Burleson St. Joseph Health Center of Caldwell, Texas
Burleson St. Joseph Health Center of Caldwell, Texas in Caldwell, TX publishes cash prices for 251 common procedures listed here, from its own machine-readable price file updated Feb 28, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Texas median for 245 of 248 procedures and above it for 2. By typical cash price it ranks #11 of 211 Texas hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
1101 Woodson Drive, Caldwell, TX 77836 Collected Sep 27, 2026 Source price file (979) 567-3245
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 451305 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ARTERIAL DOPPLER ANKLE/ARM | $321.48 | $1,837.00 | $200.08–$1,653.30 | 47% below | 82% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $321.48 | $1,837.00 | $77.00–$1,653.30 | 47% below | 82% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ARTERIAL DOPPLER ANKLE/ARM | $321.48 | $1,837.00 | $694.39–$1,837.00 | — | 82% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $321.48 | $1,837.00 | $694.39–$1,837.00 | — | 82% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 BARIUM SWALLOW/ESOPHAGUS | $191.80 | $1,096.00 | $179.00–$986.40 | 62% below | 83% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 BARIUM SWALLOW/ESOPHAGUS | $191.80 | $1,096.00 | $414.29–$1,096.00 | — | 83% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE/JOINT WHOLE BODY | $853.48 | $4,877.00 | $489.74–$4,389.30 | 53% below | 82% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE/JOINT WHOLE BODY | $853.48 | $4,877.00 | $1,843.51–$4,877.00 | — | 82% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED | $221.20 | $1,264.00 | $109.09–$1,137.60 | 36% below | 83% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST LIMITED | $221.20 | $1,264.00 | $477.80–$1,264.00 | — | 83% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST | $670.60 | $3,832.00 | $220.58–$3,448.80 | 79% below | 83% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST | $670.60 | $3,832.00 | $1,448.50–$3,832.00 | — | 83% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE | $711.03 | $4,063.00 | $220.58–$3,656.70 | 56% below | 82% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HRT W/3D IMAGE | $711.03 | $4,063.00 | $1,535.82–$4,063.00 | — | 82% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART W/O CONT CAL SCORING | $76.13 | $435.00 | $95.70–$1,676.00 | 60% below | 82% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART W/O CONT CAL SCORING | $76.13 | $435.00 | $164.43–$435.00 | — | 82% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT STONE PROTOCOL | $1,400.70 | $8,004.00 | $294.17–$7,203.60 | 60% below | 83% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT STONE PROTOCOL | $1,400.70 | $8,004.00 | $3,025.52–$8,004.00 | — | 83% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT TRAUMA ABDOMEN/PELVIS | $1,474.38 | $8,425.00 | $461.69–$7,582.50 | 62% below | 82% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT TRAUMA ABDOMEN/PELVIS | $1,474.38 | $8,425.00 | $3,184.65–$8,425.00 | — | 82% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PELV 1+ SECTION/REGNS | $1,489.25 | $8,510.00 | $461.69–$7,659.00 | 66% below | 83% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD&PELV 1+ SECTION/REGNS | $1,489.25 | $8,510.00 | $3,216.78–$8,510.00 | — | 83% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST | $746.20 | $4,264.00 | $220.58–$3,837.60 | 71% below | 83% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST | $746.20 | $4,264.00 | $1,611.80–$4,264.00 | — | 83% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST | $666.93 | $3,811.00 | $131.99–$3,429.90 | 69% below | 82% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST | $666.93 | $3,811.00 | $1,440.56–$3,811.00 | — | 82% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONTRAST | $550.73 | $3,147.00 | $131.99–$2,832.30 | 68% below | 82% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONTRAST | $550.73 | $3,147.00 | $1,189.57–$3,147.00 | — | 82% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN W/O CONTRAST | $510.65 | $2,918.00 | $131.99–$2,626.20 | 75% below | 83% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN W/O CONTRAST | $510.65 | $2,918.00 | $1,103.01–$2,918.00 | — | 83% |
| CT scan of the head with contrast CPT 70460 CT BRAIN W/CONTRAST | $745.33 | $4,259.00 | $220.58–$3,833.10 | 66% below | 82% |
| CT scan of the head with contrast inpatient CPT 70460 CT BRAIN W/CONTRAST | $745.33 | $4,259.00 | $1,609.91–$4,259.00 | — | 82% |
| CT scan of the head without and with contrast CPT 70470 CT BRAIN W/WO CONTRAST | $837.38 | $4,785.00 | $220.58–$4,306.50 | 68% below | 82% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN W/WO CONTRAST | $837.38 | $4,785.00 | $1,808.73–$4,785.00 | — | 82% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST | $527.98 | $3,017.00 | $131.99–$2,715.30 | 77% below | 82% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST | $527.98 | $3,017.00 | $1,140.43–$3,017.00 | — | 82% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONTRAST | $568.58 | $3,249.00 | $131.99–$2,924.10 | 76% below | 82% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONTRAST | $568.58 | $3,249.00 | $1,228.13–$3,249.00 | — | 82% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST | $537.43 | $3,071.00 | $220.58–$2,763.90 | 79% below | 82% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST | $537.43 | $3,071.00 | $1,160.84–$3,071.00 | — | 82% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID DOPPLER | $338.28 | $1,933.00 | $263.00–$1,739.70 | 76% below | 82% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID DOPPLER | $338.28 | $1,933.00 | $730.68–$1,933.00 | — | 82% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 ABDOMINAL US RETROPERITONEAL | $274.58 | $1,569.00 | $131.99–$1,412.10 | 63% below | 82% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 ABDOMINAL US RETROPERITONEAL | $274.58 | $1,569.00 | $593.09–$1,569.00 | — | 82% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX W/O CONTRAST | $565.43 | $3,231.00 | $131.99–$2,907.90 | 73% below | 82% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX W/O CONTRAST | $565.43 | $3,231.00 | $1,221.32–$3,231.00 | — | 82% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX W/CONTRAST | $645.58 | $3,689.00 | $220.58–$3,320.10 | 76% below | 82% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX W/CONTRAST | $645.58 | $3,689.00 | $1,394.45–$3,689.00 | — | 82% |
| Diagnostic mammogram, both breasts CPT 77066 MAMMO ADDL VIEWS RETURN VISIT | $100.98 | $577.00 | $126.94–$519.30 | 72% below | 82% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMO ADDL VIEWS RETURN VISIT | $100.98 | $577.00 | $218.11–$577.00 | — | 82% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 VAS SCAN LOWER EXT ART BILAT | $329.18 | $1,881.00 | $263.00–$1,692.90 | — | 82% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 VAS SCAN LOWER EXT ART BILAT | $329.18 | $1,881.00 | $711.02–$1,881.00 | — | 82% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS DOPPLER BILAT | $385.53 | $2,203.00 | $263.00–$1,982.70 | — | 82% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS DOPPLER BILAT | $385.53 | $2,203.00 | $832.74–$2,203.00 | — | 82% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARD TRANSTHORACIC COMPLET | $819.88 | $4,685.00 | $269.66–$4,216.50 | 68% below | 82% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARD TRANSTHORACIC COMPLET | $819.88 | $4,685.00 | $1,770.93–$4,685.00 | — | 82% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING | $584.68 | $3,341.00 | $489.74–$3,006.90 | 67% below | 82% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING | $584.68 | $3,341.00 | $1,262.90–$3,341.00 | — | 82% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STY UNATT&RESP EFFT | $253.75 | $1,450.00 | $112.00–$1,305.00 | 68% below | 83% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STY UNATT&RESP EFFT | $253.75 | $1,450.00 | $548.10–$1,450.00 | — | 83% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY CPAP | $2,094.58 | $11,969.00 | $1,047.79–$10,772.10 | 60% below | 82% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY CPAP | $2,094.58 | $11,969.00 | $4,524.29–$11,969.00 | — | 82% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD REAL TIME W/IMAGE LMTD | $231.70 | $1,324.00 | $131.99–$1,191.60 | 63% below | 83% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD REAL TIME W/IMAGE LMTD | $231.70 | $1,324.00 | $500.48–$1,324.00 | — | 83% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT PULMONARY LUNG SCAN | $55.30 | $316.00 | $69.52–$1,676.00 | 76% below | 83% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT PULMONARY LUNG SCAN | $55.30 | $316.00 | $119.45–$316.00 | — | 83% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST | $747.78 | $4,273.00 | $294.17–$3,845.70 | 69% below | 82% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST | $747.78 | $4,273.00 | $1,615.20–$4,273.00 | — | 82% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO CONTRAST | $1,289.23 | $7,367.00 | $461.69–$6,630.30 | 61% below | 82% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO CONTRAST | $1,289.23 | $7,367.00 | $2,784.73–$7,367.00 | — | 82% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST | $784.18 | $4,481.00 | $294.17–$4,032.90 | 65% below | 82% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST | $784.18 | $4,481.00 | $1,693.82–$4,481.00 | — | 82% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONTRAST | $1,074.15 | $6,138.00 | $461.69–$5,524.20 | 66% below | 83% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONTRAST | $1,074.15 | $6,138.00 | $2,320.17–$6,138.00 | — | 83% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE WO CONTRAST | $827.75 | $4,730.00 | $294.17–$4,257.00 | 65% below | 83% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-SPINE WO CONTRAST | $827.75 | $4,730.00 | $1,787.94–$4,730.00 | — | 83% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W/WO CONTRAST | $1,250.03 | $7,143.00 | $461.69–$6,428.70 | 61% below | 82% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L-SPINE W/WO CONTRAST | $1,250.03 | $7,143.00 | $2,700.06–$7,143.00 | — | 82% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE WO CONTRAST | $827.75 | $4,730.00 | $294.17–$4,257.00 | 62% below | 83% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T-SPINE WO CONTRAST | $827.75 | $4,730.00 | $1,787.94–$4,730.00 | — | 83% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE WO/W CONTRAST | $1,460.03 | $8,343.00 | $461.69–$7,508.70 | 60% below | 82% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-SPINE WO/W CONTRAST | $1,460.03 | $8,343.00 | $3,153.66–$8,343.00 | — | 82% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE W/O CONTRST | $869.05 | $4,966.00 | $294.17–$4,469.40 | 64% below | 83% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE W/O CONTRST | $869.05 | $4,966.00 | $1,877.15–$4,966.00 | — | 83% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO CONTRAST | $1,100.93 | $6,291.00 | $461.69–$5,661.90 | 68% below | 82% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO CONTRAST | $1,100.93 | $6,291.00 | $2,378.00–$6,291.00 | — | 82% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WITHOUT CONTRAST | $649.60 | $3,712.00 | $294.17–$3,340.80 | 76% below | 83% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WITHOUT CONTRAST | $649.60 | $3,712.00 | $1,403.14–$3,712.00 | — | 83% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL SPECT MULTIPLE | $1,755.78 | $10,033.00 | $929.34–$9,029.70 | 60% below | 82% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL SPECT MULTIPLE | $1,755.78 | $10,033.00 | $3,792.48–$10,033.00 | — | 82% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET W/CT SKULL-THIGH | $2,270.10 | $12,972.00 | $1,653.00–$11,674.80 | 52% below | 83% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET W/CT SKULL-THIGH | $2,270.10 | $12,972.00 | $4,903.42–$12,972.00 | — | 83% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 NON-OB US TRANSABDOMINAL | $138.95 | $794.00 | $69.81–$714.60 | 71% below | 83% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 NON-OB US TRANSABDOMINAL | $138.95 | $794.00 | $300.14–$794.00 | — | 83% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 IUD LOCALIZATION | $295.40 | $1,688.00 | $137.30–$1,519.20 | 66% below | 83% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 IUD LOCALIZATION | $295.40 | $1,688.00 | $638.07–$1,688.00 | — | 83% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 COMPLETE PREGNANCY ECHO | $329.00 | $1,880.00 | $131.99–$1,692.00 | 50% below | 83% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 COMPLETE PREGNANCY ECHO | $329.00 | $1,880.00 | $710.64–$1,880.00 | — | 83% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US 1ST GEST < 14 WEEKS | $282.98 | $1,617.00 | $131.99–$1,455.30 | 54% below | 82% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US 1ST GEST < 14 WEEKS | $282.98 | $1,617.00 | $611.23–$1,617.00 | — | 82% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULT PREG LIMITED 1 OR + FETUS | $249.73 | $1,427.00 | $131.99–$1,284.30 | 46% below | 82% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULT PREG LIMITED 1 OR + FETUS | $249.73 | $1,427.00 | $539.41–$1,427.00 | — | 82% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO BILATERAL SCREENING DDI | $78.93 | $451.00 | $99.22–$405.90 | — | 82% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO BILATERAL SCREENING DDI | $78.93 | $451.00 | $170.48–$451.00 | — | 82% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY4 OR MORE | $1,780.45 | $10,174.00 | $996.87–$9,156.60 | 62% below | 83% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY4 OR MORE | $1,780.45 | $10,174.00 | $3,845.78–$10,174.00 | — | 83% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 BA SWALLOW W/SPEECH THERAPIST | $178.33 | $1,019.00 | $179.00–$917.10 | 71% below | 82% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BA SWALLOW W/SPEECH THERAPIST | $178.33 | $1,019.00 | $385.19–$1,019.00 | — | 82% |
| Transvaginal pelvic ultrasound CPT 76830 NON-OB US TRANSVAGINAL | $196.35 | $1,122.00 | $131.99–$1,009.80 | 69% below | 83% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 NON-OB US TRANSVAGINAL | $196.35 | $1,122.00 | $424.12–$1,122.00 | — | 83% |
| Transvaginal ultrasound during pregnancy CPT 76817 OB US TRANSVAGINAL | $284.73 | $1,627.00 | $131.99–$1,464.30 | 44% below | 82% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 OB US TRANSVAGINAL | $284.73 | $1,627.00 | $615.01–$1,627.00 | — | 82% |
| Ultrasound of the abdomen, complete CPT 76700 ABDOMINAL ULTRASOUND | $305.73 | $1,747.00 | $131.99–$1,572.30 | 65% below | 82% |
| Ultrasound of the abdomen, complete CPT 76700 ABDOMINAL ECHO | $310.45 | $1,774.00 | $131.99–$1,596.60 | 64% below | 83% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMINAL ULTRASOUND | $305.73 | $1,747.00 | $660.37–$1,747.00 | — | 82% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMINAL ECHO | $310.45 | $1,774.00 | $670.58–$1,774.00 | — | 83% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI SINGLE CONTRAST (NO AIR) | $287.53 | $1,643.00 | $179.00–$1,478.70 | 59% below | 82% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI SINGLE CONTRAST (NO AIR) | $287.53 | $1,643.00 | $621.06–$1,643.00 | — | 82% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES ROUTINE | $124.43 | $711.00 | $85.14–$639.90 | 56% below | 82% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES ROUTINE | $124.43 | $711.00 | $268.76–$711.00 | — | 82% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (PANEL) | $22.05 | $126.00 | $4.77–$113.40 | 58% below | 83% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (PANEL) | $22.05 | $126.00 | $47.63–$126.00 | — | 83% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST (PANEL) | $24.85 | $142.00 | $4.66–$127.80 | 52% below | 83% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (PANEL) | $24.85 | $142.00 | $53.68–$142.00 | — | 83% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL (AB) | $131.78 | $753.00 | $42.87–$677.70 | 67% below | 82% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANEL (AB) | $131.78 | $753.00 | $284.64–$753.00 | — | 82% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP IGG ANTIBODY | $39.03 | $223.00 | $11.66–$200.70 | 36% below | 82% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP IGG ANTIBODY | $39.03 | $223.00 | $84.30–$223.00 | — | 82% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI NUC ABS | $45.68 | $261.00 | $10.88–$234.90 | 50% below | 82% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI NUC ABS | $45.68 | $261.00 | $98.66–$261.00 | — | 82% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PROTEIN | $65.45 | $374.00 | $35.33–$336.60 | 69% below | 83% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC PROTEIN | $65.45 | $374.00 | $141.38–$374.00 | — | 83% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $98.88 | $565.00 | $7.61–$508.50 | 61% below | 82% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $98.88 | $565.00 | $213.57–$565.00 | — | 82% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 GROSS & MICRO LEVEL 4 | $208.43 | $1,191.00 | $45.68–$1,071.90 | 30% below | 82% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 GROSS & MICRO LEVEL 4 | $208.43 | $1,191.00 | $450.20–$1,191.00 | — | 82% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE | $79.10 | $452.00 | $9.29–$406.80 | 67% below | 83% |
| Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE | $79.10 | $452.00 | $170.86–$452.00 | — | 83% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $10.15 | $58.00 | $2.70–$52.20 | 57% below | 83% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $10.15 | $58.00 | $21.93–$58.00 | — | 83% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM (PANEL) | $23.45 | $134.00 | $3.54–$120.60 | 55% below | 83% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE SERUM (PANEL) | $23.45 | $134.00 | $50.66–$134.00 | — | 83% |
| Blood lead test CPT 83655 LEAD | $30.45 | $174.00 | $10.90–$156.60 | 27% below | 83% |
| Blood lead test inpatient CPT 83655 LEAD | $30.45 | $174.00 | $65.78–$174.00 | — | 83% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 B-HCG SERUM QUAL | $57.93 | $331.00 | $6.77–$297.90 | 58% below | 82% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 B-HCG SERUM QUAL | $57.93 | $331.00 | $125.12–$331.00 | — | 82% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO | $79.45 | $454.00 | $2.69–$450.29 | 14% below | 83% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO | $79.45 | $454.00 | $171.62–$454.00 | — | 83% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRPS | $45.50 | $260.00 | $4.66–$234.00 | 11% below | 83% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRPS | $45.50 | $260.00 | $98.28–$260.00 | — | 83% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE BY PCR | $37.80 | $216.00 | $33.54–$194.40 | 82% below | 83% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE BY PCR | $37.80 | $216.00 | $81.65–$216.00 | — | 83% |
| CA 19-9 blood test (tumor marker) CPT 86301 CARB ANTIGEN 19-9 | $58.10 | $332.00 | $18.73–$298.80 | 65% below | 83% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CARB ANTIGEN 19-9 | $58.10 | $332.00 | $125.50–$332.00 | — | 83% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125 | $61.43 | $351.00 | $18.73–$315.90 | 62% below | 82% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125 | $61.43 | $351.00 | $132.68–$351.00 | — | 82% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 NON-CDC SARS-COV-2HIGH | $75.08 | $429.00 | $46.18–$386.10 | at median | 82% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 2019 NON-CDC SARS-COV-2HIGH | $75.08 | $429.00 | $162.17–$429.00 | — | 82% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY PCR | $59.15 | $338.00 | $31.58–$304.20 | 51% below | 83% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA BY PCR | $59.15 | $338.00 | $127.77–$338.00 | — | 83% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE W/O ELECTROPHORE | $56.35 | $322.00 | $12.05–$289.80 | 70% below | 83% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE W/O ELECTROPHORE | $56.35 | $322.00 | $121.72–$322.00 | — | 83% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF | $37.63 | $215.00 | $6.99–$193.50 | 62% below | 82% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF | $37.63 | $215.00 | $81.27–$215.00 | — | 82% |
| Complete blood count (CBC), no differential CPT 85027 HEMAGRAM & PLATELET COUNT AUTO | $42.35 | $242.00 | $5.82–$217.80 | 63% below | 83% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMAGRAM & PLATELET COUNT AUTO | $42.35 | $242.00 | $91.48–$242.00 | — | 83% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $135.80 | $776.00 | $9.50–$698.40 | 65% below | 83% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $135.80 | $776.00 | $293.33–$776.00 | — | 83% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE | $88.90 | $508.00 | $9.16–$457.20 | 51% below | 83% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE | $88.90 | $508.00 | $192.03–$508.00 | — | 83% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA - SULFATE | $32.90 | $188.00 | $20.01–$169.20 | 79% below | 83% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA - SULFATE | $32.90 | $188.00 | $71.07–$188.00 | — | 83% |
| Estradiol blood test CPT 82670 ESTRADIOL | $87.85 | $502.00 | $25.15–$451.80 | 33% below | 83% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL | $87.85 | $502.00 | $189.76–$502.00 | — | 83% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $62.30 | $356.00 | $16.72–$320.40 | 61% below | 83% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH | $62.30 | $356.00 | $134.57–$356.00 | — | 83% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL | $45.33 | $259.00 | $17.67–$233.10 | 79% below | 82% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL | $45.33 | $259.00 | $97.91–$259.00 | — | 82% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $45.85 | $262.00 | $12.27–$235.80 | 42% below | 83% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $45.85 | $262.00 | $99.04–$262.00 | — | 83% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $37.10 | $212.00 | $13.23–$190.80 | 65% below | 83% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID | $37.10 | $212.00 | $80.14–$212.00 | — | 83% |
| Free T3 thyroid hormone test CPT 84481 FREE T3 | $46.55 | $266.00 | $15.25–$239.40 | 71% below | 83% |
| Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 | $46.55 | $266.00 | $100.55–$266.00 | — | 83% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 | $33.43 | $191.00 | $8.12–$171.90 | 73% below | 82% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 | $33.43 | $191.00 | $72.20–$191.00 | — | 82% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $58.63 | $335.00 | $22.92–$301.50 | 40% below | 82% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE | $58.63 | $335.00 | $126.63–$335.00 | — | 82% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $296.45 | $1,694.00 | $26.84–$1,524.60 | 41% below | 83% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL | $296.45 | $1,694.00 | $640.34–$1,694.00 | — | 83% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE - GESTATIONAL | $38.68 | $221.00 | $4.28–$198.90 | 66% below | 82% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE - GESTATIONAL | $38.68 | $221.00 | $83.54–$221.00 | — | 82% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPECIMEN | $87.33 | $499.00 | $11.58–$449.10 | 43% below | 82% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 SPECIMEN | $87.33 | $499.00 | $188.63–$499.00 | — | 82% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE BY PCR | $59.15 | $338.00 | $31.58–$304.20 | 54% below | 83% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE BY PCR | $59.15 | $338.00 | $127.77–$338.00 | — | 83% |
| H. pylori stool antigen test CPT 87338 H. PYLORI SPECIFIC ATG | $39.20 | $224.00 | $12.94–$201.60 | 68% below | 83% |
| H. pylori stool antigen test inpatient CPT 87338 H. PYLORI SPECIFIC ATG | $39.20 | $224.00 | $84.68–$224.00 | — | 83% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA PCR | $151.90 | $868.00 | $76.59–$781.20 | 59% below | 83% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA PCR | $151.90 | $868.00 | $328.11–$868.00 | — | 83% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV ABS BY EIA | $73.15 | $418.00 | $12.34–$376.20 | 41% below | 83% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV ABS BY EIA | $73.15 | $418.00 | $158.01–$418.00 | — | 83% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 AB/AG SCREEN | $54.08 | $309.00 | $21.67–$278.10 | 63% below | 82% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 AB/AG SCREEN | $54.08 | $309.00 | $116.81–$309.00 | — | 82% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA ON TISSUE | $16.28 | $93.00 | $27.35–$114.41 | 80% below | 82% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA ON TISSUE | $16.28 | $93.00 | $35.16–$93.00 | — | 82% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $28.00 | $160.00 | $8.74–$144.00 | 70% below | 83% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C | $28.00 | $160.00 | $60.48–$160.00 | — | 83% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY | $47.78 | $273.00 | $9.67–$245.70 | 46% below | 82% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY | $47.78 | $273.00 | $103.20–$273.00 | — | 82% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE ANTIGEN | $37.10 | $212.00 | $9.30–$190.80 | 74% below | 83% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE ANTIGEN | $37.10 | $212.00 | $80.14–$212.00 | — | 83% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $46.55 | $266.00 | $12.84–$239.40 | 46% below | 83% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY | $46.55 | $266.00 | $100.55–$266.00 | — | 83% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA BY BDNA PCR-QUANT | $164.85 | $942.00 | $38.56–$847.80 | 22% below | 83% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA BY BDNA PCR-QUANT | $164.85 | $942.00 | $356.08–$942.00 | — | 83% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES 1 IGG | $35.53 | $203.00 | $11.87–$182.70 | 51% below | 82% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES 1 IGG | $35.53 | $203.00 | $76.74–$203.00 | — | 82% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES 2 IGG | $60.90 | $348.00 | $17.42–$313.20 | 29% below | 83% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES 2 IGG | $60.90 | $348.00 | $131.55–$348.00 | — | 83% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENS | $33.08 | $189.00 | $11.66–$170.10 | 67% below | 82% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HIGH SENS | $33.08 | $189.00 | $71.45–$189.00 | — | 82% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE ULTRAQUANT | $50.58 | $289.00 | $16.13–$260.10 | 66% below | 82% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE ULTRAQUANT | $50.58 | $289.00 | $109.25–$289.00 | — | 82% |
| Insulin blood test CPT 83525 INSULIN | $37.98 | $217.00 | $10.29–$195.30 | 45% below | 82% |
| Insulin blood test inpatient CPT 83525 INSULIN | $37.98 | $217.00 | $82.03–$217.00 | — | 82% |
| Iron blood test (serum iron) CPT 83540 IRON | $31.50 | $180.00 | $5.82–$162.00 | 66% below | 83% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $31.50 | $180.00 | $68.04–$180.00 | — | 83% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING | $30.28 | $173.00 | $7.87–$155.70 | 70% below | 82% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING | $30.28 | $173.00 | $65.40–$173.00 | — | 82% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION | $170.28 | $973.00 | $7.81–$875.70 | 52% below | 82% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION | $170.28 | $973.00 | $367.80–$973.00 | — | 82% |
| LH (luteinizing hormone) test CPT 83002 LH | $68.25 | $390.00 | $16.67–$351.00 | 55% below | 83% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH | $68.25 | $390.00 | $147.42–$390.00 | — | 83% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $54.25 | $310.00 | $6.20–$279.00 | 20% below | 83% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $54.25 | $310.00 | $117.18–$310.00 | — | 83% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $111.13 | $635.00 | $7.35–$571.50 | 65% below | 82% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $111.13 | $635.00 | $240.03–$635.00 | — | 82% |
| Lyme disease antibody test CPT 86618 LYME DISEASE IA | $44.80 | $256.00 | $15.33–$230.40 | 46% below | 83% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE IA | $44.80 | $256.00 | $96.77–$256.00 | — | 83% |
| Magnesium blood test CPT 83735 MAGNESIUM | $39.73 | $227.00 | $6.03–$204.30 | 31% below | 82% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $39.73 | $227.00 | $85.81–$227.00 | — | 82% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA AB EA 1G CLASS | $26.25 | $150.00 | $11.59–$135.00 | 7% below | 83% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB EA 1G CLASS | $26.25 | $150.00 | $56.70–$150.00 | — | 83% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO RAPID TEST | $18.03 | $103.00 | $4.66–$92.70 | 81% below | 82% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST | $54.78 | $313.00 | $4.66–$281.70 | 43% below | 82% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO RAPID TEST | $18.03 | $103.00 | $38.94–$103.00 | — | 82% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST | $54.78 | $313.00 | $118.32–$313.00 | — | 82% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $159.43 | $911.00 | $43.03–$819.90 | 37% below | 82% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL | $159.43 | $911.00 | $344.36–$911.00 | — | 82% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $41.83 | $239.00 | $16.55–$215.10 | 67% below | 82% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE | $41.83 | $239.00 | $90.35–$239.00 | — | 82% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $51.10 | $292.00 | $16.55–$262.80 | 49% below | 83% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL | $51.10 | $292.00 | $110.38–$292.00 | — | 83% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP TEST LIQID BASED ANY METH | $73.50 | $420.00 | $23.95–$378.00 | 28% below | 83% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP TEST LIQID BASED ANY METH | $73.50 | $420.00 | $158.76–$420.00 | — | 83% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP TEST - THIN LAYER SCREEN | $76.83 | $439.00 | $18.23–$395.10 | 15% below | 82% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP TEST - THIN LAYER SCREEN | $76.83 | $439.00 | $165.95–$439.00 | — | 82% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE C-TERMINAL | $70.35 | $402.00 | $37.15–$361.80 | 70% below | 83% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE C-TERMINAL | $70.35 | $402.00 | $151.96–$402.00 | — | 83% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $53.38 | $305.00 | $5.41–$274.50 | 9% below | 82% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $53.38 | $305.00 | $115.29–$305.00 | — | 82% |
| Progesterone blood test CPT 84144 PROGESTERONE | $72.10 | $412.00 | $18.77–$370.80 | 32% below | 83% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $72.10 | $412.00 | $155.74–$412.00 | — | 83% |
| Prolactin blood test CPT 84146 PROLACTIN | $74.90 | $428.00 | $17.44–$385.20 | 26% below | 83% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $74.90 | $428.00 | $161.79–$428.00 | — | 83% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PRO-TIME W/INR | $47.25 | $270.00 | $3.86–$243.00 | 30% below | 83% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PRO-TIME W/INR | $47.25 | $270.00 | $102.06–$270.00 | — | 83% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 10 PANEL N/DOT URINE DRUG SCR | $14.00 | $80.00 | $11.34–$72.00 | 91% below | 83% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 10 PANEL N/DOT URINE DRUG SCR | $14.00 | $80.00 | $30.24–$80.00 | — | 83% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A DETECTION | $53.55 | $306.00 | $14.90–$275.40 | 52% below | 83% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A DETECTION | $53.55 | $306.00 | $115.67–$306.00 | — | 83% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANTITATIVE | $21.35 | $122.00 | $5.10–$109.80 | 52% below | 83% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANTITATIVE | $21.35 | $122.00 | $46.12–$122.00 | — | 83% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG | $39.55 | $226.00 | $12.95–$203.40 | 19% below | 83% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG | $39.55 | $226.00 | $85.43–$226.00 | — | 83% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE | $20.30 | $116.00 | $2.43–$104.40 | 70% below | 83% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE | $20.30 | $116.00 | $43.85–$116.00 | — | 83% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS | $63.88 | $365.00 | $11.08–$328.50 | 61% below | 82% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS | $63.88 | $365.00 | $137.97–$365.00 | — | 82% |
| Stool ova and parasites exam CPT 87177 PINWORM PREP | $93.80 | $536.00 | $8.01–$482.40 | 9% below | 83% |
| Stool ova and parasites exam inpatient CPT 87177 PINWORM PREP | $93.80 | $536.00 | $202.61–$536.00 | — | 83% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 TEST FOR BLOOD FECES | $3.15 | $18.00 | $3.94–$18.00 | 94% below | 83% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD - SCREENING POC | $4.90 | $28.00 | $3.94–$25.20 | 90% below | 83% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD - SCREENING | $4.90 | $28.00 | $3.94–$25.20 | 90% below | 83% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 TEST FOR BLOOD FECES | $3.15 | $18.00 | $6.81–$18.00 | — | 83% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD - SCREENING | $4.90 | $28.00 | $10.59–$28.00 | — | 83% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD - SCREENING POC | $4.90 | $28.00 | $10.59–$28.00 | — | 83% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR | $40.95 | $234.00 | $3.84–$210.60 | 4% below | 83% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR | $40.95 | $234.00 | $88.46–$234.00 | — | 83% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD | $169.75 | $970.00 | $55.78–$873.00 | 23% below | 83% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD | $169.75 | $970.00 | $366.66–$970.00 | — | 83% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE | $65.45 | $374.00 | $23.23–$336.60 | 28% below | 83% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE | $65.45 | $374.00 | $141.38–$374.00 | — | 83% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI TPO | $49.35 | $282.00 | $13.10–$253.80 | 52% below | 83% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI TPO | $49.35 | $282.00 | $106.60–$282.00 | — | 83% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS BY NAA | $36.23 | $207.00 | $31.58–$186.30 | 59% below | 82% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS BY NAA | $36.23 | $207.00 | $78.25–$207.00 | — | 82% |
| Uric acid blood test CPT 84550 URIC ACID SERUM | $39.03 | $223.00 | $4.07–$200.70 | 68% below | 82% |
| Uric acid blood test inpatient CPT 84550 URIC ACID SERUM | $39.03 | $223.00 | $84.30–$223.00 | — | 82% |
| Urinalysis with microscope exam, automated CPT 81001 UA COMPLETE | $58.28 | $333.00 | $2.85–$299.70 | 46% below | 82% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA COMPLETE | $58.28 | $333.00 | $125.88–$333.00 | — | 82% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS | $2.63 | $15.00 | $3.62–$15.00 | 93% below | 82% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS | $2.63 | $15.00 | $5.67–$15.00 | — | 82% |
| Urinalysis without microscope exam, manual CPT 81002 URINE-NO MICRO | $3.15 | $18.00 | $3.13–$16.20 | 91% below | 83% |
| Urinalysis without microscope exam, manual CPT 81002 URINE BY DIPSTICKNON-AUTO | $9.98 | $57.00 | $3.13–$51.30 | 72% below | 82% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE-NO MICRO | $3.15 | $18.00 | $6.81–$18.00 | — | 83% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE BY DIPSTICKNON-AUTO | $9.98 | $57.00 | $21.55–$57.00 | — | 82% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE QUANT COUNT URINE | $31.85 | $182.00 | $7.26–$163.80 | 82% below | 83% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE QUANT COUNT URINE | $31.85 | $182.00 | $68.80–$182.00 | — | 83% |
| Urine pregnancy test, read by color change CPT 81025 URIN PREG TEST | $76.13 | $435.00 | $7.75–$391.50 | 37% below | 82% |
| Urine pregnancy test, read by color change inpatient CPT 81025 URIN PREG TEST | $76.13 | $435.00 | $164.43–$435.00 | — | 82% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $37.45 | $214.00 | $13.57–$192.60 | 62% below | 83% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 | $37.45 | $214.00 | $80.90–$214.00 | — | 83% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY | $73.15 | $418.00 | $26.64–$376.20 | 41% below | 83% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY | $73.15 | $418.00 | $158.01–$418.00 | — | 83% |
| Zinc blood test CPT 84630 ZINC - SERUM | $23.10 | $132.00 | $10.25–$118.80 | 69% below | 83% |
| Zinc blood test inpatient CPT 84630 ZINC - SERUM | $23.10 | $132.00 | $49.90–$132.00 | — | 83% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 B-HCG SERUM QUANT | $62.30 | $356.00 | $13.55–$320.40 | 30% below | 83% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 B-HCG SERUM QUANT | $62.30 | $356.00 | $134.57–$356.00 | — | 83% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 MAMMO BRST BX STEREO | $1,827.53 | $10,443.00 | $511.75–$9,398.70 | 51% below | 82% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 MAMMO BRST BX STEREO | $1,827.53 | $10,443.00 | $3,947.46–$10,443.00 | — | 82% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE | $84.00 | $480.00 | $89.76–$2,888.00 | 82% below | 83% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TREATMENT OF ANKLE FRACTURE | $84.00 | $480.00 | $181.44–$480.00 | — | 83% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE | $52.85 | $302.00 | $66.44–$1,508.00 | 81% below | 83% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TREAT METATARSAL FRACTURE | $52.85 | $302.00 | $114.16–$302.00 | — | 83% |
| Cardiac catheterization with coronary angiogram CPT 93458 LT HEART CATH W/SELECT COR | $4,932.03 | $28,183.00 | $875.00–$25,364.70 | 68% below | 82% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 LT HEART CATH W/SELECT COR | $4,932.03 | $28,183.00 | $10,653.18–$28,183.00 | — | 82% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL | $798.00 | $4,560.00 | $188.00–$4,104.00 | 59% below | 83% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL | $798.00 | $4,560.00 | $1,723.68–$4,560.00 | — | 83% |
| Catheter ablation for atrial fibrillation CPT 93656 A FIB ABLATION | $12,806.85 | $73,182.00 | $875.00–$65,863.80 | 65% below | 83% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 A FIB ABLATION | $12,806.85 | $73,182.00 | $27,662.80–$73,182.00 | — | 83% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK | $415.28 | $2,373.00 | $522.06–$4,479.00 | 66% below | 82% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONL BLOCK | $415.28 | $2,373.00 | $897.00–$2,373.00 | — | 82% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/ULNA | $118.83 | $679.00 | $89.76–$1,508.00 | 77% below | 82% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREAT FRACTURE RADIUS/ULNA | $118.83 | $679.00 | $256.67–$679.00 | — | 82% |
| Coronary stent placement, one artery CPT 92928 STENT W PTCA WP | $3,785.95 | $21,634.00 | $875.00–$39,633.92 | 69% below | 83% |
| Coronary stent placement, one artery inpatient CPT 92928 STENT W PTCA WP | $3,785.95 | $21,634.00 | $8,177.66–$21,634.00 | — | 83% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY | $295.40 | $1,688.00 | $188.00–$2,888.00 | 80% below | 83% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY | $295.40 | $1,688.00 | $250.53–$2,888.00 | 80% below | 83% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY | $295.40 | $1,688.00 | $638.07–$1,688.00 | — | 83% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY | $295.40 | $1,688.00 | $638.07–$1,688.00 | — | 83% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE | $803.25 | $4,590.00 | $188.00–$4,479.00 | 81% below | 83% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURETTAGE | $803.25 | $4,590.00 | $1,735.02–$4,590.00 | — | 83% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION | $18.03 | $103.00 | $22.66–$1,508.00 | 90% below | 82% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT PREMALG LESION | $18.03 | $103.00 | $38.94–$103.00 | — | 82% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI | $29.05 | $166.00 | $36.52–$1,508.00 | 74% below | 83% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI | $29.05 | $166.00 | $62.75–$166.00 | — | 83% |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED CERUMEN | $56.88 | $325.00 | $71.50–$1,508.00 | 63% below | 82% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL OF IMPACTED CERUMEN | $56.88 | $325.00 | $122.85–$325.00 | — | 82% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY | $64.75 | $370.00 | $48.35–$1,508.00 | 82% below | 83% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BIOPSY | $64.75 | $370.00 | $139.86–$370.00 | — | 83% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC | $448.53 | $2,563.00 | $276.53–$2,888.00 | 64% below | 82% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTERLAMINAR CRV/THRC | $448.53 | $2,563.00 | $968.82–$2,563.00 | — | 82% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET JOINT INJECTION LUMBAR | $742.35 | $4,242.00 | $358.49–$3,817.80 | 54% below | 83% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV | $742.35 | $4,242.00 | $358.49–$3,817.80 | 54% below | 83% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV | $742.35 | $4,242.00 | $1,603.48–$4,242.00 | — | 83% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 FACET JOINT INJECTION LUMBAR | $742.35 | $4,242.00 | $1,603.48–$4,242.00 | — | 83% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S) | $211.40 | $1,208.00 | $172.13–$2,888.00 | 76% below | 83% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LIGATION OF HEMORRHOID(S) | $211.40 | $1,208.00 | $456.63–$1,208.00 | — | 83% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ PROC-HYSTERSALPINGOGRAPHY | $218.58 | $1,249.00 | $274.78–$1,508.00 | 45% below | 82% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJ PROC-HYSTERSALPINGOGRAPHY | $218.58 | $1,249.00 | $472.13–$1,249.00 | — | 82% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D OF ABSCESS SIMPLE | $118.30 | $676.00 | $68.44–$1,508.00 | 75% below | 83% |
| Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS | $118.30 | $676.00 | $68.44–$1,508.00 | 75% below | 83% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABSCESS | $118.30 | $676.00 | $255.53–$676.00 | — | 83% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D OF ABSCESS SIMPLE | $118.30 | $676.00 | $255.53–$676.00 | — | 83% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDON/LIGAMENT/CYST | $205.63 | $1,175.00 | $24.76–$2,888.00 | 53% below | 82% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT TENDON/LIGAMENT/CYST | $205.63 | $1,175.00 | $444.15–$1,175.00 | — | 82% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJECT MAJOR JOINT/BURSA | $298.38 | $1,705.00 | $29.41–$2,888.00 | 50% below | 82% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJECT MAJOR JOINT/BURSA | $298.38 | $1,705.00 | $644.49–$1,705.00 | — | 82% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJECT INTER JOINT/BURSA | $241.85 | $1,382.00 | $24.76–$2,888.00 | 59% below | 83% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJECT INTER JOINT/BURSA | $241.85 | $1,382.00 | $522.40–$1,382.00 | — | 83% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJECT SMALL JOINT/BURSA | $235.73 | $1,347.00 | $23.88–$2,888.00 | 34% below | 82% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJECT SMALL JOINT/BURSA | $235.73 | $1,347.00 | $509.17–$1,347.00 | — | 82% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 WOUND CLOSE S/TR/EXT <2.5CM | $96.25 | $550.00 | $121.00–$1,508.00 | 83% below | 83% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 WOUND CLOSE S/TR/EXT <2.5CM | $96.25 | $550.00 | $207.90–$550.00 | — | 83% |
| Left heart catheterization, diagnostic one side CPT 93452 LEFT HEART ONLY | $2,178.05 | $12,446.00 | $875.00–$11,399.80 | 81% below | 83% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HEART ONLY | $2,178.05 | $12,446.00 | $4,704.59–$12,446.00 | — | 83% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ LUMBAR W IMAGING | $448.53 | $2,563.00 | $276.53–$2,888.00 | 72% below | 82% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ LUMBAR W IMAGING | $448.53 | $2,563.00 | $968.82–$2,563.00 | — | 82% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION SPINE LUMBAR/SACRAL | $314.13 | $1,795.00 | $276.53–$2,888.00 | 74% below | 82% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION SPINE LUMBAR/SACRAL | $314.13 | $1,795.00 | $678.51–$1,795.00 | — | 82% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ FORAMEN EPIDURAL L/S | $530.78 | $3,033.00 | $358.49–$2,888.00 | 64% below | 82% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ FORAMEN EPIDURAL L/S | $530.78 | $3,033.00 | $1,146.48–$3,033.00 | — | 82% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM< | $205.63 | $1,175.00 | $81.84–$2,888.00 | 75% below | 82% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REMOVAL OF SKIN LESION <.5CM | $205.63 | $1,175.00 | $81.84–$2,888.00 | 75% below | 82% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR-EXT B9+MARG 0.5 CM< | $205.63 | $1,175.00 | $444.15–$1,175.00 | — | 82% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 REMOVAL OF SKIN LESION <.5CM | $205.63 | $1,175.00 | $444.15–$1,175.00 | — | 82% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/< | $184.45 | $1,054.00 | $90.87–$2,888.00 | 73% below | 83% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EX BENIGN LES <.5CM FAC/EA/NS | $184.45 | $1,054.00 | $90.87–$2,888.00 | 73% below | 83% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/< | $184.45 | $1,054.00 | $398.42–$1,054.00 | — | 83% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EX BENIGN LES <.5CM FAC/EA/NS | $184.45 | $1,054.00 | $398.42–$1,054.00 | — | 83% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE SINGLE | $83.30 | $476.00 | $104.72–$1,508.00 | 71% below | 83% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE SINGLE | $83.30 | $476.00 | $179.93–$476.00 | — | 83% |
| Occipital nerve block (injection for headaches) CPT 64405 N BLOCK INJ OCCIPITAL | $189.00 | $1,080.00 | $31.75–$2,888.00 | 70% below | 83% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 N BLOCK INJ OCCIPITAL | $189.00 | $1,080.00 | $408.24–$1,080.00 | — | 83% |
| Pacemaker implant (dual chamber) CPT 33208 PACEMAKER INSERT ATRIAL & VENT | $5,322.10 | $30,412.00 | $875.00–$27,370.80 | 72% below | 83% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 PACEMAKER INSERT ATRIAL & VENT | $5,322.10 | $30,412.00 | $11,495.74–$30,412.00 | — | 83% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $637.70 | $3,644.00 | $352.37–$3,279.60 | 61% below | 83% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING | $637.70 | $3,644.00 | $1,377.44–$3,644.00 | — | 83% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED | $271.60 | $1,552.00 | $89.11–$2,888.00 | 48% below | 83% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED | $271.60 | $1,552.00 | $586.66–$1,552.00 | — | 83% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT | $994.70 | $5,684.00 | $694.26–$5,372.00 | 67% below | 83% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTROY LUMB/SAC FACET JNT | $994.70 | $5,684.00 | $2,148.56–$5,684.00 | — | 83% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY SIMPLE | $189.00 | $1,080.00 | $90.87–$1,508.00 | 72% below | 83% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY | $189.00 | $1,080.00 | $90.87–$1,508.00 | 72% below | 83% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY SIMPLE | $189.00 | $1,080.00 | $408.24–$1,080.00 | — | 83% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY | $189.00 | $1,080.00 | $408.24–$1,080.00 | — | 83% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY EACH KIDNEY | $2,561.30 | $14,636.00 | $875.00–$13,172.40 | 63% below | 83% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY EACH KIDNEY | $2,561.30 | $14,636.00 | $3,750.00–$14,636.00 | — | 83% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST | $67.55 | $386.00 | $47.48–$1,508.00 | 78% below | 83% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF FOREARM CAST | $67.55 | $386.00 | $145.91–$386.00 | — | 83% |
| Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT | $125.83 | $719.00 | $152.64–$1,508.00 | 56% below | 82% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT | $125.83 | $719.00 | $271.79–$719.00 | — | 82% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $106.58 | $609.00 | $41.06–$1,508.00 | 69% below | 82% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST | $106.58 | $609.00 | $230.21–$609.00 | — | 82% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT | $128.28 | $733.00 | $36.12–$1,508.00 | 53% below | 82% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION LOWER LEG SPLINT | $128.28 | $733.00 | $277.08–$733.00 | — | 82% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC REP SIM 0-2.5CM PERIPH | $418.78 | $2,393.00 | $188.00–$2,153.70 | 9% above | 82% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC REP SIM 0-2.5CM PERIPH | $418.78 | $2,393.00 | $904.56–$2,393.00 | — | 82% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN 1ST | $85.75 | $490.00 | $83.59–$1,508.00 | 81% below | 83% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN 1ST | $85.75 | $490.00 | $185.22–$490.00 | — | 83% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS ANY METHOD | $45.85 | $262.00 | $57.64–$1,508.00 | 82% below | 83% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS ANY METHOD | $45.85 | $262.00 | $99.04–$262.00 | — | 83% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DIAGNOSTIC | $403.90 | $2,308.00 | $276.53–$2,888.00 | 64% below | 83% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE ONLY W/FLUORO | $403.90 | $2,308.00 | $276.53–$2,888.00 | 64% below | 83% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL FLUID TAP DIAGNOSTIC | $403.90 | $2,308.00 | $872.43–$2,308.00 | — | 83% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE ONLY W/FLUORO | $403.90 | $2,308.00 | $872.43–$2,308.00 | — | 83% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC REP SIM 2.6-7.5CM PERIPH | $548.63 | $3,135.00 | $188.00–$2,821.50 | 14% above | 82% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC REP SIM 2.6-7.5CM PERIPH | $548.63 | $3,135.00 | $1,185.03–$3,135.00 | — | 82% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC REP SIM TO 2.5CM FACE | $117.43 | $671.00 | $147.62–$1,508.00 | 74% below | 82% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/< | $117.43 | $671.00 | $147.62–$1,508.00 | 74% below | 82% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC REP SIM TO 2.5CM FACE | $117.43 | $671.00 | $253.64–$671.00 | — | 82% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR F/E/E/N/L/M 2.5 CM/< | $117.43 | $671.00 | $253.64–$671.00 | — | 82% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN 1ST | $83.30 | $476.00 | $67.57–$1,508.00 | 73% below | 83% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN 1ST | $83.30 | $476.00 | $179.93–$476.00 | — | 83% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING | $626.33 | $3,579.00 | $235.39–$3,221.10 | 56% below | 82% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAG GUIDANCE | $626.33 | $3,579.00 | $235.39–$3,221.10 | 56% below | 82% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGING | $626.33 | $3,579.00 | $1,352.87–$3,579.00 | — | 82% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAG GUIDANCE | $626.33 | $3,579.00 | $1,352.87–$3,579.00 | — | 82% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECT TRIGGER POINT 1 OR 2 | $191.63 | $1,095.00 | $24.47–$2,888.00 | 60% below | 82% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECT TRIGGER POINT 1 OR 2 | $191.63 | $1,095.00 | $413.91–$1,095.00 | — | 82% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BX US GUIDED | $1,651.65 | $9,438.00 | $511.75–$8,494.20 | 47% below | 83% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BX US GUIDED | $1,651.65 | $9,438.00 | $3,567.57–$9,438.00 | — | 83% |
| Upper endoscopy (EGD), diagnostic CPT 43235 UPPR GI ENDOSCOPY DIAGNOSIS | $393.75 | $2,250.00 | $188.00–$2,888.00 | 63% below | 83% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPR GI ENDOSCOPY DIAGNOSIS | $393.75 | $2,250.00 | $850.50–$2,250.00 | — | 83% |
| Wart removal, up to 14 warts CPT 17110 DESTROY LESIONS BENIGN 1-14 | $46.73 | $267.00 | $58.74–$1,508.00 | 78% below | 82% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTROY LESIONS BENIGN 1-14 | $46.73 | $267.00 | $100.93–$267.00 | — | 82% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SQ TISS 1ST 20 SQ CM | $539.88 | $3,085.00 | $150.52–$3,346.00 | 47% below | 82% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SQ TISS 1ST 20SQ CM | $539.88 | $3,085.00 | $150.52–$3,346.00 | 47% below | 82% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SQ TISS 1ST 20SQ CM | $539.88 | $3,085.00 | $1,166.13–$3,085.00 | — | 82% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SQ TISS 1ST 20 SQ CM | $539.88 | $3,085.00 | $1,166.13–$3,085.00 | — | 82% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION FEE | $342.13 | $1,955.00 | $32.33–$2,888.00 | 68% below | 82% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION FEE | $342.13 | $1,955.00 | $738.99–$1,955.00 | — | 82% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT | $93.98 | $537.00 | $118.14–$670.00 | 55% below | 82% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT | $93.98 | $537.00 | $202.99–$537.00 | — | 82% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADM IV INFUSION INIT HR | $256.03 | $1,463.00 | $284.73–$1,316.70 | 62% below | 82% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADM IV INFUSION INIT HR | $256.03 | $1,463.00 | $553.02–$1,463.00 | — | 82% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR | $1,019.73 | $5,827.00 | $1,281.94–$5,244.30 | 65% below | 82% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST HOUR | $1,019.73 | $5,827.00 | $2,202.61–$5,827.00 | — | 82% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY | $330.58 | $1,889.00 | $415.58–$1,700.10 | 68% below | 82% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 RAPID EEG | $330.58 | $1,889.00 | $188.00–$1,700.10 | 68% below | 82% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 RAPID EEG | $330.58 | $1,889.00 | $714.05–$1,889.00 | — | 82% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY | $330.58 | $1,889.00 | $714.05–$1,889.00 | — | 82% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACING | $107.28 | $613.00 | $109.47–$551.70 | 63% below | 82% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING | $107.28 | $613.00 | $77.00–$551.70 | 63% below | 82% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING | $107.28 | $613.00 | $231.72–$613.00 | — | 82% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEADS TRACING | $107.28 | $613.00 | $231.72–$613.00 | — | 82% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE STRESS TEST | $555.45 | $3,174.00 | $503.67–$2,856.60 | 61% below | 83% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EXERCISE STRESS TEST | $555.45 | $3,174.00 | $1,199.78–$3,174.00 | — | 83% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY W/PATIENT | $68.25 | $390.00 | $85.80–$351.00 | 70% below | 83% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY W/PATIENT | $68.25 | $390.00 | $147.42–$390.00 | — | 83% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY THERAPY W/O PATIENT | $61.25 | $350.00 | $77.00–$315.00 | 75% below | 83% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY THERAPY W/O PATIENT | $61.25 | $350.00 | $132.30–$350.00 | — | 83% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY | $67.20 | $384.00 | $84.48–$345.60 | 58% below | 83% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY | $67.20 | $384.00 | $145.16–$384.00 | — | 83% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INIT HR | $146.48 | $837.00 | $76.73–$753.30 | 70% below | 82% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INIT HR | $146.48 | $837.00 | $316.39–$837.00 | — | 82% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY INIT 1 HR | $146.48 | $837.00 | $89.00–$753.30 | 72% below | 82% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY INIT 1 HR | $146.48 | $837.00 | $316.39–$837.00 | — | 82% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THER/PROPH/DIAG SC/IM | $95.90 | $548.00 | $120.34–$1,475.00 | 44% below | 83% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ THER/PROPH/DIAG SC/IM | $95.90 | $548.00 | $207.15–$548.00 | — | 83% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION | $52.68 | $301.00 | $66.22–$270.90 | 85% below | 82% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAGNOSTIC EVALUATION | $52.68 | $301.00 | $113.78–$301.00 | — | 82% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEVEL 3 | $31.15 | $178.00 | $39.16–$178.00 | 89% below | 83% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT LEVEL 3 | $31.15 | $178.00 | $67.29–$178.00 | — | 83% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LEVEL 4 | $47.43 | $271.00 | $59.62–$271.00 | 87% below | 82% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT LEVEL 4 | $47.43 | $271.00 | $102.44–$271.00 | — | 82% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT LEVEL 5 | $51.63 | $295.00 | $64.90–$295.00 | 86% below | 82% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT LEVEL 5 | $51.63 | $295.00 | $111.51–$295.00 | — | 82% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT LEVEL 2 | $21.70 | $124.00 | $27.28–$124.00 | 90% below | 83% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 DAY SERVICES | $203.88 | $1,165.00 | $102.56–$1,048.50 | 2% below | 82% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 TREATMENT ROOM 1 | $203.88 | $1,165.00 | $102.56–$1,048.50 | 2% below | 82% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PATIENT LEVEL 2 | $21.70 | $124.00 | $46.88–$124.00 | — | 83% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 TREATMENT ROOM 1 | $203.88 | $1,165.00 | $440.37–$1,165.00 | — | 82% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 DAY SERVICES | $203.88 | $1,165.00 | $440.37–$1,165.00 | — | 82% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INI ASSESS W/PAT EA 15 MIN | $22.58 | $129.00 | $28.38–$116.10 | 66% below | 82% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INI ASSESS W/PAT EA 15 MIN | $22.58 | $129.00 | $48.77–$129.00 | — | 82% |
| Preventive checkup, new patient aged 40–64 CPT 99386 NEW PAT PREVENTIVE MED 40-64YR | $26.25 | $150.00 | $33.00–$150.00 | 78% below | 83% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 NEW PAT PREVENTIVE MED 40-64YR | $26.25 | $150.00 | $56.70–$150.00 | — | 83% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PREVENTIVE CARE EST PT 18-39 | $19.08 | $109.00 | $23.98–$109.00 | 80% below | 82% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREVENTIVE CARE EST PT 18-39 | $19.08 | $109.00 | $41.21–$109.00 | — | 82% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 EST PAT PREVENTIVE MED 40-64YR | $22.40 | $128.00 | $28.16–$128.00 | 89% below | 83% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 EST PAT PREVENTIVE MED 40-64YR | $22.40 | $128.00 | $48.39–$128.00 | — | 83% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 EST PAT PREVENTIVE MED >65 YRS | $23.10 | $132.00 | $29.04–$132.00 | 87% below | 83% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 EST PAT PREVENTIVE MED >65 YRS | $23.10 | $132.00 | $49.90–$132.00 | — | 83% |
| Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W/MED SRVCS | $61.78 | $353.00 | $77.66–$317.70 | 81% below | 82% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL W/MED SRVCS | $61.78 | $353.00 | $133.44–$353.00 | — | 82% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN | $52.68 | $301.00 | $66.22–$270.90 | 84% below | 82% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYTX CRISIS INITIAL 60 MIN | $52.68 | $301.00 | $113.78–$301.00 | — | 82% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY (30 MINUTES) | $44.28 | $253.00 | $55.66–$227.70 | 77% below | 82% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY (30 MINUTES) | $44.28 | $253.00 | $95.64–$253.00 | — | 82% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY (45 MINUTES) | $61.25 | $350.00 | $77.00–$315.00 | 78% below | 83% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY (45 MINUTES) | $61.25 | $350.00 | $132.30–$350.00 | — | 83% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY (60 MINUTES) | $70.00 | $400.00 | $88.00–$360.00 | 75% below | 83% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY (60 MINUTES) | $70.00 | $400.00 | $151.20–$400.00 | — | 83% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $3.68 | $21.00 | $4.62–$77.00 | 92% below | 82% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING/TOBACCO USE CESS COUNS | $13.13 | $75.00 | $16.50–$67.50 | 73% below | 82% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING&TOBACCO CESSATION 3-10 | $14.18 | $81.00 | $17.82–$77.00 | 71% below | 82% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $3.68 | $21.00 | $7.94–$21.00 | — | 82% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING/TOBACCO USE CESS COUNS | $13.13 | $75.00 | $28.35–$75.00 | — | 82% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING&TOBACCO CESSATION 3-10 | $14.18 | $81.00 | $30.62–$81.00 | — | 82% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT LEVEL 5 | $41.83 | $239.00 | $52.58–$239.00 | 89% below | 82% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTABLISHED PATIENT LEVEL 5 | $41.83 | $239.00 | $90.35–$239.00 | — | 82% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT LEVEL 3 | $21.18 | $121.00 | $26.62–$121.00 | 91% below | 82% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTABLISHED PATIENT LEVEL 3 | $21.18 | $121.00 | $45.74–$121.00 | — | 82% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT LEVEL 4 | $31.15 | $178.00 | $39.16–$178.00 | 89% below | 83% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTABLISHED PATIENT LEVEL 4 | $31.15 | $178.00 | $67.29–$178.00 | — | 83% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT LEVEL 2 | $12.60 | $72.00 | $15.84–$77.00 | 94% below | 83% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTABLISHED PATIENT LEVEL 2 | $12.60 | $72.00 | $27.22–$72.00 | — | 83% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT INTERMEDIATE | $64.58 | $369.00 | $77.00–$332.10 | 7% below | 82% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULTATION LEVEL3 | $64.58 | $369.00 | $81.18–$332.10 | 7% below | 82% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE CONSULTATION LEVEL3 | $64.58 | $369.00 | $139.49–$369.00 | — | 82% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE CONSULT INTERMEDIATE | $64.58 | $369.00 | $139.49–$369.00 | — | 82% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULTATION LEVEL4 | $100.80 | $576.00 | $77.00–$518.40 | 5% below | 83% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE CONSULTATION LEVEL4 | $100.80 | $576.00 | $217.73–$576.00 | — | 83% |
| Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST | $149.63 | $855.00 | $188.10–$769.50 | 58% below | 82% |
| Spirometry (breathing test) inpatient CPT 94010 BREATHING CAPACITY TEST | $149.63 | $855.00 | $323.19–$855.00 | — | 82% |
| Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING | $308.88 | $1,765.00 | $93.95–$1,588.50 | 51% below | 82% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 EVALUATION OF WHEEZING | $308.88 | $1,765.00 | $667.17–$1,765.00 | — | 82% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY | $77.88 | $445.00 | $97.90–$400.50 | 72% below | 82% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY | $77.88 | $445.00 | $168.21–$445.00 | — | 82% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOC 20-VAL CONJ-DIP CRMPF | $284.73 | $1,627.00 | $357.94–$1,464.30 | 49% below | 82% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOC 20-VAL CONJ-DIP CRMPF | $284.73 | $1,627.00 | $276.59–$1,627.00 | — | 82% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN OF HEPATITIS B VACCINE | $29.40 | $168.00 | $36.96–$166.90 | 62% below | 83% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN OF HEPATITIS B VACCINE | $29.40 | $168.00 | $63.51–$168.00 | — | 83% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EA ADDL | $15.23 | $87.00 | $19.14–$78.30 | 72% below | 82% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EA ADDL | $15.23 | $87.00 | $32.89–$87.00 | — | 82% |