 - New Patient - MOU | $112.68 | $187.79 | $48.83–$182.96 | 59% below | 40% |
| New patient office visit, about 30 minutes CPT 99203 Low Complex Visit-TeleHealth - CCC | $112.68 | $187.79 | $48.83–$182.96 | 59% below | 40% |
| New patient office visit, about 30 minutes CPT 99203 Office Visit Initial, 30min | $112.68 | $187.79 | $48.83–$182.96 | 59% below | 40% |
| New patient office visit, about 30 minutes CPT 99203 E & M New Pt Interm w/Mod - WCC | $121.95 | $203.24 | $52.84–$182.96 | 55% below | 40% |
| New patient office visit, about 30 minutes CPT 99203 New Patient E/M Level 3 Hospital - CCC | $121.95 | $203.24 | $52.84–$182.96 | 55% below | 40% |
| New patient office visit, about 30 minutes CPT 99203 E & M New Pt Interm - WCC | $121.95 | $203.24 | $52.84–$182.96 | 55% below | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Low Complex Visit-TeleHealth - CCC | $112.68 | $187.79 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 E/M level 3 - New Patient - MOU | $112.68 | $187.79 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office Visit Initial, 30min | $112.68 | $187.79 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 E & M New Pt Interm - WCC | $121.95 | $203.24 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 New Patient E/M Level 3 Hospital - CCC | $121.95 | $203.24 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 E & M New Pt Interm w/Mod - WCC | $121.95 | $203.24 | — | — | 40% |
| New patient office visit, about 45 minutes CPT 99204 New Patient E/M Level 4 Hospital - CCC | $170.53 | $284.21 | $73.89–$275.78 | 55% below | 40% |
| New patient office visit, about 45 minutes CPT 99204 E/M level 4 - New Patient - MOU | $170.53 | $284.21 | $73.89–$275.78 | 55% below | 40% |
| New patient office visit, about 45 minutes CPT 99204 Mod Complex Visit-TeleHealth - CCC | $170.53 | $284.21 | $73.89–$275.78 | 55% below | 40% |
| New patient office visit, about 45 minutes CPT 99204 E & M New Pt Extend w/ Mod - WCC | $184.56 | $307.59 | $79.97–$275.78 | 51% below | 40% |
| New patient office visit, about 45 minutes CPT 99204 E & M New Pt Extend - WCC | $184.56 | $307.59 | $79.97–$275.78 | 51% below | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Mod Complex Visit-TeleHealth - CCC | $170.53 | $284.21 | — | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 New Patient E/M Level 4 Hospital - CCC | $170.53 | $284.21 | — | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 E/M level 4 - New Patient - MOU | $170.53 | $284.21 | — | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 E & M New Pt Extend w/ Mod - WCC | $184.56 | $307.59 | — | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 E & M New Pt Extend - WCC | $184.56 | $307.59 | — | — | 40% |
| New patient office visit, about 60 minutes CPT 99205 New Patient E/M Level 5 Hospital - CCC | $214.22 | $357.02 | $92.83–$368.49 | 59% below | 40% |
| New patient office visit, about 60 minutes CPT 99205 High Complex Visit-TeleHealth - CCC | $214.22 | $357.02 | $92.83–$368.49 | 59% below | 40% |
| New patient office visit, about 60 minutes CPT 99205 E/M level 5 - New Patient - MOU | $214.22 | $357.02 | $92.83–$368.49 | 59% below | 40% |
| New patient office visit, about 60 minutes CPT 99205 E & M New Pt Complex - WCC | $231.84 | $386.39 | $100.46–$368.49 | 56% below | 40% |
| New patient office visit, about 60 minutes CPT 99205 E & M New Pt Complex w/ Mod - WCC | $231.84 | $386.39 | $100.46–$368.49 | 56% below | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 E/M level 5 - New Patient - MOU | $214.22 | $357.02 | — | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 New Patient E/M Level 5 Hospital - CCC | $214.22 | $357.02 | — | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 High Complex Visit-TeleHealth - CCC | $214.22 | $357.02 | — | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 E & M New Pt Complex - WCC | $231.84 | $386.39 | — | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 E & M New Pt Complex w/ Mod - WCC | $231.84 | $386.39 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 E/M level 2 - New Patient - MOU | $79.35 | $132.25 | $34.39–$116.81 | 60% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Patient E/M Level 2 Hospital - CCC | $79.35 | $132.25 | $34.39–$116.81 | 60% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Probl Expanded Visit-TeleHealth - CCC | $79.35 | $132.25 | $34.39–$116.81 | 60% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 E & M New Pt Limited - WCC | $85.88 | $143.13 | $37.21–$124.52 | 57% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 E/M level 2 - New Patient - MOU | $79.35 | $132.25 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 New Patient E/M Level 2 Hospital - CCC | $79.35 | $132.25 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Probl Expanded Visit-TeleHealth - CCC | $79.35 | $132.25 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 E & M New Pt Limited - WCC | $85.88 | $143.13 | — | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Mnt Initial Ea 15 - NC | $83.85 | $139.75 | $18.37–$139.00 | 66% above | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Mnt Initial Individual TeleHealth - NC | $85.80 | $143.00 | $18.37–$139.00 | 70% above | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 T-2 Initial Indiv Mnt 15min | $85.80 | $143.00 | $18.37–$139.00 | 70% above | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Mnt Initial Individual TeleHealth | $85.80 | $143.00 | $18.37–$139.00 | 70% above | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 G Initial Indiv Mnt 15min | $85.80 | $143.00 | $18.37–$139.00 | 70% above | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 T-1 Initial Indiv Mnt 15min | $85.80 | $143.00 | $18.37–$139.00 | 70% above | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Mnt Initial Ea 15 - NC | $83.85 | $139.75 | — | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 T-1 Initial Indiv Mnt 15min | $85.80 | $143.00 | — | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Mnt Initial Individual TeleHealth - NC | $85.80 | $143.00 | — | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 T-2 Initial Indiv Mnt 15min | $85.80 | $143.00 | — | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 G Initial Indiv Mnt 15min | $85.80 | $143.00 | — | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Mnt Initial Individual TeleHealth | $85.80 | $143.00 | — | — | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 Eval Low Complex 30min - OT | $186.83 | $311.37 | $48.48–$155.29 | 44% below | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Eval Low Complex 30min - RDC | $186.83 | $311.37 | $48.48–$155.29 | 44% below | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Eval Low Complex 30min - PedR | $186.83 | $311.37 | $48.48–$155.29 | 44% below | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Eval Low Complex 30min - SMD | $186.83 | $311.37 | $48.48–$155.29 | 44% below | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Eval Low Complex 30min - Lymph | $186.83 | $311.37 | $48.48–$155.29 | 44% below | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Eval Low Complex 30min - Lymph | $186.83 | $311.37 | — | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Eval Low Complex 30min - RDC | $186.83 | $311.37 | — | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Eval Low Complex 30min - PedR | $186.83 | $311.37 | — | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Eval Low Complex 30min - SMD | $186.83 | $311.37 | — | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 Eval Low Complex 30min - OT | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval High Complex 45min - Lymph | $186.83 | $311.37 | $61.09–$187.21 | 45% below | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval High Complex 45min - FEAST | $186.83 | $311.37 | $61.09–$187.21 | 45% below | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval High Complex 45min - SMD | $186.83 | $311.37 | $61.09–$187.21 | 45% below | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval High Complex 45min - PedR | $186.83 | $311.37 | $61.09–$187.21 | 45% below | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval High Complex 45min - RDC | $186.83 | $311.37 | $61.09–$187.21 | 45% below | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Eval High Complex 45min - PT | $186.83 | $311.37 | $61.09–$187.21 | 45% below | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Eval High Complex 45min - Lymph | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Eval High Complex 45min - PT | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Eval High Complex 45min - SMD | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Eval High Complex 45min - PedR | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Eval High Complex 45min - RDC | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Eval High Complex 45min - FEAST | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Eval Low Complex 20min - SMD | $186.83 | $311.37 | $48.48–$151.12 | 36% below | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Eval Low Complex 20min - RDC | $186.83 | $311.37 | $48.48–$151.12 | 36% below | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Eval Low Complex 20min - FEAST | $186.83 | $311.37 | $48.48–$151.12 | 36% below | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Eval Low Complex 20min - Lymph | $186.83 | $311.37 | $48.48–$151.12 | 36% below | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Eval Low Complex 20min - PT | $186.83 | $311.37 | $48.48–$151.12 | 36% below | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Eval Low Complex 20min - PedR | $186.83 | $311.37 | $48.48–$151.12 | 36% below | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval Low Complex 20min - Lymph | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Eval Low Complex 20min - PT | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval Low Complex 20min - SMD | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval Low Complex 20min - PedR | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval Low Complex 20min - RDC | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval Low Complex 20min - FEAST | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Eval Mod Complex 30min - PedR | $186.83 | $311.37 | $60.60–$156.00 | 40% below | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Eval Mod Complex 30min - SMD | $186.83 | $311.37 | $60.60–$156.00 | 40% below | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Eval Mod Complex 30min - PT | $186.83 | $311.37 | $60.60–$156.00 | 40% below | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Eval Mod Complex 30min - Lymph | $186.83 | $311.37 | $60.60–$156.00 | 40% below | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Eval Mod Complex 30min - FEAST | $186.83 | $311.37 | $60.60–$156.00 | 40% below | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Eval Mod Complex 30min - RDC | $186.83 | $311.37 | $60.60–$156.00 | 40% below | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Eval Mod Complex 30min - FEAST | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Eval Mod Complex 30min - PT | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Eval Mod Complex 30min - SMD | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Eval Mod Complex 30min - PedR | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Eval Mod Complex 30min - RDC | $186.83 | $311.37 | — | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Eval Mod Complex 30min - Lymph | $186.83 | $311.37 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Techniques 15min - Lymph | $91.80 | $153.00 | $18.18–$144.00 | 30% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Techniques 15min - Lymph | $91.80 | $153.00 | $18.18–$144.00 | 30% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Joint Mob Man Ther 15min - SMD | $92.40 | $154.00 | $18.18–$144.00 | 29% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Technique 15min - SMD | $92.40 | $154.00 | $18.18–$144.00 | 29% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Techniques 15min - RDC | $92.40 | $154.00 | $18.18–$144.00 | 29% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Myofascial Release 15min - SMD | $92.40 | $154.00 | $18.18–$144.00 | 29% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Techniques 15min - FEAST | $92.40 | $154.00 | $18.18–$144.00 | 29% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Techniques 15min - Lymph | $91.80 | $153.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Techniques 15min - Lymph | $91.80 | $153.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Techniques 15min - FEAST | $92.40 | $154.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Technique 15min - SMD | $92.40 | $154.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Myofascial Release 15min - SMD | $92.40 | $154.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Joint Mob Man Ther 15min - SMD | $92.40 | $154.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Techniques 15min - RDC | $92.40 | $154.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise 15min - Lymph | $126.90 | $211.50 | $11.69–$144.00 | at median | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise 15min - FEAST | $126.90 | $211.50 | $11.69–$144.00 | at median | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Ther Exercise 15min - PedR | $126.90 | $211.50 | $11.69–$144.00 | at median | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise 15min - SMD | $126.90 | $211.50 | $11.69–$144.00 | at median | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise - SMD | $126.90 | $211.50 | $11.69–$144.00 | at median | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise 15min - PT | $126.90 | $211.50 | $11.69–$144.00 | at median | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise - 15min - OT | $126.90 | $211.50 | $11.69–$144.00 | at median | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Ther Exercise 15min - RDC | $131.40 | $219.00 | $11.69–$144.00 | 4% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise - Lymph | $131.40 | $219.00 | $11.69–$144.00 | 4% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Ther Exercise 15min - RDC | $131.40 | $219.00 | $11.69–$144.00 | 4% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise 15min - SMD | $126.90 | $211.50 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise - SMD | $126.90 | $211.50 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise 15min - PT | $126.90 | $211.50 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise 15min - Lymph | $126.90 | $211.50 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise - 15min - OT | $126.90 | $211.50 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Ther Exercise 15min - PedR | $126.90 | $211.50 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise 15min - FEAST | $126.90 | $211.50 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Ther Exercise 15min - RDC | $131.40 | $219.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Ther Exercise 15min - RDC | $131.40 | $219.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise - Lymph | $131.40 | $219.00 | — | — | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy for Crisis First 60min - TeleHealth | $244.92 | $408.20 | $106.13–$355.13 | 41% above | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy for Crisis-First 60min | $244.92 | $408.20 | $106.13–$355.13 | 41% above | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy for Crisis-First 60min - RICH | $244.92 | $408.20 | $106.13–$355.13 | 41% above | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Psychotherapy for Crisis-First 60min - RICH | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Psychotherapy for Crisis-First 60min | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Psychotherapy for Crisis First 60min - TeleHealth | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy session, 30 minutes CPT 90832 Individual Psychotherapy 30min - TeleHealth | $244.92 | $408.20 | $106.13–$355.13 | 5% above | 40% |
| Psychotherapy session, 30 minutes CPT 90832 Individual Psychotherapy 30min | $244.92 | $408.20 | $106.13–$355.13 | 5% above | 40% |
| Psychotherapy session, 30 minutes CPT 90832 Individual Psychotherapy 30mins | $244.92 | $408.20 | $106.13–$355.13 | 5% above | 40% |
| Psychotherapy session, 30 minutes CPT 90832 Individual Psychotherapy 30min - RICH | $244.92 | $408.20 | $106.13–$355.13 | 5% above | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Individual Psychotherapy 30mins | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Individual Psychotherapy 30min - RICH | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Individual Psychotherapy 30min - TeleHealth | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Individual Psychotherapy 30min | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy session, 45 minutes CPT 90834 Individual Psychotherapy 45min | $244.92 | $408.20 | $106.13–$355.13 | 2% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 Individual Psychotherapy 45min - TeleHealth | $244.92 | $408.20 | $106.13–$355.13 | 2% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 Individual Psychotherapy 45min - RICH | $244.92 | $408.20 | $106.13–$355.13 | 2% below | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Individual Psychotherapy 45min | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Individual Psychotherapy 45min - TeleHealth | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Individual Psychotherapy 45min - RICH | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy session, 60 minutes CPT 90837 Individual Psychotherapy 60min | $244.92 | $408.20 | $106.13–$355.13 | 19% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 Individual Psychotherapy 60min - RICH | $244.92 | $408.20 | $106.13–$355.13 | 19% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 Individual Psychotherapy 60min - TeleHealth | $244.92 | $408.20 | $106.13–$355.13 | 19% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 Individual Psychotherapy 60mins | $244.92 | $408.20 | $106.13–$355.13 | 19% below | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Individual Psychotherapy 60min - RICH | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Individual Psychotherapy 60min | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Individual Psychotherapy 60mins | $244.92 | $408.20 | — | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Individual Psychotherapy 60min - TeleHealth | $244.92 | $408.20 | — | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Cessation Counseling 3 - 10min - CCC | $107.28 | $178.79 | $37.94–$155.55 | 135% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Cessation Counseling 3 - 10min - ER | $107.28 | $178.79 | $37.94–$1,227.00 | 135% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking Cessation Counseling 3 - 10min - CCC | $107.28 | $178.79 | — | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking Cessation Counseling 3 - 10min - ER | $107.28 | $178.79 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Established Patient E/M Level 5 Hospital - CCC | $150.70 | $251.16 | $65.30–$298.79 | 48% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Compre, High Neoplastic Visit-TeleHealth - CCC | $150.70 | $251.16 | $65.30–$298.79 | 48% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 E/M level 5 - Established Patient - MOU | $163.10 | $271.82 | $70.67–$298.79 | 44% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OB Triage E & M Level V - L & D | $163.10 | $271.82 | $70.67–$298.79 | 44% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 E & M Est Pt Complex - WCC | $163.10 | $271.82 | $70.67–$298.79 | 44% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Established Patient E/M Level 5 Hospital - CCC | $150.70 | $251.16 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Compre, High Neoplastic Visit-TeleHealth - CCC | $150.70 | $251.16 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OB Triage E & M Level V - L & D | $163.10 | $271.82 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E/M level 5 - Established Patient - MOU | $163.10 | $271.82 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E & M Est Pt Complex - WCC | $163.10 | $271.82 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Expand, Probl Focused Visit-TeleHealth - CCC | $76.95 | $128.25 | $32.00–$147.83 | 61% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office Visit Established, 15min | $76.95 | $128.25 | $32.00–$147.83 | 61% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OTV Expanded Visit - CCC | $76.95 | $128.25 | $32.00–$147.83 | 61% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB Triage E & M Level III - L & D | $83.28 | $138.80 | $32.00–$147.83 | 58% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 E & M Est Pt Interm - WCC | $83.28 | $138.80 | $32.00–$147.83 | 58% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 E/M level 3 - Established Patient - MOU | $83.28 | $138.80 | $32.00–$147.83 | 58% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Established Patient E/M Level 3 Hospital - CCC | $83.28 | $138.80 | $32.00–$147.83 | 58% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office Visit Established, 15min | $76.95 | $128.25 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Expand, Probl Focused Visit-TeleHealth - CCC | $76.95 | $128.25 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OTV Expanded Visit - CCC | $76.95 | $128.25 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Established Patient E/M Level 3 Hospital - CCC | $83.28 | $138.80 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 E & M Est Pt Interm - WCC | $83.28 | $138.80 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OB Triage E & M Level III - L & D | $83.28 | $138.80 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 E/M level 3 - Established Patient - MOU | $83.28 | $138.80 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Established Patient E/M Level 4 Hospital - CCC | $112.49 | $187.47 | $48.74–$210.61 | 51% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Detailed, Mod Neoplastic Visit-TeleHealth - CCC | $112.49 | $187.47 | $48.74–$210.61 | 51% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office Visit Established, 25min | $112.49 | $187.47 | $48.74–$210.61 | 51% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB Triage E & M Level IV - L & D | $121.74 | $202.89 | $52.75–$210.61 | 47% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E/M level 4 - Established Patient - MOU | $121.74 | $202.89 | $52.75–$210.61 | 47% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E & M Est Pt Extend - WCC | $121.74 | $202.89 | $52.75–$210.61 | 47% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Detailed, Mod Neoplastic Visit-TeleHealth - CCC | $112.49 | $187.47 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Established Patient E/M Level 4 Hospital - CCC | $112.49 | $187.47 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office Visit Established, 25min | $112.49 | $187.47 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OB Triage E & M Level IV - L & D | $121.74 | $202.89 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 E & M Est Pt Extend - WCC | $121.74 | $202.89 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 E/M level 4 - Established Patient - MOU | $121.74 | $202.89 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Established Patient E/M Level 2 Hospital - CCC | $165.00 | $275.00 | $32.00–$239.25 | 2% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office Visit Established, 10min | $165.00 | $275.00 | $32.00–$239.25 | 2% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Respiratory Visit - RESP | $165.00 | $275.00 | $32.00–$239.25 | 2% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OB Triage E & M Level II - L & D | $165.00 | $275.00 | $32.00–$239.25 | 2% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E/M level 2 - Established Patient - MOU | $165.00 | $275.00 | $32.00–$239.25 | 2% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PEG Tube Removal - ACU | $165.00 | $275.00 | $32.00–$239.25 | 2% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Probl Focused Visit-Estb-TeleHealth - CCC | $165.00 | $275.00 | $32.00–$239.25 | 2% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E & M Est Pt Limited - WCC | $165.00 | $275.00 | $32.00–$239.25 | 2% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OTV Moderate Visit - CCC | $165.00 | $275.00 | $32.00–$239.25 | 2% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Probl Focused Visit-Estb-TeleHealth - CCC | $165.00 | $275.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OTV Moderate Visit - CCC | $165.00 | $275.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office Visit Established, 10min | $165.00 | $275.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 E & M Est Pt Limited - WCC | $165.00 | $275.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Respiratory Visit - RESP | $165.00 | $275.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PEG Tube Removal - ACU | $165.00 | $275.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 E/M level 2 - Established Patient - MOU | $165.00 | $275.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OB Triage E & M Level II - L & D | $165.00 | $275.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Established Patient E/M Level 2 Hospital - CCC | $165.00 | $275.00 | — | — | 40% |
| Speech and language evaluation CPT 92523 Eval Speech Language Comp - Speech | $421.98 | $703.29 | $126.34–$349.27 | 17% below | 40% |
| Speech and language evaluation CPT 92523 ST Eval Speech Language Comp - RDC | $421.98 | $703.29 | $126.34–$349.27 | 17% below | 40% |
| Speech and language evaluation CPT 92523 Eval Speech Language Comp - PedR | $421.98 | $703.29 | $126.34–$349.27 | 17% below | 40% |
| Speech and language evaluation inpatient CPT 92523 ST Eval Speech Language Comp - RDC | $421.98 | $703.29 | — | — | 40% |
| Speech and language evaluation inpatient CPT 92523 Eval Speech Language Comp - Speech | $421.98 | $703.29 | — | — | 40% |
| Speech and language evaluation inpatient CPT 92523 Eval Speech Language Comp - PedR | $421.98 | $703.29 | — | — | 40% |
| Speech therapy session, individual CPT 92507 Speech Therapy Adult - Speech | $185.40 | $309.00 | $30.27–$211.00 | 38% below | 40% |
| Speech therapy session, individual CPT 92507 Speech Therapy Ped - PedR | $185.40 | $309.00 | $30.27–$211.00 | 38% below | 40% |
| Speech therapy session, individual CPT 92507 Passy Muir Valve - Training & Evaluation - Speech | $199.66 | $332.76 | $30.27–$211.00 | 33% below | 40% |
| Speech therapy session, individual CPT 92507 ST Speech Therapy Adult - RDC | $199.66 | $332.76 | $30.27–$211.00 | 33% below | 40% |
| Speech therapy session, individual inpatient CPT 92507 Speech Therapy Adult - Speech | $185.40 | $309.00 | — | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 Speech Therapy Ped - PedR | $185.40 | $309.00 | — | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 Passy Muir Valve - Training & Evaluation - Speech | $199.66 | $332.76 | — | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 ST Speech Therapy Adult - RDC | $199.66 | $332.76 | — | — | 40% |
| Spirometry (breathing test) CPT 94010 Spirogram with Flow-Volume Loop - RESP | $295.32 | $492.19 | $20.93–$428.21 | 8% below | 40% |
| Spirometry (breathing test) inpatient CPT 94010 Spirogram with Flow-Volume Loop - RESP | $295.32 | $492.19 | — | — | 40% |
| Spirometry before and after a bronchodilator CPT 94060 Spirogram Pre and Post w/ Flow Volume Loops - RESP | $535.94 | $893.23 | $14.59–$777.11 | 18% below | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Spirogram Pre and Post w/ Flow Volume Loops - RESP | $535.94 | $893.23 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities 15min - PedR | $126.90 | $211.50 | $18.14–$144.00 | at median | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities - PT | $126.90 | $211.50 | $18.14–$144.00 | at median | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities 15min - OT | $126.90 | $211.50 | $18.14–$144.00 | at median | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities - FEAST | $131.40 | $219.00 | $18.14–$144.00 | 4% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities - Lymph | $131.40 | $219.00 | $18.14–$144.00 | 4% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities 15min - PedR | $131.40 | $219.00 | $18.14–$144.00 | 4% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities - RDC | $131.40 | $219.00 | $18.14–$144.00 | 4% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapuetic Activites - RDC | $131.40 | $219.00 | $18.14–$144.00 | 4% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities 15min - SMD | $131.40 | $219.00 | $18.14–$144.00 | 4% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities - SMD | $131.40 | $219.00 | $18.14–$144.00 | 4% above | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities 15min - PedR | $126.90 | $211.50 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities - PT | $126.90 | $211.50 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities 15min - OT | $126.90 | $211.50 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities - FEAST | $131.40 | $219.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities - RDC | $131.40 | $219.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapuetic Activites - RDC | $131.40 | $219.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities 15min - PedR | $131.40 | $219.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities - SMD | $131.40 | $219.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities 15min - SMD | $131.40 | $219.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities - Lymph | $131.40 | $219.00 | — | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic - MOU | $211.24 | $352.06 | $2.63–$306.29 | 9% below | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic - MOU | $211.24 | $352.06 | — | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varivax Vaccine w/ Diluent | $189.12 | $315.20 | $81.95–$242.70 | 8% below | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varivax Vaccine w/ Diluent | $189.12 | $315.20 | — | — | 40% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 Pentacel Vaccine | $111.60 | $186.00 | $48.36–$143.22 | 29% above | 40% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 Pentacel Vaccine | $111.60 | $186.00 | — | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone TIV 0.5ml Syringe 2025-2026 | $45.00 | $75.00 | $19.50–$57.75 | 31% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluzone TIV 0.5ml Syringe 2025-2026 | $45.00 | $75.00 | — | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vacc Adult-3 Dose-IM - ER | $205.41 | $342.34 | $73.83–$263.60 | 174% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vacc Adult-3 Dose-IM - ER | $205.41 | $342.34 | — | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Virus Vaccine VFC | $24.78 | $41.29 | $10.74–$35.21 | 51% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Virus Vaccine PFS | $78.60 | $131.00 | $33.22–$100.87 | 56% above | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Engerix-B 10mg/0.5ml PFS | $94.80 | $158.00 | $33.22–$121.66 | 88% above | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Virus Vaccine VFC | $24.78 | $41.29 | — | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Virus Vaccine PFS | $78.60 | $131.00 | — | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Engerix-B 10mg/0.5ml PFS | $94.80 | $158.00 | — | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Hepatitis B Immuneglobulin 0.5ml (90648) | $344.74 | $574.56 | $19.80–$442.41 | 972% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Hepatitis B Immuneglobulin 0.5ml (90648) | $344.74 | $574.56 | — | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menveo Vaccine 0.5ml Vial | $535.25 | $892.08 | $164.35–$776.11 | 472% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menveo Vaccine 0.5ml Vial | $535.25 | $892.08 | — | — | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Bexsero PFS 0.5ml Vaccine | $743.15 | $1,238.58 | $230.75–$1,077.56 | 287% above | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Bexsero PFS 0.5ml Vaccine | $743.15 | $1,238.58 | — | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20 PFS 0.5ml | $837.60 | $1,396.00 | $268.56–$1,074.92 | 159% above | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Prevnar 20 PFS 0.5ml | $837.60 | $1,396.00 | — | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax Inj 0.5ml Syr | $431.68 | $719.46 | $124.08–$553.98 | 380% above | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumovax Inj 0.5ml Syr | $431.68 | $719.46 | — | — | 40% |
| Polio vaccine, inactivated (IPV) CPT 90713 IPOL Vaccine 5ml Box | $60.48 | $100.80 | $26.21–$77.62 | 14% below | 40% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL Vaccine 5ml Box | $60.48 | $100.80 | — | — | 40% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Nirsevimab-ALIP 100mg/1ml PFS | $2,094.12 | $3,490.20 | $526.75–$2,687.45 | 77% above | 40% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 Nirsevimab-ALIP 100mg/1ml PFS | $2,094.12 | $3,490.20 | — | — | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Nirsevimab-ALIP 50mg/0.5ml PFS | $1,662.00 | $2,770.00 | $526.75–$2,132.90 | 85% above | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Nirsevimab-ALIP 50mg/0.5ml PFS | $1,662.00 | $2,770.00 | — | — | 40% |
| Rabies vaccine, one dose CPT 90675 Rabies Vacc IM - ER | $597.12 | $995.19 | $258.75–$766.30 | at median | 40% |
| Rabies vaccine, one dose CPT 90675 Rabies Vacc 2.5 Units/Vial | $597.12 | $995.19 | $258.75–$766.30 | at median | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Vacc 2.5 Units/Vial | $597.12 | $995.19 | — | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Vacc IM - ER | $597.12 | $995.19 | — | — | 40% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Rotateq Oral Vaccine Liq 2ml | $275.94 | $459.90 | $102.96–$354.12 | 207% above | 40% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Rotateq Oral Vaccine Liq 2ml | $275.94 | $459.90 | — | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD Vaccine No Presv; 7 yr+ IM - ER | $231.08 | $385.13 | $236.00–$1,227.00 | 314% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus/Diphtheria Toxoid 0.5ml Syringe | $315.11 | $525.18 | $34.99–$404.39 | 465% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD Vaccine No Presv; 7 yr+ IM - ER | $231.08 | $385.13 | — | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus/Diphtheria Toxoid 0.5ml Syringe | $315.11 | $525.18 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine (VFC) - NICU | $110.84 | $184.72 | $24.00–$160.71 | 73% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine - NRSY | $110.84 | $184.72 | $24.00–$160.71 | 73% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine (VFC) - NRSY | $110.84 | $184.72 | $24.00–$160.71 | 73% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine - 2 North | $113.41 | $189.01 | $24.00–$164.44 | 77% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine - HATH | $113.41 | $189.01 | $24.00–$164.44 | 77% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine - SBH | $113.41 | $189.01 | $24.00–$164.44 | 77% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine - MOU | $113.41 | $189.01 | $24.00–$164.44 | 77% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine - ICCU/CCU | $113.41 | $189.01 | $24.00–$164.44 | 77% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine - 3 South | $113.41 | $189.01 | $24.00–$164.44 | 77% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine - 4 Central | $113.41 | $189.01 | $24.00–$164.44 | 77% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine - NICU | $113.41 | $189.01 | $24.00–$164.44 | 77% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine - ER | $122.74 | $204.56 | $24.00–$177.97 | 92% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine - 2 South | $122.74 | $204.56 | $24.00–$177.97 | 92% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, 1 Vaccine - 3 North | $122.74 | $204.56 | $24.00–$177.97 | 92% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine (VFC) - NRSY | $110.84 | $184.72 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine (VFC) - NICU | $110.84 | $184.72 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine - NRSY | $110.84 | $184.72 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine - MOU | $113.41 | $189.01 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine - NICU | $113.41 | $189.01 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine - ICCU/CCU | $113.41 | $189.01 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine - 3 South | $113.41 | $189.01 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine - 4 Central | $113.41 | $189.01 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine - SBH | $113.41 | $189.01 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine - 2 North | $113.41 | $189.01 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine - HATH | $113.41 | $189.01 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine - ER | $122.74 | $204.56 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine - 2 South | $122.74 | $204.56 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin, 1 Vaccine - 3 North | $122.74 | $204.56 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine (VFC) - NICU | $18.35 | $30.58 | $7.95–$26.60 | 37% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine (VFC) - NRSY | $18.35 | $30.58 | $7.95–$26.60 | 37% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine - SBH | $18.78 | $31.30 | $8.14–$27.23 | 36% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine - 2 North | $18.78 | $31.30 | $8.14–$27.23 | 36% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine - HATH | $18.78 | $31.30 | $8.14–$27.23 | 36% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine - MOU | $18.78 | $31.30 | $8.14–$27.23 | 36% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine - ICCU/CCU | $18.78 | $31.30 | $8.14–$27.23 | 36% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine - 3 South | $18.78 | $31.30 | $8.14–$27.23 | 36% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine - 2 South | $18.78 | $31.30 | $8.14–$27.23 | 36% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine - 4 Central | $18.78 | $31.30 | $8.14–$27.23 | 36% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine - NICU | $18.78 | $31.30 | $8.14–$27.23 | 36% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine - NRSY | $18.78 | $31.30 | $8.14–$27.23 | 36% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine - ER | $27.11 | $45.17 | $11.74–$39.30 | 7% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Addtl Vaccine - 3 North | $27.11 | $45.17 | $11.74–$39.30 | 7% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine (VFC) - NICU | $18.35 | $30.58 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine (VFC) - NRSY | $18.35 | $30.58 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine - NICU | $18.78 | $31.30 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine - SBH | $18.78 | $31.30 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine - 4 Central | $18.78 | $31.30 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine - 2 South | $18.78 | $31.30 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine - MOU | $18.78 | $31.30 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine - 2 North | $18.78 | $31.30 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine - NRSY | $18.78 | $31.30 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine - ICCU/CCU | $18.78 | $31.30 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine - 3 South | $18.78 | $31.30 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine - HATH | $18.78 | $31.30 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine - ER | $27.11 | $45.17 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Addtl Vaccine - 3 North | $27.11 | $45.17 | — | — | 40% |
| Yellow fever vaccine, live CPT 90717 YF-Vax 1 Dose Vial/Diluent | $244.65 | $407.74 | $106.01–$313.96 | at median | 40% |
| Yellow fever vaccine, live inpatient CPT 90717 YF-Vax 1 Dose Vial/Diluent | $244.65 | $407.74 | — | — | 40% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.