Hospital

Vandalia Health Broaddus Hospital

Listed in its price file as “Broaddus Hospital Association Inc”.

Vandalia Health Broaddus Hospital in Philippi, WV publishes cash prices for 337 common procedures listed here, from its own machine-readable price file updated Jul 31, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the West Virginia median for 186 of 337 procedures and below it for 146. By typical cash price it ranks #27 of 36 West Virginia hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

1 Healthcare Drive, Philippi, WV 26416 Collected Sep 27, 2026 Source price file Check a bill from this hospital (304) 457-1760

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 511300 · CMS hospital register NPI 1548246622

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Vandalia Health Broaddus Hospital 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 West Virginia	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/O, W/ CONTRAST	$1,834.97	$2,621.38	$160.87–$2,545.36	49% above	30%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/O, W/ CONTRAST	$1,834.97	$2,621.38	$2,228.17–$2,545.36	—	30%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN, MULTIPLE FILMS	$298.29	$426.12	$24.36–$413.76	36% above	30%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN, MULTIPLE FILMS	$298.29	$426.12	$362.20–$413.76	—	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE, RIGHT COMP (MIN 3 VIEW)	$244.12	$348.74	$24.12–$338.63	35% above	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE, LEFT COMP (MIN 3 VIEW)	$244.12	$348.74	$24.12–$338.63	35% above	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE, RIGHT COMP (MIN 3 VIEW)	$244.12	$348.74	$296.43–$338.63	—	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE, LEFT COMP (MIN 3 VIEW)	$244.12	$348.74	$296.43–$338.63	—	30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER LEFT EXTREMITY W/O CONTRAST	$1,127.10	$1,610.14	$101.67–$1,563.45	60% above	30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER RIGHT EXTREMITY W/O CONTRAST	$1,127.10	$1,610.14	$101.67–$1,563.45	60% above	30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER RIGHT EXTREMITY W/O CONTRAST	$1,127.10	$1,610.14	$1,368.62–$1,563.45	—	30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER LEFT EXTREMITY W/O CONTRAST	$1,127.10	$1,610.14	$1,368.62–$1,563.45	—	30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 BARIUM SWALLOW (ESOPHAGUS)	$495.66	$708.08	$64.48–$687.55	35% above	30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 BARIUM SWALLOW (ESOPHAGUS)	$495.66	$708.08	$601.87–$687.55	—	30%
Breast ultrasound, complete, one breast both sides CPT 76641 ULTRASOUND BREAST BILATERAL COMPLETE	$348.00	$497.14	$68.42–$482.72	—	30%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREASTS	$298.29	$426.12	$68.42–$413.76	3% above	30%
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND BREAST LEFT	$298.29	$426.12	$68.42–$413.76	3% above	30%
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND BREAST RIGHT	$298.29	$426.12	$68.42–$413.76	3% above	30%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 ULTRASOUND BREAST BILATERAL COMPLETE	$348.00	$497.14	$422.57–$482.72	—	30%
Breast ultrasound, complete, one breast inpatient CPT 76641 ULTRASOUND BREASTS	$298.29	$426.12	$362.20–$413.76	—	30%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND BREAST RIGHT	$298.29	$426.12	$362.20–$413.76	—	30%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND BREAST LEFT	$298.29	$426.12	$362.20–$413.76	—	30%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 ULTRASOUND BREAST BILATERAL LIMITED	$348.00	$497.14	$57.10–$482.72	—	30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRASOUND BREAST LIMITED AXILLA LEFT	$203.31	$290.44	$57.10–$282.02	23% below	30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRASOUND BREAST LIMITED ANILL RIGHT	$203.31	$290.44	$57.10–$282.02	23% below	30%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 ULTRASOUND BREAST BILATERAL LIMITED	$348.00	$497.14	$422.57–$482.72	—	30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRASOUND BREAST LIMITED AXILLA LEFT	$203.31	$290.44	$246.87–$282.02	—	30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRASOUND BREAST LIMITED ANILL RIGHT	$203.31	$290.44	$246.87–$282.02	—	30%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABDOMEN & PELVIS W/(WWO) CONTR	$1,602.72	$2,289.60	$257.67–$2,223.20	7% below	30%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABDOMEN & PELVIS W/(WWO) CONTR	$1,602.72	$2,289.60	$1,946.16–$2,223.20	—	30%
CT angiography (CTA) of the head CPT 70496 CT ANGIO HEAD W/O & W/ CONTRAS	$1,449.13	$2,070.18	$172.80–$2,010.14	20% above	30%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIO HEAD W/O & W/ CONTRAS	$1,449.13	$2,070.18	$1,759.65–$2,010.14	—	30%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO NECK W/O & W/ CONTRAS	$2,033.08	$2,904.40	$172.80–$2,820.17	77% above	30%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO NECK W/O & W/ CONTRAS	$2,033.08	$2,904.40	$2,468.74–$2,820.17	—	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST W/ OR W/O & W/ CONTRAST	$2,721.66	$3,888.08	$175.28–$3,775.33	116% above	30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST W/ OR W/O & W/ CONTRAST	$2,721.66	$3,888.08	$3,304.87–$3,775.33	—	30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD W/O & PELVIS W/O CONTRAST	$3,087.47	$4,410.66	$126.74–$4,282.75	127% above	30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD W/O & PELVIS W/O CONTRAST	$3,087.47	$4,410.66	$3,749.06–$4,282.75	—	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/ CONTRAST	$2,415.21	$3,450.30	$205.74–$3,350.24	50% above	30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/ CONTRAST	$2,415.21	$3,450.30	$2,932.76–$3,350.24	—	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD W/O W & PELVIS W/ CONTRAST	$2,818.12	$4,025.88	$230.60–$3,909.13	65% above	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS W/ & W/O CONTRAST	$2,818.12	$4,025.88	$230.60–$3,909.13	65% above	30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD W/O W & PELVIS W/ CONTRAST	$2,818.12	$4,025.88	$3,422.00–$3,909.13	—	30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELVIS W/ & W/O CONTRAST	$2,818.12	$4,025.88	$3,422.00–$3,909.13	—	30%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ CONTRAST	$966.09	$1,380.12	$156.83–$1,340.10	9% below	30%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ CONTRAST	$966.09	$1,380.12	$1,173.10–$1,340.10	—	30%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$1,516.65	$2,166.64	$93.76–$2,103.81	105% above	30%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$1,516.65	$2,166.64	$1,841.64–$2,103.81	—	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL/SINUS W/O CONTRAST	$1,449.13	$2,070.18	$87.12–$2,010.14	109% above	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL/SINUS W/O CONTRAST	$1,449.13	$2,070.18	$1,759.65–$2,010.14	—	30%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST	$1,128.59	$1,612.26	$72.60–$1,565.50	59% above	30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONTRAST	$1,128.59	$1,612.26	$1,370.42–$1,565.50	—	30%
CT scan of the head with contrast CPT 70460 CT HEAD WITH CONTRAST	$1,780.06	$2,542.94	$101.39–$2,469.19	75% above	30%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD WITH CONTRAST	$1,780.06	$2,542.94	$2,161.50–$2,469.19	—	30%
CT scan of the head without and with contrast CPT 70470 CT HEAD W AND W/O CONTRAST	$1,771.16	$2,530.22	$118.62–$2,456.84	52% above	30%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W AND W/O CONTRAST	$1,771.16	$2,530.22	$2,150.69–$2,456.84	—	30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L SPINE W/O CONTRAST	$1,649.47	$2,356.38	$88.35–$2,288.04	96% above	30%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L SPINE W/O CONTRAST	$1,649.47	$2,356.38	$2,002.92–$2,288.04	—	30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONT	$1,649.47	$2,356.38	$88.84–$2,288.04	101% above	30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONT	$1,649.47	$2,356.38	$2,002.92–$2,288.04	—	30%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST	$1,571.56	$2,245.08	$152.94–$2,179.97	66% above	30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH CONTRAST	$1,571.56	$2,245.08	$1,908.32–$2,179.97	—	30%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/O AND W CONTRAST	$2,021.95	$2,888.50	$133.39–$2,804.73	60% above	30%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/O AND W CONTRAST	$2,021.95	$2,888.50	$2,455.23–$2,804.73	—	30%
Chest X-ray, 2 views CPT 71046 CHEST, PA & LATERAL	$241.90	$345.56	$22.40–$335.54	28% above	30%
Chest X-ray, 2 views inpatient CPT 71046 CHEST, PA & LATERAL	$241.90	$345.56	$293.73–$335.54	—	30%
Chest X-ray, single view CPT 71045 INFANT CHEST/ABD SINGLE VIEW	$240.41	$343.44	$17.23–$333.48	37% above	30%
Chest X-ray, single view CPT 71045 CHEST, DECUBITUS	$241.90	$345.56	$17.23–$335.54	37% above	30%
Chest X-ray, single view CPT 71045 CHEST, SINGLE VIEW	$241.90	$345.56	$17.23–$335.54	37% above	30%
Chest X-ray, single view inpatient CPT 71045 INFANT CHEST/ABD SINGLE VIEW	$240.41	$343.44	$291.92–$333.48	—	30%
Chest X-ray, single view inpatient CPT 71045 CHEST, DECUBITUS	$241.90	$345.56	$293.73–$335.54	—	30%
Chest X-ray, single view inpatient CPT 71045 CHEST, SINGLE VIEW	$241.90	$345.56	$293.73–$335.54	—	30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE RIGHT, COMP	$244.12	$348.74	$21.66–$338.63	39% above	30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE LEFT, COMP	$244.12	$348.74	$21.66–$338.63	39% above	30%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE LEFT, COMP	$244.12	$348.74	$296.43–$338.63	—	30%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE RIGHT, COMP	$244.12	$348.74	$296.43–$338.63	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 ULTRASOUND-AORTA	$327.23	$467.46	$72.11–$453.90	25% below	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 ULTRASOUND-KIDNEY	$339.84	$485.48	$72.11–$471.40	22% below	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 ULTRASOUND-AORTA	$327.23	$467.46	$397.34–$453.90	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 ULTRASOUND-KIDNEY	$339.84	$485.48	$412.66–$471.40	—	30%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITOMETRY (DEXA SCAN)	$288.64	$412.34	$25.84–$400.38	9% below	30%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITOMETRY (DEXA SCAN)	$288.64	$412.34	$350.49–$400.38	—	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$1,693.99	$2,419.98	$91.06–$2,349.80	115% above	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST	$1,693.99	$2,419.98	$2,056.98–$2,349.80	—	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/ CONTRAST	$1,693.99	$2,419.98	$113.94–$2,349.80	54% above	30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/ CONTRAST	$1,693.99	$2,419.98	$2,056.98–$2,349.80	—	30%
Diagnostic mammogram, both breasts CPT 77066 MAMMO DIGITAL DIAG BCCSP/ABC	$221.86	$316.94	$105.08–$307.75	27% below	30%
Diagnostic mammogram, both breasts CPT 77066 MAMMO DIGITAL DIAG BIL	$221.86	$316.94	$105.08–$307.75	27% below	30%
Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMO DIGITAL DIAG BIL	$221.86	$316.94	$269.40–$307.75	—	30%
Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMO DIGITAL DIAG BCCSP/ABC	$221.86	$316.94	$269.40–$307.75	—	30%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO RIGHT UNILATERAL BCCSP OR ABC	$127.63	$182.32	$83.18–$177.03	42% below	30%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO LEFT UNILATERAL BCCSP OR ABC	$127.63	$182.32	$83.18–$177.03	42% below	30%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIGITAL DIAG RIGHT UNIL	$167.70	$239.56	$83.18–$232.61	23% below	30%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIGITAL DIAG LEFT UNIL	$167.70	$239.56	$83.18–$232.61	23% below	30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO RIGHT UNILATERAL BCCSP OR ABC	$127.63	$182.32	$154.97–$177.03	—	30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO LEFT UNILATERAL BCCSP OR ABC	$127.63	$182.32	$154.97–$177.03	—	30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIGITAL DIAG RIGHT UNIL	$167.70	$239.56	$203.63–$232.61	—	30%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIGITAL DIAG LEFT UNIL	$167.70	$239.56	$203.63–$232.61	—	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO W/DOPP/COLOFLOW (2D MODE)	$1,393.48	$1,990.68	$130.93–$1,932.95	21% above	30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO W/DOPP/COLOFLOW (2D MODE)	$1,393.48	$1,990.68	$1,692.08–$1,932.95	—	30%
Elbow X-ray, 2 views one side CPT 73070 ELBOW (2) LEFT	$244.12	$348.74	$19.44–$338.63	28% above	30%
Elbow X-ray, 2 views one side CPT 73070 ELBOW RIGHT (2VIEW)	$244.12	$348.74	$19.44–$338.63	28% above	30%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW RIGHT (2VIEW)	$244.12	$348.74	$296.43–$338.63	—	30%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW (2) LEFT	$244.12	$348.74	$296.43–$338.63	—	30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW, LEFT COMP (MIN 3)	$244.12	$348.74	$21.90–$338.63	36% above	30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW, RIGHT COMP (MIN 3)	$244.12	$348.74	$21.90–$338.63	36% above	30%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW, LEFT COMP (MIN 3)	$244.12	$348.74	$296.43–$338.63	—	30%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW, RIGHT COMP (MIN 3)	$244.12	$348.74	$296.43–$338.63	—	30%
Eye socket (orbit) CT scan without contrast CPT 70480 CT TEMPORAL BONES W/O CONTRAST	$819.91	$1,171.30	$109.02–$1,137.33	18% above	30%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SELLA TURCICA W/0 CONTRAST	$1,700.67	$2,429.52	$109.02–$2,359.06	145% above	30%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS W/O CONTRAST	$1,700.67	$2,429.52	$109.02–$2,359.06	145% above	30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT TEMPORAL BONES W/O CONTRAST	$819.91	$1,171.30	$995.61–$1,137.33	—	30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS W/O CONTRAST	$1,700.67	$2,429.52	$2,065.09–$2,359.06	—	30%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT SELLA TURCICA W/0 CONTRAST	$1,700.67	$2,429.52	$2,065.09–$2,359.06	—	30%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES, COMP (MIN 3)	$186.99	$267.12	$31.25–$259.37	21% below	30%
Facial bones X-ray, complete, 3 or more views CPT 70150 ZYGOMATIC ARCHES	$269.35	$384.78	$31.25–$373.62	14% above	30%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES, COMP (MIN 3)	$186.99	$267.12	$227.05–$259.37	—	30%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 ZYGOMATIC ARCHES	$269.35	$384.78	$327.06–$373.62	—	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RIGHT (2)	$244.12	$348.74	$19.44–$338.63	37% above	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LEFT (2)	$244.12	$348.74	$19.44–$338.63	37% above	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM RIGHT (2)	$244.12	$348.74	$296.43–$338.63	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM LEFT (2)	$244.12	$348.74	$296.43–$338.63	—	30%
Hand X-ray, 2 views one side CPT 73120 HAND RIGHT (2)	$281.96	$402.80	$20.92–$391.12	44% above	30%
Hand X-ray, 2 views one side CPT 73120 HAND LEFT (2)	$281.96	$402.80	$20.92–$391.12	44% above	30%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND LEFT (2)	$281.96	$402.80	$342.38–$391.12	—	30%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND RIGHT (2)	$281.96	$402.80	$342.38–$391.12	—	30%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL RIGHT (CALCANEUS,MIN 2)	$244.12	$348.74	$19.20–$338.63	42% above	30%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL LEFT (CALCANEUS,MIN 2)	$244.12	$348.74	$19.20–$338.63	42% above	30%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL LEFT (CALCANEUS,MIN 2)	$244.12	$348.74	$296.43–$338.63	—	30%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL RIGHT (CALCANEUS,MIN 2)	$244.12	$348.74	$296.43–$338.63	—	30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT&RESP EFFT (RSP)	$270.83	$386.90	$63.74–$375.68	23% below	30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATT&RESP EFFT (RSP)	$270.83	$386.90	$328.87–$375.68	—	30%
Knee X-ray, 3 views one side CPT 73562 KNEE LEFT (3 VIEW)	$280.48	$400.68	$27.07–$389.06	41% above	30%
Knee X-ray, 3 views one side CPT 73562 KNEE RIGHT (3 VIEW)	$280.48	$400.68	$27.07–$389.06	41% above	30%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE RIGHT (3 VIEW)	$280.48	$400.68	$340.58–$389.06	—	30%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE LEFT (3 VIEW)	$280.48	$400.68	$340.58–$389.06	—	30%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE, RIGHT COMP (MIN 4 VIEW)	$280.48	$400.68	$31.25–$389.06	5% above	30%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE, LEFT COMP (MIN 4 VIEW)	$280.48	$400.68	$31.25–$389.06	5% above	30%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE, LEFT COMP (MIN 4 VIEW)	$280.48	$400.68	$340.58–$389.06	—	30%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE, RIGHT COMP (MIN 4 VIEW)	$280.48	$400.68	$340.58–$389.06	—	30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER RIGHT EXTREMITY W/O CONTRAST	$1,693.99	$2,419.98	$88.60–$2,349.80	135% above	30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER LEFT EXTREMITY W/O CONTRAST	$1,693.99	$2,419.98	$88.60–$2,349.80	135% above	30%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER LEFT EXTREMITY W/O CONTRAST	$1,693.99	$2,419.98	$2,056.98–$2,349.80	—	30%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER RIGHT EXTREMITY W/O CONTRAST	$1,693.99	$2,419.98	$2,056.98–$2,349.80	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND GB BILARY SYS/PANCREAS	$309.42	$442.02	$57.83–$429.20	23% below	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND ABDOMEN LIMITED	$392.52	$560.74	$57.83–$544.48	2% below	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND LIMITED (SINGLE ORGAN,QUAD)	$392.52	$560.74	$57.83–$544.48	2% below	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND ASCITES	$493.43	$704.90	$57.83–$684.46	23% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND GB BILARY SYS/PANCREAS	$309.42	$442.02	$375.72–$429.20	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND LIMITED (SINGLE ORGAN,QUAD)	$392.52	$560.74	$476.63–$544.48	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMEN LIMITED	$392.52	$560.74	$476.63–$544.48	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ASCITES	$493.43	$704.90	$599.17–$684.46	—	30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND SOFT TISSUE TRUNK (GROIN, HER	$324.26	$463.22	$43.31–$449.79	10% above	30%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY - RIGHT	$324.26	$463.22	$43.31–$449.79	10% above	30%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 ULTRASOUND RIGHT EXTREM- LIMITED	$324.26	$463.22	$43.31–$449.79	10% above	30%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 ULTRASOUND LEFT ETREM.- LIMITED	$324.26	$463.22	$43.31–$449.79	10% above	30%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY - LEFT	$324.26	$463.22	$43.31–$449.79	10% above	30%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 ULTRASOUND LEFT EXTREM- LIMITED	$442.82	$632.59	$43.31–$614.24	50% above	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND SOFT TISSUE TRUNK (GROIN, HER	$324.26	$463.22	$393.74–$449.79	—	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 ULTRASOUND LEFT ETREM.- LIMITED	$324.26	$463.22	$393.74–$449.79	—	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 ULTRASOUND RIGHT EXTREM- LIMITED	$324.26	$463.22	$393.74–$449.79	—	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY - LEFT	$324.26	$463.22	$393.74–$449.79	—	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY - RIGHT	$324.26	$463.22	$393.74–$449.79	—	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 ULTRASOUND LEFT EXTREM- LIMITED	$442.82	$632.59	$537.70–$614.24	—	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LDCT FOR LUNG CA SCREEN	$1,598.27	$2,283.24	$94.50–$2,217.03	925% above	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LDCT FOR LUNG CA SCREEN	$1,598.27	$2,283.24	$1,940.75–$2,217.03	—	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA AND FIBULA LEFT (2 VIEW)	$244.12	$348.74	$20.92–$338.63	27% above	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA AND FIBULA RIGHT (2 VIEW)	$244.12	$348.74	$20.92–$338.63	27% above	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA AND FIBULA RIGHT (2 VIEW)	$244.12	$348.74	$296.43–$338.63	—	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA AND FIBULA LEFT (2 VIEW)	$244.12	$348.74	$296.43–$338.63	—	30%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRAST	$1,502.55	$2,146.50	$146.18–$2,084.25	7% above	30%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CONTRAST	$1,502.55	$2,146.50	$1,824.53–$2,084.25	—	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-LWR LEFT EXT, ANY JOINT W/O CONTRAST	$1,618.31	$2,311.86	$138.31–$2,244.82	24% above	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-LWR RIGHT EXT, ANY JOINT W/O CONTRAS	$1,618.31	$2,311.86	$138.31–$2,244.82	24% above	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-LWR LEFT EXT, ANY JOINT W/O CONTRAST	$1,618.31	$2,311.86	$1,965.08–$2,244.82	—	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-LWR RIGHT EXT, ANY JOINT W/O CONTRAS	$1,618.31	$2,311.86	$1,965.08–$2,244.82	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-LWR LEFT EXT,JOINT,W/O W CONT	$2,617.04	$3,738.62	$261.36–$3,630.20	41% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-LWR RIGHT EXT,JOINT,W/O W CONT	$2,617.04	$3,738.62	$261.36–$3,630.20	41% above	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-LWR RIGHT EXT,JOINT,W/O W CONT	$2,617.04	$3,738.62	$3,177.83–$3,630.20	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-LWR LEFT EXT,JOINT,W/O W CONT	$2,617.04	$3,738.62	$3,177.83–$3,630.20	—	30%
MRI of the abdomen without contrast CPT 74181 MRI-ABDOMEN W/O CONTRAST	$1,618.31	$2,311.86	$134.12–$2,244.82	28% above	30%
MRI of the abdomen without contrast inpatient CPT 74181 MRI-ABDOMEN W/O CONTRAST	$1,618.31	$2,311.86	$1,965.08–$2,244.82	—	30%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI-ABDOMEN W/ & W/O CONTRAST	$2,711.27	$3,873.24	$230.35–$3,760.92	39% above	30%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI-ABDOMEN W/ & W/O CONTRAST	$2,711.27	$3,873.24	$3,292.25–$3,760.92	—	30%
MRI of the brain, no contrast dye CPT 70551 MRI-BRAIN W/O CONTRAST	$1,618.31	$2,311.86	$134.37–$2,244.82	18% above	30%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI-BRAIN W/O CONTRAST	$1,618.31	$2,311.86	$1,965.08–$2,244.82	—	30%
MRI of the brain, with and without contrast dye CPT 70553 MRI-BRAIN W/ & W/O CONTRAST	$2,711.27	$3,873.24	$217.80–$3,760.92	39% above	30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI-BRAIN W/ & W/O CONTRAST	$2,711.27	$3,873.24	$3,292.25–$3,760.92	—	30%
MRI of the lower back, no contrast dye CPT 72148 MRI-LUMBAR W/O CONTRAST	$1,665.05	$2,378.64	$131.17–$2,309.66	23% above	30%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI-LUMBAR W/O CONTRAST	$1,665.05	$2,378.64	$2,021.84–$2,309.66	—	30%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI-LUMBAR W/O AND W/CONTRAST	$2,657.11	$3,795.86	$218.54–$3,685.78	39% above	30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI-LUMBAR W/O AND W/CONTRAST	$2,657.11	$3,795.86	$3,226.48–$3,685.78	—	30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI-THORACIC SPINE W/O CONTRAST	$1,618.31	$2,311.86	$130.68–$2,244.82	20% above	30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI-THORACIC SPINE W/O CONTRAST	$1,618.31	$2,311.86	$1,965.08–$2,244.82	—	30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI-CERVICAL SPINE W/O FOLL BY	$2,657.11	$3,795.86	$218.78–$3,685.78	41% above	30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI-CERVICAL SPINE W/O FOLL BY	$2,657.11	$3,795.86	$3,226.48–$3,685.78	—	30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI-CERVICAL SPINE W/O CONTRAS	$1,618.31	$2,311.86	$130.93–$2,244.82	11% above	30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI-CERVICAL SPINE W/O CONTRAS	$1,618.31	$2,311.86	$1,965.08–$2,244.82	—	30%
MRI of the pelvis without and with contrast CPT 72197 MRI-PELVIS W/ & W/O CONTRAST	$2,013.05	$2,875.78	$229.61–$2,792.38	4% above	30%
MRI of the pelvis without and with contrast CPT 72197 MRI-PROSTATE W/ & W/O CONTRAST	$2,829.25	$4,041.78	$229.61–$3,924.57	46% above	30%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI-PELVIS W/ & W/O CONTRAST	$2,013.05	$2,875.78	$2,444.41–$2,792.38	—	30%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI-PROSTATE W/ & W/O CONTRAST	$2,829.25	$4,041.78	$3,435.51–$3,924.57	—	30%
MRI of the pelvis, no contrast dye CPT 72195 MRI-PELVIS W/O CONTRAST	$1,618.31	$2,311.86	$156.03–$2,244.82	20% above	30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI-PELVIS W/O CONTRAST	$1,618.31	$2,311.86	$1,965.08–$2,244.82	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-FINGER JOINT RIGHT W/O CONTRAST	$1,039.55	$1,485.06	$138.31–$1,441.99	22% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-FINGER JOINT LEFT W/O CONTRAST	$1,039.55	$1,485.06	$138.31–$1,441.99	22% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-ELBOW RIGHT W/O CONTRAST	$1,094.45	$1,563.50	$138.31–$1,518.16	18% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-WRIST RIGHT W/O CONTRAST	$1,094.45	$1,563.50	$138.31–$1,518.16	18% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-WRIST LEFT W/O CONTRAST	$1,094.45	$1,563.50	$138.31–$1,518.16	18% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-ELBOW LEFT W/O CONTRAST	$1,094.45	$1,563.50	$138.31–$1,518.16	18% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-UPR LEFT EXT, ANY JOINT, W/O CONTR	$1,113.75	$1,591.06	$138.31–$1,544.92	17% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-UPR RIGHT EXT, ANY JOINT, W/O CONTR	$1,128.59	$1,612.26	$138.31–$1,565.50	16% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-FINGER JOINT LEFT W/O CONTRAST	$1,039.55	$1,485.06	$1,262.30–$1,441.99	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-FINGER JOINT RIGHT W/O CONTRAST	$1,039.55	$1,485.06	$1,262.30–$1,441.99	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-WRIST LEFT W/O CONTRAST	$1,094.45	$1,563.50	$1,328.98–$1,518.16	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-ELBOW LEFT W/O CONTRAST	$1,094.45	$1,563.50	$1,328.98–$1,518.16	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-ELBOW RIGHT W/O CONTRAST	$1,094.45	$1,563.50	$1,328.98–$1,518.16	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-WRIST RIGHT W/O CONTRAST	$1,094.45	$1,563.50	$1,328.98–$1,518.16	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-UPR LEFT EXT, ANY JOINT, W/O CONTR	$1,113.75	$1,591.06	$1,352.40–$1,544.92	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-UPR RIGHT EXT, ANY JOINT, W/O CONTR	$1,128.59	$1,612.26	$1,370.42–$1,565.50	—	30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE, CERVICAL (MIN 4)	$281.96	$402.80	$35.44–$391.12	1% above	30%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SPINE, CERVICAL (MIN 4)	$281.96	$402.80	$342.38–$391.12	—	30%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK W/CONTRAST	$1,493.65	$2,133.78	$126.00–$2,071.90	38% above	30%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK W/CONTRAST	$1,493.65	$2,133.78	$1,813.71–$2,071.90	—	30%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK W/O CONTRAST	$1,493.65	$2,133.78	$103.12–$2,071.90	117% above	30%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK W/O CONTRAST	$1,493.65	$2,133.78	$1,813.71–$2,071.90	—	30%
Neck soft tissue X-ray CPT 70360 NECK, SOFT TISSUE	$241.90	$345.56	$20.92–$335.54	32% above	30%
Neck soft tissue X-ray inpatient CPT 70360 NECK, SOFT TISSUE	$241.90	$345.56	$293.73–$335.54	—	30%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$1,571.56	$2,245.08	$91.30–$2,179.97	96% above	30%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST	$1,571.56	$2,245.08	$1,908.32–$2,179.97	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND PELVIS, LIMITED	$309.42	$442.02	$33.47–$429.20	at median	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND PELVIS, LIMITED	$309.42	$442.02	$375.72–$429.20	—	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULTRASOUND PELVIC	$305.71	$436.72	$69.65–$424.06	26% below	30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULTRASOUND PELVIC	$305.71	$436.72	$371.21–$424.06	—	30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND FETAL COMP =OR>14 WKS GEST	$348.74	$498.20	$90.32–$483.75	18% below	30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ULTRASOUND FETAL COMP =OR>14 WKS GEST	$348.74	$498.20	$423.47–$483.75	—	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND FETAL COMP<14WKS GEST	$298.29	$426.12	$78.75–$413.76	27% below	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND FETAL COMP<14WKS GEST	$298.29	$426.12	$362.20–$413.76	—	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND FETAL LIMITED	$298.29	$426.12	$54.14–$413.76	1% below	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND FETAL LIMITED	$298.29	$426.12	$362.20–$413.76	—	30%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS LEFT UNILATERAL	$241.90	$345.56	$24.36–$335.54	25% above	30%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS RIGHT UNILATERAL	$241.90	$345.56	$24.36–$335.54	25% above	30%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS LEFT UNILATERAL	$241.90	$345.56	$293.73–$335.54	—	30%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS RIGHT UNILATERAL	$241.90	$345.56	$293.73–$335.54	—	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS, LEFT UNI W/PA CHEST (MIN3)	$281.96	$402.80	$28.06–$391.12	22% above	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS, RIGHT UNI W/PA CHEST (MIN3)	$281.96	$402.80	$28.06–$391.12	22% above	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS, LEFT UNI W/PA CHEST (MIN3)	$281.96	$402.80	$342.38–$391.12	—	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS, RIGHT UNI W/PA CHEST (MIN3)	$281.96	$402.80	$342.38–$391.12	—	30%
Screening mammogram, both breasts CPT 77067 MAMMO DIGITAL SCR CC	$193.67	$276.66	$84.66–$268.64	33% below	30%
Screening mammogram, both breasts CPT 77067 MAMMO DIGITAL SCR BCCSP/ABC	$193.67	$276.66	$84.66–$268.64	33% below	30%
Screening mammogram, both breasts CPT 77067 CAD, SCREENING MAMMOMOGRAM	$193.67	$276.66	$84.66–$268.64	33% below	30%
Screening mammogram, both breasts CPT 77067 CAD, BCCSP OR ABC SCREENING	$193.67	$276.66	$84.66–$268.64	33% below	30%
Screening mammogram, both breasts CPT 77067 MAMMO DIGITAL SCREEN BIL	$193.67	$276.66	$84.66–$268.64	33% below	30%
Screening mammogram, both breasts one side CPT 77067 MAMMO DIGITAL SCREENING UNILATERAL RIGHT	$184.05	$262.92	$84.66–$255.30	36% below	30%
Screening mammogram, both breasts one side CPT 77067 MAMMO DIGITAL SCREENING UNILATERAL LEFT	$184.05	$262.92	$84.66–$255.30	36% below	30%
Screening mammogram, both breasts inpatient CPT 77067 CAD, SCREENING MAMMOMOGRAM	$193.67	$276.66	$235.16–$268.64	—	30%
Screening mammogram, both breasts inpatient CPT 77067 MAMMO DIGITAL SCR CC	$193.67	$276.66	$235.16–$268.64	—	30%
Screening mammogram, both breasts inpatient CPT 77067 MAMMO DIGITAL SCR BCCSP/ABC	$193.67	$276.66	$235.16–$268.64	—	30%
Screening mammogram, both breasts inpatient CPT 77067 MAMMO DIGITAL SCREEN BIL	$193.67	$276.66	$235.16–$268.64	—	30%
Screening mammogram, both breasts inpatient CPT 77067 CAD, BCCSP OR ABC SCREENING	$193.67	$276.66	$235.16–$268.64	—	30%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO DIGITAL SCREENING UNILATERAL RIGHT	$184.05	$262.92	$223.48–$255.30	—	30%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO DIGITAL SCREENING UNILATERAL LEFT	$184.05	$262.92	$223.48–$255.30	—	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER, LEFT COMP (MIN 2)	$146.92	$209.88	$23.13–$203.79	18% below	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER, RIGHT COMP (MIN 2)	$146.92	$209.88	$23.13–$203.79	18% below	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER, LEFT COMP (MIN 2)	$146.92	$209.88	$178.40–$203.79	—	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER, RIGHT COMP (MIN 2)	$146.92	$209.88	$178.40–$203.79	—	30%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES,COMPLETE 3V	$241.90	$345.56	$25.10–$335.54	10% above	30%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES,COMPLETE 3V	$241.90	$345.56	$293.73–$335.54	—	30%
Skull X-ray, fewer than 4 views CPT 70250 SKULL, AP AND LATERAL	$138.02	$197.16	$24.12–$191.44	32% below	30%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL, AP AND LATERAL	$138.02	$197.16	$167.59–$191.44	—	30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 BARIUM SWALLOW, MODIF W/VIDEO	$493.43	$704.90	$81.46–$684.46	24% above	30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNCTION W VIDEO	$493.43	$704.90	$81.46–$684.46	24% above	30%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOWING FUNCTION W VIDEO	$493.43	$704.90	$599.17–$684.46	—	30%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BARIUM SWALLOW, MODIF W/VIDEO	$493.43	$704.90	$599.17–$684.46	—	30%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR LEFT (2 VIEW)	$244.12	$348.74	$23.63–$338.63	30% above	30%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR RIGHT (2 VIEW)	$244.12	$348.74	$23.63–$338.63	30% above	30%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR RIGHT (2 VIEW)	$244.12	$348.74	$296.43–$338.63	—	30%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR LEFT (2 VIEW)	$244.12	$348.74	$296.43–$338.63	—	30%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE W/O CONT	$1,649.47	$2,356.38	$88.84–$2,288.04	99% above	30%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE W/O CONT	$1,649.47	$2,356.38	$2,002.92–$2,288.04	—	30%
Toe X-ray, 2 or more views one side CPT 73660 TOE(S) RIGHT (MIN 2)	$244.12	$348.74	$19.44–$338.63	41% above	30%
Toe X-ray, 2 or more views one side CPT 73660 TOE(S) LEFT (MIN 2)	$244.12	$348.74	$19.44–$338.63	41% above	30%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE(S) RIGHT (MIN 2)	$244.12	$348.74	$296.43–$338.63	—	30%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE(S) LEFT (MIN 2)	$244.12	$348.74	$296.43–$338.63	—	30%
Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND TRANSVAG - NON OBSTERIC	$306.45	$437.78	$79.00–$425.08	24% below	30%
Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND TRANSVAG - NON OBSTERIC	$306.45	$437.78	$372.11–$425.08	—	30%
Transvaginal ultrasound during pregnancy CPT 76817 ULTRASOUND FETAL AGE TRANSVAG	$186.99	$267.12	$62.02–$259.37	35% below	30%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 ULTRASOUND FETAL AGE TRANSVAG	$186.99	$267.12	$227.05–$259.37	—	30%
Ultrasound of the abdomen, complete CPT 76700 ULTRASOUND ABDOMEN COMPLETE	$515.69	$736.70	$77.52–$715.34	17% above	30%
Ultrasound of the abdomen, complete inpatient CPT 76700 ULTRASOUND ABDOMEN COMPLETE	$515.69	$736.70	$626.20–$715.34	—	30%
Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND TESTES	$298.29	$426.12	$66.20–$413.76	21% below	30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 ULTRASOUND TESTES	$298.29	$426.12	$362.20–$413.76	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND THYROID, SFT TISSUE HEAD/NECK	$298.29	$426.12	$72.60–$413.76	19% below	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND THYROID, SFT TISSUE HEAD/NECK	$298.29	$426.12	$362.20–$413.76	—	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS LEFT (MIN 2 VIEWS)	$244.12	$348.74	$21.16–$338.63	35% above	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS RIGHT (MIN 2 VIEWS)	$244.12	$348.74	$21.16–$338.63	35% above	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS RIGHT (MIN 2 VIEWS)	$244.12	$348.74	$296.43–$338.63	—	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS LEFT (MIN 2 VIEWS)	$244.12	$348.74	$296.43–$338.63	—	30%
Wrist X-ray, 2 views one side CPT 73100 WRIST RIGHT 2 VIEWS	$244.12	$348.74	$22.40–$338.63	53% above	30%
Wrist X-ray, 2 views one side CPT 73100 WRIST LEFT 2 VIEWS	$244.12	$348.74	$22.40–$338.63	53% above	30%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST LEFT 2 VIEWS	$244.12	$348.74	$296.43–$338.63	—	30%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST RIGHT 2 VIEWS	$244.12	$348.74	$296.43–$338.63	—	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST, LEFT COMP (MIN 3)	$244.12	$348.74	$27.32–$338.63	38% above	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST, RIGHT COMP (MIN 3)	$244.12	$348.74	$27.32–$338.63	38% above	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST, RIGHT COMP (MIN 3)	$244.12	$348.74	$296.43–$338.63	—	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST, LEFT COMP (MIN 3)	$244.12	$348.74	$296.43–$338.63	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP/PELVIS (INFANT/CH) (MIN2)	$244.12	$348.74	$31.50–$338.63	29% above	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP RIGHT AP & LAT (MIN 2)	$244.12	$348.74	$31.50–$338.63	29% above	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP LEFT AP & LAT (MIN 2)	$244.12	$348.74	$31.50–$338.63	29% above	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP/PELVIS (INFANT/CH) (MIN2)	$244.12	$348.74	$296.43–$338.63	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP LEFT AP & LAT (MIN 2)	$244.12	$348.74	$296.43–$338.63	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP RIGHT AP & LAT (MIN 2)	$244.12	$348.74	$296.43–$338.63	—	30%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN, SINGLE AP (KUB)	$241.90	$345.56	$20.18–$335.54	31% above	30%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN, FLAT	$241.90	$345.56	$20.18–$335.54	31% above	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN, FLAT	$241.90	$345.56	$293.73–$335.54	—	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN, SINGLE AP (KUB)	$241.90	$345.56	$293.73–$335.54	—	30%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE LEFT 2 VIEWS	$244.12	$348.74	$21.41–$338.63	38% above	30%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE RIGHT 2 VIEWS	$244.12	$348.74	$21.41–$338.63	38% above	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE RIGHT 2 VIEWS	$244.12	$348.74	$296.43–$338.63	—	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE LEFT 2 VIEWS	$244.12	$348.74	$296.43–$338.63	—	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER LEFT (MIN 2)	$244.12	$348.74	$25.10–$338.63	38% above	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER RIGHT (MIN 2)	$244.12	$348.74	$25.10–$338.63	38% above	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER RIGHT (MIN 2)	$244.12	$348.74	$296.43–$338.63	—	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER LEFT (MIN 2)	$244.12	$348.74	$296.43–$338.63	—	30%
X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT 2 VIEW	$241.90	$345.56	$19.20–$335.54	51% above	30%
X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT 2 VIEW	$241.90	$345.56	$19.20–$335.54	51% above	30%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RIGHT 2 VIEW	$241.90	$345.56	$293.73–$335.54	—	30%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LEFT 2 VIEW	$241.90	$345.56	$293.73–$335.54	—	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT,LEFT COMP (MIN 3)	$241.90	$345.56	$22.64–$335.54	36% above	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT,RIGHT COMP (MIN 3)	$241.90	$345.56	$22.64–$335.54	36% above	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT,RIGHT COMP (MIN 3)	$241.90	$345.56	$293.73–$335.54	—	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT,LEFT COMP (MIN 3)	$241.90	$345.56	$293.73–$335.54	—	30%
X-ray of the hand, 3 or more views one side CPT 73130 HAND LEFT (MIN 3)	$244.12	$348.74	$24.61–$338.63	34% above	30%
X-ray of the hand, 3 or more views one side CPT 73130 HAND RIGHT (MIN 3)	$244.12	$348.74	$24.61–$338.63	34% above	30%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND LEFT (MIN 3)	$244.12	$348.74	$296.43–$338.63	—	30%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND RIGHT (MIN 3)	$244.12	$348.74	$296.43–$338.63	—	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RIGHT (1-2 VIEW)	$244.12	$348.74	$22.64–$338.63	35% above	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LEFT (1-2 VIEW)	$244.12	$348.74	$22.64–$338.63	35% above	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE RIGHT (1-2 VIEW)	$244.12	$348.74	$296.43–$338.63	—	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LEFT (1-2 VIEW)	$244.12	$348.74	$296.43–$338.63	—	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE, LUMBOSCARAL (2-3)	$281.96	$402.80	$26.58–$391.12	30% above	30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE, LUMBOSCARAL (2-3)	$281.96	$402.80	$342.38–$391.12	—	30%
X-ray of the lower back, 4 or more views CPT 72110 SPINE, LUMBOSAC (MIN 4)	$281.96	$402.80	$34.21–$391.12	at median	30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE, LUMBOSAC (MIN 4)	$281.96	$402.80	$342.38–$391.12	—	30%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES, COMP (MIN 3)	$241.90	$345.56	$24.86–$335.54	30% above	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES, COMP (MIN 3)	$241.90	$345.56	$293.73–$335.54	—	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE, CERVICAL AP/LAT 2-3	$241.90	$345.56	$26.33–$335.54	24% above	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE, CERVICAL AP/LAT 2-3	$241.90	$345.56	$293.73–$335.54	—	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS (1-2)	$281.96	$402.80	$18.70–$391.12	43% above	30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS (1-2)	$281.96	$402.80	$342.38–$391.12	—	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX (MIN 2)	$117.24	$167.48	$21.66–$162.62	35% below	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX (MIN 2)	$117.24	$167.48	$142.36–$162.62	—	30%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
ACTH blood test CPT 82024 ACTH ADRENOCORTICOTROPHIC HOR	$281.22	$401.74	$279.61–$390.09	50% above	30%
ACTH blood test inpatient CPT 82024 ACTH ADRENOCORTICOTROPHIC HOR	$281.22	$401.74	$341.48–$390.09	—	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$35.62	$50.88	$35.41–$49.40	23% above	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 NASH/HCV FIBROSURE ADDL CPT 84460	$38.59	$55.12	$38.36–$53.52	33% above	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT)	$35.62	$50.88	$43.25–$49.40	—	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 NASH/HCV FIBROSURE ADDL CPT 84460	$38.59	$55.12	$46.85–$53.52	—	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT)	$35.62	$50.88	$35.41–$49.40	17% above	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 NASH FIBROSURE ADDL CPT 84450	$38.59	$55.12	$38.36–$53.52	27% above	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT)	$35.62	$50.88	$43.25–$49.40	—	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 NASH FIBROSURE ADDL CPT 84450	$38.59	$55.12	$46.85–$53.52	—	30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$166.95	$238.50	$166.00–$231.58	24% below	30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$166.95	$238.50	$202.73–$231.58	—	30%
Albumin blood test CPT 82040 ALBUMIN SERUM	$31.17	$44.52	$30.99–$43.23	73% above	30%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$31.17	$44.52	$37.84–$43.23	—	30%
Aldosterone blood test CPT 82088 ALDOSTERONE, SERUM	$89.79	$128.26	$89.27–$124.54	144% above	30%
Aldosterone blood test CPT 82088 ALDOSTERONE, 24HR URINE	$265.64	$379.48	$264.12–$368.48	623% above	30%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE, SERUM	$89.79	$128.26	$109.02–$124.54	—	30%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE, 24HR URINE	$265.64	$379.48	$322.56–$368.48	—	30%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE ISOENZYME 84075	$26.72	$38.16	$26.56–$37.05	29% above	30%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$31.17	$44.52	$30.99–$43.23	50% above	30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE ISOENZYME 84075	$26.72	$38.16	$32.44–$37.05	—	30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$31.17	$44.52	$37.84–$43.23	—	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #3	$13.36	$19.08	$13.28–$18.53	22% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003#30	$23.75	$33.92	$23.61–$32.94	39% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003#29	$23.75	$33.92	$23.61–$32.94	39% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003#28	$23.75	$33.92	$23.61–$32.94	39% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #10	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #8	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #7	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #6	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #5	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #11	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #9	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #13	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #4	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #2	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #12	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #15	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003#27	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #20	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #14	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003#21	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #19	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #18	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #17	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003 #16	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003#22	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003#23	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003#24	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003#25	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN- ADDL CPT 86003#26	$24.49	$34.98	$24.35–$33.97	43% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 SUGAR CANE, IGE ALLERGEN	$25.23	$36.04	$25.08–$34.99	47% above	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #3	$13.36	$19.08	$16.22–$18.53	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003#28	$23.75	$33.92	$28.83–$32.94	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003#30	$23.75	$33.92	$28.83–$32.94	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003#29	$23.75	$33.92	$28.83–$32.94	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #11	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003#21	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003#22	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003#23	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003#24	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003#25	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003#26	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003#27	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #2	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #4	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #5	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #6	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #7	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #8	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #9	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #10	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #12	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #16	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #13	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #14	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #15	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #20	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #19	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #18	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN- ADDL CPT 86003 #17	$24.49	$34.98	$29.73–$33.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SUGAR CANE, IGE ALLERGEN	$25.23	$36.04	$30.63–$34.99	—	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP TETRA INDIVIDUAL	$31.17	$44.52	$30.99–$43.23	59% below	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP EXTRA ADDL CPT 82105	$31.17	$44.52	$30.99–$43.23	59% below	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETO.(TUMOR MARKER)	$86.82	$124.02	$86.32–$120.42	14% above	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETO-PROTEIN, MATERNAL	$106.11	$151.58	$105.50–$147.18	40% above	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP EXTRA ADDL CPT 82105	$31.17	$44.52	$37.84–$43.23	—	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP TETRA INDIVIDUAL	$31.17	$44.52	$37.84–$43.23	—	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETO.(TUMOR MARKER)	$86.82	$124.02	$105.42–$120.42	—	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETO-PROTEIN, MATERNAL	$106.11	$151.58	$128.84–$147.18	—	30%
Ammonia blood test CPT 82140 AMMONIA	$65.30	$93.28	$64.92–$90.57	42% above	30%
Ammonia blood test inpatient CPT 82140 AMMONIA	$65.30	$93.28	$79.29–$90.57	—	30%
Amylase blood test CPT 82150 AMYLASE, SERUM OR URINE	$47.49	$67.84	$47.22–$65.87	23% above	30%
Amylase blood test inpatient CPT 82150 AMYLASE, SERUM OR URINE	$47.49	$67.84	$57.66–$65.87	—	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEP (CCP)	$43.04	$61.48	$42.79–$59.70	2% above	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEP (CCP)	$43.04	$61.48	$52.26–$59.70	—	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY (ANA)-DIRECT	$36.36	$51.94	$36.15–$50.43	40% below	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CENTRAMERE B ANTIBODY	$36.36	$51.94	$36.15–$50.43	40% below	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY (ANA)	$94.98	$135.68	$94.43–$131.75	56% above	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY (ANA)-DIRECT	$36.36	$51.94	$44.15–$50.43	—	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CENTRAMERE B ANTIBODY	$36.36	$51.94	$44.15–$50.43	—	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY (ANA)	$94.98	$135.68	$115.33–$131.75	—	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$117.24	$167.48	$116.57–$162.62	2% below	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$117.24	$167.48	$142.36–$162.62	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, B. PERTUSSIS NASOPHAR	$10.39	$14.84	$10.33–$14.41	80% below	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, GENITAL	$63.07	$90.10	$62.71–$87.49	23% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, ROUTINE	$66.78	$95.40	$66.40–$92.63	30% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, B. PERTUSSIS NASOPHAR	$10.39	$14.84	$12.61–$14.41	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, GENITAL	$63.07	$90.10	$76.59–$87.49	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, ROUTINE	$66.78	$95.40	$81.09–$92.63	—	30%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$69.75	$99.64	$69.35–$96.75	29% above	30%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$69.75	$99.64	$84.69–$96.75	—	30%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$33.39	$47.70	$33.20–$46.32	36% above	30%
Bilirubin blood test, total CPT 82247 NASH/HCV FIBROSURE ADDL CPT 82247	$38.59	$55.12	$38.36–$53.52	58% above	30%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$33.39	$47.70	$40.55–$46.32	—	30%
Bilirubin blood test, total inpatient CPT 82247 NASH/HCV FIBROSURE ADDL CPT 82247	$38.59	$55.12	$46.85–$53.52	—	30%
Blood culture for bacteria CPT 87040 CULTURE, BLOOD BR	$71.24	$101.76	$70.82–$98.81	4% below	30%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BLOOD BR	$71.24	$101.76	$86.50–$98.81	—	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION FEE	$12.62	$18.02	$12.54–$17.50	20% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE (BFC)	$14.84	$21.20	$14.76–$20.59	41% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$14.84	$21.20	$14.76–$20.59	41% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION FEE(DRUG SCREEN)	$17.81	$25.44	$17.71–$24.70	70% above	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION FEE	$12.62	$18.02	$15.32–$17.50	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE (BFC)	$14.84	$21.20	$18.02–$20.59	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$14.84	$21.20	$18.02–$20.59	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION FEE(DRUG SCREEN)	$17.81	$25.44	$21.62–$24.70	—	30%
Blood glucose (sugar) test CPT 82947 DLA GLUCOSE	$7.00	$10.00	$6.96–$9.71	70% below	30%
Blood glucose (sugar) test CPT 82947 GLUCOSE; SERUM OR PLASMA	$33.39	$47.70	$33.20–$46.32	45% above	30%
Blood glucose (sugar) test CPT 82947 NASH FIBROSURE ADDL CPT 82947	$38.59	$55.12	$38.36–$53.52	68% above	30%
Blood glucose (sugar) test inpatient CPT 82947 DLA GLUCOSE	$7.00	$10.00	$8.50–$9.71	—	30%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE; SERUM OR PLASMA	$33.39	$47.70	$40.55–$46.32	—	30%
Blood glucose (sugar) test inpatient CPT 82947 NASH FIBROSURE ADDL CPT 82947	$38.59	$55.12	$46.85–$53.52	—	30%
Blood lead test CPT 83655 LEAD	$57.14	$81.62	$56.81–$79.25	59% above	30%
Blood lead test CPT 83655 HEAVY METAL ADDL CPT 83655	$81.62	$116.60	$81.15–$113.22	127% above	30%
Blood lead test inpatient CPT 83655 LEAD	$57.14	$81.62	$69.38–$79.25	—	30%
Blood lead test inpatient CPT 83655 HEAVY METAL ADDL CPT 83655	$81.62	$116.60	$99.11–$113.22	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY,HCG SERUM,QUAL	$31.91	$45.58	$31.72–$44.26	23% below	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY,HCG SERUM,QUAL	$31.91	$45.58	$38.74–$44.26	—	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE (ABO)	$113.53	$162.18	$112.88–$157.48	178% above	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ARC-ABO TYPE	$113.53	$162.18	$112.88–$157.48	178% above	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE(ABO) (CROSSMATCH RELATED)	$113.53	$162.18	$112.88–$157.48	178% above	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 RHOGAM STUDIES 86900	$113.53	$162.18	$112.88–$157.48	178% above	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE (ABO)	$113.53	$162.18	$137.85–$157.48	—	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE(ABO) (CROSSMATCH RELATED)	$113.53	$162.18	$137.85–$157.48	—	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 RHOGAM STUDIES 86900	$113.53	$162.18	$137.85–$157.48	—	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ARC-ABO TYPE	$113.53	$162.18	$137.85–$157.48	—	30%
Blood urea nitrogen (BUN) test CPT 84520 BUN,QUANT	$34.14	$48.76	$33.94–$47.35	24% above	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN,QUANT	$34.14	$48.76	$41.45–$47.35	—	30%
C-peptide blood test CPT 84681 C-PEPTIDE	$68.27	$97.52	$67.87–$94.69	7% below	30%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$68.27	$97.52	$82.89–$94.69	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HEALTH FAIR CRP	$7.42	$10.60	$7.38–$10.29	76% below	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN-INFLAM QUAN	$45.27	$64.66	$45.00–$62.78	48% above	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HEALTH FAIR CRP	$7.42	$10.60	$9.01–$10.29	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN-INFLAM QUAN	$45.27	$64.66	$54.96–$62.78	—	30%
C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFFICILE TOXIN (PCR) W/REFLEX TOXIN	$89.04	$127.20	$88.53–$123.51	22% below	30%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. DIFFICILE TOXIN (PCR) W/REFLEX TOXIN	$89.04	$127.20	$108.12–$123.51	—	30%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19.9	$68.27	$97.52	$67.87–$94.69	18% below	30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19.9	$68.27	$97.52	$82.89–$94.69	—	30%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$101.66	$145.22	$101.07–$141.01	5% below	30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125	$101.66	$145.22	$123.44–$141.01	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 (COVID-19 AMP) PCR	$98.69	$140.98	$98.12–$136.89	8% below	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 (COVID-19 AMP) PCR	$98.69	$140.98	$119.83–$136.89	—	30%
Calcium blood test, total CPT 82310 CALCIUM SERUM	$30.43	$43.46	$30.25–$42.20	21% above	30%
Calcium blood test, total inpatient CPT 82310 CALCIUM SERUM	$30.43	$43.46	$36.94–$42.20	—	30%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$69.75	$99.64	$69.35–$96.75	33% below	30%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$69.75	$99.64	$84.69–$96.75	—	30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA,IGG	$35.62	$50.88	$35.41–$49.40	7% below	30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGM	$41.56	$59.36	$41.31–$57.64	9% above	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA,IGG	$35.62	$50.88	$43.25–$49.40	—	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGM	$41.56	$59.36	$50.46–$57.64	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS, URINE OR SWAB	$31.17	$44.52	$30.99–$43.23	45% below	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA ANTIGEN	$78.66	$112.36	$78.20–$109.10	39% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS, URINE OR SWAB	$31.17	$44.52	$37.84–$43.23	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA ANTIGEN	$78.66	$112.36	$95.51–$109.10	—	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 DLA LIPID PANEL	$10.50	$15.00	$10.44–$14.57	83% below	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$86.08	$122.96	$85.58–$119.39	38% above	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 DLA LIPID PANEL	$10.50	$15.00	$12.75–$14.57	—	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$86.08	$122.96	$104.52–$119.39	—	30%
Complete blood count (CBC) with differential CPT 85025 DLA CBC W/AUTOMATED DIFF	$7.00	$10.00	$6.96–$9.71	83% below	30%
Complete blood count (CBC) with differential CPT 85025 HEALTH FAIR CBC	$12.62	$18.02	$12.54–$17.50	70% below	30%
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTOMATED DIFFERENTIAL	$39.33	$56.18	$39.10–$54.55	5% below	30%
Complete blood count (CBC) with differential inpatient CPT 85025 DLA CBC W/AUTOMATED DIFF	$7.00	$10.00	$8.50–$9.71	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 HEALTH FAIR CBC	$12.62	$18.02	$15.32–$17.50	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTOMATED DIFFERENTIAL	$39.33	$56.18	$47.75–$54.55	—	30%
Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFF	$34.14	$48.76	$33.94–$47.35	3% below	30%
Complete blood count (CBC), no differential CPT 85027 CBC W/MAN DIFF ADDL CPT 85027	$34.88	$49.82	$34.67–$48.38	1% below	30%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITHOUT DIFF	$34.14	$48.76	$41.45–$47.35	—	30%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/MAN DIFF ADDL CPT 85027	$34.88	$49.82	$42.35–$48.38	—	30%
Comprehensive metabolic panel (blood test) CPT 80053 HEALTH FAIR CHEMISTRY PANEL	$13.36	$19.08	$13.28–$18.53	73% below	30%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$90.53	$129.32	$90.01–$125.57	85% above	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HEALTH FAIR CHEMISTRY PANEL	$13.36	$19.08	$16.22–$18.53	—	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$90.53	$129.32	$109.92–$125.57	—	30%
Cortisol blood test, total CPT 82533 CORTISOL, SALIVA	$51.94	$74.20	$51.64–$72.05	12% below	30%
Cortisol blood test, total CPT 82533 CORTISOL SERUM,TOTAL	$77.91	$111.30	$77.46–$108.07	31% above	30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL, SALIVA	$51.94	$74.20	$63.07–$72.05	—	30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL SERUM,TOTAL	$77.91	$111.30	$94.61–$108.07	—	30%
Creatine kinase (CK) blood test, total CPT 82550 CPK ISOENZYMES CPT 82550	$21.52	$30.74	$21.40–$29.85	51% below	30%
Creatine kinase (CK) blood test, total CPT 82550 CPK SERUM	$47.49	$67.84	$47.22–$65.87	9% above	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK ISOENZYMES CPT 82550	$21.52	$30.74	$26.13–$29.85	—	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK SERUM	$47.49	$67.84	$57.66–$65.87	—	30%
Creatinine blood test CPT 82565 CREATININE SERUM	$34.14	$48.76	$33.94–$47.35	16% above	30%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM	$34.14	$48.76	$41.45–$47.35	—	30%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS, CMV AB IGG	$20.04	$28.62	$19.92–$27.79	60% below	30%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG & IGM ADDL CPT 86644	$21.52	$30.74	$21.40–$29.85	57% below	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS, CMV AB IGG	$20.04	$28.62	$24.33–$27.79	—	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG & IGM ADDL CPT 86644	$21.52	$30.74	$26.13–$29.85	—	30%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER,QUANT	$42.30	$60.42	$42.05–$58.67	34% below	30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER,QUANT	$42.30	$60.42	$51.36–$58.67	—	30%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$60.11	$85.86	$59.76–$83.37	35% below	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$60.11	$85.86	$72.98–$83.37	—	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREENING ACHC ONLY	$25.97	$37.10	$25.82–$36.02	15% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DLA DRUG ABUSE SCREEN	$31.50	$45.00	$31.32–$43.70	4% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PROPOXYPHENE (DARVON) URINE CONF	$60.85	$86.92	$60.50–$84.40	100% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN, TOXASSURE SELECT 19 (80307)	$66.78	$95.40	$66.40–$92.63	120% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 MEDPRO PANEL 11 DRUGS -#764888	$98.69	$140.98	$98.12–$136.89	225% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BUPRENORPHINE, SCR WITH CONFIRMATION	$112.05	$160.06	$111.40–$155.42	269% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TOXASSURE COMP TOX SCR PRESUMP 80307	$112.05	$160.06	$111.40–$155.42	269% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL, URINE SCREEN	$117.98	$168.54	$117.30–$163.65	288% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 METHYLPHENIDATE, URINE SCREEN	$235.96	$337.08	$234.61–$327.30	677% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 8 PANEL DRUG SCR W/ETOH /REFLEX(700889)	$235.96	$337.08	$234.61–$327.30	677% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 10 PANEL DRUG SCREEN/REFLEX, BLOOD	$275.29	$393.26	$273.71–$381.86	806% above	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREENING ACHC ONLY	$25.97	$37.10	$31.54–$36.02	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DLA DRUG ABUSE SCREEN	$31.50	$45.00	$38.25–$43.70	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PROPOXYPHENE (DARVON) URINE CONF	$60.85	$86.92	$73.88–$84.40	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN, TOXASSURE SELECT 19 (80307)	$66.78	$95.40	$81.09–$92.63	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MEDPRO PANEL 11 DRUGS -#764888	$98.69	$140.98	$119.83–$136.89	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BUPRENORPHINE, SCR WITH CONFIRMATION	$112.05	$160.06	$136.05–$155.42	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TOXASSURE COMP TOX SCR PRESUMP 80307	$112.05	$160.06	$136.05–$155.42	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL, URINE SCREEN	$117.98	$168.54	$143.26–$163.65	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 METHYLPHENIDATE, URINE SCREEN	$235.96	$337.08	$286.52–$327.30	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 8 PANEL DRUG SCR W/ETOH /REFLEX(700889)	$235.96	$337.08	$286.52–$327.30	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 10 PANEL DRUG SCREEN/REFLEX, BLOOD	$275.29	$393.26	$334.27–$381.86	—	30%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$66.78	$95.40	$66.40–$92.63	105% above	30%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$66.78	$95.40	$81.09–$92.63	—	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN AB ADDL CPT 86665 #2	$31.91	$45.58	$31.72–$44.26	47% below	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN AB ADDL CPT 86665	$31.91	$45.58	$31.72–$44.26	47% below	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV-VCA, IGM	$61.59	$87.98	$61.23–$85.43	1% above	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN AB ADDL CPT 86665 #2	$31.91	$45.58	$38.74–$44.26	—	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN AB ADDL CPT 86665	$31.91	$45.58	$38.74–$44.26	—	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV-VCA, IGM	$61.59	$87.98	$74.78–$85.43	—	30%
Estradiol blood test CPT 82670 ESTRADIOL, TOTAL	$89.04	$127.20	$88.53–$123.51	4% above	30%
Estradiol blood test inpatient CPT 82670 ESTRADIOL, TOTAL	$89.04	$127.20	$108.12–$123.51	—	30%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$151.37	$216.24	$150.50–$209.97	80% above	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE	$151.37	$216.24	$183.80–$209.97	—	30%
Fecal calprotectin (stool inflammation test) CPT 83993 FECAL CALPROTECTIN	$195.89	$279.84	$194.77–$271.72	117% above	30%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 FECAL CALPROTECTIN	$195.89	$279.84	$237.86–$271.72	—	30%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$120.21	$171.72	$119.52–$166.74	71% above	30%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$120.21	$171.72	$145.96–$166.74	—	30%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$44.52	$63.60	$44.27–$61.76	13% below	30%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$44.52	$63.60	$54.06–$61.76	—	30%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$87.56	$125.08	$87.06–$121.45	24% above	30%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$87.56	$125.08	$106.32–$121.45	—	30%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$69.75	$99.64	$69.35–$96.75	24% below	30%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$69.75	$99.64	$84.69–$96.75	—	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, FREE	$65.30	$93.28	$64.92–$90.57	13% above	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4, FREE	$65.30	$93.28	$79.29–$90.57	—	30%
Free testosterone test CPT 84402 TESTOSTERONE,FREE	$67.53	$96.46	$67.14–$93.66	4% below	30%
Free testosterone test CPT 84402 TESTOSTERONE FREE AND TOTAL COMPONENT	$126.14	$180.20	$125.42–$174.97	79% above	30%
Free testosterone test inpatient CPT 84402 TESTOSTERONE,FREE	$67.53	$96.46	$81.99–$93.66	—	30%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE AND TOTAL COMPONENT	$126.14	$180.20	$153.17–$174.97	—	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 NASHHCV FIBROSURE ADDL CPT 82977	$38.59	$55.12	$38.36–$53.52	12% above	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$53.43	$76.32	$53.12–$74.11	55% above	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 NASHHCV FIBROSURE ADDL CPT 82977	$38.59	$55.12	$46.85–$53.52	—	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$53.43	$76.32	$64.87–$74.11	—	30%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL CHARGE	$226.31	$323.30	$225.02–$313.92	1% below	30%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL CHARGE	$226.31	$323.30	$274.81–$313.92	—	30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE ONE HOUR	$34.14	$48.76	$33.94–$47.35	2% above	30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE ONE HOUR	$34.14	$48.76	$41.45–$47.35	—	30%
Glucose tolerance test, 3 samples CPT 82951 2 HR GLUCOSE TOLERANCE TEST	$66.78	$95.40	$66.40–$92.63	3% above	30%
Glucose tolerance test, 3 samples CPT 82951 GTT ADDL CPT 82951	$69.75	$99.64	$69.35–$96.75	7% above	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 2 HR GLUCOSE TOLERANCE TEST	$66.78	$95.40	$81.09–$92.63	—	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT ADDL CPT 82951	$69.75	$99.64	$84.69–$96.75	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/CHLAMY ADDL CPT 87591 (BH)	$77.91	$111.30	$77.46–$108.07	28% above	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/CHLAMY ADDL CPT 87591 (DM)	$96.60	$138.00	$96.05–$134.00	59% above	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC/CHLAMY ADDL CPT 87591 (BH)	$77.91	$111.30	$94.61–$108.07	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC/CHLAMY ADDL CPT 87591 (DM)	$96.60	$138.00	$117.30–$134.00	—	30%
H. pylori antibody blood test CPT 86677 H PYLORI AB IGA	$60.11	$85.86	$59.76–$83.37	13% above	30%
H. pylori antibody blood test CPT 86677 H PYLORI AB IGM	$60.11	$85.86	$59.76–$83.37	13% above	30%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI IGG	$65.30	$93.28	$64.92–$90.57	23% above	30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB IGA	$60.11	$85.86	$72.98–$83.37	—	30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB IGM	$60.11	$85.86	$72.98–$83.37	—	30%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI IGG	$65.30	$93.28	$79.29–$90.57	—	30%
H. pylori stool antigen test CPT 87338 H PYLORI ANTIGEN -STOOL	$48.98	$69.96	$48.69–$67.93	17% below	30%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI ANTIGEN -STOOL	$48.98	$69.96	$59.47–$67.93	—	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV, PCR, QUANT	$121.69	$173.84	$120.99–$168.80	52% below	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV, PCR, QUANT	$121.69	$173.84	$147.76–$168.80	—	30%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/2 ABS W/ RFLX	$77.91	$111.30	$77.46–$108.07	23% above	30%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1/2 ABS W/ RFLX	$77.91	$111.30	$94.61–$108.07	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV AG/AB 4TH GEN, W/REFLEX	$43.04	$61.48	$42.79–$59.70	32% below	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4TH GEN, REFLEX DIFF	$66.78	$95.40	$66.40–$92.63	5% above	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4TH GEN, REFLEX AMPLIFICATION	$79.40	$113.42	$78.94–$110.13	25% above	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV AG/AB 4TH GEN, W/REFLEX	$43.04	$61.48	$52.26–$59.70	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 4TH GEN, REFLEX DIFF	$66.78	$95.40	$81.09–$92.63	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 4TH GEN, REFLEX AMPLIFICATION	$79.40	$113.42	$96.41–$110.13	—	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 PAP HPV HR CPT 87624	$45.27	$64.66	$45.00–$62.78	29% below	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HSV HIGH RISK REFLEX 87624	$51.20	$73.14	$50.91–$71.02	20% below	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HSV HIGH RISK REFLEX 87624#2	$51.20	$73.14	$50.91–$71.02	20% below	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK REFLEX TEST #198300	$60.11	$85.86	$59.76–$83.37	6% below	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 PAP HPV HR CPT 87624	$45.27	$64.66	$54.96–$62.78	—	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HSV HIGH RISK REFLEX 87624	$51.20	$73.14	$62.17–$71.02	—	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HSV HIGH RISK REFLEX 87624#2	$51.20	$73.14	$62.17–$71.02	—	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK REFLEX TEST #198300	$60.11	$85.86	$72.98–$83.37	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 DLA HEMOGLOBIN A1C	$10.50	$15.00	$10.44–$14.57	79% below	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEALTH FAIR HEMOGLOBIN A1C	$14.84	$21.20	$14.76–$20.59	70% below	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN (GHB), TOTAL	$46.75	$66.78	$46.48–$64.84	6% below	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$66.04	$94.34	$65.66–$91.60	32% above	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 DLA HEMOGLOBIN A1C	$10.50	$15.00	$12.75–$14.57	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEALTH FAIR HEMOGLOBIN A1C	$14.84	$21.20	$18.02–$20.59	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOHEMOGLOBIN (GHB), TOTAL	$46.75	$66.78	$56.76–$64.84	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$66.04	$94.34	$80.19–$91.60	—	30%
Hemoglobin blood test CPT 85018 H & H CPT 85018 only	$14.84	$21.20	$14.76–$20.59	6% above	30%
Hemoglobin blood test inpatient CPT 85018 H & H CPT 85018 only	$14.84	$21.20	$18.02–$20.59	—	30%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE IGG/IGM TOTAL	$92.01	$131.44	$91.48–$127.63	84% above	30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE IGG/IGM TOTAL	$92.01	$131.44	$111.72–$127.63	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$62.33	$89.04	$61.97–$86.46	31% above	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY	$62.33	$89.04	$75.68–$86.46	—	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$105.37	$150.52	$104.76–$146.15	203% above	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$105.37	$150.52	$127.94–$146.15	—	30%
Hepatitis C antibody blood test (screening) CPT 86803 HCV AB W/RFLX TO RIBA	$45.27	$64.66	$45.00–$62.78	23% below	30%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB	$54.91	$78.44	$54.59–$76.17	6% below	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV AB W/RFLX TO RIBA	$45.27	$64.66	$54.96–$62.78	—	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB	$54.91	$78.44	$66.67–$76.17	—	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C,RNA BY PCR W/REFEX TO GENOTY	$87.56	$125.08	$87.06–$121.45	56% below	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV ,RNA BY PCR,QUANT	$156.57	$223.66	$155.67–$217.17	22% below	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C,RNA BY PCR W/REFEX TO GENOTY	$87.56	$125.08	$106.32–$121.45	—	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV ,RNA BY PCR,QUANT	$156.57	$223.66	$190.11–$217.17	—	30%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1/2 SPECIFIC IGG CPT 86695	$20.04	$28.62	$19.92–$27.79	54% below	30%
Herpes blood test, HSV-1 antibody CPT 86695 HSV I/II TYPE SPECIFIC	$46.75	$66.78	$46.48–$64.84	7% above	30%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE I & II IGM CPT 86695	$59.36	$84.80	$59.02–$82.34	36% above	30%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE I ANTIBODIES, IGM	$71.24	$101.76	$70.82–$98.81	63% above	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1/2 SPECIFIC IGG CPT 86695	$20.04	$28.62	$24.33–$27.79	—	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV I/II TYPE SPECIFIC	$46.75	$66.78	$56.76–$64.84	—	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE I & II IGM CPT 86695	$59.36	$84.80	$72.08–$82.34	—	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE I ANTIBODIES, IGM	$71.24	$101.76	$86.50–$98.81	—	30%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 1/2 SPECIFIC IGG CPT 86696	$20.04	$28.62	$19.92–$27.79	58% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2-SPECIFIC ANTIBODIES, IgG	$39.33	$56.18	$39.10–$54.55	18% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX VIRUS I/II IGG ADDL CPT	$45.27	$64.66	$45.00–$62.78	6% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 SPECIFIC AB IGG	$54.91	$78.44	$54.59–$76.17	14% above	30%
Herpes blood test, HSV-2 antibody CPT 86696 HSV I/II SPECIFIC ADD CPT86696	$55.65	$79.50	$55.33–$77.19	16% above	30%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE I & II IGM CPT 86696	$59.36	$84.80	$59.02–$82.34	24% above	30%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES AB 1&2 IGM AD CPT 86696	$79.40	$113.42	$78.94–$110.13	65% above	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 1/2 SPECIFIC IGG CPT 86696	$20.04	$28.62	$24.33–$27.79	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2-SPECIFIC ANTIBODIES, IgG	$39.33	$56.18	$47.75–$54.55	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX VIRUS I/II IGG ADDL CPT	$45.27	$64.66	$54.96–$62.78	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 SPECIFIC AB IGG	$54.91	$78.44	$66.67–$76.17	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV I/II SPECIFIC ADD CPT86696	$55.65	$79.50	$67.58–$77.19	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE I & II IGM CPT 86696	$59.36	$84.80	$72.08–$82.34	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES AB 1&2 IGM AD CPT 86696	$79.40	$113.42	$96.41–$110.13	—	30%
High-sensitivity CRP (hs-CRP) test CPT 86141 C REACTIVE PROTEIN (HS)CARDIAC	$69.01	$98.58	$68.61–$95.72	12% above	30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C REACTIVE PROTEIN (HS)CARDIAC	$69.01	$98.58	$83.79–$95.72	—	30%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$65.30	$93.28	$64.92–$90.57	26% below	30%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$65.30	$93.28	$79.29–$90.57	—	30%
Insulin blood test CPT 83525 INSULIN,TOTAL	$101.66	$145.22	$101.07–$141.01	83% above	30%
Insulin blood test inpatient CPT 83525 INSULIN,TOTAL	$101.66	$145.22	$123.44–$141.01	—	30%
Iron blood test (serum iron) CPT 83540 IRON TOTAL	$34.14	$48.76	$33.94–$47.35	19% below	30%
Iron blood test (serum iron) inpatient CPT 83540 IRON TOTAL	$34.14	$48.76	$41.45–$47.35	—	30%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY CPT 83550	$34.14	$48.76	$33.94–$47.35	23% below	30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY CPT 83550	$34.14	$48.76	$41.45–$47.35	—	30%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$84.59	$120.84	$84.10–$117.34	97% above	30%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$84.59	$120.84	$102.71–$117.34	—	30%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$129.85	$185.50	$129.11–$180.12	83% above	30%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$129.85	$185.50	$157.68–$180.12	—	30%
Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID)	$93.50	$133.56	$92.96–$129.69	65% above	30%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID)	$93.50	$133.56	$113.53–$129.69	—	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH ISOENZYMES ADDL CPT 83615	$30.43	$43.46	$30.25–$42.20	60% above	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$35.62	$50.88	$35.41–$49.40	87% above	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH ISOENZYMES ADDL CPT 83615	$30.43	$43.46	$36.94–$42.20	—	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$35.62	$50.88	$43.25–$49.40	—	30%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$49.72	$71.02	$49.43–$68.96	24% above	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$49.72	$71.02	$60.37–$68.96	—	30%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$77.17	$110.24	$76.73–$107.04	63% above	30%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$77.17	$110.24	$93.70–$107.04	—	30%
Lyme disease antibody test CPT 86618 LYMES W/WB REFLEX ADD CPT86618	$48.98	$69.96	$48.69–$67.93	55% above	30%
Lyme disease antibody test CPT 86618 LYMES DISEASE, TOTAL AB W/REFLEX	$51.20	$73.14	$50.91–$71.02	63% above	30%
Lyme disease antibody test CPT 86618 LYME IGG/IGM,AB TOTAL	$51.20	$73.14	$50.91–$71.02	63% above	30%
Lyme disease antibody test CPT 86618 LYME IGM W/ REFLEX TO WESTERN BLOT	$59.36	$84.80	$59.02–$82.34	88% above	30%
Lyme disease antibody test CPT 86618 LYMES DISEASE C6 ANTIGEN	$160.28	$228.96	$159.36–$222.32	409% above	30%
Lyme disease antibody test inpatient CPT 86618 LYMES W/WB REFLEX ADD CPT86618	$48.98	$69.96	$59.47–$67.93	—	30%
Lyme disease antibody test inpatient CPT 86618 LYME IGG/IGM,AB TOTAL	$51.20	$73.14	$62.17–$71.02	—	30%
Lyme disease antibody test inpatient CPT 86618 LYMES DISEASE, TOTAL AB W/REFLEX	$51.20	$73.14	$62.17–$71.02	—	30%
Lyme disease antibody test inpatient CPT 86618 LYME IGM W/ REFLEX TO WESTERN BLOT	$59.36	$84.80	$72.08–$82.34	—	30%
Lyme disease antibody test inpatient CPT 86618 LYMES DISEASE C6 ANTIGEN	$160.28	$228.96	$194.62–$222.32	—	30%
Magnesium blood test CPT 83735 MAGNESIUM, 24HR URINE	$23.75	$33.92	$23.61–$32.94	22% above	30%
Magnesium blood test CPT 83735 MAGNESIUM, RBC	$40.07	$57.24	$39.84–$55.58	105% above	30%
Magnesium blood test CPT 83735 MAGNESIUM SERUM	$41.56	$59.36	$41.31–$57.64	113% above	30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, 24HR URINE	$23.75	$33.92	$28.83–$32.94	—	30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, RBC	$40.07	$57.24	$48.65–$55.58	—	30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM SERUM	$41.56	$59.36	$50.46–$57.64	—	30%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG	$31.91	$45.58	$31.72–$44.26	19% below	30%
Measles (rubeola) antibody test CPT 86765 MMR TITER ADDL CPT 86765	$55.65	$79.50	$55.33–$77.19	42% above	30%
Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA), AB IGM, SERUM	$138.02	$197.16	$137.22–$191.44	252% above	30%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG	$31.91	$45.58	$38.74–$44.26	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 MMR TITER ADDL CPT 86765	$55.65	$79.50	$67.58–$77.19	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA), AB IGM, SERUM	$138.02	$197.16	$167.59–$191.44	—	30%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT TEST (BFC)	$10.39	$14.84	$10.33–$14.41	70% below	30%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN	$36.36	$51.94	$36.15–$50.43	4% above	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSPOT TEST (BFC)	$10.39	$14.84	$12.61–$14.41	—	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SCREEN	$36.36	$51.94	$44.15–$50.43	—	30%
Mumps immunity blood test CPT 86735 MMR IMMUNE PROFILE CPT 86735	$49.72	$71.02	$49.43–$68.96	12% above	30%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$66.04	$94.34	$65.66–$91.60	48% above	30%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY, IGG	$77.17	$110.24	$76.73–$107.04	73% above	30%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY, IGM	$77.17	$110.24	$76.73–$107.04	73% above	30%
Mumps immunity blood test inpatient CPT 86735 MMR IMMUNE PROFILE CPT 86735	$49.72	$71.02	$60.37–$68.96	—	30%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY	$66.04	$94.34	$80.19–$91.60	—	30%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY, IGM	$77.17	$110.24	$93.70–$107.04	—	30%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY, IGG	$77.17	$110.24	$93.70–$107.04	—	30%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$164.73	$235.32	$163.78–$228.50	26% below	30%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$164.73	$235.32	$200.02–$228.50	—	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA TOTAL& %FREE CPT 84154	$37.85	$54.06	$37.63–$52.49	37% below	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA TOTAL& %FREE CPT 84154	$37.85	$54.06	$45.95–$52.49	—	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPECIFIC ANTIGEN	$57.14	$81.62	$56.81–$79.25	10% below	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL& %FREE CPT 84153	$60.85	$86.92	$60.50–$84.40	4% below	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPECIFIC ANTIGEN	$57.14	$81.62	$69.38–$79.25	—	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL& %FREE CPT 84153	$60.85	$86.92	$73.88–$84.40	—	30%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP SMEAR-IMAGE GUIDED- DIAGN	$50.46	$72.08	$50.17–$69.99	38% below	30%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP IMAGE GUID, RFX HPV ASCU	$52.69	$75.26	$52.38–$73.08	36% below	30%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP HPV HR CPT 88175	$53.43	$76.32	$53.12–$74.11	35% below	30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP SMEAR-IMAGE GUIDED- DIAGN	$50.46	$72.08	$61.27–$69.99	—	30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP IMAGE GUID, RFX HPV ASCU	$52.69	$75.26	$63.97–$73.08	—	30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP HPV HR CPT 88175	$53.43	$76.32	$64.87–$74.11	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH, PAP W/PHYS INTERP	$43.78	$62.54	$43.53–$60.73	12% below	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 GYNECOLOGIC PAP SMEAR,LIQ PREP	$59.36	$84.80	$59.02–$82.34	19% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP RFX HIGH- RISK HPV	$71.24	$101.76	$70.82–$98.81	42% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH, PAP W/PHYS INTERP	$43.78	$62.54	$53.16–$60.73	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 GYNECOLOGIC PAP SMEAR,LIQ PREP	$59.36	$84.80	$72.08–$82.34	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP RFX HIGH- RISK HPV	$71.24	$101.76	$86.50–$98.81	—	30%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$109.08	$155.82	$108.45–$151.30	28% below	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$109.08	$155.82	$132.45–$151.30	—	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOLPLASTIN TIME	$49.72	$71.02	$49.43–$68.96	20% above	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 VON WILLEBRAND PROF CPT 85730	$195.15	$278.78	$194.03–$270.70	370% above	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOLPLASTIN TIME	$49.72	$71.02	$60.37–$68.96	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 VON WILLEBRAND PROF CPT 85730	$195.15	$278.78	$236.96–$270.70	—	30%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS SERUM	$35.62	$50.88	$35.41–$49.40	14% above	30%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS SERUM	$35.62	$50.88	$43.25–$49.40	—	30%
Potassium blood test CPT 84132 POTASSIUM, SERUM	$35.62	$50.88	$35.41–$49.40	32% above	30%
Potassium blood test inpatient CPT 84132 POTASSIUM, SERUM	$35.62	$50.88	$43.25–$49.40	—	30%
Progesterone blood test CPT 84144 PROGESTERONE	$143.21	$204.58	$142.39–$198.65	44% above	30%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$143.21	$204.58	$173.89–$198.65	—	30%
Prolactin blood test CPT 84146 PROLACTIN	$62.33	$89.04	$61.97–$86.46	3% below	30%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$62.33	$89.04	$75.68–$86.46	—	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TEST -POINT OF SERV (BFC)	$8.17	$11.66	$8.12–$11.32	72% below	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT)	$37.10	$53.00	$36.89–$51.46	29% above	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TEST -POINT OF SERV (BFC)	$8.17	$11.66	$9.91–$11.32	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT)	$37.10	$53.00	$45.05–$51.46	—	30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE ETHANOL	$36.36	$51.94	$36.15–$50.43	at median	30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 COCAINE LEVEL	$47.49	$67.84	$47.22–$65.87	31% above	30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE ETHANOL	$36.36	$51.94	$44.15–$50.43	—	30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 COCAINE LEVEL	$47.49	$67.84	$57.66–$65.87	—	30%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA SWAB (BFC)	$44.52	$63.60	$44.27–$61.76	4% below	30%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA (FLUTEST) A/B CPT 87804 #2	$57.14	$81.62	$56.81–$79.25	23% above	30%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA (FLUTEST) A/B CPT 87804	$57.14	$81.62	$56.81–$79.25	23% above	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA SWAB (BFC)	$44.52	$63.60	$54.06–$61.76	—	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA (FLUTEST) A/B CPT 87804	$57.14	$81.62	$69.38–$79.25	—	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA (FLUTEST) A/B CPT 87804 #2	$57.14	$81.62	$69.38–$79.25	—	30%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP TEST BETA OR RAPID (BFC)	$22.26	$31.80	$22.13–$30.88	45% below	30%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP QUICK, (RAPID)	$41.56	$59.36	$41.31–$57.64	2% above	30%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP TEST BETA OR RAPID (BFC)	$22.26	$31.80	$27.03–$30.88	—	30%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP QUICK, (RAPID)	$41.56	$59.36	$50.46–$57.64	—	30%
Renin blood test CPT 84244 RENIN PLASMA	$165.47	$236.38	$164.52–$229.52	186% above	30%
Renin blood test inpatient CPT 84244 RENIN PLASMA	$165.47	$236.38	$200.92–$229.52	—	30%
Rh blood typing CPT 86901 TYPE/RH ADDL CPT 86901	$28.20	$40.28	$28.03–$39.11	1% below	30%
Rh blood typing CPT 86901 TYPE (RH)	$31.91	$45.58	$31.72–$44.26	12% above	30%
Rh blood typing CPT 86901 RHOGAM STUDIES ADDL CPT 86901	$34.14	$48.76	$33.94–$47.35	19% above	30%
Rh blood typing CPT 86901 TYPE(RH) (CROSSMATCH RELATED)	$35.62	$50.88	$35.41–$49.40	25% above	30%
Rh blood typing inpatient CPT 86901 TYPE/RH ADDL CPT 86901	$28.20	$40.28	$34.24–$39.11	—	30%
Rh blood typing inpatient CPT 86901 TYPE (RH)	$31.91	$45.58	$38.74–$44.26	—	30%
Rh blood typing inpatient CPT 86901 RHOGAM STUDIES ADDL CPT 86901	$34.14	$48.76	$41.45–$47.35	—	30%
Rh blood typing inpatient CPT 86901 TYPE(RH) (CROSSMATCH RELATED)	$35.62	$50.88	$43.25–$49.40	—	30%
Rheumatoid factor (RF) test CPT 86431 RA TITER LATEX	$35.62	$50.88	$35.41–$49.40	1% below	30%
Rheumatoid factor (RF) test inpatient CPT 86431 RA TITER LATEX	$35.62	$50.88	$43.25–$49.40	—	30%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$37.10	$53.00	$36.89–$51.46	25% below	30%
Rubella antibody test (immunity check) CPT 86762 MMR TITER ADDL CPT 86762	$55.65	$79.50	$55.33–$77.19	12% above	30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$37.10	$53.00	$45.05–$51.46	—	30%
Rubella antibody test (immunity check) inpatient CPT 86762 MMR TITER ADDL CPT 86762	$55.65	$79.50	$67.58–$77.19	—	30%
Sodium blood test CPT 84295 SODIUM SERUM	$29.68	$42.40	$29.51–$41.17	14% above	30%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$29.68	$42.40	$36.04–$41.17	—	30%
Stool ova and parasites exam CPT 87177 OVA & PARASITES	$63.07	$90.10	$62.71–$87.49	31% above	30%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES	$63.07	$90.10	$76.59–$87.49	—	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 FECAL OCCULT BLOOD SCREENING (BFC)	$11.88	$16.96	$11.80–$16.47	26% below	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 COLORECTAL CANCER SCREENING	$20.78	$29.68	$20.66–$28.82	29% above	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 IMMUNOCHEM COLORECTAL CANCER SCREENING	$25.23	$36.04	$25.08–$34.99	57% above	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 FECAL OCCULT BLOOD SCREENING (BFC)	$11.88	$16.96	$14.42–$16.47	—	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 COLORECTAL CANCER SCREENING	$20.78	$29.68	$25.23–$28.82	—	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 IMMUNOCHEM COLORECTAL CANCER SCREENING	$25.23	$36.04	$30.63–$34.99	—	30%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 COLORECTAL CANCER SCREENING	$39.33	$56.18	$39.10–$54.55	8% above	30%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 COLORECTAL CANCER SCREENING	$39.33	$56.18	$47.75–$54.55	—	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS	$45.27	$64.66	$45.00–$62.78	46% above	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 TP-PA	$48.23	$68.90	$47.95–$66.90	56% above	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-ABS	$45.27	$64.66	$54.96–$62.78	—	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TP-PA	$48.23	$68.90	$58.57–$66.90	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SEROLOGY	$33.39	$47.70	$33.20–$46.32	24% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR SEROLOGY	$33.39	$47.70	$40.55–$46.32	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$108.34	$154.76	$107.71–$150.27	43% below	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD	$108.34	$154.76	$131.55–$150.27	—	30%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE FREE AND TOTAL ADDL CPT	$80.88	$115.54	$80.42–$112.19	8% below	30%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE PLAS	$190.70	$272.42	$189.60–$264.52	117% above	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE FREE AND TOTAL ADDL CPT	$80.88	$115.54	$98.21–$112.19	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE PLAS	$190.70	$272.42	$231.56–$264.52	—	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 TPO/ANTIMICROSOMAL AB	$51.94	$74.20	$51.64–$72.05	29% below	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE 86376 (PART OF PANEL)	$53.43	$76.32	$53.12–$74.11	27% below	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE (TPO) AB	$53.43	$76.32	$53.12–$74.11	27% below	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TPO/ANTIMICROSOMAL AB	$51.94	$74.20	$63.07–$72.05	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE (TPO) AB	$53.43	$76.32	$64.87–$74.11	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE 86376 (PART OF PANEL)	$53.43	$76.32	$64.87–$74.11	—	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HEALTH FAIR TSH	$7.42	$10.60	$7.38–$10.29	89% below	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 DLA TSH	$10.50	$15.00	$10.44–$14.57	84% below	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH)	$96.46	$137.80	$95.91–$133.80	49% above	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HEALTH FAIR TSH	$7.42	$10.60	$9.01–$10.29	—	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 DLA TSH	$10.50	$15.00	$12.75–$14.57	—	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH)	$96.46	$137.80	$117.13–$133.80	—	30%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN IGE	$43.04	$61.48	$42.79–$59.70	21% below	30%
Total IgE blood test CPT 82785 ALLERGEN-BASIC INHALANT ADDL CPT 82785	$83.85	$119.78	$83.37–$116.31	54% above	30%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN IGE	$43.04	$61.48	$52.26–$59.70	—	30%
Total IgE blood test inpatient CPT 82785 ALLERGEN-BASIC INHALANT ADDL CPT 82785	$83.85	$119.78	$101.81–$116.31	—	30%
Total cholesterol blood test CPT 82465 DLA CHOLESTEROL	$7.42	$10.60	$7.38–$10.29	68% below	30%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL	$31.91	$45.58	$31.72–$44.26	36% above	30%
Total cholesterol blood test CPT 82465 LIPOPROT PHENO ADDL CPT 82465	$35.62	$50.88	$35.41–$49.40	52% above	30%
Total cholesterol blood test CPT 82465 NASH FIBROSURE ADDL CPT 82565	$38.59	$55.12	$38.36–$53.52	64% above	30%
Total cholesterol blood test inpatient CPT 82465 DLA CHOLESTEROL	$7.42	$10.60	$9.01–$10.29	—	30%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL	$31.91	$45.58	$38.74–$44.26	—	30%
Total cholesterol blood test inpatient CPT 82465 LIPOPROT PHENO ADDL CPT 82465	$35.62	$50.88	$43.25–$49.40	—	30%
Total cholesterol blood test inpatient CPT 82465 NASH FIBROSURE ADDL CPT 82565	$38.59	$55.12	$46.85–$53.52	—	30%
Total thyroxine (T4) blood test CPT 84436 T-4	$49.72	$71.02	$49.43–$68.96	9% above	30%
Total thyroxine (T4) blood test inpatient CPT 84436 T-4	$49.72	$71.02	$60.37–$68.96	—	30%
Total triiodothyronine (T3) blood test CPT 84480 T3, TOTAL	$45.27	$64.66	$45.00–$62.78	42% below	30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3, TOTAL	$45.27	$64.66	$54.96–$62.78	—	30%
Transferrin blood test CPT 84466 TRANSFERRIN	$76.43	$109.18	$75.99–$106.01	37% above	30%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$76.43	$109.18	$92.80–$106.01	—	30%
Trichomonas test (NAAT) CPT 87661 TRICH, VAG, BY NAA	$59.36	$84.80	$59.02–$82.34	23% below	30%
Trichomonas test (NAAT) inpatient CPT 87661 TRICH, VAG, BY NAA	$59.36	$84.80	$72.08–$82.34	—	30%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$38.59	$55.12	$38.36–$53.52	32% above	30%
Triglycerides blood test CPT 84478 NASH FIBROSURE ADDL CPT 84478	$38.59	$55.12	$38.36–$53.52	32% above	30%
Triglycerides blood test CPT 84478 LIPOPROT PHENO ADDL CPT 84478	$68.27	$97.52	$67.87–$94.69	133% above	30%
Triglycerides blood test inpatient CPT 84478 NASH FIBROSURE ADDL CPT 84478	$38.59	$55.12	$46.85–$53.52	—	30%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$38.59	$55.12	$46.85–$53.52	—	30%
Triglycerides blood test inpatient CPT 84478 LIPOPROT PHENO ADDL CPT 84478	$68.27	$97.52	$82.89–$94.69	—	30%
Troponin test, quantitative CPT 84484 TROPONIN,QUANT	$65.30	$93.28	$64.92–$90.57	13% below	30%
Troponin test, quantitative inpatient CPT 84484 TROPONIN,QUANT	$65.30	$93.28	$79.29–$90.57	—	30%
Uric acid blood test CPT 84550 URIC ACID	$34.88	$49.82	$34.67–$48.38	6% above	30%
Uric acid blood test inpatient CPT 84550 URIC ACID	$34.88	$49.82	$42.35–$48.38	—	30%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS, COMPLETE	$41.56	$59.36	$41.31–$57.64	39% above	30%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS, COMPLETE	$41.56	$59.36	$50.46–$57.64	—	30%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS DIPSTICK W/MICRO (BFC)	$14.84	$21.20	$14.76–$20.59	7% below	30%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS DIPSTICK W/MICRO (BFC)	$14.84	$21.20	$18.02–$20.59	—	30%
Urinalysis without microscope exam, automated CPT 81003 URIN NO MICRO	$16.33	$23.32	$16.23–$22.64	5% above	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 URIN NO MICRO	$16.33	$23.32	$19.82–$22.64	—	30%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS BY DIPSTICK NO MICRO (BFC)	$5.51	$7.87	$5.48–$7.64	56% below	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS BY DIPSTICK NO MICRO (BFC)	$5.51	$7.87	$6.69–$7.64	—	30%
Urine culture for bacteria, with colony count CPT 87086 CULTURE, URINE REFERENCE LAB	$57.14	$81.62	$56.81–$79.25	2% below	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE, URINE REFERENCE LAB	$57.14	$81.62	$69.38–$79.25	—	30%
Urine microalbumin (albumin) test CPT 82043 M ALB/CRE RATIO ADDL CPT 82043	$18.55	$26.50	$18.44–$25.73	44% below	30%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN RANDOM URINE,QUAN	$31.17	$44.52	$30.99–$43.23	6% below	30%
Urine microalbumin (albumin) test CPT 82043 MICRO ALB/CREAT RATIO URIN, QUAN	$51.94	$74.20	$51.64–$72.05	57% above	30%
Urine microalbumin (albumin) test inpatient CPT 82043 M ALB/CRE RATIO ADDL CPT 82043	$18.55	$26.50	$22.53–$25.73	—	30%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN RANDOM URINE,QUAN	$31.17	$44.52	$37.84–$43.23	—	30%
Urine microalbumin (albumin) test inpatient CPT 82043 MICRO ALB/CREAT RATIO URIN, QUAN	$51.94	$74.20	$63.07–$72.05	—	30%
Urine pregnancy test, read by color change CPT 81025 DLA PREGNANCY TEST, URINE	$7.00	$10.00	$6.96–$9.71	69% below	30%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY (BFC)	$12.62	$18.02	$12.54–$17.50	43% below	30%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY, HCG, URINE	$27.46	$39.22	$27.30–$38.08	23% above	30%
Urine pregnancy test, read by color change inpatient CPT 81025 DLA PREGNANCY TEST, URINE	$7.00	$10.00	$8.50–$9.71	—	30%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY (BFC)	$12.62	$18.02	$15.32–$17.50	—	30%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY, HCG, URINE	$27.46	$39.22	$33.34–$38.08	—	30%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B 12	$109.08	$155.82	$108.45–$151.30	35% above	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B 12	$109.08	$155.82	$132.45–$151.30	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D, 25-HYDROXY	$135.05	$192.92	$134.27–$187.33	58% above	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D, 25OH D2+D3 LCMS	$141.73	$202.46	$140.91–$196.59	65% above	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VIT D, 25-HYDROXY	$135.05	$192.92	$163.98–$187.33	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VIT D, 25OH D2+D3 LCMS	$141.73	$202.46	$172.09–$196.59	—	30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 PTH (PARATHYROID HORMONE)	$40.07	$57.24	$39.84–$55.58	48% below	30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT,D,1,25 DIHYDROXY	$74.95	$107.06	$74.51–$103.96	3% below	30%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 PTH (PARATHYROID HORMONE)	$40.07	$57.24	$48.65–$55.58	—	30%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT,D,1,25 DIHYDROXY	$74.95	$107.06	$91.00–$103.96	—	30%
Zinc blood test CPT 84630 ZINC	$87.56	$125.08	$87.06–$121.45	124% above	30%
Zinc blood test inpatient CPT 84630 ZINC	$87.56	$125.08	$106.32–$121.45	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFP EXTRA ADDL CPT 84702	$54.17	$77.38	$53.86–$75.14	26% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 H.C.G. QUANTATIVE	$77.91	$111.30	$77.46–$108.07	6% above	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG, B SUBUNIT, QUANT (MALE)	$109.08	$155.82	$108.45–$151.30	48% above	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 AFP EXTRA ADDL CPT 84702	$54.17	$77.38	$65.77–$75.14	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 H.C.G. QUANTATIVE	$77.91	$111.30	$94.61–$108.07	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG, B SUBUNIT, QUANT (MALE)	$109.08	$155.82	$132.45–$151.30	—	30%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREAT CL DIST FIB FX WO MAN, PROI	$793.20	$1,133.14	$206.72–$1,100.28	160% above	30%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TREAT CL DIST FIB FX WO MAN, PROI	$793.20	$1,133.14	$963.17–$1,100.28	—	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT CL METATARSAL FX WO, PRO	$598.80	$855.42	$145.69–$830.61	153% above	30%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TREAT CL METATARSAL FX WO, PRO	$598.80	$855.42	$727.11–$830.61	—	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT BENIGN SKIN LES,1ST,P-FAC	$195.89	$279.84	$37.90–$271.72	5% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT BENIGN SKIN LES,1ST,F	$195.89	$279.84	$37.90–$271.72	5% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT BENIGN SKIN LES,1ST,F	$195.89	$279.84	$237.86–$271.72	—	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT BENIGN SKIN LES,1ST,P-FAC	$195.89	$279.84	$237.86–$271.72	—	30%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI FAC	$65.30	$93.28	$10.34–$90.57	22% below	30%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI FAC	$65.30	$93.28	$79.29–$90.57	—	30%
Earwax removal with instruments, one ear CPT 69210 69210 FAC REMOVE IMPACTED CERUMEN	$75.69	$108.12	$23.63–$104.98	7% above	30%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN,FAC	$75.69	$108.12	$23.63–$104.98	7% above	30%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN,FAC	$75.69	$108.12	$91.90–$104.98	—	30%
Earwax removal with instruments, one ear inpatient CPT 69210 69210 FAC REMOVE IMPACTED CERUMEN	$75.69	$108.12	$91.90–$104.98	—	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY, FLEX, DIAG,PRO	$865.18	$1,235.96	$40.11–$1,200.12	1% above	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY, FLEX, DIAG,PRO	$865.18	$1,235.96	$1,050.57–$1,200.12	—	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS, SIMPLE, FAC	$195.89	$279.84	$73.83–$271.72	17% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 FAC I&D ABSCESS, SIMPLE (MC)	$195.89	$279.84	$73.83–$271.72	17% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 INCIS & DRAIN- SIMPLE/SINGLE FAC	$376.94	$538.48	$73.83–$522.86	60% above	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS, SIMPLE, FAC	$195.89	$279.84	$237.86–$271.72	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 FAC I&D ABSCESS, SIMPLE (MC)	$195.89	$279.84	$237.86–$271.72	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCIS & DRAIN- SIMPLE/SINGLE FAC	$376.94	$538.48	$457.71–$522.86	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIG/CYST,FAC	$479.34	$684.76	$28.30–$664.90	44% above	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIG/CYST,FAC	$479.34	$684.76	$582.05–$664.90	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS LARGE JT,FAC	$479.34	$684.76	$32.98–$664.90	40% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 FAC ARTHROCENTESIS, MAJOR JT	$479.34	$684.76	$32.98–$664.90	40% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 FAC ARTHROCENTESIS, MAJOR JT	$479.34	$684.76	$582.05–$664.90	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS LARGE JT,FAC	$479.34	$684.76	$582.05–$664.90	—	30%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG IMPLANT DEVICE (BFC) FAC	$123.92	$177.02	$46.02–$171.89	25% below	30%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG IMPLANT DEVICE (BFC) FAC	$123.92	$177.02	$150.47–$171.89	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS, INTER JT, FAC	$285.67	$408.10	$26.58–$396.27	17% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS, INTER JT, PRO	$285.67	$408.10	$26.58–$396.27	17% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS, INTER JT, PRO	$285.67	$408.10	$346.89–$396.27	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS, INTER JT, FAC	$285.67	$408.10	$346.89–$396.27	—	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS, SMALL JT, FAC	$285.67	$408.10	$26.09–$396.27	18% below	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS, SMALL JT, FAC	$285.67	$408.10	$346.89–$396.27	—	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REP WOUND,SCALP,INT,TO 2.5, PRO	$457.82	$654.02	$105.82–$635.05	8% above	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REP WOUND,SCALP,INT,TO 2.5, FA	$457.82	$654.02	$105.82–$635.05	8% above	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REP WOUND,SCALP,INT,TO 2.5, FA	$457.82	$654.02	$555.92–$635.05	—	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REP WOUND,SCALP,INT,TO 2.5, PRO	$457.82	$654.02	$555.92–$635.05	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENIGN LES TNK TO 0.5,FAC	$678.19	$968.84	$58.57–$940.74	3% above	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 FAC EXC BENIGN LES TNK TO 0.5	$678.19	$968.84	$58.57–$940.74	3% above	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 11400 FAC EXC BENIGN LES TNK TO 0.5	$678.19	$968.84	$823.51–$940.74	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BENIGN LES TNK TO 0.5,FAC	$678.19	$968.84	$823.51–$940.74	—	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440 FAC EXC BENIGN LES FACE TO 0.5C	$678.19	$968.84	$73.58–$940.74	1% below	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 11440 FAC EXC BENIGN LES FACE TO 0.5C	$678.19	$968.84	$823.51–$940.74	—	30%
Nail removal (partial or complete), one nail CPT 11730 11730 FAC AVULSION NAIL,SIMP	$195.89	$279.84	$38.64–$271.72	27% below	30%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE, 1,SIMP,FA	$195.89	$279.84	$38.64–$271.72	27% below	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE, 1,SIMP,FA	$195.89	$279.84	$237.86–$271.72	—	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730 FAC AVULSION NAIL,SIMP	$195.89	$279.84	$237.86–$271.72	—	30%
Occipital nerve block (injection for headaches) CPT 64405 NERVE BLOCK AND TRANSF INJ, FAC	$256.74	$366.76	$39.13–$356.12	30% below	30%
Occipital nerve block (injection for headaches) inpatient CPT 64405 NERVE BLOCK AND TRANSF INJ, FAC	$256.74	$366.76	$311.75–$356.12	—	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL/NAIL MATRIX, FAC	$910.44	$1,300.62	$71.62–$1,262.90	95% above	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 FAC EXCISE NAIL/MATRIX	$1,071.45	$1,530.64	$71.62–$1,486.25	130% above	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL/NAIL MATRIX, FAC	$910.44	$1,300.62	$1,105.53–$1,262.90	—	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 FAC EXCISE NAIL/MATRIX	$1,071.45	$1,530.64	$1,301.04–$1,486.25	—	30%
Removal of a foreign object under the skin, simple CPT 10120 INCISE/REMOVE FB, SIMP, FAC	$330.94	$472.76	$73.58–$459.05	15% below	30%
Removal of a foreign object under the skin, simple CPT 10120 10120 FAC INCISE/REMOVE FB, SIMP (MC)	$376.94	$538.48	$73.58–$522.86	3% below	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISE/REMOVE FB, SIMP, FAC	$330.94	$472.76	$401.85–$459.05	—	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 10120 FAC INCISE/REMOVE FB, SIMP (MC)	$376.94	$538.48	$457.71–$522.86	—	30%
Short arm cast (elbow to hand) CPT 29075 APPLY SHORT ARM CAST,PRO	$262.67	$375.24	$44.54–$364.36	9% below	30%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY SHORT ARM CAST,PRO	$262.67	$375.24	$318.95–$364.36	—	30%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT, PRO	$117.24	$167.48	$28.55–$162.62	36% below	30%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT, FAC	$143.95	$205.64	$28.55–$199.68	22% below	30%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT, PRO	$117.24	$167.48	$142.36–$162.62	—	30%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT, FAC	$143.95	$205.64	$174.79–$199.68	—	30%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST, PRO	$262.67	$375.24	$41.59–$364.36	18% below	30%
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST, PRO	$262.67	$375.24	$318.95–$364.36	—	30%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT, FAC	$150.63	$215.18	$35.68–$208.94	35% below	30%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT, PRO	$154.34	$220.48	$35.68–$214.09	33% below	30%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT, FAC	$150.63	$215.18	$182.90–$208.94	—	30%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT, PRO	$154.34	$220.48	$187.41–$214.09	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REP WOUND,SCALP,SIM TO 2.5,FAC	$380.65	$543.78	$32.98–$528.01	35% above	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 FAC REP WOUND,SCALP,SIM TO 2.5	$380.65	$543.78	$32.98–$528.01	35% above	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REP WOUND,SCALP,SIM TO 2.5,FAC	$380.65	$543.78	$462.21–$528.01	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 FAC REP WOUND,SCALP,SIM TO 2.5	$380.65	$543.78	$462.21–$528.01	—	30%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SINGLE SKIN LES FAC	$376.94	$538.48	$33.47–$522.86	2% below	30%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX OF SKIN 1 LESION	$382.13	$545.90	$33.47–$530.07	1% below	30%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SIM CLOSURE, FAC	$3,299.52	$4,713.60	$33.47–$4,576.91	759% above	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SINGLE SKIN LES FAC	$376.94	$538.48	$457.71–$522.86	—	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX OF SKIN 1 LESION	$382.13	$545.90	$464.02–$530.07	—	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SIM CLOSURE, FAC	$3,299.52	$4,713.60	$4,006.56–$4,576.91	—	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 11600 FAC EXC MAL LES TNK 0.5 OR <	$678.19	$968.84	$86.14–$940.74	16% below	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 11600 FAC EXC MAL LES TNK 0.5 OR <	$678.19	$968.84	$823.51–$940.74	—	30%
Skin tag removal, up to 15 tags CPT 11200 11200 FAC REMOVE SKIN TAG(S) TO 15	$195.89	$279.84	$52.91–$271.72	at median	30%
Skin tag removal, up to 15 tags CPT 11200 11200 REMOVE SKIN TAG(S) UP TO 15 FAC	$195.89	$279.84	$52.91–$271.72	at median	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 11200 REMOVE SKIN TAG(S) UP TO 15 FAC	$195.89	$279.84	$237.86–$271.72	—	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 11200 FAC REMOVE SKIN TAG(S) TO 15	$195.89	$279.84	$237.86–$271.72	—	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PUNCTURE, LUMBAR,DIAG,FAC	$692.29	$988.98	$47.50–$960.30	31% below	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PUNCTURE, LUMBAR,DIAG,FAC	$692.29	$988.98	$840.63–$960.30	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REP WOUND,SCALP,SIM 2.6-7.5,FA	$380.65	$543.78	$43.56–$528.01	47% above	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 FAC REP WOUND,SCALP,SIM 2.6-7.5	$380.65	$543.78	$43.56–$528.01	47% above	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REP WOUND,SCALP,SIM 2.6-7.5,FA	$380.65	$543.78	$462.21–$528.01	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 FAC REP WOUND,SCALP,SIM 2.6-7.5	$380.65	$543.78	$462.21–$528.01	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REP WOUND,FACE,SIM TO 2.5,FAC	$302.00	$431.42	$41.34–$418.91	5% above	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 FAC REP WOUND,FACE,SIM TO 2.5	$302.00	$431.42	$41.34–$418.91	5% above	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011 FAC REP WOUND,FACE,SIM TO 2.5	$302.00	$431.42	$366.71–$418.91	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REP WOUND,FACE,SIM TO 2.5,FAC	$302.00	$431.42	$366.71–$418.91	—	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BX SKIN SINGLE LES, FAC	$376.94	$538.48	$26.82–$522.86	9% above	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BX SKIN SINGLE LES, FAC	$376.94	$538.48	$457.71–$522.86	—	30%
Thoracentesis with imaging guidance CPT 32555 32555 FAC ASPIRATE PLEURA W/ IMAGING	$1,044.00	$1,491.42	$78.01–$1,448.17	17% below	30%
Thoracentesis with imaging guidance inpatient CPT 32555 32555 FAC ASPIRATE PLEURA W/ IMAGING	$1,044.00	$1,491.42	$1,267.71–$1,448.17	—	30%
Trigger finger release surgery CPT 26055 INCISE TENDON SHEATH,FINGER,PRO	$1,518.14	$2,168.76	$207.95–$2,105.87	19% below	30%
Trigger finger release surgery inpatient CPT 26055 INCISE TENDON SHEATH,FINGER,PRO	$1,518.14	$2,168.76	$1,843.45–$2,105.87	—	30%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 FAC TRIGGER PT 1-2 MUSCLE(S)	$479.34	$684.76	$26.58–$664.90	63% above	30%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT 1-2 MUSCLE GRP,FAC	$479.34	$684.76	$26.58–$664.90	63% above	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT 1-2 MUSCLE GRP,FAC	$479.34	$684.76	$582.05–$664.90	—	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 FAC TRIGGER PT 1-2 MUSCLE(S)	$479.34	$684.76	$582.05–$664.90	—	30%
Wart removal, up to 14 warts CPT 17110 17110 FAC DESTRUCT BENIGN LES, TO 14	$195.89	$279.84	$47.01–$271.72	5% below	30%
Wart removal, up to 14 warts inpatient CPT 17110 17110 FAC DESTRUCT BENIGN LES, TO 14	$195.89	$279.84	$237.86–$271.72	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/< FAC	$376.94	$538.48	$43.31–$522.86	at median	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SQ TISSUE 1ST20SQ,FAC	$376.94	$538.48	$43.31–$522.86	at median	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SQ TISSUE, 1ST 20 SQ CM FAC	$670.03	$957.18	$43.31–$929.42	78% above	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SQ TISSUE 1ST20SQ,FAC	$376.94	$538.48	$457.71–$522.86	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 20 SQ CM/< FAC	$376.94	$538.48	$457.71–$522.86	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SQ TISSUE, 1ST 20 SQ CM FAC	$670.03	$957.18	$813.60–$929.42	—	30%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION - ACUTE	$431.11	$615.86	$27.32–$598.00	32% below	30%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION-OP	$431.11	$615.86	$27.32–$598.00	32% below	30%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINSTRATION -SWING	$431.11	$615.86	$27.32–$598.00	32% below	30%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION - ED	$433.33	$619.04	$27.32–$601.09	32% below	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION - ACUTE	$431.11	$615.86	$523.48–$598.00	—	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINSTRATION -SWING	$431.11	$615.86	$523.48–$598.00	—	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION-OP	$431.11	$615.86	$523.48–$598.00	—	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION - ED	$433.33	$619.04	$526.18–$601.09	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEBULIZER	$204.80	$292.56	$5.17–$284.08	at median	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$204.80	$292.56	$5.17–$284.08	at median	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZ PAP THERAPY	$204.80	$292.56	$5.17–$284.08	at median	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$204.80	$292.56	$248.68–$284.08	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND HELD NEBULIZER	$204.80	$292.56	$248.68–$284.08	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZ PAP THERAPY	$204.80	$292.56	$248.68–$284.08	—	30%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUS,INITIAL,1ST HOUR	$285.67	$408.10	$83.92–$396.27	53% below	30%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUS,INITIAL,1ST HOUR	$285.67	$408.10	$346.89–$396.27	—	30%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE - FIRST HOUR,FAC	$828.08	$1,182.96	$154.06–$1,148.65	34% below	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE - FIRST HOUR,FAC	$828.08	$1,182.96	$1,005.52–$1,148.65	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG-TRACING ONLY	$89.04	$127.20	$4.18–$123.51	26% below	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$163.52	$233.59	$4.18–$226.82	35% above	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG-TRACING ONLY	$89.04	$127.20	$108.12–$123.51	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$163.52	$233.59	$198.55–$226.82	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMER DEPT VISIT LEV 1,FAC	$157.31	$224.72	$8.37–$218.20	1% below	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMER DEPT VISIT LEV 1,FAC	$157.31	$224.72	$191.01–$218.20	—	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 E&M 2,FAC	$251.54	$359.34	$30.52–$348.92	1% below	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 E&M 2,FAC	$251.54	$359.34	$305.44–$348.92	—	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PICC LINE CARE OR REMOVAL	$252.28	$360.40	$52.17–$349.95	37% below	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMER DEPT VISIT LEV 3, EXTENDED	$406.62	$580.88	$52.17–$564.03	1% above	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMER DEPT VISIT LEV 3,FAC	$406.62	$580.88	$52.17–$564.03	1% above	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 PICC LINE CARE OR REMOVAL	$252.28	$360.40	$306.34–$349.95	—	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMER DEPT VISIT LEV 3,FAC	$406.62	$580.88	$493.75–$564.03	—	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMER DEPT VISIT LEV 3, EXTENDED	$406.62	$580.88	$493.75–$564.03	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMER DEPT VISIT LEV 4,EXPANDED	$606.96	$867.08	$88.84–$841.93	12% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMER DEPT VISIT LEV 4,FAC	$606.96	$867.08	$88.84–$841.93	12% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMER DEPT VISIT LEV 4,FAC	$606.96	$867.08	$737.02–$841.93	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMER DEPT VISIT LEV 4,EXPANDED	$606.96	$867.08	$737.02–$841.93	—	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMER DEPT VISIT LEV 5,FAC	$635.90	$908.42	$128.71–$882.08	33% below	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMER DEPT VISIT LEV 5,EXPANDED	$635.90	$908.42	$128.71–$882.08	33% below	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMER DEPT VISIT LEV 5,FAC	$635.90	$908.42	$772.16–$882.08	—	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMER DEPT VISIT LEV 5,EXPANDED	$635.90	$908.42	$772.16–$882.08	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION, HYDRATION, INITIAL HR	$364.33	$520.46	$21.16–$505.37	62% above	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION,HYDRATION, INITIAL HOUR	$364.33	$520.46	$21.16–$505.37	62% above	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION,HYDRATION, INITIAL HO	$364.33	$520.46	$21.16–$505.37	62% above	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INFUSION,HYDRATION, INITIAL HO	$364.33	$520.46	$442.39–$505.37	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INFUSION, HYDRATION, INITIAL HR	$364.33	$520.46	$442.39–$505.37	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INFUSION,HYDRATION, INITIAL HOUR	$364.33	$520.46	$442.39–$505.37	—	30%
IV infusion of a medicine, first hour CPT 96365 INFUSION, IV, FIRST HOUR	$364.33	$520.46	$41.10–$505.37	47% above	30%
IV infusion of a medicine, first hour CPT 96365 INFUSION, IV, 1ST HOUR	$364.33	$520.46	$41.10–$505.37	47% above	30%
IV infusion of a medicine, first hour CPT 96365 INFUSION,IV,1ST HOUR	$364.33	$520.46	$41.10–$505.37	47% above	30%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION, IV, FIRST HOUR	$364.33	$520.46	$442.39–$505.37	—	30%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION, IV, 1ST HOUR	$364.33	$520.46	$442.39–$505.37	—	30%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION,IV,1ST HOUR	$364.33	$520.46	$442.39–$505.37	—	30%
IV push of a medicine, first drug CPT 96374 INJECTION INTRAVENOUS,INITIAL	$223.35	$319.06	$24.36–$309.81	9% above	30%
IV push of a medicine, first drug CPT 96374 INJECTION, INTRAVENOUS, INITIAL	$223.35	$319.06	$24.36–$309.81	9% above	30%
IV push of a medicine, first drug inpatient CPT 96374 INJECTION INTRAVENOUS,INITIAL	$223.35	$319.06	$271.20–$309.81	—	30%
IV push of a medicine, first drug inpatient CPT 96374 INJECTION, INTRAVENOUS, INITIAL	$223.35	$319.06	$271.20–$309.81	—	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION, SUBCU/IM	$68.27	$97.52	$9.84–$94.69	5% below	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUBCU/IM	$68.27	$97.52	$9.84–$94.69	5% below	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION, SUBCU/IM	$68.27	$97.52	$82.89–$94.69	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUBCU/IM	$68.27	$97.52	$82.89–$94.69	—	30%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCA,EA 15MIN (ASST CHG	$60.11	$85.86	$23.13–$83.37	22% below	30%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCA,EA 15MIN	$60.11	$85.86	$23.13–$83.37	22% below	30%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUC15MIN (ASST CHG)	$60.11	$85.86	$23.13–$83.37	22% below	30%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION,15MI	$60.11	$85.86	$23.13–$83.37	22% below	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCATION,15MI	$60.11	$85.86	$72.98–$83.37	—	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCA,EA 15MIN	$60.11	$85.86	$72.98–$83.37	—	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCA,EA 15MIN (ASST CHG	$60.11	$85.86	$72.98–$83.37	—	30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUC15MIN (ASST CHG)	$60.11	$85.86	$72.98–$83.37	—	30%
New patient office visit, about 30 minutes CPT 99203 99203 FAC NEW VISIT LEVEL III (MC)	$122.43	$174.90	$59.06–$169.83	48% above	30%
New patient office visit, about 30 minutes CPT 99203 LEVEL III INITIAL VISIT FAC	$252.28	$360.40	$59.06–$349.95	204% above	30%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 FAC NEW VISIT LEVEL III (MC)	$122.43	$174.90	$148.67–$169.83	—	30%
New patient office visit, about 30 minutes inpatient CPT 99203 LEVEL III INITIAL VISIT FAC	$252.28	$360.40	$306.34–$349.95	—	30%
New patient office visit, about 45 minutes CPT 99204 99204 FAC NEW VISIT LEVEL IV (MC)	$122.43	$174.90	$95.73–$169.83	33% above	30%
New patient office visit, about 45 minutes CPT 99204 LEVEL IV INITIAL VISIT FAC	$263.41	$376.30	$95.73–$365.39	187% above	30%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 FAC NEW VISIT LEVEL IV (MC)	$122.43	$174.90	$148.67–$169.83	—	30%
New patient office visit, about 45 minutes inpatient CPT 99204 LEVEL IV INITIAL VISIT FAC	$263.41	$376.30	$319.86–$365.39	—	30%
New patient office visit, about 60 minutes CPT 99205 99205 FAC NEW VISIT LEVEL V (MC)	$122.43	$174.90	$121.73–$169.83	at median	30%
New patient office visit, about 60 minutes CPT 99205 LEVEL V INITIAL VISIT FAC	$280.48	$400.68	$130.19–$389.06	129% above	30%
New patient office visit, about 60 minutes inpatient CPT 99205 99205 FAC NEW VISIT LEVEL V (MC)	$122.43	$174.90	$148.67–$169.83	—	30%
New patient office visit, about 60 minutes inpatient CPT 99205 LEVEL V INITIAL VISIT FAC	$280.48	$400.68	$340.58–$389.06	—	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202FAC NEW VISIT LEVEL II (MC)	$122.43	$174.90	$33.96–$169.83	79% above	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 LEVEL II INITIAL VISIT FAC	$255.25	$364.64	$33.96–$354.07	273% above	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202FAC NEW VISIT LEVEL II (MC)	$122.43	$174.90	$148.67–$169.83	—	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 LEVEL II INITIAL VISIT FAC	$255.25	$364.64	$309.94–$354.07	—	30%
Occupational therapy evaluation, low complexity CPT 97165 OCCUPATIONAL THER EVAL LOW COMPLEX 97165	$113.53	$162.18	$70.14–$157.48	38% below	30%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OCCUPATIONAL THER EVAL LOW COMPLEX 97165	$113.53	$162.18	$137.85–$157.48	—	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PHYSICAL THERAPY EVAL HIGH COMPLEX 97163	$140.98	$201.40	$69.40–$195.56	33% below	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PHYSICAL THERAPY EVAL HIGH COMPLEX 97163	$140.98	$201.40	$171.19–$195.56	—	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PHYSICAL THERAPY EVAL LOW COMPLEX 97161	$116.50	$166.42	$69.40–$161.59	37% below	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PHYSICAL THERAPY EVAL LOW COMPLEX 97161	$116.50	$166.42	$141.46–$161.59	—	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PHYSICAL THERAPY EVAL MOD COMPLEX 97162	$128.37	$183.38	$69.40–$178.06	39% below	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PHYSICAL THERAPY EVAL MOD COMPLEX 97162	$128.37	$183.38	$155.87–$178.06	—	30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY, EACH 15MIN	$60.11	$85.86	$18.70–$83.37	10% below	30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY, EACH 15 MIN (ASST CHG)	$60.11	$85.86	$18.70–$83.37	10% below	30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY, EACH 15 MINUTE	$60.11	$85.86	$18.70–$83.37	10% below	30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY, EACH 15MIN (ASST CHG)	$60.11	$85.86	$18.70–$83.37	10% below	30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY, EACH 15MIN	$60.11	$85.86	$72.98–$83.37	—	30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY, EACH 15 MINUTE	$60.11	$85.86	$72.98–$83.37	—	30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY, EACH 15 MIN (ASST CHG)	$60.11	$85.86	$72.98–$83.37	—	30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY, EACH 15MIN (ASST CHG)	$60.11	$85.86	$72.98–$83.37	—	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES, EA 15MI (ASST CHG	$56.40	$80.56	$20.18–$78.22	20% below	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE,EA 15MINS (ASST CHG	$56.40	$80.56	$20.18–$78.22	20% below	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE,EA 15MINS	$56.40	$80.56	$20.18–$78.22	20% below	30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES, EA 15MI	$56.40	$80.56	$20.18–$78.22	20% below	30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE,EA 15MINS (ASST CHG	$56.40	$80.56	$68.48–$78.22	—	30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE,EA 15MINS	$56.40	$80.56	$68.48–$78.22	—	30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES, EA 15MI (ASST CHG	$56.40	$80.56	$68.48–$78.22	—	30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES, EA 15MI	$56.40	$80.56	$68.48–$78.22	—	30%
Preventive checkup, new patient aged 18–39 CPT 99385 PREVENTIVE MEDICINE AGE 18-39 NEW, FAC	$122.43	$174.90	$66.94–$169.83	48% above	30%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREVENTIVE MEDICINE AGE 18-39 NEW, FAC	$122.43	$174.90	$148.67–$169.83	—	30%
Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE MEDICINE AGE 40-64 NEW, FAC	$122.43	$174.90	$81.21–$169.83	36% above	30%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREVENTIVE MEDICINE AGE 40-64 NEW, FAC	$122.43	$174.90	$148.67–$169.83	—	30%
Preventive checkup, new patient aged 65 or older CPT 99387 PREVENTIVE MEDICINE AGE 65+ NEW, FAC	$122.43	$174.90	$87.12–$169.83	11% above	30%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PREVENTIVE MEDICINE AGE 65+ NEW, FAC	$122.43	$174.90	$148.67–$169.83	—	30%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREVENTIVE MEDICINE AGE 18-39 EST, FAC	$122.43	$174.90	$61.28–$169.83	86% above	30%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREVENTIVE MEDICINE AGE 18-39 EST, FAC	$122.43	$174.90	$148.67–$169.83	—	30%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREVENTIVE MEDICINE AGE 40-64 EST, FAC	$122.43	$174.90	$66.45–$169.83	64% above	30%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PREVENTIVE MEDICINE AGE 40-64 EST, FAC	$122.43	$174.90	$148.67–$169.83	—	30%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREVENTIVE MEDICINE AGE 65+ EST, FAC	$122.43	$174.90	$69.65–$169.83	82% above	30%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PREVENTIVE MEDICINE AGE 65+ EST, FAC	$122.43	$174.90	$148.67–$169.83	—	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 FAC EST VISIT LEVEL V (MC)	$122.43	$174.90	$102.87–$169.83	44% above	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 LEVEL V FOLLOW UP VISIT, FAC	$253.77	$362.52	$102.87–$352.01	199% above	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 FAC EST VISIT LEVEL V (MC)	$122.43	$174.90	$148.67–$169.83	—	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 LEVEL V FOLLOW UP VISIT, FAC	$253.77	$362.52	$308.14–$352.01	—	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 FAC EST VISIT LEVEL III (MC)	$122.43	$174.90	$47.01–$169.83	57% above	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 LEVEL III FOLLOW UP VISIT, FAC	$221.86	$316.94	$47.01–$307.75	184% above	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 FAC EST VISIT LEVEL III (MC)	$122.43	$174.90	$148.67–$169.83	—	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 LEVEL III FOLLOW UP VISIT, FAC	$221.86	$316.94	$269.40–$307.75	—	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 FAC EST VISIT LEVEL IV (MC)	$122.43	$174.90	$69.65–$169.83	25% above	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 LEVEL IV FOLLOW UP VISIT, FAC	$245.61	$350.86	$69.65–$340.69	152% above	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 FAC EST VISIT LEVEL IV (MC)	$122.43	$174.90	$148.67–$169.83	—	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 LEVEL IV FOLLOW UP VISIT, FAC	$245.61	$350.86	$298.23–$340.69	—	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 FAC EST VISIT LEVEL II (MC)	$122.43	$174.90	$25.35–$169.83	90% above	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 LEVEL II FOLLOW UP VISIT, FAC	$204.05	$291.50	$25.35–$283.05	216% above	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 FAC EST VISIT LEVEL II (MC)	$122.43	$174.90	$148.67–$169.83	—	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 LEVEL II FOLLOW UP VISIT, FAC	$204.05	$291.50	$247.78–$283.05	—	30%
Speech and language evaluation CPT 92523 SPEECH/EVAL FOR SPEECH AND LANGUAGE	$238.93	$341.32	$159.23–$331.42	14% below	30%
Speech and language evaluation inpatient CPT 92523 SPEECH/EVAL FOR SPEECH AND LANGUAGE	$238.93	$341.32	$290.12–$331.42	—	30%
Speech therapy session, individual CPT 92507 SPEECH/LANGUAGE TREATMENT	$119.47	$170.66	$53.40–$165.71	22% below	30%
Speech therapy session, individual inpatient CPT 92507 SPEECH/LANGUAGE TREATMENT	$119.47	$170.66	$145.06–$165.71	—	30%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$152.86	$218.36	$18.21–$212.03	26% below	30%
Spirometry (breathing test) CPT 94010 SIMPLE SPIROMETRY (BFC)	$152.86	$218.36	$18.21–$212.03	26% below	30%
Spirometry (breathing test) inpatient CPT 94010 SIMPLE SPIROMETRY (BFC)	$152.86	$218.36	$185.61–$212.03	—	30%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$152.86	$218.36	$185.61–$212.03	—	30%
Spirometry before and after a bronchodilator CPT 94060 COMPLETE SPIROMETRY W BRONCHOD	$266.38	$380.54	$25.84–$369.50	31% below	30%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY PRE/POST DIL (BFC)	$288.64	$412.34	$25.84–$400.38	26% below	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 COMPLETE SPIROMETRY W BRONCHOD	$266.38	$380.54	$323.46–$369.50	—	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY PRE/POST DIL (BFC)	$288.64	$412.34	$350.49–$400.38	—	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY, DIR.15MI	$56.40	$80.56	$24.86–$78.22	26% below	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVIT,DIR EA 15M	$56.40	$80.56	$24.86–$78.22	26% below	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACT, DIR. 15MIN (ASST CHG	$56.40	$80.56	$24.86–$78.22	26% below	30%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVIT,DIR EA 15M (ASST CHG	$56.40	$80.56	$24.86–$78.22	26% below	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY, DIR.15MI	$56.40	$80.56	$68.48–$78.22	—	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACT, DIR. 15MIN (ASST CHG	$56.40	$80.56	$68.48–$78.22	—	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVIT,DIR EA 15M	$56.40	$80.56	$68.48–$78.22	—	30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVIT,DIR EA 15M (ASST CHG	$56.40	$80.56	$68.48–$78.22	—	30%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 "FLU VAC TS 2025-26(6MOS UP)-PF 45 MCG (15 MCG X 3)/0.5 ML SYRG"	$59.75	$85.35	$59.40–$82.87	206% above	30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 "FLU VAC TS 2025-26(6MOS UP)-PF 45 MCG (15 MCG X 3)/0.5 ML SYRG"	$59.75	$85.35	$72.55–$82.87	—	30%
Hepatitis A vaccine, adult dose CPT 90632 "HEPATITIS A VIRUS VACCINE (PF) 1440 EL UNIT/ML INJ"	$250.06	$357.22	$248.63–$346.86	156% above	30%
Hepatitis A vaccine, adult dose inpatient CPT 90632 "HEPATITIS A VIRUS VACCINE (PF) 1440 EL UNIT/ML INJ"	$250.06	$357.22	$303.64–$346.86	—	30%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 "HEPATITIS B VIRUS VACCINE (PF) 20 MCG/ML SYRG"	$168.44	$240.62	$167.47–$233.64	153% above	30%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 "HEPATITIS B VIRUS VACCINE (PF) 20 MCG/ML SYRG"	$168.44	$240.62	$204.53–$233.64	—	30%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 "FLU VACC TS2025-26(65YR UP)-PF 180 MCG/0.5 ML SYRG"	$232.75	$332.50	$231.42–$322.86	191% above	30%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 "FLU VACC TS2025-26(65YR UP)-PF 180 MCG/0.5 ML SYRG"	$232.75	$332.50	$282.63–$322.86	—	30%
MMR vaccine (measles, mumps and rubella), live CPT 90707 "MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SOLR"	$290.87	$415.52	$289.20–$403.47	148% above	30%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 "MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SOLR"	$290.87	$415.52	$353.19–$403.47	—	30%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 "PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML SYRG"	$713.81	$1,019.72	$709.73–$990.15	245% above	30%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 "PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML SYRG"	$713.81	$1,019.72	$866.76–$990.15	—	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 "PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML SYRG"	$509.76	$728.22	$506.84–$707.10	40% above	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 "PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML SYRG"	$509.76	$728.22	$618.99–$707.10	—	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 "PNEUMOCOCCAL 23-VALPS VACCINE 25 MCG/0.5 ML SOLN"	$113.53	$162.18	$112.88–$157.48	4% above	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 "PNEUMOCOCCAL 23-VALPS VACCINE 25 MCG/0.5 ML SOLN"	$113.53	$162.18	$137.85–$157.48	—	30%
Rabies vaccine, one dose CPT 90675 "RABIES VACC, HUMAN DIPLOID 2.5 UNIT SOLR"	$599.54	$856.48	$596.11–$831.64	22% above	30%
Rabies vaccine, one dose inpatient CPT 90675 "RABIES VACC, HUMAN DIPLOID 2.5 UNIT SOLR"	$599.54	$856.48	$728.01–$831.64	—	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 "TETANUS AND DIPHTH TOX (PF) 5-2 LF UNIT/0.5 ML SYRG"	$55.65	$79.50	$55.33–$77.19	8% above	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 "TETANUS AND DIPHTH TOX (PF) 5-2 LF UNIT/0.5 ML SYRG"	$55.65	$79.50	$67.58–$77.19	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 "DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML SUSP"	$109.08	$155.82	$108.45–$151.30	112% above	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 "DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML SUSP"	$109.08	$155.82	$132.45–$151.30	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION SINGLE state	$13.90	$19.85	$13.82–$19.27	68% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION SINGLE	$68.27	$97.52	$67.87–$94.69	57% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HEPATITIS ADMINISTRATION (BFC)34	$68.27	$97.52	$67.87–$94.69	57% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMIN, OTHER, 1ST	$68.27	$97.52	$67.87–$94.69	57% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471VACCINE ADMIN, 1ST	$68.27	$97.52	$67.87–$94.69	57% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION SINGLE state	$13.90	$19.85	$16.87–$19.27	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471VACCINE ADMIN, 1ST	$68.27	$97.52	$82.89–$94.69	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION SINGLE	$68.27	$97.52	$82.89–$94.69	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HEPATITIS ADMINISTRATION (BFC)34	$68.27	$97.52	$82.89–$94.69	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMIN, OTHER, 1ST	$68.27	$97.52	$82.89–$94.69	—	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION TWO OR MORE STATE	$13.90	$19.85	$13.82–$19.27	43% below	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION TWO OR MORE	$31.17	$44.52	$30.99–$43.23	27% above	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 VACCINE ADMIN, 2+	$31.91	$45.58	$31.72–$44.26	30% above	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINE ADMIN, MISC, OTHER 2+	$32.65	$46.64	$32.46–$45.29	33% above	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION TWO OR MORE STATE	$13.90	$19.85	$16.87–$19.27	—	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION TWO OR MORE	$31.17	$44.52	$37.84–$43.23	—	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 VACCINE ADMIN, 2+	$31.91	$45.58	$38.74–$44.26	—	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINE ADMIN, MISC, OTHER 2+	$32.65	$46.64	$39.64–$45.29	—	30%

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.

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/8554/550379108_broaddus-hospital-association-inc_standardcharges.csv